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What You Should Know About Current Birth Control MethodsThere are some new choices available for birth control. We will discuss some of the methods recently arriving to the U.S. and currently available in Europe and South America. There are two reasons for the delay: First, the Food and Drug Administration (FDA) has a more lengthy approval process than in Europe. Second, since more American women are already satisfied with birth control pills, start-up costs for a new method could easily exceed 150 million dollars. This may give American women a hidden advantage—women in other countries test these methods before they become available here, and potential adverse effects are discovered. The new methods make highly effective contraceptive options available to women who:
EXTENDED DOSE ORAL CONTRACEPTIVESNo longer must a woman have a “monthly” cycle. New birth control pills are available for four periods, or no periods per year. PROGESTERONE-ONLY Birth Control Pill (“MINI-PILL”)Many women who have not had good results with regular birth control pills have done well with the “Mini-Pill,” because it contains no estrogen. Many women who quit pills did so because of the side effects of estrogen, NOT the progesterone. The “Mini-Pill” is about 97% effective, may be used by breast-feeding mothers, and is a safer option for smokers over 35. DEPO PROVERA®Women complain about the amount of effort required with most birth control methods. Pills should be taken the same time each day, a diaphragm must be inserted before intercourse, and lovemaking can be interrupted for use of condoms and spermicides. Many have been pleased with Depo-Provera---a long-acting injection given every three months. It provides +/- 98% protection against pregnancy. Among side effects of Depo-Provera is unpredictable return to fertility and interrupted menstrual patterns, usually resolving after the second injection. It contains only progesterone, and can be used by nursing mothers and smokers over age 35. Eventually, most women report very scant periods. THE IUDThe IUD is a small “T”-shaped plastic device inserted into the uterus. Its presence acts to disrupt the balance/environment within the uterus in such a manner as to prevent pregnancy about 99% of the time. The Mirena® IUD can be kept in place for five years, and provides an immediate return to fertility on removal. While in place, it requires no attention. This IUD decreases or eliminates menstrual flow because it contains the synthetic progesterone levonorgestrel. There may be cramps after insertion. The ParaGard® IUD contains copper, but no hormones. It is highly effective for up to ten years. The user may have more cramps and slightly longer periods compared to Mirena. THE CONTRACEPTIVE “RING”The contraceptive “ring” NuvaRing® is a soft silicon ring about 2 inches in diameter that a woman inserts in her vagina, and then removes and discards it after 4 weeks. The device contains both a synthetic estrogen and a progestin, just like the Pill. After four weeks, there is a week without the ring, just like the week of “sugar pills” in a pack of birth control pills. The effectiveness is equal to the Pill, and there are fewer side effects. Because the hormones in the ring are absorbed directly into the bloodstream, there is much less nausea. The ring can be removed for very short periods of time if the patient or her partner desires. THE SINGLE ROD IMPLANTImplanon® is a single-rod contraceptive implant that is inserted under the skin of the upper arm and provides highly reliable protection against pregnancy for up to 3 years. Implanon does not contain estrogen, making it suitable for women who do not tolerate or should not take estrogens. The implant can be removed at any time, after which fertility is rapidly restored. It is a very reliable contraceptive method, as was shown in the clinical trials, in which no pregnancies occurred during use over 73,000 monthly cycles. It is important for women to know that no form of contraception is 100 percent effective. Like other progestogen-only contraceptives, the use of Implanon is associated with irregular menstrual bleeding and sometimes absence of bleeding, and counseling is required to ensure women make informed choices.
"MORNING-AFTER-PILL” (EMERGENCY CONTRACEPTION)The “morning after pill” is really not one pill, but several birth control pills taken under our supervision to prevent a pregnancy following unprotected intercourse or condom failure. It is not meant to be used for routine birth control. If properly taken, the “morning after pills” are almost 95% effective in preventing pregnancy. The critical time for success is less than 72 hours after intercourse. To use this “emergency” method, the woman should contact our office as soon as possible following unprotected intercourse. PERMANENT STERILIZATIONOur office provides two methods of permanent sterilization: Laparoscopic tubal sterilization and the ESSURE® method. Laparoscopy uses an incision in the umbilicus and a tiny incision in the lower abdomen. This procedure is done under general anesthesia, and there is a 2-4 day recovery period. ESSURE uses 2 “micro-inserts” threaded through a hysteroscope inserted through the cervix and into the uterus, permanently blocking the tubes as they enter the uterine cavity. There is no incision with ESSURE, it can be performed in our office using i.v. sedation, and there is no post-op recovery period. WHEN YOU NEED OUR HELP:Drs. Hodes and Nauser, and Colleen O’Donnell, RN-C are known for their dedication in helping women find suitable contraceptive methods. Because of their research association with major pharmaceutical companies, the office has access to new developments that are not yet widely available. They have been involved with the research protocols necessary for approval in the U.S. of some of the methods mentioned above. To discover whether these new methods--or traditional ones--are appropriate for you, call our office for an appointment. We are eager to provide care for you, and your friends or family.
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Last modified: 01/13/09 09:01:29 PM |
