Birth control takes many forms

The pill. The patch. The shot. The ring. Birth control comes in so many different forms these days, it’s hard to believe they all share the same end result – preventing pregnancy.

While the many different types can be a bit mind-boggling, the benefit is that you can now access a birth control that fits your needs. Do you have a low tolerance to hormones? There are many non-hormone based contraceptives available today. Do you have trouble remembering to take your pill every day? Then check out some of the “set it and forget it” options. Are you done having children and want a permanent solution? There are choices for you there as well.

Here is a brief primer on some of the most popular birth control options available today.

Hormonal-based forms

There are many hormone-based contraceptives including the very popular pill. Many people like the pill because it doesn’t require any procedures in the doctor’s office, it is extremely reliable if used correctly, and it is easy to use – as long as you remember to take it. Another benefit to the pill is the number of types out there so if you’re on one and you don’t like the way it makes you feel, you can try a different one. On the other hand, if you’d like to opt out of the pill because you do not like it or cannot remember to take it daily, there are new, perhaps even more desirable, substitutes including:

• NuvaRing is a small vaginal ring that is self-inserted into the back of the vagina. Its exact positioning is not important to the effectiveness of the ring. Once inserted, it will stay in place and release steady amounts of both estrogen and progestin for three weeks, then taken out for one week to experience the monthly period. After your period has ended, you insert a new ring.

• Ortho Evra is a skin patch that has the hormones estrogen and progestin located in the adhesive layer. You can stick the patch on your lower abdomen, buttocks, or upper body, not including the breasts. After a week, you peel off the adhesive and replace it with a new one. For one week every month, you leave it off entirely so you can have your period.

Progestin-based forms (no estrogen)

If you are not interested in using a birth control that contains estrogen because of some of the side effects – which sometimes include nausea, bloating, high blood pressure – there are other great progestin-only options:

• Nexplanon is a match-stick sized rod that is implanted into the upper arm and releases a progestin called etonogestrel. This contraceptive prevents pregnancy for up to three years.

• IUD (intrauterine device) is implanted through the vagina into the uterus, and continuously releases progestin called levonorgestrel. This implant remains intact for up to five years or longer. There is a copper IUD as well. This IUD has metal wrapped around a T-shaped plastic frame, and emits no hormones. The copper IUD lasts up to 10 years. There is a new “mini-IUD” that has come out this month called Skyla that I would recommend for teenagers and women who haven’t had children. They are smaller, and easier to insert. However, they last only three years as opposed to the five to 10 years for regular IUDs.

• Depo-Provera is a long-lasting form of progestin taken in the form of injection. This injection takes place in either the upper arm or the buttocks and is only needed once every three months. This form primarily works by preventing ovulation.

• Mini-Pills do not have any estrogen in it, just progestin only. However, I do caution, the mini-pills are not as effective a contraception as the combined pill.

Permanent forms

There are two extremely effective uses of permanent birth control. The first is commonly known as tubal ligation. This is a surgical procedure that creates a block preventing fallopian tubes from carrying the eggs to the uterus. The second is a nonsurgical option – brand names are Essure and Adiana. In this case, doctors use a hysteroscope to place an insert through your vagina and cervix, into the opening of your fallopian tubes. Within three months, the insert causes your body to form a tissue barrier that prevents sperm from reaching the egg. Both of these contraceptives are nonreversible.

There are so many birth control options out there today, which is a great thing for women. There is a birth control that is right for you. The best place to start is with your OB/GYN who can talk to you about the benefits and side effects of each and tailor your contraception to your lifestyle and preference.

Dr. Jennifer Shinners is a board-certified obstetrician-gynecologist at Coastal Women’s Healthcare in Scarborough. She can be reached at 885-8400.


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