Birth Control
Choices, Choices, Choices…
When the time comes to choose a birth control method or try a different method, there are many different options. Some have been around for centuries and others have recently been developed. The things you need to take into consideration before choosing include: effectiveness, cost, convenience, side effects, acceptability, return to fertility and partner input. Even the most effective method of birth control will fail if it is either not used or not used properly.
Contraceptive options include:
- The Pill:
- Hormonal method
- Cost is variable although out of pocket price at this time is $40–60 per month.
- Insurance plans will vary on coverage
- Pills are taken daily
- Side effects may include headaches, breakthrough bleeding, nausea, acne and weight gain
- Widely accepted and is the #1 choice at this time
- Fertility usually returns 1–3 cycles after stopping the pills
- Partners typically accept the pill usage without reservation
- Vaginal ring (Nuvaring)
- Hormonal method
- Greater than 99% effective
- Cost is comparable to birth control pills
- The ring is inserted once a month and left in place for three weeks
- Side effects may include increased vaginal discharge and increased incidence of bladder infections
- Widely accepted, although some women are uncomfortable with insertion and removal
- Fertility returns 1%ndash;3 cycles after discontinuing
- Depo Provera
- Hormonal method
- Greater than 99% effective
- Cost is approximately $120 every 3 months. Insurance plans will vary on coverage
- Injection is given in the office
- Side effects include irregular vaginal bleeding, weight gain, acne and worsening depression
- Widely accepted and used extensively around the world
- Fertility may be delayed for as much as a year after stopping injections
- Implanon
- Hormonal
- Greater than 99% effective and lasts for 3 years
- Cost is around $1100. Insurance plans will vary on coverage
- Implanted into underside of upper arm during a procedure in the office
- Side effects include bruising and pain at site of insertion, irregular vaginal bleeding, weight gain and acne
- Accepted but relatively new to the market
- Rapid return to fertility
- Birth control patch
- Hormonal
- Greater than 99% effective
- Cost is comparable to the pill
- Patch is applied to the skin and changed weekly for 3 weeks
- Side effects include irritation at site of application and there is some evidence that patches may increase incidence of blood clots
- Acceptance has fallen off since blood clot issue came to light
- Fertility usually returns in 2–3 cycles
- IUD (Intrauterine Device)
- Hormonal and non-hormonal
- Greater than 99% effective and lasts for 5 or 10 years depending on IUD
- Cost is $1300. Insurance plans will vary on coverage
- Device is inserted into the uterus during a procedure in the office
- Side effects include irregular vaginal bleeding initially followed by absence of menses in most women, pelvic pain and cramping
- Widely accepted and utilized world wide
- Fertility usually returns within a year
- Diaphragm
- Non-hormonal
- 94% effective with correct usage
- Available through a pharmacy and cost is less than $50 each
- Must be fitted for correct size of diaphragm and refitted if loss or gain of 15 pounds
- Must be inserted vaginally using a spermicide before intercourse
- Side effects include increase incidence of bladder infections in susceptible individuals
- Widely accepted and used
- Fertility is not affected
- Condom (male)
- Non-hormonal
- 98% effective
- Available over the counter without a prescription
- Must be worn before and throughout intercourse
- Side effect can be vaginal irritation from spermicidal lubricant
- Affords some protection from sexually transmitted diseases
- Widely used although partner may be less accepting
- Fertility is not affected
- Condom (female)
- Non-hormonal
- 95% effective
- Available over the counter without a prescription
- Must be in place throughout intercourse to be effective
- Affords some protection from sexually transmitted diseases
- Fertility is not affected
- Tubal ligation
- Non-hormonal
- Greater than 99% effective
- Out-patient surgical procedure
- Side effects are uncommon. Certain risks are possible due to surgery, reaction to anesthesia and possible bleeding
- Widely accepted
- Should be considered irreversible
- Tubal implant sterilization (Essure) http://essure.com/
- Non-hormonal
- Greater than 99% effective
- In-office surgical procedure
- Certain risks are associated with any surgery including bleeding and anesthesia complications
- Need to continue current birth control method for at least 3 months after the procedure until a follow up test is done to verify blockage of both tubes
- Relatively new procedure, gaining acceptance
- Should be considered irreversible