For a woman seeking a contraceptive, today’s health-care market offers plenty of choices.
There are short-term birth control avenues such as the pill. Long-term options such as the implant. And a third option that is absolutely permanent.
Dr. Ryan Miller, an OB/GYN at Tanner Clinic Syracuse, said the decision will depend on how a woman sees her future — Is she hoping for a first pregnancy? Or maybe had enough pregnancies?
“A lot of women,” he says, “are surprised at the numerous options that are available.”
The birth-control pill and other short-term methods are acceptable at preventing pregnancy. But the long-term contraceptives such as an implant are more effective. The reason, said Dr. Miller, is that a woman doesn’t have to remember to take a pill every day. Also, he adds, “You have to be compliant with the NuvaRing or the patch, or they can become less effective.”
Dr. Miller provides this rundown of the primary types of contraceptives he consults with patients about:
“The pill” isn’t just one pill — today, there are hundreds of brand names that fall into different categories and use different mechanisms. But as a group, the birth-control pill remains the No. 1 choice of contraception because it’s short-term and easily reversible.
Although there are multiple hormonal combinations, oral contraceptives work by regulating hormones to stop ovulation — if there’s no ovulation there is no egg.
Dr. Miller added that the pill has other benefits, such as controlling periods, not to mention monthly moods and pain levels. And because it blocks ovulation, the risk of ovarian cysts declines.
If a woman is fed up with monthly periods regulated by the pill, Dr. Miller will recommend a birth control pill that reduces menstrual periods to once every three months. This pill contraceptive, known as Seasonique, must still be taken daily for optimal effectiveness.
NuvaRing — the vaginal ring
NuvaRing is a hormonal contraceptive in the form of a flexible plastic ring inserted in the vagina. It releases a low dose of progestin and estrogen, preventing the ovaries from releasing eggs.
The ring offers protection for three weeks. To have continued pregnancy protection, the woman must insert a new ring one week after the previous one was removed.
The skin patch
The patch is another short-term method, but it doesn’t require a daily pill. This small, beige patch releases estrogen and progestin through your skin for a period of seven days. Over a four-week period, a woman uses one patch per week for three weeks, then no patch for a week. It’s best known by its brand name Ortho Evra.
The intrauterine device is a small, T-shaped device inserted into the uterus. It must be inserted by a physician, usually in an office exam room and without the need for anesthesia. There are two choices for this long-term contraceptive: a 5-year device and a 10-year device.
Dr. Miller said the IUD is “a nice, reversible option for someone who’s not ready to get pregnant for a few years.”
A small implant is placed under the skin of a woman’s upper arm. Known as Nexplanon or Implanon, the implant is about the size of a matchstick. Dr. Miller said the procedure to insert it is simple — it’s a 5-minute procedure that requires local anesthesia. Removal is done through a small incision that leaves a small 2 to 3 mm scar.
Nexplanon provides a long-term approach to birth control by releasing progesterone over a period of three years. Thereafter, it becomes less effective as the levels of the hormone drop.
Contraception by injection
Depo-Provera is an injection of a hormone (similar to progesterone) into the hip muscle. Each shot provides protection against pregnancy for up to 14 weeks, but the patient must return to the doctor for an injection every three months to remain fully protected.
Dr. Miller said the shot suits those women who don’t want to put up with a daily pill, yet want a longer-term option that is reversible.
“Tying your tubes” is basically sterilization for women. In this surgical procedure, the fallopian tubes are tied, cut or sealed. Though meant to be permanent pregnancy control, it can, with difficulty, be reversed.
The real permanent — Essure
Only available for about a decade, this permanent contraceptive works by having a small, spring-like device placed in the fallopian tubes. Over a few weeks, the devices become a natural block, preventing ovulation. Though the procedure is done in-office, Dr. Miller offers the services of an anesthesiologist.
And lest we forget
Men can also practice birth control, said Dr. Miller, but their choices are pretty limited:
› Condoms, or