Contraceptive Options Update

Contraception means preventing pregnancy. Most people know about options such as birth control pills and condoms. However, there are also other options. This article explains some of the newer choices for women. If you're thinking about birth control, talk with your family doctor. Your choice will depend on your health, your desire for protection against disease, and your personal beliefs and preferences. As always, when looking at birth control, keep in mind that any method only works if you use it consistently and correctly.

In the past few years, some options have disappeared and others have emerged. For example, contraceptive sponges aren't currently available in the United States. Likewise, the hormone implant system Norplant is no longer being made here. In contrast, the U.S. Food and Drug Administration (FDA) approved a new birth control pill that you take for 12 weeks. During the 13th week, you have a period. This pill (brand name: Seasonale) reduces the number of periods from one a month to about one every three months.

Three new birth control options for women have become available in this county:

All three are about as effective and safe as birth control pills, but they were made to have fewer side effects and to avoid the need to take a pill every day. You can only get them from a doctor or other health care provider. The chart [below] compares their side effects, reversibility (how soon you can get pregnancy after you stop them) and other factors. These methods have not yet been tested in teenagers.

The vaginal contraceptive ring (brand name: NuvaRing) uses the same hormones as most birth control pills. It is a circular, flexible ring that is inserted in the vagina. The ring releases hormones that prevent you from getting pregnant. Unlike the diaphragm, the vaginal ring doesn't have to be in a specific position in your vagina. You insert the ring, leave it there for three weeks and then take it out. During the week the ring is out, your period starts. After a week without the ring, you put in a new one. Most women say the ring is easy to use, and most have no problem using it correctly. However, some women stop using the ring because of concerns such as feeling the ring in their vagina, problems with sex, and the vagina pushing out the ring.

The contraceptive patch (brand name: Ortho Evra) is put on your upper arm, buttocks, stomach or chest (but not on your breasts). It releases birth control hormones in almost the same way as birth control pills do. You put on a patch once a week for three weeks, then you wait a week before putting on the next patch. During the week you don't wear a patch, your period starts. The side effects are like those with birth control pills. Breast discomfort is more common in the first two months using the patch. The area of skin where the patch was placed can become irritated.

This IUD (brand name: Mirena) is like the older copper-containing IUD, but it is safer and has fewer side effects. It lasts for five years. It must be inserted by a doctor. Within a week after you start your period, you go to the doctor for a pelvic exam. After cleaning your vagina and cervix, the doctor slides a thin plastic tube containing the device into your uterus. Your doctor removes the plastic tube and makes sure that the IUD is in the right place. The IUD has strings that the doctor cuts to the right length. You have to check these threads each month to make sure that the IUD is in place. As with a copper-containing IUDs, some women find that their uterus pushes out the IUD. There is a risk of ectopic pregnancy (when a fertilized egg grows outside the uterus). There is also a risk of pelvic inflammatory disease, but the risk is lower than for traditional IUDs.

These hormone injections contain two hormones. Unlike other shots, it is given once a month. Even though the monthly hormone injection was approved by the FDA, it's currently not made in this country. Its future is unknown.