Birth control and contraception are terms used to refer to ways to prevent pregnancy. There are many ways to prevent pregnancy when you are having sexual intercourse. They include the use of hormone medicines, contraceptive devices (barriers), periods of avoiding sex, and surgery. Some birth control methods work better than others.
Remember that you need to consider whether the method you choose will also protect you from getting sexually transmitted diseases (STDs). Sometimes you may need to use more than one method to prevent pregnancy and infection. The latex or polyurethane male condom and the female condom are the best protection currently available against STDs. They are the only birth control methods that will reduce your risk of being infected with HIV, the virus that causes AIDS. Hormones, natural family planning, and withdrawal do not give any protection against infection.
• Birth control pills (also called oral contraceptives), shots, vaginal rings, skin patches, and implants contain manufactured forms of the hormones estrogen and/or progesterone. The hormones stop a woman’s ovaries from releasing an egg each month. They also have some effects on the uterus that make it harder for sperm to enter the uterus or for a fertilized egg to stay in the uterus. Birth control pills are taken around the same time every day.
• The Depo-Provera shot, which contains progesterone only, is given in the office every three months to prevent pregnancy during that time. This shot usually causes your menstrual cycle to stop.
• Vaginal rings are flexible rings that are inserted into the vagina for three weeks. They are then removed for 1 week, and then replaced with a new ring for another three weeks. The rings release hormones into your body.
• Patches containing hormones may be put on the skin. Each patch is worn for one week then thrown away. This is repeated each week for a total of three weeks. Then no patch is worn for one week, and you will have a menstrual cycle at that time.
• The Nexplanon implant is a small, thin rod containing progesterone that is placed under the skin of a woman’s arm. Nexplanon prevents pregnancy for up to three years, the length of time recommended for leaving the implant in place. It may also cause your menstrual cycle to stop.
You will need to be seen in the office in order to get any of these hormonal forms of birth control.
Most contraceptive devices form physical or chemical barriers that stop sperm from entering the uterus.
• The male condom is a tube of thin material (latex rubber or polyurethane is best). It is rolled over the erect penis just before any contact of the penis with a woman’s genitals. The male condom must be changed after ejaculation. If anal intercourse is performed, a new condom should be placed on the penis before vaginal intercourse occurs. The male condom provides the best protection against STDs, including HIV and Hepatitis B.
• The female condom is a 7-inch-long pouch of polyurethane with two flexible rings. It is inserted into the vagina before sex. It covers the cervix, vagina, and area around the vagina. The female condom also provides protection against some STDs, including HIV and Hepatitis B.
• Spermicides are sperm-killing chemicals. They are available as foam, jelly, foaming tablets, vaginal suppositories, or cream. They are inserted into the vagina no longer than 30 minutes before sex. Spermicides should NOT be used alone. They should be used with another form of birth control, such as a condom, for increased effectiveness. Spermicides do not protect against STDs.
You can buy condoms and spermicides at drug and grocery stores without a prescription.
• The diaphragm is a soft rubber dome stretched over a flexible ring. No more than 6 hours before sex, you fill the diaphragm with a spermicidal jelly or cream and insert it into the vagina. You will have to be fitted for this device in the office by your GYN provider.
• The cervical cap is made of latex rubber or plastic and is shaped like a cup. It is smaller and more rigid than a diaphragm. No more than 24 hours before sex, the cap is filled with a spermicidal jelly or cream and inserted into the vagina and over the cervix.
• The intrauterine device (IUD) is a small plastic device containing either copper or hormones. Instead of stopping sperm from entering the uterus, the IUD changes the physical environment of the reproductive tract. This change prevents the egg from being fertilized. An IUD is inserted into the uterus by your health care provider. Depending on the type, it may be kept in the uterus for 3, 5 or 10 years before it must be replaced.
The Skyla IUD is a newer IUD that is designed for women who have not had a baby. It has the same ingredients as its sister IUD, Mirena, but is smaller. It can lighten your menstrual cycle and is used for three years. The Mirena IUD is for five years and has progesterone only that may lighten or stop your menstrual cycle completely. The Paraguard IUD has no hormones and is used for ten years. It does not have any effect on your menstrual cycle. Any of these IUDs may be removed at any time.
NATURAL FAMILY PLANNING
The natural family planning methods of birth control do not depend on any devices or drugs. To prevent pregnancy, you cannot have sex for a short period of time during each menstrual cycle. To know when it is safest to have sex, a woman must record her body temperature and changes in cervical mucus every day. For most people, other methods of birth control are more reliable.
The withdrawal method involves removing the penis from the vagina just before semen starts coming out (ejaculation). Often sperm get into the vagina before or during withdrawal, making this method unreliable.
Sterilization is the surgical closing of the tubes that normally carry the sperm or eggs. A woman or man who has this surgery will no longer be able to conceive children. For a woman, this procedure is called a tubal ligation and is performed by your GYN physician as a same-day surgery. A small incision in the belly button and three small incisions in the lower abdomen are made in order to perform the surgery. The tubes are cut, ends burned, and a section is removed. You are asleep for the procedure—referred to as general anesthesia.
The ESSURE is an in-office procedure performed by your GYN physician that has no risks of anesthesia and has a quicker recovery time than a tubal ligation. The physician first performs a D&C/Hysteroscopy to look inside the uterus. A special coil is then inserted into the opening of each fallopian tube and over the next 3 months, the body makes scar tissue to fill in each tube. During this process, you will need to use another form of birth control—preferably Depo Provera. After 3 months, you will have a hysterosalpingogram (HSG) performed in the radiology department of the hospital to make sure the tubes are completely closed.
As you can see, there are several different methods of birth control to consider. Contact your health care provider to see which form of birth control would best fit your lifestyle.
Melissa Waddell, WHNP, a Hampton Roads native, is a nurse practitioner at Atlantic Ob/Gyn. Please call 757-463-1234 or visit www.atlanticobgyn.com.