Today there are so many options and trends to protect against pregnancy, it’s difficult to know which one is right for you at whatever your stage in life. We encourage you to read your options and then come in and see one of our board-certified OB/GYNs.
“The pill,” the first oral contraceptive drug approved in the United States, had its origins locally at the Worcester Foundation for Biomedical Research, a nonprofit institute in Shrewsbury. Approved by the federal Food and Drug Administration as a contraceptive in 1960, the pill is the most commonly prescribed and widely used method of birth control. It comes in two forms: the combination pill and the progestin-only pill. Both are 99-percent effective against pregnancy when taken at approximately the same time every day. Women who are over 35, smokers, or get frequent migraines should not use the combination pill. The estrogen in these pills also puts women at a higher risk for blood clots. The progestin-only pill does not contain estrogen, making it safe for smokers, diabetics, heart disease patients, and those who are at risk for blood clots. Progestin-only pills are also recommended for women who are breastfeeding since they do not reduce a new mother’s milk supply. Women who have trouble remembering to take a pill at the same time every day should consider another option to optimize effectiveness.
Extended-cycle pills are also a good option for women who do not want to have a period every month. Research has found that there is no scientific reason that women have to get their period, so contraceptives like Lybrel, Seasonale, and Seasonique were released in 2003 to give women the option to limit their period to once every four months or even only once a year.
Women who don’t want to take a pill every day might want to consider a combined hormonal contraceptive vaginal ring option for pregnancy prevention. The vaginal ring is commonly called NuvaRing, its brand name. This option has similar side effects and risks to the combination pill in that it delivers estrogen and progestin to the body to prevent pregnancy, except rather than taking a daily pill, it regulates these hormone levels through a flexible, plastic ring that is inserted into the vagina for three weeks and then removed the fourth week for a regular period. When used as directed, it has the same effectiveness as the pill.
The birth control patch is another option for women who do not want to worry about remembering to take a pill every day. The patch releases hormones directly into the skin and can be placed on an arm, buttock, or abdomen and left for one week. Because birth control patches like Ortho Evra have 60 percent more estrogen than a low-estrogen pill, they may affect individual women’s bodies differently.
This birth control option is ideal for women who are not looking to have children anytime in the near future. An intrauterine device (IUD), like Mirena or ParaGard, is a T-shaped device that is implanted by a physician over the cervix to prevent the sperm from reaching the egg. The simple outpatient surgery can prevent pregnancy for up to 10 years. An IUD is a good option for women who have never had children and those who have children and do not wish to have anymore. Women who are considering having children within a year or two should consider a different option as it can be costly to remove.
The implant, which is about the size of a matchstick, is placed into the arm by a physician and can remain there to prevent pregnancy for up to three years. Women who take St. John’s wart medication or are overweight should not use this method as it decreases effectiveness. Women who have diabetes, high cholesterol, any seizure disorders, or have ever had depression should be wary of this option. The implant is easily reversed, so it is appropriate for women who might want to have children within the next few years.
Sterilization can be effective for both men and women. The female procedure is called a tubal ligation, in which the fallopian tubes are blocked from carrying eggs to the uterus. There is an implant called Essure, which is a small coil that is inserted in the fallopian tubes. For men, a vasectomy is a quick outpatient procedure in which the physician cuts the tubes that carry sperm. Although sterilization is reversible, it is not intended to be, so couples who wish to have children must consider another option.
Plan B One-Step is emergency contraception, commonly called the “morning-after pill,” but this should not be used as a regular form of birth control. It is intended as a backup method to be used within 72 hours of having unprotected intercourse or when regular birth control fails. This can be purchased over the counter if you are over 18 years old, but must be prescribed for those under 18.
Dr. Lourdes Uy received her medical degree from Manilla Central University, Philippines, and completed a residency at UMass Medical School. She offers a full line of women’s health services, including gynecology and obstetric care.
For more information on birth control options or to schedule an appointment with Dr. Shilpa Monga or Dr. Lourdes Uy at Harrington’s new women’s health office in Charlton, call 508-765-5981.