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There are a number of methods to avoid becoming pregnant. You should discuss the alternatives with your partner and your physician to determine the best method for your situation. Below is a brief description of some of the primary means of preventing contraception. Please consider this discussion as an introduction to the contraception issue.
BIRTH CONTROL PILLS. “The Pill” is an oral contraceptive taken by millions of women to prevent pregnancy. It is a safe and effective way to prevent pregnancy for most women. It is easy and convenient to use and is reversible.
The pill, and there is a wide variety of brands and dosage, prevent ovulation. When there is no egg to be fertilized, pregnancy cannot occur. Additionally these hormones cause changes in the cervical mucus and uterus that can also help prevent pregnancy.
There are both combination pills which contain estrogen and progestin and progestin-only pills. The combination pills affect the menstrual cycle, ovulation and fertility. They also help to keep your periods regular, lighter, and shorter; they also reduce menstrual cramps. Among the initial side effects of taking the combination pill are headache, tender breasts, nausea, irregular bleeding, missed periods and depression. After a few months of regular use, these side effects typically go away. This type of pill may not be a good choice if you are a smoker, are over 35 years old, or have other health problems. As previously stated, consult with your doctor about whether the combination pill is a good choice for you.
The progestin only pill is also call the “minipill.” It contains about 25 to 70 percent of the progestin that is in the combination pill. It prevents ovulation in about half of a woman’s menstrual cycles. This pill will thicken the cervical mucus, making it harder for sperm to penetrate the cervix. Most women who take the progestin-only pill do so because there are clinical reasons why they should not take estrogen. It is not as effective as the combination pill; you may also have more bleeding/spotting days.
BARRIER METHODS. Barrier methods are safe and effective ways to prevent pregnancy. They are effective when used correctly and every time you have sex with your partner. Among the methods discussed below are Spermicides, Condoms (both male and female), Diaphragm and Cervical Cap. These methods are not as effective as birth control pills or IUD’s and, unless you have a latex allergy, do not normally have any side effects.
Spermicides. They contain a chemical that kills sperm or makes them more inactive so that they cannot pass through the cervix. Spermicides come as tablets, foam, cream, jelly and thin film and should be placed in the vagina, close to the cervix before each act of sex.
Condoms. A male condom is a thin sheath made of latex, polyurethane or animal membrane. It is worn by a man over an erect penis. It acts as a physical barrier to keep the sperm from entering the cervix and fertilizing the egg. It can be used only once and only one should be used at a time.
A female condom is a thin plastic pouch that lines the vagina and is held in place by a closed inner ring at the cervix and an outer ring at the opening of the vagina. It also can only be used once and can be difficult to insert, reducing its efficiency.
Diaphragm. The diaphragm is a small, round rubber device, some with a firm but flexible rim that fits inside the vagina and covers the cervix. It requires a prescription and, since there are a range of sizes, needs to be properly fitted by your provider. You should only use water-based lubricants with the diaphragm. Oil-based lubricants such as petroleum jelly or body lotion can damage the rubber. It should last approximately two years and should then be replaced.
Cervical Cap. The cervical cap is a small, thin rubber or plastic dome shaped like a thimble. It is small than a diaphragm and is held in place over the cervix with suction. Since there are various sizes, you need to be fitted by your provider. Care for the cervical cap should be the same as for a diaphragm.
INTRAUTERINE DEVICE. This method is more popular in other places in the world than in the United States; only about 1 percent of women use this method in the U.S. There are two types of IUD available; the hormonal and the copper. The hormonal IUD must be replaced every five years while the copper IUD can last up to 10 years. It must be inserted and removed by your provider.
While both types are T-shaped, they work in different ways. The hormonal IUD releases a small amount of progestin into the uterus. This thickens the cervical mucus, which blocks the sperm from entering the cervix. The copper IUD releases a small amount of copper into the uterus. This causes a reaction inside the uterus and fallopian tubes which can prevent the egg from being fertilized or attaching to the wall of the uterus.
Among the risks of using an IUD are expulsion of the IUD, perforation of the uterine wall or infections which can make future pregnancies more difficult. The copper IUD seems to increase menstrual pain and bleeding, while these side effects are reduced with the hormonal IUD.
NATURAL FAMILY PLANNING. This form of birth control is based on the timing of sex during a woman’s menstrual cycle. Other names for this type of birth control are the rhythm method, periodic abstinence, or fertility awareness.
For this method to work, a woman needs to know her body well. Her partner must also be willing to follow this method. If a woman has irregular periods, this method may not be as effective.
There are a number of methods that can be used to help the woman identify the timing of her cycle. Your provider can review these with you and help determine which is best for you.
EMERGENCY CONTRACEPTION. It is used to prevent pregnancy after having sex without birth control of if a problem occurred with the chosen method of birth control used. It is a good option for women who have had unprotected sex and do not want to become pregnant. It should not be used on a routine basis.
The “morning after” pill requires a prescription from your doctor, or the Saginaw County Health Department (989-895-4015). The first dosage of pills must begin with 72 hours of having unprotected sex and will significantly reduce the chance of pregnancy. The second dosage of pills is taken 12 hours after the first dose. If you are already pregnant, the pills will not work. There are two types of pills; one contains both estrogen and progestin while the other type contains only progestin.
Both pills work in the same way by disrupting the normal menstrual cycle patterns. Depending on where the woman is in her cycle, the pills may prevent ovulation, block fertilization or keep a fertilized egg from implanting in the uterus.
Among the side effects that may occur are nausea, vomiting, abdominal pain and cramps, tender breasts, headache, dizziness and fatigue. Also be aware that emergency contraception does not prevent sexually transmitted diseases.
IMPLANON. It is a flexible plastic rod (about the size of a matchstick) that is placed under the skin of your arm in an office procedure by a certified health care provider. This device has been used worldwide since 1998 and now is also available in the United States. It is a progestin-only form of birth control, with no estrogen present. Implanon can remain in your arm for up to three years, after which time it must be removed, again in an office setting.
It works by both stopping the release of an egg from your ovary and by thickening the cervical mucus, making it more difficult for the sperm to reach the egg. The most common side effect is irregular bleeding. Once Implanon is removed, your ability to become pregnant returns quickly. It will not protect you from HIV (AIDS) or other sexually transmitted diseases.
You should not use Implanon if you think you may be pregnant. Other contra-indicated factors include liver diseases, unexplained vaginal bleeding and a history of breast cancer.
Your health care provider can fully discuss these and other related issues with you as you consider which form of birth control is best for you.
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