By Dr. Jennifer Pofahl, Chief of Women’s Health
Nearly half of the six million pregnancies in the US every year are unintended, and about a third of these women thought they were unable to become pregnant at the time.
Contraception, or birth control, is an important aspect of a woman’s healthcare. At every visit, we assess your need for contraception and discuss options, given your preferences and medical history.
When should you discuss contraception with your provider? If you are menstruating (even if your menstrual cycles are irregular) and are sexually active or think you may become sexually active.
If you choose to skip contraception, your odds of pregnancy could be as high as 50 percent. Even if your periods are irregular or you only have a few periods a year, you are still at risk of unplanned pregnancy because you may still ovulate (make an egg).
What are your contraception options?
Withdrawl
This is when the man avoids ejaculating inside of the woman. Since some sperm can be transferred before actual ejaculation happens, this is not a fail-proof method.
About 22 out of 100 women practicing this method will become pregnant every year.
Natural family planning
There are many methods in this category, and websites and smart phone apps that can help with this. The basic idea is that you follow your cycles (either with a calendar or symptoms such as cervical mucous or body temperature) to identify your “fertile window.” If you want to avoid pregnancy, you avoid having sex on these days (your fertile window could be up to 2 weeks every month).
About 24 out of 100 women practicing this method will become pregnant each year.
Diaphragms, cervical caps, vaginal sponges, and spermicidal jellies
These devices are placed in the vagina every time you have sex to block sperm from entering the uterus.
The effectiveness of these methods depend on several factors but around 12-29 out of 100 women practicing these methods will become pregnant each year.
Condoms
Both male and female condoms are the only forms of birth control that also prevent Sexually Transmitted Diseases (STD). Regardless of your contraceptive choice, it’s always a good idea to use condoms every time you have sex, especially with a new partner or if you are not in a monogamous (exclusive) relationship.
About 18 out of 100 women practicing this method will become pregnant each year.
Emergency contraception
Both the morning after pill and the nonhormonal (copper) IUD can be used as emergency contraception in the event you have sex without birth control. They can be used up to 5 days after unprotected sex but the earlier they are administered, the more effective they are. The pill can be purchased over the counter without a prescription.
Pills, the patch, and the ring
The birth control pill is taken daily. The patch is a sticker that you place on your skin and change weekly. The ring, made of flexible plastic, is inserted into the vagina, and changed every 3 weeks. These methods can make your periods lighter, less painful, and very predictable. They can also help with acne. Some people experience side effects such as breast tenderness, moodiness, nausea, and (rarely) weight gain.
About 9 out of 100 women practicing this method will become pregnant each year.
Depo provera
This is a shot, or injection, that’s repeated every 3 months. It tends to stop your periods. Some people experience irregular bleeding, weight gain, or moodiness. If used for many years, it can cause thinning of the bones.
About 6 out of 100 women practicing this method will become pregnant each year.
Hormonal IUDs
Intrauterine devices (IUDs), placed inside the uterus, last 3 to 5 years. They tend to make your bleeding lighter, or cause it to stop. They can be removed at any time and do not affect fertility. Some women experience cramping, irregular bleeding, or acne.
Less than 1 out of 100 women practicing this method will become pregnant each year.
Nonhormonal IUD
The copper IUD, placed inside the uterus, can last for up to 10 years and may be removed at any time. It can cause periods to be heavier or more crampy but since it does not have any hormones, side effects are minimal.
Less than 1 out of 100 women practicing this method will become pregnant each year.
Implant
This small rod, placed in the inner upper arm, contains a hormone that lasts for up to 3 years. It can be easily removed at any time. Some women experience irregular bleeding, weight gain, acne or moodiness.
Less than 1 out of 100 women practicing this method will become pregnant each year.
Permanent contraception (vasectomy or tubal ligation)
These methods require a surgical procedure, either in a doctor’s office or an operating room.
Less than 1 out of 100 women practicing this method will become pregnant each year.
Which option is right for you? Contraception is a very personal choice and there is no perfect birth control that works for every woman. The best option is one that you can use reliably and will help you reach your personal life and health goals.
If you are in need of birth control or are unhappy with your current contraceptive method, call us to discuss your options!