Several factors come into play when deciding which method of
birth
control is
best for you. Your overall health, age, frequency of sexual
intercourse, the number of partners you have, and whether you desire
to have children in the future must all be considered before deciding
upon a birth control method.
The
Pill
The pill is the
first contraceptive that most women think of when considering birth
control. Today the pill is available as combined oral contraceptives
(COC) which contain both estrogen and progestin, or in progestin only
pills (POP) which contain only progestin.
COCs work by
suppressing ovulation and may make periods more regular. According to
an FDA Consumer report, they also offer a protective effect
against pelvic
inflammatory disease
(PID), as well as ovarian and endometrial cancers.
These pills are considered safe for most women, however
women
who smokeand are over 35 or who have a significant family history ofcardiovascular disease should not use oral contraceptives due to an
increased risk of cardiovasculardiseases.Women with a medical history of blood clots, or breast or endometrialcancers also should not use combined oral contraceptives. Possibleside effects which may subside after a few months include nausea,headache,breast tenderness, weight
gain,
irregular
bleeding,
and depression.
POPs work by
reducing and thickening the cervical mucus to prevent sperm from
reaching the egg, and by keeping the uterine lining from thickening
to prevent implantation of a fertilized egg. Because these pills
contain no estrogen the risk of blood clots is not present as with
the combined oral contraceptives. This type of birth control pill is
a good option for women who cannot take estrogen because they are
breast feeding or because of headaches or high blood pressure
problems associated with estrogen. The progestin only pill may cause
menstrual changes, weight gain, and breast tenderness.
Injectable
Progestins
Pregnancy can be
prevented up to three months by injection of Depo-Provera.
Depo-Provera
prevents pregnancy by inhibiting ovulation, changing the cervical
mucus to prevent sperm from reaching an egg, and by changing the
uterine lining so that a fertilized egg will be unable to implant.
This method is extremely effective since all that's required of a
woman is to return to her health care provider for a shot every three
months. Benefits and side effects of Depo-Provera are similar to
those of progestin only pills.
Interuterine
Devices (IUD)
The IUD has
experienced some bad publicity in the past when the Dalkon Shield was
associated with a high incidence of pelvic infections, infertility,
and some deaths. However, today's IUDs have one of the lowest failure
rates of any contraceptive method. An IUD is a T-shaped device that
is inserted into the
uterus
by a health care professional. There are two types of IUD available,
the Paragard CopperT 380A which protects against pregnancy for 10
years, and the Progestasert Progesterone T which must be replaced
every year. The IUD is an appropriate choice for those in long term
monogamous relationships who are not at high risk for sexually
transmitted diseases or infections.
The
Sponge
AllendalePharmaceuticals was recently given approval by the FDA to manufacturethe Today Sponge again in the US. The sponge works by releasing
spermicidal gel over the vaginal mucus while the sponge forms a
barrier to kill or immobilize sperm before it can reach the cervix
and enter the uterus. The sponge can be inserted several hours before
intercourse and can be left in place up to 12 hours after sex. It
does not need to be replaced if sexual intercourse is repeated. Women
who are allergic to nonoxyl-9 or who have had toxic shock syndrome
should not use the sponge. Protectaid® is currently available in
Canada, and US residents can expect to find the Today Sponge on
pharmacy shelves in the fall.
Diaphragm
The diaphragm is
available by prescription and is sized by a health care professional
to ensure a proper fit. The diaphragm works by covering the cervix
with a dome-shaped rubber disk with a flexible rim to prevent sperm
from entering the uterus. A spermicidal is applied to the diaphragm
before insertion to kill sperm. The diaphragm may be left in place
for 6 hours, however for repeated sexual intercourse or intercourse
after 6 hours spermicide should be inserted into the vagina while the
diaphragm is still in place. Diaphragms should never be left in for
more than 24 hours due to risk of toxic shock syndrome
(TSS).
Cervical
Cap
The cervical capis similar to the diaphragm. It is a soft rubber cup with a roundedrim and is sized to fit, by a health car professional, tightly around the cervix. Like the diaphragm, spermicide is required with the
cervical cap. It protects against pregnancy for 48 hours and for
multiple acts of sexual intercourse during this time. Prolonged use
(over 48 hours) may increase the risk of TSS and can
produce a foul odor or discharge.
