One of the ways I serve my patients is to provide family planning counsel and options for birth control.
Birth control alternatives have come a long way since the high-dose contraception pills of our mother’s era. The wide variety of contemporary options make it easier to stick with — and have better control over —your chosen method than ever before.
Some of the options I talk to my female patients about include:
BIRTH CONTROL PILLS
Small pills, taken daily, that contain hormones to prevent ovulation. With the modern low-dose formulas, it’s important they not only be taken daily without fail, but also at the same time daily as much as possible. When taken as prescribed, birth control pills are 99% effective at preventing pregnancy. Many providers use these pills to suppress Polycystic Ovarian Syndrome or Acne but I prefer to reserve them for birth control and use other nutritional and herbal options to promote a balanced foundation instead. Possible but minor, and usually short term side effects can include headaches, break through bleeding, and nausea. If you have other risk factors for blood clots, we can choose:
Progestin-only Pills which do not contain estrogen so are somewhat safer in some people who can’t use estrogen. Combined BCPs are still very low risk and have less risk of clotting than in pregnancy!
BIRTH CONTROL PATCH
The hormones in a birth control patch are time-released through the skin. A patch, roughly two inches square, is applied to the hip or abdomen every week for three weeks. (If you’ve seen the commercials for nicotine patches, it’s a similar concept.) The fourth week no patch is worn, which triggers menstruation. You still have to remember to change your patches, once a week, but that may be easier than a daily reminder for the pill. The ingredients, action, and side effects are the same but the dosing is a little more evenly provided as opposed to the peaks and troughs with pills, though the total dose may be slightly higher.
The birth control ring (AKA NuvaRing) is a small, “insert-it-and-forget-it,” flexible ring that is worn inside the vagina for 3 weeks and it is removed for a week when you have your period as with the inactive pills. Containing time-released estrogen and progestin hormones to stop ovulation, the ring has the same effectiveness at pregnancy prevention as pills but doesn’t require daily use. It is also safe to use continuously, avoiding menstruation. It seems to have fewer incidents of side effects than pills.
CERVICAL CAPS AND DIAPHRAGMS
One of the few non-hormonal options for family planning, these soft silicone products are used with spermicide to block the cervix and kill any sperm that try to get by them. Diaphragms are 94% effective but cervical caps are most effective in women who have never given birth. I have a source for ordering diaphragms and enjoy fitting them but you’d need to go to Planned Parenthood or Emma Goldman clinic for the cervical cap.
Five different FDA approved brands of IUDs are in use, divided into 2 types: copper IUDs and hormonal IUDs. The copper IUD has a thin coating of copper preventing pregnancy for up to 12 years. The other brands use the hormone progestin to prevent pregnancy for three to six years (depending on the brand). All are 99% effective at protecting against pregnancy. IUDs can be inserted during a brief appointment at our office and removed any time. In fact, it’s possible to get pregnant as soon as your IUD is out. No waiting period required.
BIRTH CONTROL SHOT
The birth control shot (sometimes called Depo-Provera, the Depo shot, or DMPA) contains the hormone progestin and doesn’t contain estrogen. To get the shot’s full birth control powers, must get a new shot every 12-13 weeks. I don’t stock the Depo in my office since I’ve seen more side effects with it than with other methods. However for some it is the best choice so I can prescribe it and inject it if needed.
BIRTH CONTROL IMPLANT
The birth control implant, currently branded Nexplanon, is a tiny, thin rod about the size of a matchstick. During an office visit, a special syringe is used to insert the implant just under the skin of your forearm. It will prevent pregnancy for up to 4 years. If you decide you want to get pregnant or you just don’t want to have your implant anymore, it can be removed. You’re able to get pregnant quickly after the implant is removed. I recommend my clients get this method in an office where the procedure is done on a daily basis so I can refer you to a clinic if needed.
FERTILITY AWARENESS METHOD
Some of my clients prefer to monitor their body temperature and cervical mucous for their level of fertility. This method requires a high level of training, motivation, and consistency in your schedule and lifestyle. Foods, alcohol, stresses, and schedule changes can impact our physiology and make it difficult to feel confident in an ability to read these particular signs.
If family planning is a concern of yours, know that several options are available to you. I encourage you to make an appointment to talk about which ones might be best for you.