By Kathleen Ammon, N.P.
Women’s health nurse practitioner in Malden, MA
You have choices when it comes to birth control. Ask questions – that’s what we’re here for!
In 2010, unintended pregnancies accounted for 47 percent of all pregnancies in Massachusetts. That’s 54,000 women who didn’t want a child, didn’t want a child yet, or otherwise weren’t prepared for this huge responsibility. And our state ranks slightly higher than the national average for unintended pregnancy.
Unintended pregnancy often can be avoided. There are several effective birth control options available. You and your doctor can decide on the birth control plan that’s right for you.
Birth control that fits your lifestyle
When patients come to my office in Malden to talk about birth control, I like to get to know them a little better. This helps me make good recommendations for birth control that meets their particular needs.
Some of the questions that go into choosing the right birth control include:
- Are you a teenager getting ready to have sex for the first time?
- Are you single and dating?
- Are you married or in another monogamous (exclusive, one-partner) relationship?
- Do you want to start a family someday? If so, when?
For single women, young women, and teens, I first talk with them about the importance of safe sex. Birth control is only one part of practicing safe sex. Safe sex also involves taking the necessary steps to prevent getting a sexually transmitted disease (STD). The most important part of practicing safe sex is to use a condom — always. If you’re not in a monogamous relationship, any birth control you use should be combined with using condoms every time you have sex.
Birth control option No. 1: The pill
The birth control pill, most commonly referred to as just “the pill,” is the option most of my patients know the most about. According to the Centers for Disease Control and Prevention (CDC), birth control pills are about 91 percent effective when taken properly.
Birth control pills can have other benefits besides preventing unintended pregnancies. Some women may have particularly difficult menstrual cycles, with intense cramping, excessive bleeding, and other symptoms. Birth control pills can be used to control these symptoms. Birth control pills contain synthetic hormones that are used to regulate your period, but your doctor may prescribe the pill to adjust your hormone levels and lessen period symptoms. Some birth control pills can even help treat acne!
Birth control pills aren’t for everyone, though. Some women have negative side effects from the pill’s synthetic hormones, and some have medical conditions that prevent them from taking birth control pills. Also, some antibiotics and other medications can lower the effectiveness of birth control pills, increasing your chances of getting pregnant even if you take the pill as prescribed. Talk with your doctor to decide if the pill is the best choice for you.
Birth control option No. 2: Intrauterine devices
Intrauterine devices (IUDs) are popular with patients who want a longer-term birth control solution.
Two options my patients often ask me about are Mirena and Skyla. Both Mirena and Skyla are examples of levonorgestrel intrauterine systems. These systems work by releasing small amounts of synthetic hormones to prevent pregnancy. You have to have an IUD inserted into your uterus by your doctor. But once it’s there, it can stay for up to five years. The CDC notes that these types of IUDs are more than 99 percent effective.
If you’re sensitive to hormones, I recommend a copper T IUD, such as Paraguard. Instead of using hormones, the copper in this IUD acts as a spermicide to kill the sperm. A copper T IUD can stay in your uterus for up to 10 years, and this type of IUD is also more than 99 percent effective at preventing pregnancy.
Birth control option No. 3: Hormonal choices
If you don’t care for the previous options (or your doctor decides they’re not a good fit for you), there are other effective birth control choices available.
One such option is a birth control implant, such as Nexplanon. This is a rod your doctor can insert under the skin of your arm, and it releases synthetic hormones to prevent pregnancy for more than three years. The CDC notes that these implants have one of the lowest failure rates: just 0.05 percent!
Another option is a birth control injection (shot), like Depo-Provera. This contains the hormone progestin, and you get a shot from your doctor every three months. Birth control shots are about 94 percent effective. The birth control shots can help women with period problems such as::
- Irregular bleeding/spotting
- Irregular cycles, such as missed periods
- Unusually heavy or light periods
If you want something that doesn’t require frequent visits to your doctor, a vaginal contraceptive ring like NuvaRing might be a good choice for you. You insert the ring into your vagina, leave it in for three weeks, remove it the week of your period, and start the process over again once your period’s done. Much like birth control pills, the contraceptive ring releases synthetic hormones to prevent pregnancy. It is about 91 percent effective, like the pill.
How to know which birth control option is right for you
First and foremost, you should talk to your doctor about your birth control options. You may have health concerns (like high blood pressure, blood clots, breast cancer, or others) that limit which options will work for you.
You also should talk to your partner about birth control. If you’re a teen, or if you’re not in a monogamous relationship, your partner should understand the importance of using a condom every time you have sex (in addition to your prescribed birth control method). If you’re in a monogamous relationship, talk to your partner about your options and how they can influence when (or if) you would like to start a family.
At the end of the day, it’s your body and your choice. Birth control gives you the choice of when you want to get pregnant. It’s a powerful tool to help you stay in control of your life.
Tags: family health, family medicine, internal medicine, malden, OB/GYN, women's health