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The nice thing about condoms is that you can go to your local store and pick them up, which makes it very convenient. However, their effectiveness for pregnancy prevention is only approximately around 70% because they can break and/or people don’t actually take them out and use them. In addition, the nice thing about condoms is that they actually are the only form of birth control that can help prevent and/or decrease your risk of sexually transmitted infections. I often tell my patients to practice the electrical fence rule: as you know, some people have electrical fences around their homes to prevent dogs from coming out. I say: have an electrical fence around your body. Use a condom to prevent the dogs from coming in.
When comparing LARCs versus other forms of birth control, one has to realize that you have to be honest with yourself. Most often when it requires a patient to actually do something themselves, they may be less compliant. The nice thing about LARCs is that they don’t require a patient factor – meaning that once the doctor inserts the device, then that will be more effective and has a higher effective rate because it does not have the variable of requiring a patient to actually do something (i.e. Take a pill, put a condom on, put a patch on, place of NuvaRing in.)
When a person is deciding what birth control works for them, they first and foremost have to be honest with themselves about what type of person they are. Some people can do something every day, others would be noncompliant and forget, and so you have to realize what’s going to fit your lifestyle.
There are various side effects from the birth control pill. Sometimes people can have a slight breast tenderness and/or cramping and bloating, but that typically resolves after the first few months of taking the pill. Some also may experience menstrual headaches with the birth control pill and this may require you to see your provider and consider a different form of birth control as an option. Also, the dosage of medication in the birth control pill may need to be adjusted depending on your response – that is if you have irregular bleeding that is not resolved with initial efforts of a birth control pill, as there are various different dosages.
Most birth control is actually about 98% effective, but the problem is that people are not compliant. That is: if you don’t take your birth control pill every day, you have a higher risk of getting pregnant. If you don’t put your patch on every week, you have a higher risk of getting pregnant. If you don’t put the NuvaRing in every 3 weeks (or 3 weeks in and 1 week off) – you have a higher risk of getting pregnant. If you don’t come in and get your shot every 3 months, you have a higher risk of getting pregnant. As you can see, we have a continuous pattern here. It’s when you don’t do what you’re supposed to do in taking whatever form of contraception you’ve chosen is right for you, is oftentimes the most common reason of why people conceive on contraception.
If the pill makes you nauseous, one thing is that you can try to eat before you actually take the pill and/or take it at bedtime. In addition, sometimes the birth control pill may not be the best option for you. You may want to consider the NuvaRing that doesn’t have to be digested.
When one decides they want to have sterilization as their form of contraception, you should be 100% sure that you don’t want any more children. There are several options of sterilization. There’s the vasectomy from the male’s perspective. Then from the female perspective, there’s the Essure, which is done through the vagina, and then there are laparoscopic approaches as well as a postpartum tubal, which is done in the immediate postpartum period.
Those at risk for birth control – specifically speaking of hormonal birth control – are those that have a hypercoagulable state. That is, they personally have had a history of a blood clot formation. In particular, we’re speaking of deep venous thrombosis and/or pulmonary embolus. That is: blood clots in your extremities, particularly your legs and/or a blood clot in your lungs. Also, people that have hormonal cancers – in particular, some breast cancers and endometrial cancers – typically are not candidates for hormonal birth control.
In general, all forms of birth control (essentially that is all forms of hormonal birth control) have a risk of about a 5 pound weight gain. The only birth control that has a larger risk than that typically is the Depo-Provera shot as it is an appetite stimulant, and people have been known to gain a significant amount of weight with this form of birth control.
There is no form of birth control that is actually 100% effective because even when you have a procedure like a permanent sterilization, there is still a risk of pregnancy because you still have a uterus and you still have sperm that can actually fertilize an egg. Although this is very rare, as most sterilizations are 99% effective – this is why we never say 100%.
The patch is a form of contraception that is placed on the arm. You place the patch on the arm for a week at a time and you use 3 patches in a month’s time and then 1 week off and that’s when you have your cycle. The side effects of the patch include: some people have an allergy to the adhesive of the patch. Although this is not common, this can occur. The main concern about the patch is that it does have a higher profile risk of blood clot formation compared to all other forms of birth control.
Spermicides are typically a gel that are used in conjunction with barrier methods. That is the condom, the cervical cup, the diaphragm, and the sponge. These are very effective in conjunction with these barrier methods. However, alone they are not very effective, so whenever using a spermicide, make sure that you’re using a barrier method along with the spermicide. Oftentimes, if in a sample of a diaphragm, if you have used the spermicide and you have not had sexual relations, it is important to replace the spermicide within a 2 hour window.
The side effects of using the ring are: number one – some people (although rare) have some discomfort with the placement if they’re not comfortable with their body and comfortable actually placing it. Some people do not have the comfort level of actually inserting something in their vagina. In addition, they also can have irregular bleeding – as any form of birth control can do that occasionally. Most people do not have the problem of it falling out and it does not have to be removed with intercourse. However, on occasion there are people that have some difficulty due to their elasticity in their vagina in maintaining the vaginal ring.
We’re going to break the different types of IUDs into categories. First, there are progesterone-only IUDs and the subset of progesterone-only IUDs is that they are specifically for nulliparous patients – meaning patients that have not had any children. They are a little bit smaller in width to accommodate the smaller uterus that has not bore children. That is the 3-year Syla and the 5-year Kyleena. Then another subset of progesterone IUDs is the Liletta (which is 4 years) and the Mirena (which is 5 years.) These are slightly larger but can also be used in nulliparous patients. There’s also an IUD that has no hormones at all, and that’s called the ParaGard. It lasts for 10 years.
Birth control in general doesn’t necessarily cause depression. However, some people have reported some mood instabilities when they’re on various forms of birth control. This is not a common side effect, but if it does occur when you try birth control, you may need to try a different dosage and/or a different method of birth control that may not give you these same symptoms.
The NuvaRing is a type of hormone therapy that is a plastic ring made of estrogen and progesterone and it is about the size of this circle. You squeeze it and put it in similar to a tampon. It stays in for 3 weeks, then you take it out a week and that’s when you have a cycle and you continue that process.
If you’re stopping your birth control in efforts to conceive (that is get pregnant) then it’s often advisable to start prenatal vitamins prior to even the cessation or stopping of the birth control that you’re using. It’s recommended to start your pregnancy prenatal vitamins approximately 1-2 months prior to you actually stopping your birth control. The reasoning behind this is that if you get pregnant in a soon or quick interval of cessation, then you will actually have the protective component of primarily folic acid and/or DHA. Folic acid actually helps the neuro tube which is developed in the first 4-6 weeks of life, and oftentimes women do not even realize they are pregnant until after this time.
The major side effect of the Nexplanon is that some people can have irregular bleeding. Now, that doesn’t happen with everyone, but some people will have bleeding where they bleed for a couple of days and then they don’t bleed for 15-20, then they bleed a couple of days and so on. Or: they may have persistent bleeding for several weeks. Oftentimes if it happens for more than 3 weeks, your provider can give you a sample of birth control pills and then you take it for one month and that will help to resolve the irregular bleeding. Some people have just regular periods and also you may get amenorrhea or no bleeding at all.
The Nexplanon (or implantable subdermal device) is a type of birth control that lasts for 3 years. It is one of the long acting reversible contraceptions, meaning it lasts for an extended period of time. However, it’s reversible because it can be removed. Once it’s removed, your fertility resilience within 5 days. The nice thing about the Nexplanon is that it’s done in the office and it is about the size of a matchstick. It goes right in between the inside of your arm – between the biceps and the triceps. It’s right underneath the skin and you just get a local anesthetic and it’s placed and it only takes a few moments.
Oftentimes people come in requesting birth control because they have acne. The point is that acne can actually be improved with birth control pills specifically. The nice thing is that it helps to stabilize the hormonal fluctuations that most women experience in their reproductive cycle.
The shot (also known as the DepoProvera shot) is an injection of progesterone-only agent. It lasts for 3 months and one variable about this is that you have to come in every 3 months to get the shot. Otherwise, the effectiveness will expire.
Other than the inconvenience of coming in every 3 months, you also have to consider that Depo-Provera is an appetite stimulant, meaning that it can make people hungry and some people can gain weight on it. In addition, even when you stop the shot, it can last in your system for up to a year, meaning if you decide that you’d the shot to get pregnant, your fertility may take a while to resume. Also, you may have irregular bleeding with the Depo-Provera shot. Sometimes people have persistent bleeding with each injection and/or sometimes you may have no period at all.
Birth control is a form of contraception. They come in many forms and types and they are used to help prevent pregnancy. However, we also use it sometimes to help with menstrual regulation.
The nice thing about emergency contraception is that now it is available over the counter. It is important that you use this emergency contraception in emergency situations where you have had unprotected intercourse and/or accidental episodes of, for example, a condom breaking. It’s best to use it within the first 24 hours. However, it has been known to be actually effective up to 5 days. You may experience irregular bleeding when you have this and use this form of device. However, also understand that this is for emergency purposes and should not be used as you’re maintaining or maintenance of contraception. For that, you should seek a gynecological provider to decide what form of contraception is best for you.
There are various types of birth control. There are the barrier methods which include the condom, the cervical cup, the sponge, and the diaphragm. Then there are some hormonal components like the birth control pill, the patch, the ring, and the shot. Then there’s also what we call LARCs, which are Long Acting Reversible Contraceptions. That includes the implant in the arm or Nexplanon, and then there’s also IUDs (or intrauterine devices) which are several types.
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