A to Z Disease

Text Summary for HealthiNation's Birth Control

Hosted by Dr. Isabel Blumberg, OBGYN

What is Birth Control?

Without the use of some type of birth control, 85 percent of all sexually active women can expect to become pregnant within one year, and studies show that one-half of all pregnancies in the U.S. are unintended. While abstinence is the surest way to avoid an unwanted pregnancy, there are also numerous safe and effective birth control options available.

Various birth control methods attempt to inhibit pregnancy in different ways. Some prevent sperm from reaching an egg during sexual intercourse, while others affect a woman's reproductive process to prevent a pregnancy from occurring, either by preventing ovulation (the release of an egg from the ovary) or inhibiting an embryo from implanting into the uterine wall.

Types of Birth Control

Barrier Birth Control Methods

Barrier contraceptives all work by stopping sperm from reaching an egg, and therefore prevent pregnancy. There are several types of barrier devices:

· Condoms. The most well-known barrier method is the condom, it comes in both male and female versions. Condoms are made of latex, plastic or polyurethane, or animal membrane, and can be purchased over-the-counter without a prescription.. Latex and polyurethane condoms are the only form of birth control found to be effective in preventing the spread of sexually transmitted diseases (STDs). Because of this condoms are frequently used with other forms of birth control. Condoms are disposable, and can only be used once. Some people are allergic to latex allergies and may want to consider using polyureathane or plastic condoms.

• Male condoms are put over an erect penis before intercourse to prevent sperm from entering the vagina during sex.When used correctly they are 89 percent effective.
• Female condoms are inserted into the vagina before intercourse, and are 79 percent effective.

· Diaphragm. Diaphragms are small latex disks you fill with spermicide and insert into the vagina, covering or capping the cervix opening, before intercourse. The diaphragm prevents sperm from entering the uterus and fertilizing an egg by inhibiting the movement of sperm. It must be left in place for 6 to 8 hours after sex to ensure proper protection. To get a diaphragm, you'll need to visit a doctor and be measured and fitted for the right size. The diaphragm is re-usable, and with proper care can last for up to one or two years. Some people may be allergic to latex, so the diaphragm could cause a reaction, and in rare cases women may be subject to vaginal or urinary tract infections, and toxic shock syndrome. When used correctly, a diaphragm is 85 percent effective in preventing pregnancy.

· Contraceptive Sponge & Contraceptive Shield. The sponge and the shield are over-the-counter methods that are similar to the diaphragm. They are also inserted into the vagina before sex and fit over the cervix, and work with a spermicide to prevent sperm from reaching an egg. These also need to be left place for 6 to 8 hours after intercourse to ensure protection.

· The sponge is a disposable device that can only be used once, and is 84 percent effective when used properly.

· The shield is reusable, and can last for up to 6 months. It can be left in place for up to 48 hours, and it is 85 percent effective in preventing pregnancy.

To get full protection from any of these barrier devices, you'll need to use them with a spermicide. Spermicides inhibit the movement of sperm, and they come as gels, creams, or foams.

Hormonal Birth Control Methods

Hormonal contraceptives offer highly effective, reversible pregnancy prevention by affecting the female reproductive system. These methods use the hormones estrogen and progestin, and work by preventing ovulation and implantation of an egg, and increasing mucus to hamper sperm mobility. Hormonal contraceptives require a prescription and come in a few different forms, they are:

· Oral Contraceptives. Oral contraceptives come in both an estrogen-progestin combination and as progestin only pills. These pills must be taken daily, to keep the concentration of hormones constant and provide consistent birth control protection. These hormones regulate your menstrual cycle, and allow for monthly periods. Some types can reduce the number of periods you get per year, or eliminate them all together. Progestin only, or so-called "mini-pills", are useful for women who are breastfeeding or who cannot take estrogen.

· The Patch. The Patch works as an adhesive bandage, which gets placed on the skin and releases estrogen and progestin into the system over time to prevent ovulation and implantation. It works on a monthly cycle and needs to be replaced each week for three weeks a month.

· The Ring. The Ring is a device you insert into the vagina once a month and it releases both estrogen and progestin to prevent ovulation and implantation.

· Shots. Progestin shots provide 12 weeks of pregnancy prevention and are administered by a health professional.

· Implants. Implants are tiny devices that are inserted under the skin by a doctor. They release progestin over time and provide up to three years of protection. They do have some possible side effects like hair loss, ovarian cysts, loss of sex drive and appetite, and possible infection at the site of the implant.

These all provide a 92 to 99 percent success rate when used as directed. When stopped, fertility usually returns to normal in one to two months. Their effectiveness can be diminished if taken with some other medications, such as some antibiotics, over-the-counter drugs, and herbal supplements like St John's Wort.

No one birth control method is perfect, and none of these protect against sexually transmitted diseases (STDs). They all come with certain risk factors. The estrogen-progestin combinations increase the risk for blood clots, stroke, and heart attack. And they shouldn't be taken by women who are 35 or older and smoke, have a history of heart disease, a family history of blood clotting disease, are breastfeeding, and a history of certain cancers. However, some of the pills also have benefits like lowering your risk of some cancers, improving acne, and preventing severe menstrual cramps, and decreasing menstrual bleeding.

Choosing a Birth Control Method

When choosing a birth control method it is important to take certain factors into consideration:

• Convenience & Comfort. How many sexual partners do you have? Are you in a monogamous relationship? Are you able to keep up with routines, like taking pills daily? How comfortable are you with using certain methods? Do you want to have children soon, down the road, or not at all?
• Effectiveness. Each method of birth control has a different effectiveness rate, ranging from 71 to 99 percent. You'll need to determine what level of risk you are comfortable taking on.
• Health Concerns & Risks. Some birth control methods should not be used by people with certain health concerns. Pre-existing conditions, age, family health history, and other risk factors should be taken into account. Ask your physician whether you have any health problems that rule out some of the options or make others particularly well-suite for you.
• Cost. Birth control methods vary in price, both in the short and long term. Some may be covered by health insurance while others may not.