Birth Control

Quick look at birth control

Birth control, or contraception, is the intentional act of trying to prevent pregnancy by means of devices, medications, medical procedures or personal behavior.

The primary benefit of birth control is preventing a woman from getting pregnant when she doesn’t want to, thereby giving her more control over her reproductive choices. Some types of contraception may also be used to treat painful or irregular periods.

What is birth control?

Women and men practice birth control when they actively try to prevent a pregnancy. This can involve behaviors, such as abstinence from sexual intercourse or timed intercourse to avoid ovulation. For couples having sexual intercourse, means of birth control include the use of barrier methods (condoms), medications (hormone-based), devices (implants), or procedures (sterilization) to prevent pregnancy. These options are detailed below.

Typically, women are at risk of getting pregnant from sexual intercourse after they have reached puberty (around age 12) and until they enter menopause (average age of 51 in the United States). Birth control helps prevent unwanted pregnancies.

Birth control can also be used to regulate a woman’s menstrual cycle. Controlling a woman’s cycle can help with cramps, irregular cycle length, mood swings, acne or heavy menstrual flow.

There are many effective and safe birth control options women have to choose from with the help of their OB-GYN. CU Medicine OB-GYN East Denver (Rocky Mountain) helps our patients navigate the many birth control options and find what works best for them. Most forms of birth control, other than condoms, require a prescription from a healthcare provider.

Birth control options

The type of birth control chosen is a very personal decision best made in consultation with a healthcare provider. A thorough discussion of the benefits and risks of each method is necessary, and a gynecologic examination may also reveal anatomical issues affecting options.

Barrier method

Condoms are a barrier method of contraception that prevents a man’s sperm from entering a woman’s vagina during ejaculation. They are the most popular form of birth control. Another significant benefit of condoms is that they are the only type of contraception that can prevent the transmission of many sexually transmitted infections.  Other barrier methods include the female condom and the diaphragm.

Natural family planning

Natural family planning involves a woman tracking her menstrual cycle so she is aware of when she is most likely to ovulate (release a mature egg), and avoiding sexual intercourse at those times. Abstinence is not having sexual intercourse and is the most effective form of birth control.

Hormonal methods of contraception

Hormones (either estrogen, progesterone or both) used in birth control pills, patch, implant, shot, vaginal ring, hormonal intrauterine device (IUD) and emergency birth control (the morning after pill) prevent women from ovulating, providing effective contraception. Some forms of hormone-based birth control use only progesterone and work by thickening cervical mucus to prevent the sperm from being able to reach the female egg. Hormone-based contraception is delivered in the following ways.

Birth control pills, or “the pill”

Taken daily, by mouth, by a woman to prevent pregnancy. The most common form is called combination pills that contain both estrogen and progestin hormones. Some types only include progestin.

Birth control pills’ effectiveness is linked to whether a woman takes her pill as directed. Ideally, the pill is taken at the same time every day; progestin-only pills must be taken at the exact same time each day. This consistent dosing helps keep the correct level of hormones in a woman’s body at any given time.

If taken as directed, fewer than 1 in 100 women will get pregnant each year on the pill. Even when not taken as directed, the pill still helps prevent pregnancy. With inconsistent dosing, around 9 out of 100 women get pregnant each year. Some medications or supplements can decrease the effectiveness of birth control pills. It is important to discuss all of your medications with a healthcare provider before relying on the pill for birth control.

Birth control shot (Depo-Provera)

A progesterone-only injection that is given every three months. The shot is given in the upper arm or buttock.

Patch

A small adhesive patch that slowly releases hormones into the body. A woman wears it on her skin for three consecutive weeks, changing to a new patch each week. In the fourth week of the month, the patch is not worn and the lack of hormones will cause the woman to begin her period.

Vaginal ring (NuvaRing)

A flexible silicone ring that the woman places in her vagina each month. The ring gradually releases hormones that are absorbed through the skin of the vagina into the bloodstream. The ring remains in the vagina for three weeks and then the woman removes it. During the one week that the ring is out, the woman will get her menstrual period.

Intrauterine device (IUD)

A small, flexible, t-shaped device a healthcare provider inserts into the uterus to prevent pregnancy. The IUD is one of the most effective birth control methods and is a long-term, reversible option for many women. There are five IUD brands approved for use in the U.S. and they fall into two categories:

• Hormonal IUDs — There are four hormonal IUD brands that release progestin into the body to prevent pregnancy by thickening the cervical mucus to prevent sperm from reaching the egg. The Liletta and Skyla work for up to three years, and Kyleena and Mirena work for up to five years.
• Copper IUDs ­— The only copper IUD available in the U.S. is Paragard. The Paragard does not have hormones. It is wrapped in copper that acts like a spermicide, preventing sperm from reaching the egg. It can protect a woman from pregnancy for up to 10 years. It also works well as emergency contraception if inserted within five days of unprotected sex.

All IUD types are inserted and removed during a medical office visit. Insertion of the IUD usually takes less than five minutes. Many women get cramps or feel a little bit of pain during insertion. Taking Motrin (ibuprofen) prior to insertion can often minimize this discomfort. Removal is an easy process and a new IUD can be inserted at the same time if a woman so chooses. If removed, a woman’s fertility goes back to normal and it is possible to get pregnant right way.

Implant

A small flexible rod a healthcare provider inserts under the skin of a woman’s upper arm. It releases hormones for up to three years. The implant is one of the top birth control methods for effectiveness. There are two types of implants, Implanon and Nexplanon.

Emergency contraception

Can be used after unprotected sex to prevent pregnancy. There are two kinds of emergency contraceptive: “The morning after pill” and the Paragard IUD. Plan B is a brand of morning after pill now available over the counter without a prescription. It helps prevent pregnancy when taken within 72 hours of unprotected sex. Plan B is not an abortion pill.

Medical procedures

Several medical procedures help prevent pregnancy or eliminate the ability to conceive.

• Tubal sterilization is a surgery that is meant to permanently prevent pregnancy by having a woman’s fallopian tubes cut, blocked or removed. This is often called tubal ligation, or having one’s “tubes tied.”
• Essure is a permanent birth control option that can be completed in an OB-GYN office. During this visit, the OB-GYN will insert a soft flexible insert into each of the fallopian tubes. Once in place, the inserts cause scar tissue to form blocking the tubes. Three months after insertion, the woman will need to return to her doctor to confirm the scar tissue has formed and the tubes are blocked. Until it is confirmed that a woman’s tubes are fully blocked, she must use another form of birth control to prevent pregnancy.
• Vasectomy is a surgical procedure for a man in which a doctor blocks or closes the tubes that carry sperm.

Each kind of birth control has its own unique risks and side effects, which could include higher risk for blood clots, breast tenderness, nausea, headaches and irregular vaginal bleeding. Women should consult with their doctor about the specific risks that may come with any form of birth control they are interested in.

The only form of birth control that is 100 percent effective is abstinence. While birth control decreases the chances of pregnancy, it is still possible that a woman could become pregnant while using birth control. Women who suspect they are pregnant while on birth control should continue using their birth control (pill, patch or ring) until they confirm or rule out a pregnancy.