More than 60 million women take the pill worldwide and it is the most popular form of contraception in the United States. Most pills contain an estrogen and progestin and work by preventing ovulation. Used correctly (taking it at about the same time every day), it is 99% effective. Pills available today are a much lower dose than the original birth control pill of the 1960's and have fewer side effects.
There are some minor side effects associated with the birth control pill. These include: breakthrough bleeding (bleeding between periods), nausea, headaches, and breast tenderness. Many of these side effects decrease during the first three months of usage.
A rare side effect that can occur with any form of contraception that contains estrogen is a blood clot (deep vein thrombosis or DVT)
Not all women are good candidates for the birth control pill. You should not take a pill that contains estrogen if you are a smoker over age 35. You should also not take the pill if you have a history of lupus or classic migraine headaches (begin with a neurologic aura prior to the headache onset). Women who have a history of blood clots or stroke, heart disease, high blood pressure, have had breast cancer, or have certain liver or kidney conditions, or have active gallbladder disease should not take the pill.
Depo Provera®is the well known brand name of an injectable form of contraception (medroxyprogesterone) that protects you against pregnancy via an injection every three months. It is a a good alternative for birth control for patients who cannot remember to take a pill. It is over 99% effective.
Nuvaring® is a form of contraception that is also a good option for patients who have a problem remembering to take a daily pill. The device is a flexible vaginal ring containing estrogen and progestin that is inserted into the vagina and stays in place for three weeks at a time. It is then removed for a week, which enables menses to occur.
Ortho Evra® Patch
The birth control patch is another good option for women that have trouble remembering to take a daily pill. A patch is worn on the skin for a week and then changed out for a new patch. After three consecutive weeks of patches, the patient has a patch free week which enables a cycle to begin. The patch does have a slightly higher risk of blood clotting (Deep Vein Thrombosis) as opposed to the risk seen in oral contraceptives. However, this risk is still lower than the risk of DVT in pregnancy, and so it is still considered a safe option.
Intrauterine Device (Mirena®/ParaGard®/Skyla®)
Intrauterine devices are T shaped devices that are placed inside the uterus during a simple exam in the office. The Paraguard® (also called the Copper T) is hormone free and is effective for up to 10 years. The Mirena® secretes daily progesterone locally to the uterus in order to regulate the menstrual cycle and is effective for up to 5 years. The Skyla® is a slightly smaller version of the Mirena® that is effective for up to 3 years. All of the IUD options are very effective and can be removed prior to their alotted time if the patient desires conception.
Nexplanon® is a flexible plastic rod the size of a matchstick that is put under the skin of your arm in an in-office procedure. It is more than 99% effective. It is a progestin only form of birth control that can be left in your body for up to three years.
Tubal ligation is a permanent form of female sterilization in which the fallopian tubes are blocked or cut in order to prevent fertilization. This is normally an outpatient laparoscopic surgical procedure done in the hospital.
Essure® Permanent Birth Control Procedure
The Essure® procedure (www.essure.com) is a method of permanent birth control for women in which micro-inserts are placed within the fallopian tubes by using hysteroscopy (placing a camera inside the uterus). The micro-inserts produce eventual occlusion of the fallopian tubes (usually in three months) by causing the in-growth of tissue. It does not involve any incisions into the body. It is performed in the office and is 99.80% effective.