Sunday, April 14, 2013

Birth Control Pills or IUD: Which Is Right For You?

There are several different types of birth control on the market now leaving women with many questions as to their effectiveness, side effects and long term consequences.  Unfortunately there is no perfect option that is ‘side effect –free’ (unless, of course, abstinence is counted however many opt not to make this choice) therefore it is important to combine your current health with your goals (true pregnancy prevention or other women’s health issues as well) and talk with your health care provider.  Here are some things to consider when looking at the two most common forms that might work for you.

First and most common is the birth control pill also known as the oral contraceptive pill.  This pill is taken daily for 3 weeks then stopped for 7 days to allow for a "period," or continued in some cases for 3 months straight or in rare cases done continuously without a bleed.  The pill is typically a combination of a synthetic estrogen and progestin that works to suppress ovulation therefore a woman cannot become pregnant if there is no egg release.  There are various forms of the pill and amounts of estrogen and progestin within. 

Typical side effects can include: change in menstrual cycle, mood changes, increased vaginal discharge, decreased libido, skin changes, weight changes, increased risk for gall stones, and increased risk for blood clots.  Women who smoke, have migraines with aura, have diabetes, or have a personal history of cardiovascular disease should not use the pill.  When used correctly (ie. taken at the same time every day) the effectiveness against pregnancy is 92-98% effective.  It does not protect against sexually transmitted infections such as gonorrhea, Chlamydia, HIV/AIDS, HPV or trichomonas. 

Next most common is the IUD or intrauterine device. This is a small T-shaped device that is inserted up into the uterus during an office procedure (only local anesthesia required).  There are two types of IUDs.  First is the Paragard that is also known as the copper-T as it does not have any hormone in it and instead relies on the copper wrapped around the T-frame causing local inflammation to create a non- hospitable environment for the egg and sperm.  This IUD lasts 10-12 years after insertion.  The Mirena and Skyla IUDs are hormonally based in that they both contain progestin, similarly to that found in the birth control pill.  They are inserted the same way as the Paragard however the Mirena lasts 5-7 years and Skyla (which is newer and has a smaller design for those women who have never been pregnant) lasts 3 years.  Their effectiveness is about 99% against pregnancy and can be removed relatively easily in office through a simple, quick procedure. 

The most common side effects for all three IUDs are pain with insertion, spotting or irregular cycles for the first 3-6 months during the adjustment period, and back pain.  There is the small risk for expulsion after insertion and perforation through the uterus.  The Paragard may increase menstrual cramps and increase menstrual flow.  The Mirena typically diminishes cramps and reduces flow however there is a risk for ovarian cysts and acne.  None of the IUDs prevent against sexually transmitted infections such as gonorrhea, Chlamydia, HIV/AIDs , HVP or trichomonas.

There are other forms of birth control such as barrier methods (condoms or diaphragm), the depo-provera injection, the implant, the patch, the ring, tubal sterilization, ablation and tubal blockers (essure).  Please talk with your health care provider about which form suits your needs and your health best.

Read more at www.empowher.com

References:

1)  Foster, D. (2009).  Optimizing the Use of Oral Contraceptives.  Web.  14 April, 2013.
2)  Reuter’s Health Information (2013).  U.S. Approves First New IUD in 12 Years.  Web.  14 April, 2013.
3)  Waknine, Y. (2009).  Levonorgestrel IUD Approved to Treat Heavy Menstrual Bleeding.  Web.  14 April, 2013.
4)  Barclay, L.  (2011). IUDs, Implants Most Effective Reversible Contraceptive.  Web.  14 April, 2013.

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