There are a variety of contraceptive options available to women, and it is important to find a method that works well, creates minimal side effects, and is manageable in an individual’s lifestyle.
Oral contraceptive Pills
There are a multitude of oral contraceptive pills that range in dosing. They are available with progesterone hormone alone, or more commonly used with both estrogen and progesterone (referred to as combined contraceptive pill). It is possible to use a pill that allows for a monthly period, or one that allows for menstruation only 4 times per year. With the many options it is possible to find a pill that minimizes individual patient’s side effects. The pill must be taken at the same time daily to be effective.
Contraceptive Patch –
The Ortho Evera contraceptive patch includes both estrogen and progesterone hormones and works similarly to a combined contraceptive pill. It is a small square and can be worn on the buttocks, chest (away from the breast), upper back, arm or abdomen. The patch is required to be changed weekly on the same day. During the 4th week a patch is not worn, and menses occurs. After week 4 a new patch is applied. With typical use it is 91% effective in preventing pregnancy.
The Nuva Ring is a flexible plastic ring that releases both estrogen and progesterone. It is placed in the upper vagina and remains there for 3 weeks. It is then removed, and a new ring is placed one week later. Bleeding occurs during the week without a ring in place. If replaced immediately it can be used as continuous-dose birth control. With typical use it is 91% effective in preventing pregnancy.
Depo-Provera is a contraceptive injection. It contains the progesterone hormone only. Depo-Provera must be administered every 3 months.
The implant currently available and administered in this office is the Nexplanon. Nexplanon is placed in the inner side of the upper arm directly beneath the skin. It remains there for 3 years. If you wish to become pregnant before the completion of 3 years, it can be removed early without delay in fertility. It contains the progesterone hormone only. With typical it is greater than 99% effective in preventing pregnancy.
Intrauterine Devices (IUD)
An intrauterine device is placed inside the uterus. Placement can be done in the office through the cervix by placing a speculum in the vagina, similar to getting a pap smear. There are 2 types of IUDs available.
Mirena IUD contains a progesterone hormone. It remains in the uterus for 5 years, and is highly effective in preventing pregnancy (>99%). It can also be used to decrease the amount of vaginal bleeding, and many women who have a Mirena in place no longer have periods.
The Paragaurd is often refered to as the copper IUD. There are no hormones in this type of contraceptive device, and it works by preventing the sperm to fertalize an egg. It is greater than 99% effective, and can remain in the uterus for up to 10 years.
Permanent contraception can be achieved in a variety of ways. The most common include a laparoscopic surgery to “clip” the tubes, and can be done at any time. Surgery can also be performed through a small incision under the umbilicus immediately following pregnancy.
The Essure is a method of permanent contraception that is performed through the cervix, and does not require an abdominal incision. It works by placing coils in the fallopian tubes which causes them to scar and create a permanent barrier. Dr. Kessler is pleased to now be able to offer this service in her clinic. It is a great option for women who desire to avoid general anesthesia and hospital stay.