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Birth Control

Effective birth control methods include barriers such as condoms, diaphragms, and the contraceptive sponge; hormonal contraception including oral pills, patches, vaginal rings, and injectable contraceptives; and intrauterine devices (IUDs). Emergency contraception can prevent pregnancy after unprotected sex. Long-acting reversible contraception such as implants, IUDs, or vaginal rings are recommended to reduce teenage pregnancy. Sterilization by means such as vasectomy and tubal ligation is permanent contraception. Some people regard sexual abstinence as birth control, but abstinence-only sex education often increases teen pregnancies when offered without contraceptive education. Non-penetrative sex and oral sex are also sometimes considered contraception. 

Method

How It Works

HORMONAL
  • Prevents ovulation
  • Thickens mucus at the cervix so sperm cannot pass through
  • Changes the environment of the uterus and fallopian tubes to prevent fertilization and to prevent implantation if fertilization occurs

INTRAUTERINE DEVICE
(IUD)

  • The progestin released by the hormonal IUD prevents fertilization by making the mucus in the cervix thick and sticky, so sperm can't get through to the uterus. The progestin and IUD change the uterine lining, preventing implantation in the rare case that fertilization occurs.
  • The copper in the copper IUD is toxic to sperm. It causes changes in the uterus and fallopian tubes that kill sperm. The IUD changes the uterine lining, which prevents implantation in the rare case that fertilization occurs.

BARRIER METHODS
  • Block sperm from reaching the egg.
  • Some are used with spermicides, which kill sperm.

FERTILITY AWARENESS
(NATURAL FAMILY
PLANNING)
  • Identifies the time during a woman's cycle when she is most likely to become pregnant (fertile).
  • An additional method or abstinence should be used during this time of fertility.

PERMANENT BIRTH CONTROL
(STERILIZATION)

  • Men: Vasectomy blocks the release of sperm.
  • Women: Tubal ligation surgery or tubal implants block the movement of an egg through the fallopian tube, preventing fertilization.
WHAT IS BIRTH CONTROL?

Birth control, also known as contraception and fertility control, refers to methods or devices used to prevent pregnancy. Planning and provision of birth control is called family planning. Safe sex, such as the use of male or female condoms, can also help prevent transmission of sexually transmitted infections. Contraceptive use in developing countries has cut the number of maternal deaths by 44% (about 270,000 deaths averted in 2008) but could prevent 73% if the full demand for birth control were met. Because teenage pregnancies are at greater risk of poor outcomes such as preterm birth, low birth weight and infant death, some authors suggest adolescents need comprehensive sex education and access to reproductive health services, including contraception. By lengthening the time between pregnancies, birth control can also improve adult women's delivery outcomes and the survival of their children.


HORMONAL

Hormonal methods are very reliable means of birth control. Hormonal methods use two basic formulas:

  • Combination hormonal methods contain both estrogen and progestin (synthetic progesterone). Combination methods include pills ("the Pill"), skin patches, and rings.
  • Progestin-only hormonal methods include pills, also called "mini-pills"; shots (such as Depo-Provera); and implants (such as Implanon). If you cannot take estrogen, a progestin-only method may be an option for you. There is also a hormonal IUD that releases a type of progestin.
Combination and progestin-only methods are prescribed for women for different reasons. Compare the recommendations for and against combination and progestin-only hormonal birth control pills, patches, implants, and rings. Each type of method has its pros and cons.

  • Combination pills may reduce acne, pain during ovulation, and premenstrual symptoms. Both types of pill reduce heavy bleeding and cramping. Unlike the combination pill, the progestin-only pill can be taken by almost all women, including those who are breast-feeding, although it must be taken at the same time each day to be effective. (Combination pills are also taken daily but without as much attention to the time of day.) When you first start taking either type of birth control pill, it is necessary to use a backup birth control method for the first week.
  • Patches or vaginal rings are similar to combination pills, but they don't require taking a daily pill. The patch is changed weekly, and the ring is changed monthly (with 1 week off after 3 weeks of use).
  • Some birth control pills reduce severe mood and physical symptoms that some women get before they start their monthly periods. These symptoms are called premenstrual dysphoric disorder (PMDD). There are birth control pills that are helpful for women who have migraines with their periods. There are also birth control pills for women who want fewer periods or who want to stop having periods.
  • The birth control shot does not require taking a daily pill. Instead, you see your health professional once every 3 months for the injection.
  • The hormone implant releases hormones that prevent pregnancy for about 3 years. It must be inserted and removed by a trained health professional. The actual implant is about the size of a matchstick and is inserted under the skin on the inside of the upper arm.

INTRAUTERINE DEVICE
(IUD)

An intrauterine device (IUD) is a small device that is placed in the uterus to prevent pregnancy. There are two main types of IUDs: copper IUDs (such as Paragard) and hormonal IUDs (such as Mirena). When an IUD is in place, it can provide birth control for 5 to 10 years, depending on the type. Unlike IUDs that were used in the 1970s, present-day IUDs are small, safe, and highly effective.  

The hormonal IUD typically reduces menstrual flow and cramping over time. On the other hand, the copper IUD can cause longer and heavier periods. But the hormonal IUD can have other side effects, including spotting, mood swings, and breast tenderness. These side effects occur less frequently than with other progestin-only methods. 

n intrauterine device (IUD) is a small device that is placed in the uterus to prevent pregnancy. There are two main types of IUDs: copper IUDs (such as Paragard) and hormonal IUDs (such as Mirena). When an IUD is in place, it can provide birth control for 5 to 10 years, depending on the type. Unlike IUDs that were used in the 1970s, present-day IUDs are small, safe, and highly effective.  

The hormonal IUD typically reduces menstrual flow and cramping over time. On the other hand, the copper IUD can cause longer and heavier periods. But the hormonal IUD can have other side effects, including spotting, mood swings, and breast tenderness. These side effects occur less frequently than with other progestin-only methods. 

BARRIER METHODS

Barrier methods (including the diaphragm; cervical cap; cervical shield; male condom; female condom; and spermicidal foam, sponge, gel, suppository, or film) prevent sperm from entering the uterus and reaching the egg. Typically, barrier methods are not highly effective, but they generally have fewer side effects than hormonal methods or IUDs. Spermicides and condoms should be used together or along with another method to increase their effectiveness. Barrier methods can interrupt sex, because they must be used every time you have sex.  

Condoms (male or female) should always be used if you are at risk of getting or spreading a sexually transmitted disease, such as genital herpes, chlamydia, or HIV. 
_

FERTILITY AWARENESS
(NATURAL FAMILY PLANNING)

Fertility awareness requires that a couple chart the time during a woman's menstrual cycle when she is most likely to become pregnant and avoid intercourse or use a barrier method during that time. Fertility awareness is not a good choice if you need a highly effective form of birth control.  

Breast-feeding may work as a form of birth control in the first 6 months after giving birth if you follow specific guidelines. For this method to work, you must breast-feed your baby every time. You can't use formula or other supplements. This is called the lactational amenorrhea method (LAM). Although LAM has been shown to be 98.5% effective when these conditions are met, many doctors recommend that you use another birth control method. 

PERMANENT BIRTH CONTROL
(STERILIZATION)

Sterilization is a surgical procedure done for men or women who decide that they do not want to have any (or more) children. Sterilization is one of the most effective forms of birth control. Sterilization is intended to be permanent, and although you can try to reverse it with another surgery, reversal is not always successful.

  • Tubal ligation or implants. Tubal ligation is a surgical procedure where the fallopian tubes, which carry the eggs from the ovaries to the uterus, are tied, cut, or blocked. A new nonsurgical sterilization technique uses a small metal coil, or tubal implant , inserted up into each fallopian tube. Over time, scar tissue grows around each tubal implant, permanently blocking the tubes. Most women are able to return home within a couple of hours after either procedure. You must use another form of birth control for 3 months after receiving tubal implants. At 3 months, you will need to have an X-ray taken to make sure that your tubes are closed.
  • Vasectomy. In this minor surgery, the vas deferens, the tubes that carry sperm from the testicles to the seminal fluid (semen), are cut and blocked so that the semen no longer contains sperm . This does not interfere with a man's ability to have an erection or enjoy sex. Men must have a sperm count check after having a vasectomy before relying on this for birth control.

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