What's Involved In Contraceptive Decisions?

• Are there any new contraceptive methods available?
  We recently received news of a new birth control injection, “Lunelle”, that is given on a monthly basis. This injection (shot) contains both progesterone and estrogen components that prevent ovulation of the ovum (egg) and most of the time will result in a regular monthly period. This method works the same as the birth control pill and has similar side effects, but does not require remembering to take a pill every day. The disadvantage is that a visit to the office for the injection would be required on a monthly basis.
• Is this shot the same as the Depo Provera injection?
  The Depo Provera injection contains only one hormone, a derivative of progesterone. This “shot” is given every three months. This method is associated with fewer side effects than pills since it does not contain estrogen. However, many women have breakthrough bleeding throughout the month, yet the longer you use this method, the more likely you will not have any periods. (Which some women see as an advantage). Because this method does not contain estrogen, it is important to assure an adequate calcium intake, either with food such as dairy products or a calcium supplement.
• Will I have any trouble getting pregnant after using hormonal methods such as birth control pills or injections?
  Normal birth control pills will not affect your fertility. However, many women who had irregular cycles before they ever started birth control pills will revert to their irregular cycles when they stop the pill. The irregular cycles may be a sign of fertility problems. These women may need help from the physician in pregnancy planning. After stopping the Depo Provera injection, it may take up to a year to resume regular cycles and thus be able to get pregnant.
• Should I consider a birth control “implant” in my arm?
  Actually, the implant uses the same type of hormone that the Depo Provera three month injection utilizes. The injection is probably a more reasonable choice, in that if you don’t like it, you can just stop getting the injections, as opposed to the implant which requires surgical removal.
• I’ve seen advertisements on television about a birth control pill that helps acne. Should I change to this pill or ask for this pill if I am having trouble with “break outs”?
  Hormones can influence acne, either making it better or worse. All pills have the potential to help; it basically is a matter of trial and error. The company that advertises their pill for acne is the first company to apply for this indication. It does NOT mean that other pills will not do the same thing.
• Is it true that birth control pills cause weight gain?
  There recently was a study done by one of the newer low dose birth control pill companies that showed NO weight gain with their oral contraceptive. If weight gain is a concern for you, ask about the newer dose pills.
• What is involved with permanent sterilization?
  Women may have their “tubes tied” as an outpatient at the hospital when they have decided that they never want to have any more children. This procedure may also be done after childbirth, either the day of the birth or the following day. Having your tubes tied does not usually prolong your hospital stay after childbirth. This procedure involves being put to sleep for a short time in the operating room. The tubes are then tied or clamped and cut, so that, even though the woman continues to ovulate, the egg is never able to travel down the tube or be fertilized by the sperm. This procedure does not cause weight gain or changes to the menstrual cycle. Most women have a quick recovery period and are able to resume most activities within a few days or week. Just like any surgical procedure, there may be small risks associated with anesthesia, bleeding or infection. And, just like everything else in life, where nothing is perfect, there may be about a one out of one hundred risk of failure. Yet, it is the best we have. One should not have this procedure done if they think that at some time they may want it reversed, as a reversal procedure is expensive, frequently not covered by insurance and often not successful.
• I’ve heard that there is a device that can be inserted into the uterus that can prevent pregnancy.
  Yes, the IUD, particularly the “Paraguard” is a small plastic and copper device that is inserted into the uterus during an office visit. The advantage to this method is that it is 99% effective and once inserted can offer continuous protection for up to ten years. This method is only available to women who have had at least one child, are in a monogamous relationship and have never had any pelvic infections, other than common vaginal infections. Many women have stronger menstrual cramps and heavier periods, but nothing that ibuprofen cannot help. There is an initial cost to the device and its insertion, however, once it is in, there is no further cost.