From shots to pills to implants, the selection of birth control available to women is larger than ever before. We talked to several local OB/GYNs to get the lowdown on today’s options.

“The first question to consider is whether you want a hormonal or non-hormonal method,” said Dr. Susan Bush with The Women’s Group. “Then, you have to look at the different delivery systems, which include mouth, injection, and skin. We have a lot of women trying newer methods who are coming back to us smiling.”

After having a baby in December, Jill Wise, 27, of Pensacola talked to her doctor about options for birth control with lower hormone levels than the pill.

“I have been on and off the pill since I was 13,” Wise said. “I starting taking it to regulate periods, then used it as birth control. It wasn’t until I went off of it to get pregnant that I realized it had been affecting my mood for years.”

Wise found how complicated birth control could be.

“I initially went with an IUD, since they have a low level of hormones. But, my anatomical make-up caused a lot of discomfort, and I had it removed. I also experienced spot bleeding, which I found to be very irritating.”

Wise returned to using a birth control pill and has not had any depression or mood swing issues so far.

“I’m on a different pill than last time. But, I’m tired of being on medication. My plan is to continue using hormones until we are ready to have another baby, then I’m going to let my husband take care of our birth control needs with a more permanent solution.’’

HORMONAL OPTIONS

The pill has been the mainstay hormonal method of birth control in the United States since the 1960s. It delivers different levels of estrogen and progestin, depending on the brand. One of the newest pills on the market is Yasmin, which has a specific type of progesterone that may decrease bloating and PMS (premenstrual syndrome) for some women. Another new pill by the same company, Berlex, is YAZ, which treats the emotional and physical symptoms associated with PMDD, including mood swings, irritability, headaches, feeling anxious, bloating and food cravings.

“A great benefit of the pill is that it is 99 percent effective and also carries with it a lot of health benefits,” Bush said. “It protects women from ovarian and uterine cancer and also helps them control the sequencing of their periods.”
A new trend in oral contraception is an extended cycle pill such as Seasonale. A woman only has her period four times a year with this method. The biggest drawback is an increased chance for breakthrough bleeding.

The patch. Called Ortho Evra, it can be applied anywhere on the body from the buttocks to the lower back or abdomen. It is switched out once a week for three weeks, then removed entirely for the fourth week to complete the 28-day cycle.
“The patch delivers higher packs of estrogen, so it may cause nausea for some women,” Dr. Lisa Tucker said. “But, some women find it easer to remember a once-a-week change out than a daily pill.”

The Ring. Another hormonal method that is easy on the memory is the NuvaRing. The flexible plastic ring, about 1½ inches in diameter, is inserted by a woman once every three weeks, followed by a week off. Similar to the patch and the pill, it releases estrogen and progestin into the body to prevent pregnancy.

“The NuvaRing is a good choice for women who tend to forget to take a pill,” said Dr. Karen Kennedy. “It also has a tendency to prevent yeast infections and bacterial shifts. Women who feel comfortable using tampons are generally OK with this method.”

Injection. Depo Provera is a progesterone-only hormone that is injected into a woman’s arm or hip once every three months. Women may inject themselves, but more commonly, they visit their doctor for the shot.
“The hormone shot has higher compliance rate than the pill because action isn’t required every day,” Tucker said. “But, it carries with it an increased risk of weight gain, irregular bleeding, and can cause temporary infertility because it often takes a year or more to return to a regular cycle.”

IUD. The most long-term birth control option is an IUD called Mirena that remains in your uterus for five years. It is inserted and removed by a physician. It also may make periods lighter or eliminate them altogether.

“Today’s IUDs are made out of nylon rather than multiple strings, which caused a lot of infections,” Kennedy said. “The new material makes IUDs more safe because there is no bacterial transfer.”

The Implant. Implanon is a flexible rod implanted under the skin of a woman’s arm, where it releases progesterone into the body. It has replaced Norplant as the implant of choice. The single implanted Implanon rod can remain in the body for up to three years.

NON-HORMONAL OPTIONS

Copper IUDs are an option for women who want to stay away from hormones entirely. They are 99 percent effective and can remain in place for up to 10 years.

Male condoms are available in a variety of styles, sizes, materials, and textures and are considered to be 97 percent effective. One female condom is also on the market, and it is 95 percent effective. Physicians recommend use of a condom in addition to hormonal birth control if you are not in a monogamous relationship.

Spermicides are available over the counter as foams, creams, and various jellies. They are only 94 percent effective.

WORDS OF ADVICE
•  Always double up with a condom to prevent disease.
•  Every woman responds differently to products. Talk with your doctor to choose a method that works with your body and your lifestyle.
•  Evaluate your goals before choosing a birth control method. Birth control methods can also reduce cramps, reduce your chance for cancer and control your cycle.
•  Make sure to take your health history into account. Some hormonal methods carry an increased risk for blood clots, heart disease, and stroke.