Contraceptive Care

If you are sexually active and not wanting to become pregnant it is important to use some form of birth control, or contraceptive care. There are many different types of contraception available, but not all types are appropriate for all situations. The most appropriate method of birth control depends on an individual’s overall health, age, frequency of sexual activity, number of sexual partners, desire to have children in the future, and family history of certain diseases. Women may also make choices about contraception based on factors like safety, effectiveness, affordability, and acceptability.

Some types of contraceptive care may also have additional benefits, like menstrual cycle regulation, prevention of ovarian cysts, or improvement of acne or premenstrual syndrome (PMS) symptoms that may guide birth control choices. Your doctor at Raleigh Gynecology & Wellness can help you decide which type of contraception meets your needs, fits your lifestyle, and offers the fewest risks given your health history.

Types Of Contraceptive Care

Long Acting Reversible Contraception (LARC) are the most effective forms of reversible contraceptive care available. They include Contraceptive Implants and Intrauterine Devices (IUDs). They are placed during a brief office appointment and are effective between 3 and 10 years depending on the specific option chosen. They can be easily removed sooner if a patient wants to change her contraceptive care method or if she is ready to become pregnant.

• Nexplanon – Nexplanon is a contraceptive implant that is placed under the skin of the upper arm. It contains a progestin that is released gradually over a three year period to prevent pregnancy. With a failure rate of only 0.01%,
  Nexplanon is the most effective reversible contraceptive that we have available.
• IUDs – There are 2 main types of IUDs available, the Copper IUD (Paragard) and 4 progestin based IUDs ( Mirena, Liletta, Kyleena and Skyla)
  • Paragard is a copper based IUD. It is a small T shaped device that is inserted into the uterus by your doctor. This IUD is effective for up to 10 years and is the most effective non-hormonal reversible contraceptive option available. It does have a tendency
    to make the menstrual cycles a bit heavier. Typical use failure rate: 0.8%.
  • The progestin based IUDs contain a hormone called levonogestrel. Levonogestrel IUDs (LNG-IUDs) vary in terms of their size, dose of hormone, and duration of activity from 3-6 years. LNG-IUDs will tend to either lighten or stop the menstrual cycles.
    Because the hormone is locally delivered the risk of systemic side effects is very low. Typical use failure rate: 0.1-0.4%.

Hormonal Contraception

There are several types of hormonal contraceptive care available. These include combination birth control which contain both estrogen and progesterone. Others, like Depoprovera and progestin only pills, contain only progestin. Today’s hormonal birth control methods have lower doses of hormones than in the past. This has greatly reduced the risk of side effects; however, you should talk with your doctor about whether this form of birth control is right for you.

• Combination Birth Control Pills – Most birth control pills contain a combination of both estrogen and progesterone. These can be used to control and manipulate the timing of the menses and may have other benefits like control of acne and prevention of ovarian cysts. Some women, like smokers over the age of 35, should not use estrogen containing birth control, because of the risk of serious side effects. Talk to your doctor about whether these are good options for you. Typical use failure rate: 7%.
• Patches – Like combination birth control pills, the contraceptive patch contains both estrogen ad progesterone. It has similar beneficial effects and risks to typical birth control pills but is delivered through a small sticker worn on the skin. The patch is changed weekly so it may be easier to keep up with than daily pill taking for some women. Typical use failure rate: 7%
• Vaginal Ring – The vaginal contraceptive ring is similar to typical birth control pills and the patch. It also contains both estrogen and progesterone. It is a soft ring made a plastic material that it is placed in the vagina each month. Most women find the ring comfortable to wear and the monthly dosing may be an advantage for some women. Typical use failure rate: 7%
• Progestin Only Pills – There are two types of birth control pills that contain only progesterone. Because they don’t have estrogen they may be a safer choice for certain women, like smokers over 35, who cannot use combination birth control pills. It is important to take the progestin only pill at the same time every day. Typical use failure rate: 7%
• Depoprovera – Depoprovera is a shot that is given every 12 weeks. It contains medroxyprogesterone acetate which is a progestin. Because the hormone is delivered continuously, most women will eventually stop having a menstrual cycle while using Depoprovera. Typical use failure rate: 4%.

Barrier Methods

Barrier methods for contraception are designed to prevent sperm from reaching the egg for fertilization. Some barrier methods, like condoms, can also be used to help prevent STD exposures. Unfortunately, barrier methods do tend to have higher failure rates than many of our other contraceptives. Talk to your doctor to see if barrier methods are right for you.

• Male Condom — Worn by the man, a male condom keeps sperm from getting into a woman’s body. Latex condoms, the most common type, help prevent pregnancy, and HIV and other STDs. “Natural” or “lambskin” condoms also help prevent pregnancy, but may not provide protection against STDs, including HIV. Do not use oil-based lubricants such as massage oils, baby oil, lotions, or petroleum jelly with latex condoms. They will weaken the condom, causing it to tear or break. Typical use failure rate: 13%.
• Female Condom — Worn by the woman, the female condom helps keeps sperm from getting into her body and also may help prevent STDs . It is packaged with a lubricant and is available at drug stores. It can be inserted up to eight hours before sexual intercourse. Typical use failure rate: 21%.
• Diaphragm Or Cervical Cap — These barrier methods are placed inside the vagina to cover the cervix to block sperm from reaching the egg. The diaphragm is shaped like a shallow cup. The cervical cap is a thimble-shaped cup. You insert them with spermicide to block or kill sperm before sexual intercourse. Diaphragms and cervical caps come in different sizes so you will need to visit your doctor for a proper fitting. Typical use failure rate for the diaphragm: 17%.
• Sponge — The contraceptive sponge contains spermicide and is placed in the vagina where it fits over the cervix. The sponge works for up to 24 hours, and must be left in the vagina for at least 6 hours after the last act of intercourse, at which time it is removed and discarded. Typical use failure rate: 14% for women who have never had a baby and 27% for women who have had a baby.
• Spermicides — Spermicides come in several forms – foam, gel, cream, film, suppository, or tablet These products can be purchased at drug stores and they work by killing sperm. They are placed in the vagina no more than one hour before intercourse. You leave them in place at least six to eight hours after intercourse. You can use a spermicide in addition to a male condom, diaphragm, or cervical cap. Typical use failure rate: 21%.
• Fertility Awareness-Based Method – Understanding your monthly fertility pattern can help you plan to get pregnant or avoid getting pregnant. Your fertility pattern is the number of days in the month when you are fertile (able to get pregnant), days when you are infertile, and days when fertility is unlikely, but possible. If you have a regular menstrual cycle, you have about nine or more fertile days each month. If you do not want to get pregnant, you do not have sex on the days you are fertile, or you use a barrier method of birth control on those days. Failure rates vary across these methods but typical use failure rates: 12-24%.

Permanent Methods Of Birth Control

Sterilization is a good option for individuals or couples that are vary certain that the will not want to get pregnant in the future. These options are considered irreversible so should not be used if there is a chance that you will want to have a baby in the future.

• Female Sterilization — Tubal ligation or “tying tubes” — A woman can have her Fallopian tubes tied or removed so that sperm and eggs cannot meet for fertilization. The procedure must be done in a hospital or in an outpatient surgical center. It is typically an outpatient surgery so you can go home the same day. This method is effective immediately. Typical use failure rate: 0.5%.1.
• Male Sterilization – Vasectomy — This operation is done to keep a man’s sperm from going to his penis, so his ejaculate never has any sperm in it that can fertilize an egg. Recovery time is less than one week. After the operation, a man visits his doctor for tests to count his sperm and to make sure the sperm count has dropped to zero; this takes about 12 weeks. Another form of birth control should be used until the man’s sperm count has dropped to zero. Typical use failure rate: 0.15%.1.

Learn More About Contraceptive Care

Our team has years of experience providing women with contraceptive care. To learn more about contraceptive care or book an appointment, please give us a call at 919.636.6670 or schedule an appointment online today.