Conditions and Management

To avoid getting pregnant, an increasing number of women are turning to intrauterine devices (IUDs) for several reasons, including convenience, effectiveness, and duration of use.

However, considering that two main types of IUDs are available on the market—hormonal and non-hormonal copper—it can be confusing to determine which is best for your needs.

When considering an IUD, you’ll want to weigh a few key factors: effectiveness rates, potential side effects, duration of use, upfront and long-term costs, desired effects on your menstrual cycle, and your comfort level with the method and available brands.

Doing homework on these aspects will help you find the right solution tailored to your body, lifestyle, and family planning goals.

A Look at Effectiveness

The first significant difference between copper and hormonal IUDs is their failure—or pregnancy rates. Copper IUDs, such as ParaGard, offer near-perfect protection against pregnancy with a failure rate of just 0.8%%. That means approximately eight out of a thousand women will become pregnant over the course of a year with typical copper IUD use.

Hormonal IUDs, such as Mirena, Kyleena, or Liletta, have even lower failure rates, typically less than 0.2%%—or two out of a thousand women getting pregnant per year. This extremely high efficacy means hormonal IUDs offer nearly fail-safe protection.

It is important to keep in mind that the effectiveness of an IUD can change at different points over its lifespan. For example, hormonal IUDs only reach peak performance about a week after being inserted.

In contrast, copper IUDs start working immediately after placement. However, the latter may have slightly higher failure rates toward the end of their approved usage window.

Evaluating Potential Side Effects

Copper and hormonal IUDs also differ in their potential effects on the body. Copper IUDs frequently lead to more significant changes in menstrual bleeding.

For example, many women report their periods getting substantially heavier and more painful with a copper device. Cramps, longer periods, spotting, and mid-cycle bleeding are also common complaints.

In contrast, women using hormonal IUDs commonly report lighter, shorter periods, and may even achieve amenorrhea (absence of menstruation periods) over time.

After the first 3-6 months, users usually see dramatic improvements in flow amount and enjoy shorter cycle lengths. Mood changes, headaches, acne, and breast tenderness are reported; however, most symptoms resolve within the first 90 days for most patients.

Checking Duration of Use

When considering the duration of contraceptive coverage, copper wins out over hormonal IUDs. A single copper IUD can protect from pregnancy for up to 10 years.

Given that the device costs up to $1,500 upfront, its longevity makes it much less expensive than other birth control options based on the usage cost per year.

Meanwhile, hormonal IUDs last 3-7 years, depending on the brand. While replacing the devices more often involves a repeat insertion procedure and purchase cost, some women prefer shorter-acting contraception in case their needs change and many women choose the hormonal IUDs for the favorable effects on their menstrual cycles.

Assessing Upfront and Long-Term Costs

Both copper and hormonal options range from $500 to $1,500 before insurance steps in. However, most providers cover all or some insertion device fees, making IUDs surprisingly affordable. Depending on your specific health plan—and deductible status—you may pay little to nothing out-of-pocket.

When considering how long you’ll be able to use it, a hormonal IUD often works out to be less expensive in light of frequent insurance benefits and lower upfront costs. Just be sure to keep in mind that you’ll have to remove or replace it every three to seven years.

Controlling Your Menstrual Cycle

If regulating your monthly flow is a top priority, then a hormonal IUD offers superior relief. The steady release of progestin thins the uterine lining and often stops ovulation altogether. This leads many users to shorter, lighter, or absent periods after the first 90 days.

For heavy or painful menstrual cycles, Mirena, Kyleena, Liletta, or Skyla can provide marked improvement. This is a significant difference over the copper IUD which is reported to frequently make cycles heavier and crampier for most women.

Reviewing Your Comfort Level

Another factor to consider is how comfortable you are with the idea of an IUD. If having a foreign device implanted in your body seems unpleasant, then additional hormones from an IUD may sound equally unappealing.

However, the low systemic absorption of hormone and steady-release dosing reduces the risk of side effects compared with other hormonal options.

Doing your homework on brands, dimensions, hormone levels, duration of use, and insertion procedures will shed light on the best selection for your comfort.

Don’t hesitate to ask your OBGYN, too. Every patient has unique needs and perspectives, so open conversations are essential in making an informed decision.

Turn to Raleigh Gynecology & Wellness for Assistance with Choosing the Right IUD for You

Deciding between copper and hormonal IUDs is a matter of determining what is most important for your lifestyle and where you see your choices heading in the near future. If you are still undecided about IUD options, consult an experienced OBGYN at Raleigh Gynecology & Wellness for guidance.

With a comprehensive review of your history and an open discussion around your goals and tolerances, an expert can help you identify the ideal IUD.

Raleigh Gynecology & Wellness offers exceptional insight into all contraception choices while supporting your journey toward confident family planning. Contact us today at (919) 636-6670 or online to schedule a consultation.

Barrier methods such as condoms, diaphragms, cervical caps, and spermicides can provide effective protection against pregnancy when used properly.

Follow these tips and tricks to select the best barrier methods for your needs, use them correctly every time you have sex, and know what to do if mistakes happen.

Understand All the Barrier Options Available

The first step to using barrier contraceptives effectively is understanding exactly what they are and the various options to choose from.

Barrier methods work by physically blocking sperm from entering the uterus and reaching an egg. Some also protect against sexually transmitted infections.

Types of barrier methods include:

• External or “male” condoms fit over the erect penis to catch semen, preventing sperm from entering the vagina.
• Internal or “female” condoms are pouches inserted in the vagina before sex. The inner ring anchors the condom behind the pubic bone, while the outer ring stays outside the vaginal opening.
• Cervical barriers, such as a diaphragm, cervical cap, or contraceptive sponge, block the cervix, so sperm can’t pass through.
• Spermicidal gels, foams, creams, films, and suppositories kill sperm trying to make their way past the vagina.

Find the Method that Fits Your Anatomy

Getting the right size is essential for cervical barriers such as diaphragms and caps that block the cervix. See a healthcare provider for a fitting to determine the product with the best anatomical match.

One-size diaphragms may work for those who haven’t given birth. The vagina changes shape during arousal, so you might try different sizes of internal condoms to see what feels most secure during sex.

External condom brands vary in shape and width, so explore to find the best fit for you and your partner.

Trying a few kinds helps ensure you have condoms that feel good and stay put. Check the package before unrolling on the penis.

Learn to Insert and Use Barriers Correctly

Following the exact usage instructions every time you have sex ensures your barrier method works effectively. Common mistakes make pregnancy or infection more likely.

For condoms, pinch the tip while rolling onto the erect penis to leave extra space at the end to collect semen. Smooth out any air bubbles.

Apply water- or silicone-based lube to prevent breakage. After ejaculation, grip the base of the condom as you withdraw to keep it from slipping off.

Always apply spermicidal gel before inserting a diaphragm, cervical cap, or sponge. Check that the barrier method completely covers your cervix before and after sex by feeling with your finger.

Leave barriers in place for the recommended time after sex before removal. First, wash your hands when using spermicidal film, suppositories, or tablets.

Insert the spermicide close to your cervix several minutes before intercourse. Apply additional doses if needed per the product instructions.

Discuss Barrier Use with Your Partner(s)

Having an open, honest conversation with your partner makes it more likely you’ll both use the barriers correctly and consistently.

Discuss the reasons barrier methods matter for preventing pregnancy or sexually transmitted infections.

Agree that you’ll always use the barriers during sex and foreplay. Talk about how you’ll put them into place for times of intimacy.

Troubleshoot any awkwardness or discomfort. Address what you would do in case of problems such as slipping, breakage, or other mistakes. This builds trust and accountability.

Consider Using a Backup Method

No single birth control method is 100% reliable with real-world use. Using a second, non-hormonal barrier method provides extra pregnancy prevention and STI protection.

Try pairing condoms with a diaphragm, cervical cap, or spermicidal gel. The condoms protect against infections, while the other method provides backup contraception.

Dual barrier use lowers the risk of user error, slippage, or breakage. If one fails, you still have pregnancy protection.

Get Tested for STIs Regularly

While barriers reduce STI risk, they can’t prevent transmission in every scenario. Use condoms properly every time you have sex, and go for regular STI testing even if neither you nor your partner(s) have symptoms.

Let partners know about positive test results immediately so you can both get treated before infecting others.

Testing every three to six months is wise if having multiple partners or casual sex. An annual screening lets those in longer-term, mutually monogamous relationships confirm everything is in order.

Make testing part of your regular health routine.

Keep Emergency Contraception as a Backup

Even individuals diligent about the proper use of barrier methods may experience mistakes such as condom breaking, cap dislodging, or forgotten spermicide doses.

Having emergency contraceptive pills on hand provides reassurance. Emergency contraception works best the sooner you take it after a barrier mistake. Both over-the-counter options and prescription pills can prevent pregnancy if started within five days of sex.

They’re safe to use more than once. A healthcare provider can insert an IUD for emergency contraception up to 5 days after unprotected intercourse.

Raleigh Gynecology & Wellness: Barrier Method Specialists

Raleigh Gynecology & Wellness’ team of experts has extensive experience helping patients choose the best barrier methods for safe, enjoyable intimacy.

We take the time to understand your relationships, activities, and preferences to recommend appropriate solutions and teach optimal usage techniques.

To explore the range of barrier options and get answers to all your questions, contact us today at (919) 636-6670 or schedule an online consultation and let our team offer you the judgment-free support you need so you can experience worry-free intimacy.

Hormonal contraceptives go beyond just preventing pregnancy. When chosen correctly, these methods offer women multiple health benefits that lead to an improved quality of life.

From lighter, predictable periods to protection against certain cancers, hormonal contraception has a lot to offer.

Lighter, More Regular Periods

One of the most appreciated benefits of hormonal contraception is its ability to tame periods. The hormones stabilize the uterine lining, leading to lighter bleeding every month.

For many, this leads to a significant reduction in the amount of blood they lose during menstruation.

Lighter periods mean less chance of iron deficiency anemia, which causes unpleasant symptoms such as weakness, dizziness, and shortness of breath.

Additionally, hormonal contraceptives promote a more regular menstrual cycle. While some experience unpredictable bleeding when first starting hormonal birth control, periods typically become much more predictable within 2-3 months of consistent use.

Less Menstrual Pain

At some point, a large proportion of menstruating women deal with painful cramps, a condition called dysmenorrhea.

For some, the pain is mild, but for others, it is severe enough to significantly negatively affect their day-to-day activities for a few days every month. The prostaglandins released when the uterus contracts are to blame for those crippling cramps and lower back pain.

The hormones in birth control quiet prostaglandin production. This prevents the severe uterine contractions that trigger intense cramping and pain. As a result, most women experience less painful periods within three months of starting hormonal contraceptives.

Fewer Premenstrual Symptoms

In addition to period problems, hormonal contraceptives can improve other issues tied to the menstrual cycle. The fluctuations in estrogen and progesterone do not only affect the uterus.

For many, these swings cause premenstrual syndrome (PMS). Days to weeks before your period, you may feel bloated, weary, and emotionally sensitive.

By regulating hormones throughout the cycle, birth control pills, patches, rings, and more can smooth out those surges and plunges. This keeps hormones at more consistent levels and alleviates PMS symptoms.

Those with moderate to severe premenstrual dysphoric disorder (PMDD) may find hormonal contraception particularly helpful for controlling mood swings and irritability.

The Option to Skip Periods

While hormonal contraceptives regulate the menstrual cycle for most users, taking it a step further is also an option. It is safe to skip the placebo pills or hormonal-free week built into most hormonal birth control regimens.

This allows you to avoid periods altogether. Without breaks or placeholders, extended use or continuous dosing works by taking active hormone pills, changing patches, or inserting new rings consecutively.

After making it through the initial months of unpredictable bleeding, you can determine your ideal frequency of withdrawal bleeding.

Reduced Cancer Risk

An important yet lesser-known benefit of hormonal contraception is its protective effect against certain cancers. By keeping estrogen levels low and steady, it may help prevent the development of cancer-causing cells.

Those who use hormonal contraceptives cut their risk of developing ovarian and endometrial cancers significantly compared to women who have never touched them.

This protective benefit strengthens the longer you use hormonal birth control. However, it may take up to 10 years of use to realize the full cancer risk reduction.

Less Pelvic Inflammatory Disease

Pelvic inflammatory disease, or PID, is an infection that occurs in female reproductive organs, often resulting from untreated sexually transmitted infections, including gonorrhea and chlamydia. In addition to pain and fever, PID can do permanent damage.

Scarring and blocked fallopian tubes increase the risk of infertility, chronic pain, and ectopic pregnancy. By thickening cervical mucus, hormonal contraceptives help prevent infectious bacteria from ascending into the uterus and pelvis.

Clearer Skin

For those plagued with pimples, oily skin, and persistent acne, hormonal birth control may offer some relief. Some people notice an improvement in their complexion within six months of starting contraceptives.

How exactly it works is not fully understood, but it is believed to help by decreasing oil production and reducing inflammation.

While contraceptives alone usually will not clear up severe nodular acne, they can be helpful alongside acne treatments. Patience is required, though, as it could take a few months.

Stronger Bones

Estrogen helps build and maintain healthy bones during youth and adolescence. During adulthood, it helps keep bone mineral density at a healthy level.

It enables the body to use calcium, a key mineral for bone health, effectively. Most hormonal contraceptives contain estrogen.

This small daily dose is just enough to maintain bone density in adults up to menopause. Therefore, hormonal contraception helps prevent bone loss and osteoporosis risk of low estrogen levels in aging women.

Relief from Endometriosis

Endometriosis, a condition causing tissue similar to the endometrium to grow outside the uterus, affects over 6 million women. Along with severe menstrual cramps, it also causes pain in between periods.

Suppressing estrogen production and preventing ovulation helps restrict endometrial tissue growth. For this reason, hormonal contraceptives often provide relief from endometriosis symptoms.

Return of Fertility

An important consideration before committing to longer-term hormonal contraceptives is understanding how they affect future fertility after stopping.

While every woman responds differently, most return to fertility within 1-3 months after discontinuing shorter-acting methods such as the pill, patch, or ring.

With the shot or implant, it may take up to 6 months for fertility to fully return. It is essential to plan accordingly if pregnancy is desired soon after stopping.

Have an open conversation with your gynecologist regarding your fertility plans and get personalized guidance.

Choose the Best Birth Control for You with Help from Raleigh Gynecology & Wellness

With all the health benefits hormonal contraceptives offer beyond pregnancy prevention, it is worth exploring if it may be a good option for you.

Every woman has unique needs, risks, and priorities. Discussing the benefits and drawbacks with your gynecologist is important to determine if hormonal birth control aligns with your health and wellness plan.

When it comes to understanding a multifaceted issue such as hormonal contraception, rely on the expertise of Raleigh Gynecology & Wellness.

Our team of healthcare experts takes time to understand your health history, goals, and preferences to ensure you make the right choice for your needs. Contact us today at (919) 636-6670 or make an appointment online.

Hormonal contraception refers to birth control methods that use synthetic hormones to prevent pregnancy. This includes the birth control pill, shot, patch, implant, ring, and hormonal IUDs. But how exactly do these synthetic hormones work to stop you from conceiving?

Read on to learn the science behind different hormonal contraceptives.

Understanding Your Menstrual Cycle

First, it helps to understand how your natural menstrual cycle works. Estrogen and progesterone are the two hormones that control what happens to your body during your cycle.

Estrogen is produced by your ovaries during your cycle’s first half. It leads to a thickening uterus lining and primes your body for ovulation. Progesterone kicks in during your cycle’s second half.

After ovaries release an egg (ovulation), progesterone prepares your uterus to carry a fetus. If pregnancy doesn’t occur, progesterone levels drop, your uterine lining breaks down, and your period starts.

Then, the whole cycle begins again. This natural ebb and flow of estrogen and progesterone is what hormonal contraceptives aim to disrupt.

How Hormonal Contraception Prevents Pregnancy

Hormonal contraceptives work in a few key ways to stop you from getting pregnant. The primary mechanism is suppressing ovulation, but these birth control methods have some backup, too.

Preventing Ovulation

The primary way hormonal contraceptives work is by stopping ovulation, meaning an egg doesn’t get released from your ovaries each month. They achieve ovulation suppression through negative feedback to your pituitary gland.

The pituitary gland is the central control for your reproductive hormones. It gets signals from your hypothalamus and then releases luteinizing hormone (LH) and follicle-stimulating hormone (FSH) to activate ovulation.

The synthetic estrogen and progestin from hormonal contraceptives send signals that pregnancy has already occurred and ovulation isn’t needed. Your pituitary gland responds by suppressing FSH production.

With inadequate FSH, your ovaries don’t receive the cue to mature follicles each month. No follicles mean no eggs develop, and no ovulation takes place.

Without ovulating, you can’t get pregnant from sex during that time. This clever fake out of your body’s normal processes is how these birth control methods primarily work.

Thickening Cervical Mucus

Some hormonal contraceptives thicken the mucus lining your cervix, which adds another layer of pregnancy prevention. This mucus plug blocks sperm from passing through your cervical canal and traveling toward your uterus and fallopian tubes.

So, if ovulation does mistakenly occur, the thickened cervical mucus acts as backup birth control by keeping sperm from meeting up with any released eggs.

Thinning the Uterine Lining

In addition to suppressing ovulation and thickening cervical mucus, some hormonal contraceptives thin the uterine lining. This makes the wall of your uterus less hospitable for an embryo to implant and grow. Without a thick, blood-rich lining, it’s difficult for a fertilized egg to develop.

Types of Hormonal Contraceptives

Now that you understand the basic mechanism behind these birth control methods, let’s break down the major categories and how they differ:

Combined Oral Contraceptives

This refers to birth control pills that contain both hormones, namely estrogen and progestin. The most common type is the combination pill with three weeks of active hormone pills and one week of placebo pills per pack. Different brands can contain varying doses and types of hormones.

There are one-, two-, and three-phase combination pills too. These provide different ratios of hormones during your cycle week to mimic your natural hormone fluctuations.

The Progestin-Only Mini-Pill

Unlike combination pills, these contain only progestin without any estrogen. That makes them a good option if you can’t take estrogen for health reasons or experience estrogen-related side effects. Because there are no breaks from hormones, you must take mini-pills at precisely the same time daily.

The Patch, Ring, and Shot

The birth control patch and vaginal ring also use estrogen and progestin to prevent ovulation. But instead of taking a daily tablet, the patch adheres to your skin to transmit hormones. The ring is inserted into the vagina.

The Depo Provera Shot

The Depo Provera Shot is given in your arm or buttocks every three months. It is a Progestin only option so it is safe to use for women who can’t use estrogen based products. Because the progestin is delivered continuously, most women stop their periods while on Depo.

Implants and Hormonal Intrauterine Devices (IUDs)

Contraceptive implants and hormonal IUDs work a bit differently. Rather than taking regular doses of hormones, they release a steady stream of progestin over several years. Both implants and IUDs are inserted by a healthcare provider and left in place for long-term pregnancy prevention.

The Chemistry Behind Synthetic Hormones

Hormonal contraceptives rely on lab-made versions of your natural hormones to work their magic. Estrogen mimics come in two main forms:

• Ethinyl estradiol – the most common estrogen used that remains active in your body longer than natural estrogen.
• Estradiol valerate – metabolized into estradiol, the predominant natural estrogen.

There are also approximately ten different forms of synthetic progestins used, including:

• Norethindrone and norgestrel – first-generation progestins similar to testosterone.
• Levonorgestrel and norgestimate – newer progestins with greater similarity to progesterone.
• Drospirenone and dienogest – recent progestins that may carry extra health risks such as blood clots.

The ideal contraceptive hormones perfectly prevent ovulation without other hormone-related side effects. So, research continues to refine these progestin and estrogen formulations for an optimal balance of effectiveness versus safety.

Choose the Right Hormonal Contraception with Raleigh Gynecology & Wellness

When considering something as essential as birth control, having an experienced perspective matters. Raleigh Gynecology & Wellness specialists stay current on the latest advancements in reproductive science and contraceptive options.

Our team learns about your health history, preferences, and objectives to find your optimal birth control method. Contact us today at (919) 636-6670 or schedule an online consultation to discuss hormonal contraception.

Contraceptive implants have become a go-to long-term birth control option for many women. These slim devices, about the size and shape of a matchstick, are introduced under the skin of the upper arm, where they steadily release the hormone progestin. This prevents pregnancy for 3-5 years, depending on the implant type, without having to remember daily pills or schedule regular injections.

This article explores the extended duration of today’s contraceptive implants. The implant’s long-lasting effectiveness is an optimal fit for busy Raleigh women focused on life’s many demands outside of starting a family.

Exceptional Efficacy Sets Implants Apart

Contraceptive implants, along with intrauterine devices, are considered some of the most effective forms of reversible birth control on the market. The failure rate is less than 1%, meaning fewer than 1 out of 100 women using this method will conceive each year.

The main reason is that contraceptive implants do not rely on you remembering to take a daily pill. The steady hormone release lasts for years without you having to do anything to maintain it actively.

Another benefit is that contraceptive implants provide long-term pregnancy prevention for 3-5 years, depending on the type. This means you can essentially “get it and forget it” when it comes to effective birth control for up to half a decade.

If you know you want to avoid pregnancy for several years, implants eliminate the need to make frequent doctor’s appointments for refills or replacements compared to short-term methods such as the pill.

Additionally, contraceptive implants are completely reversible and can be taken out at any time by a trained healthcare provider. So, unlike permanent options such as tubal ligation, fertility generally returns to normal quickly after implant removal if you decide you want to get pregnant.

Duration of Contraceptive Implants

While the FDA approves contraceptive implants in the U.S. for three years of use, studies have shown they can remain effective at preventing pregnancy for up to 5 years after insertion. Decisions regarding the timing for removal or replacement of your implant can be made by discussing with your doctor.

If continuing beyond three years, physicians recommend confirming the implant remains properly positioned in your arm. Awareness of any shifts or changes around the implant insertion site is wise.

It is also important to ensure you are not pregnant before getting a new contraceptive implant inserted after removing an old one. Return to fertility is rapid with contraceptive implants so that ovulation can resume very quickly after removal.

Nexplanon: The Only Implant Choice in the US

Currently, Nexplanon serves as the sole contraceptive implant choice available for U.S. women. This slim rod contains the hormone etonogestrel, which gradually diffuses into the body over 3-5 years of effectiveness.

Designed for no-fuss insertion and removal, Nexplanon possesses a visibly traceable inner ring, allowing medical professionals to view the implant’s precise location easily using an X-ray. The makers of Nexplanon hold an exclusive patent running until 2027, so no generic versions can debut before then.

Contraceptive Implants and Raleigh Women

When evaluating options for preventing pregnancy, Raleigh women have unique needs and preferences based on their life stages and goals. For example, suppose you are intensely focused on higher education, career growth, athletic achievements, or other priorities. In that case, a set-it-and-forget-it contraceptive akin to Nexplanon can alleviate the responsibility of taking a daily pill.

Access and insurance coverage are two other considerations for Raleigh women deciding on contraceptive methods. North Carolina has expanded Medicaid access, so many low-income residents qualify for programs covering implants at no charge.

The Affordable Care Act also established contraceptive coverage for non-grandfathered plans, meaning all FDA-approved options, such as Nexplanon, should be covered without out-of-pocket costs.

Deciding If Contraceptive Implants Are the Right Choice for You

While Nexplanon offers pregnancy prevention for up to 3 years, it is wise to consider if the implant fits your lifestyle and health status. Consulting your gynecologist or medical provider allows for an open conversation about the pros and cons when weighed against your personal reproductive goals.

Every woman has a unique medical history, so certain risk factors may make contraceptive implants less advisable. For those with blood clot risks, those taking certain anti-seizure medications that impact hormone levels, and those concerned about side effects such as irregular bleeding, other birth control alternatives may be better options.

But after a checkup and discussion to address your questions, many patients can safely use Nexplanon.

Turn to Raleigh Gynecology & Wellness for Guidance on Contraceptive Implants

When it comes to reliable birth control, the duration and efficacy of contraceptive implants such as Nexplanon provide substantial advantages for Raleigh women focused on life goals beyond starting an immediate family.

While not every woman’s health profile matches well with progestin implants, a candid discussion with your gynecologist allows you to weigh your options.

If you wish more guidance, consult with Raleigh Gynecology & Wellness to determine if a long-acting contraceptive such as Nexplanon fits your family planning needs.

Our team can help you find the optimal birth control solution tailored to your lifestyle and reproductive health. Contact us today at (919) 636-6670 or schedule a consultation online to learn how we can help you determine if the implant is right for you.