Procedures

An IUD (intrauterine device) is a type of contraceptive device that is relatively small and T-shaped that your doctor will put into your uterus. IUDs are over 99% effective at pregnancy prevention and can last anywhere from 3-10 years, depending on which one you choose.

If you’re looking for a reliable, low-maintenance, and long-term contraceptive option, an IUD may suit you. Two categories of IUDs are available: the hormonal and the copper IUD.

Hormonal IUDs contain the hormone progestin, which causes the cervical mucus to thicken, thereby blocking sperm from reaching an egg. The copper IUD doesn’t have hormones but uses copper ions acting as a spermicide. Both types also create changes in the uterine lining making it difficult for an egg to implant.

Hormonal IUDs

You can find four hormonal IUDs in the U.S.: Kyleena, Mirena, Skyla, and Liletta. They all work the same way by slowly releasing progestin into your uterus.

Mirena and Liletta can prevent pregnancy for up to eight years with 52 mg of levonorgestrel released over time. Kyleena is effective for up to five years with a dose of 19.5 mg, while Skyla lasts for three years with 13.5 mg of levonorgestrel.

The pros of hormonal IUDs are that they may make your periods lighter and shorter or stop them altogether. Many women report that hormonal IUDs help reduce menstrual cramps as well.

The cons are that for the first 3-6 months, you may experience irregular bleeding, spotting, or cramping as your body adjusts. Some other potential side effects include headaches, acne, breast tenderness, mood changes, and ovarian cysts.

Copper IUD

Currently, ParaGard is the only brand of copper IUD that can be found in the United States. It contains no hormones but uses copper wire coiled around the stem and copper sleeves on the arms release copper ions continuously.

ParaGard is over 99% effective at helping you avoid pregnancy and can work for up to 10 years, the longest duration of any IUD.

The main advantage of ParaGard is that it lasts so long, meaning you don’t have to think about birth control for a whole decade once it’s inserted. It also contains no hormones, so you don’t have to worry about hormonal side effects or interactions with other medications.

The potential downsides are that copper IUDs may cause heavier, more painful menstrual periods and cramping for some women.

Getting an IUD

The insertion process itself only takes a few minutes. Your doctor will use a speculum to access your cervix, then insert the folded-up IUD through the cervix into your uterus. You may feel some mild cramping or pinching during insertion. Taking ibuprofen an hour before can help minimize discomfort.

You’ll likely experience some cramping and spotting over the following few days as your uterus adapts to the IUD. Using a heating pad and taking ibuprofen as needed can provide relief.

It’s normal for the first 3-6 months to be accompanied by irregular bleeding and spotting between periods. By your first follow-up visit, any side effects should have improved.

Your doctor will check that your IUD is positioned correctly at your annual exams. You shouldn’t feel the IUD itself – only the thin strings at the opening of your cervix.

You can check your strings monthly to ensure your IUD hasn’t become displaced or expelled, but not every patient can feel their IUD strings.If you have concerns that your IUD is not in place,,reach out to your doctor as soon as possible.

Risks and Complications

IUDs are highly effective and very safe, but there are some rare risks to be aware of. Expulsion, or the IUD falling out of place, occurs in 2-10% of women, most often in the first year. If this happens, you’ll no longer be protected from pregnancy.

Perforation is when the IUD punctures the uterine wall, which happens in less than 1% of insertions. This requires surgical removal. Infection occurs within the first few weeks after insertion in less than 1% of women. See your doctor promptly if you have pain, fever, or unusual discharge which could indicate infection.

If you become pregnant with an IUD, the chances of an ectopic pregnancy increase significantly. An ectopic pregnancy is when the fertilized embryo ends up implanted outside the uterus and isn’t viable. An IUD won’t cause birth defects, but your doctor will need to remove the IUD early in pregnancy.

Removal and Replacement

IUDs must be replaced once they pass their FDA-approved duration, anywhere from 3 to 10 years. The removal process only takes a minute or two; most women report it’s less uncomfortable than insertion. Your doctor simply pulls on the IUD strings to slide the device out through your cervix.

If you wish to continue using an IUD, a new one can be inserted right after removing the old one. Your uterus will still be dilated from the removal, allowing for easier insertion.

Just be aware that getting a new IUD could restart the adjustment phase of irregular bleeding and spotting. This adjustment phase is typically much shorter compared with the first insertion.

Deciding if an IUD is the right contraceptive option is an important health decision. Both the hormonal and the copper IUD are over 99% effective and generally safe, so take your time to determine which device best matches your needs and lifestyle.

Discuss all your choices thoroughly with your gynecologist. With an IUD properly in place, you can enjoy years of highly reliable birth control and pregnancy prevention.

Decide on the Best IUD for Your Needs with Expertise from Raleigh Gynecology & Wellness

So many birth control options are available now that deciding which is right for your needs can feel overwhelming. But when it comes to highly effective, long-lasting, and reversible contraception, IUDs are a cut above the rest.

Both hormonal and the copper IUD prevent pregnancy for 3-10 years at a time, freeing you from daily pills, patches, or shots. Raleigh Gynecology & Wellness has years of experience helping patients choose the best IUD option for their lifestyles and reproductive health goals.

Contact us today at (919) 636-6670 or schedule a consultation online so we can answer all your questions and help you navigate the IUD selection confidently.

Combination birth control pills use a combination of estrogen and progestin to prevent you from ovulating or releasing an egg. Combination pills must be taken daily around the same to be fully effective at preventing pregnancy.

Missing pills, taking them late, vomiting, or diarrhea can all impact how well they work. So, what options do you have if you miss a pill or two? The steps depend on when and how many pills you miss.

Read on to discover what measures you should take in various missed pill scenarios.

If You Miss One Pill

If you miss one pill, don’t panic. Just take the pill you missed as soon as you realize your mistake, even if it means taking two pills at the same time or very close together. Then, take your next pill at the same time you usually do and continue with the rest of the pack as normal.

You do not necessarily have to use any backup contraceptives if you only miss one combination pill. Missing one pill will not significantly impact how effective the pill is at stopping you from getting pregnant. However, using condoms as a secondary or backup form of birth control is always acceptable if you prefer to do so.

If you frequently miss pills, the risk of pregnancy goes up. So try to make sure that you take the pill daily at the same time to keep your body in the habit. Setting a daily alarm can help with this. You can also consider switching to a long-acting reversible contraceptive such as an IUD if you struggle to take a daily pill consistently.

If You Miss Two-Three Pills in Week One or Two

If you miss two or three pills in the first or second week of a pill pack, there are a few more steps. First, take the most recently missed pill immediately, which may end up being two pills at once.

Then, use an extra birth control option, such as a condom, whenever you engage in intercourse for the following week so your body can absorb the hormones you missed and prevent ovulation.

After seven days, you can stop using backup contraception if you have not missed any other pills. Just resume your normal pill-taking schedule.
If you had unprotected sex at all after missing your pills, call your doctor. You may require an emergency contraceptive solution such as Plan B to prevent pregnancy.

If You Miss Two – Three Pills in Week Three

The third week of combination pill packs is when you take the last active pills before starting your placebo or inactive pill week. If you realize you’ve missed two – three pills in the third week, first take the most recently missed pill, even if you’re taking two pills concurrently.

Finish the rest of the active pills, skipping over the placebo pills this time. Start a new pack straight away without taking a placebo break. You may not get your expected period until you finish the second pack.

Use an extra birth control solution, such as a condom, for seven days after the missed pills. If you finished the active pills, took the missed ones, and started a new pack immediately, you should remain protected from pregnancy.

If You Miss Four or More Pills

If you miss four or more active combination pills one after the other, take the last pill you missed as quickly as possible, as missing that many pills can significantly impact their effectiveness. However, you’ll need to use backup contraception anytime you engage in intercourse for at least the following seven days.

It’s also important to call your doctor, as you may need emergency contraception if you recently engaged in unprotected sex. Missing so many pills close together brings a high risk of ovulation and pregnancy. Resume your normal pill-taking schedule after you take the missed pills and use backup contraception.

When to Call Your Doctor

In addition to the scenarios above, call your doctor if:

• You had unprotected sex at any time after missing pills before starting backup contraception since you may require emergency contraception, such as Plan B.
• You have missed more than two combination pills in the first two weeks of your pack. Your doctor can advise if you need emergency contraception.
• You are confused in any way about what options you have after missing pills. Your doctor can walk you through the proper steps.

Get Personalized Birth Control Guidance from Raleigh Gynecology & Wellness

Missing combination birth control pills can happen, but the important thing is taking the proper steps afterward and continuing to use backup contraception until you get back on track.

While the specific actions depend on when and how many pills you miss, the key is never to ignore a missed pill. Raleigh Gynecology & Wellness’s team of compassionate women’s health experts can walk you through what to do when life gets busy and pills get missed.

We’re always here to answer your questions, assuage your worries, and help you find contraceptive solutions that fit your lifestyle. Contact us today at (919) 636-6670 or schedule a consultation online for personalized guidance you can trust.

If you’ve been thinking about trying the birth control patch, you probably want to know how well it works. The patch can prevent pregnancy very effectively when you use it correctly. But mistakes happen, so success rates vary.

Let’s look at how the patch stops you from getting pregnant, what impacts effectiveness, and tips for making it as reliable as possible.

The Patch’s Pregnancy Prevention Plan

The patch has the hormones estrogen and progestin, similar to the pill. But they go through your skin instead of your stomach. You stick on a new birth control patch once a week for three weeks. Week four is patch-free for your period.

The hormones work to stop pregnancy in three key ways:

1. They keep your ovaries from releasing eggs. No eggs means you can’t get pregnant.
2. They thicken the mucus in your cervix to stop the sperm from reaching your uterus.
3. They also thin your uterus’s lining, so an egg that’s been fertilized would have trouble implanting.

Since the hormones absorb through your skin, you don’t have to stress about taking a daily pill. And throwing up or diarrhea won’t change the hormone amounts as it could with the pill.

Perfect vs Typical Use: How Effective Is It Really?

When talking about birth control effectiveness, there are two rates:

• Perfect use effectiveness: Over 99% effective if used 100% correctly. Less than one out of 100 patch users would become pregnant over a year.
• Typical use effectiveness: Around 92% effective accounting for common mistakes. About eight out of 100 patch users get pregnant over one year.

Following the directions perfectly affects your odds, but remembering the weekly schedule can be tough.

What Makes the Patch Less Effective?

Forgetting to change the patch is the first issue, as the hormones wear off after seven days. Late changes cause hormone drops that reduce protection and are the most frequent causes of patch failures. Marking your calendar and setting phone alarms can help remind you to change it on time each week.

Another issue is the patch falling off. If the patch doesn’t stick well and comes off your skin, you’ll absorb less of the hormones. How much your pregnancy protection drops depends on how long you haven’t had the patch on. If you’re not getting a steady dose of hormones, your odds of getting pregnant increase.

Additionally, some supplements and medicines such as St. John’s Wort, certain antibiotics and antifungals, and seizure medications can impact how your body absorbs or processes the hormones in the patch. The medication effectiveness interacting with the birth control hormones can make both less effective.

Another problem is if you miss the first patch after your period week. Starting your new patch cycle late after your patch-free week leaves you unprotected until you apply a new patch. The key is consistently having the hormones in your system with no gaps.

Tips for Using the Patch Perfectly

It takes dedication, but using the patch exactly as directed can give you over 99% protection from pregnancy. Here are some strategies that will help you achieve perfect use:

• Change the patch on the same day every week – many women pick Sunday. Put a weekly reminder in your calendar, planner, or phone.
• When you take off the old patch, immediately apply your new patch. Don’t wait until the day after or even hours later.
• Before applying the fresh patch, check that your skin is clean, dry, and hairless in the area you plan to apply it.
• When changing patches, press on the edges to check the stickiness. If it’s not adhering well, choose a new location.
• Never go more than seven days without a fresh patch. Stick to your schedule dutifully.
• If the patch comes off or you forget to put a new one on time, use an additional birth control method for seven days.
• Avoid any drugs or supplements that could impact the patch’s efficacy. If you must take them, use backup birth control too.
• Don’t use lotions, oils, powders, or makeup near your patch that could loosen adhesion.
• Check on your patch in the shower or bath to make sure water hasn’t loosened it.

Stay in close contact with your doctor and call immediately if you have any issues, such as the patch falling off early, reactions at the application site, or missed changes. Getting back on track is much easier when you address any problems immediately.

Possible Side Effects and Health Risks

The hormones in the patch can cause some side effects that you should be aware of:

• Increased blood clot risk. The estrogen raises your chances of a blood clot slightly higher than with the pill, especially in the first year of use. Smoking, being overweight, or being immobile also raises your clotting risk. Blood clots can be very dangerous, so the patch may not be the best option if you have multiple risk factors.
• Small increased chance of breast and cervical cancer. According to research, the hormones in the patch may raise your odds somewhat compared to non-hormonal methods. However, the overall risk is still low. Discussing your personal and family cancer history with your doctor when considering the patch is recommended so you can make an informed decision.
• For the first 2-3 months, you may have nausea, headaches, breast tenderness, or moodiness as your body adjusts to the hormones, though these symptoms often resolve over time.
• Skin irritation can occur at the patch application site from the adhesive and friction from clothing. Rotating to a new spot on your body each week helps prevent this reaction.

Determine If the Birth Control Patch Is Right for You with Raleigh Gynecology & Wellness

Alternatives to the patch, such as the pill, shot, implant, or IUD, can provide the same effective pregnancy protection without some of the potential issues, such as visibility, skin reactions, or adhesion problems. But they require taking a daily pill, getting a shot every three months, or having a medical procedure for insertion.

If you’re uncertain of the best birth control solution that aligns with your lifestyle and considers any health concerns you may have, Raleigh Gynecology & Wellness can help. Contact us today at (919) 636-6670 or schedule a consultation online to work with our healthcare experts to determine if the birth control patch is the right option for you.

The contraceptive implant is a popular, long-acting, reversible form of birth control. This device that’s the size of a matchstick is inserted under your skin in your upper arm and steadily releases progestin hormones to prevent pregnancy for as long as five years.

If you’re considering contraceptive implants, it’s essential to understand the range of benefits they offer.

Highly Effective at Preventing Pregnancy

One significant benefit of the contraceptive implant is its incredible effectiveness in helping you avoid pregnancy. It’s considered one of the best reversible birth control methods.

The implant is over 99% effective, meaning fewer than 10 out of 1,000 women using it will get pregnant in a year. Permanent options such as tubal ligation are the only birth control methods more effective than implants.

Long-Lasting Contraception

Another advantage of the contraceptive implant is its long duration of pregnancy protection. Once inserted, it prevents conception for three to five years, depending on the specific brand.

Nexplanon, the only implant currently available in the US, protects against pregnancy for up to three years. This means that after a quick insertion, you’re covered for years without having to think about other forms of birth control.

Reversible

One great thing about the contraceptive implant is that it’s reversible. If you want children or it’s no longer the right method, your doctor can remove the device. Fertility returns to normal right away after implant removal.

This reversibility gives you flexibility. You can use the implant for however long you want contraception, whether that’s a few months or several years. It doesn’t affect your fertility over the long term if you decide to have it taken out.

Low Maintenance

Continuing with the theme of convenience, the contraceptive implant is one of the lowest maintenance types of birth control you can get. Once inserted, there is no need to do anything until it’s time for removal and replacement three to five years later.

You don’t have to take a pill at the same time daily or make frequent pharmacy runs for refills. The implant’s “set it and forget it” nature makes staying protected incredibly easy. You can go about your life without contraception constantly on your mind.

Private

Unlike barrier methods such as condoms, the contraceptive implant allows private birth control. Partners do not need to be involved in any aspect of the process.

The implant is discreet once inserted, and you don’t have to discuss it with a partner if you don’t want to. You have complete control over starting or stopping the implant at any time.

Estrogen-Free

Hormonal contraceptives such as pills, rings, or patches contain estrogen in addition to progestin. The implant only uses the hormone progestin and is estrogen-free.

This makes it a great option to avoid the potential cardiovascular effects of estrogen, such as the increased risk of blood clots. The lack of estrogen may also be preferred if you experience adverse side effects from that hormone.

Quick Return to Fertility

When you’re ready to try for pregnancy, the contraceptive implant can be removed, and fertility returns immediately. Some methods can delay your ability to conceive for months after stopping.

There is no waiting period with the contraceptive implant. You can start trying for a baby right after removal with no effects on conception speed.

Relieves Endometriosis

Endometriosis is a painful condition wherein tissue similar to the uterine lining will grow outside the uterus. It afflicts over 6.5 million women in the US.

The contraceptive implant may ease endometriosis symptoms such as pelvic pain, cramping, and heavy periods. The steady progestin supply may reduce or eliminate periods, limiting menstrual bleeding that exacerbates discomfort.

Reduces Menstrual Cramps

In addition to easing cramps from endometriosis, contraceptive implants may lessen menstrual cramping. Implants minimize the uterine lining buildup that contributes to intense, painful cramping before periods.

For many users, periods also become lighter or stop entirely after getting the implant. This reduces or eliminates the discomfort and hassle of heavy, crampy periods.

Lowers Anemia Risk

The implant’s effects on menstrual bleeding may provide another useful benefit. Heavy, prolonged periods can sometimes lead to iron deficiency anemia when red blood cell counts drop too low.

The progestin in the implant thins the uterine lining and often reduces menstrual flow. In many cases, periods become lighter or stop completely within one to three months of starting the implant.

This drop in bleeding decreases the chances of developing anemia due to monthly iron loss. Lighter menstruation helps maintain adequate iron levels and protects against fatigue and other symptoms of anemia.

Get Expert Guidance on Contraceptive Implants from Raleigh Gynecology & Wellness

The contraceptive implant offers multiple advantages as a hassle-free, long-acting, and highly effective birth control method. It provides pregnancy prevention you don’t have to think about daily while retaining the flexibility of reversibility.

For expert guidance on the contraceptive implant and other birth control methods, turn to the knowledgeable team at Raleigh Gynecology & Wellness. We can help you choose the contraception that suits your reproductive health goals and lifestyle.

Contact us today at (919) 636-6670 or schedule an appointment online to learn more about the many benefits of the contraceptive implant.

If the vaginal ring interests you for birth control, a common question is: how long does it last? The vaginal ring is a piece of flexible plastic in the shape of a ring that you insert into your vagina, where it releases hormones to prevent pregnancy.

There are two options currently available – NuvaRing and Annovera. Both contain similar hormones but have different lifespans. NuvaRing lasts about one month, while Annovera is effective for a full year. Understanding how to use them properly ensures you get maximum effectiveness.

Let’s look at how long each vaginal ring remains active to see if this method is a good fit.

NuvaRing Duration

NuvaRing is a monthly vaginal ring. Each ring lasts up to five weeks but is intended for only one menstrual cycle. Here’s how to use NuvaRing:

• Position a new ring in your vagina and keep it there for three consecutive weeks.
• After three weeks, take it out on the same day of the week you inserted it.
• Take a seven-day break from NuvaRing.You’ll get your period during this break.
• At the end of the seven-day break, insert a new NuvaRing to start your next four-week cycle.

In short, you use each NuvaRing for three weeks and go without for one week. After your ring-free week, you must put in a new ring. NuvaRing is only effective for one cycle -don’t try to extend use longer than recommended.

Annovera Duration

Annovera is a vaginal ring lasting a full year or 13 cycles. It’s the first ring you don’t need to replace every month.

Here is how to use Annovera:

• Put the ring into your vagina, where you will keep it for three straight weeks.
• Once three weeks have passed, take it out on the same day you put it in.
• Take a week-long break from the ring to get your period.
• Following your seven-day ring-free break, insert the same Annovera ring to start your next three weeks.
• Continue using this ring for one complete year by repeating steps 1-4.

The key difference between NuvaRing and Annovera is that the same Annovera ring can be used for an entire year. With NuvaRing, you need 13 separate rings.

Proper Use for Maximum Effectiveness

For the highest efficacy from your vaginal ring, proper use is essential. Here are some tips:

• Always insert a new ring on time. Don’t delay at the end of your seven-day break.
• Never leave the ring out for over three hours. The hormones will start decreasing, lowering pregnancy protection.
• Follow the recommended durations. For NuvaRing, use one ring for three weeks, then replace it. For Annovera, use one ring for one full year.
• Try not to remove the ring during the three weeks it should stay inserted. The hormones work best when left undisturbed.
• Check that your ring is in the proper position after sex or exercise. Gently reposition it if needed.
• If your ring comes out, rinse and reinsert ASAP. Use backup protection such as condoms if out over 3 hours.

When used consistently and as directed, your vaginal ring will provide reliable birth control month after month or year after year. Following the instructions is important.

Expiration of the Vaginal Ring

As with any medication, vaginal rings have expiration dates to follow. An expired ring may not prevent pregnancy as effectively.

Here is how long each vaginal ring remains potent:

• NuvaRing expires four months after its manufacturing date. Replacing it monthly ensures you use a non-expired ring.
• Annovera expires one year after its manufacturing date. Before inserting a new one, confirm your Annovera ring hasn’t passed its expiration date.

Unopened rings stored properly can remain effective until expiration. But once in use, bacteria is introduced. Never use a ring longer than specified in the instructions. When unsure, start fresh with a new, unexpired ring.

Proper storage also prolongs a vaginal ring’s lifespan:

• Keep unused rings in their original foil packages without unsealing them until ready for use.
• Store rings at room temperature, out of sunlight, and away from temperature extremes.
• Refrigerate NuvaRing if the first use will occur more than four months after dispensing. Refrigeration is not recommended for Annovera.

Always check the expiration date so you insert a potent ring within its shelf life.

Get Effective Birth Control Guidance Personalized for Your Needs from Raleigh Gynecology & Wellness

NuvaRing and Annovera have different effective lifespans—NuvaRing works for about one month, while Annovera prevents pregnancy for an entire year. Use your vaginal ring exactly as your healthcare provider prescribes for optimal results.

Proper insertion, consistent use, and timely replacement are essential for your vaginal ring to prevent pregnancy effectively. Don’t extend use beyond the recommended duration, as doing so decreases effectiveness. Also, do not use an expired ring.

While both provide excellent protection when used correctly, the vaginal ring will not protect you from sexually transmitted infections. Using condoms along with the ring is suggested if STI protection is desired.

Raleigh Gynecology & Wellness has helped countless women understand their birth control options and find one suitable for their precise situation. We’re experts on all aspects of vaginal rings and women’s reproductive health.

Contact us today at (919) 636-6670 or schedule a consultation online to discuss whether NuvaRing or Annovera is a good option for you.