Routine Gynecologic Care

The statistics on unintended pregnancy rates and contraceptive use paint a concerning picture in the United States. Nearly half of all pregnancies are unintended, and the rates are significantly higher among low-income and minority women.

This points to significant barriers that prevent women from obtaining affordable contraceptives or using them effectively. Comprehensive access to contraceptive care is essential preventive care for women’s health.

By removing obstacles around affordability, knowledge, legal restrictions, insurance coverage, and access, all women can fulfill their right to determine if and when to have children.

Barriers Limiting Access and Affordability

Several complex barriers currently limit many women’s ability to access affordable contraceptive care. Examining and addressing each of these obstacles is essential.

Lack of Knowledge and Information

One major barrier is a lack of medically accurate, comprehensive information and education about contraceptive methods.

Abstinence-only approaches have been ineffective in delaying sexual activity or promoting safer behaviors. In contrast, fact-based sex education programs positively impact outcomes among young people.

However, restrictions often limit access to complete information. Knowledge gaps and misconceptions about safety and effectiveness persist among the broader population.

For example, prevalent myths that birth control pills cause health problems or that IUDs have high infection risks may deter use. Factual education for both patients and providers facilitates informed contraceptive choices.

Legal and Policy Restrictions

Unfavorable legal rulings and restrictive state and federal policies also impede access. The Supreme Court’s Hobby Lobby decision enables more employers to exclude contraceptive coverage based on religious grounds.

State measures requiring parental consent for minors, defining fertilized eggs as “persons,” or weakening contraceptive equity measures also threaten access.

These restrictions disproportionately affect disadvantaged groups, limiting affordable care. Advocacy to uphold equitable coverage mandates and evidence-based policies is paramount.

Prohibitive Costs and Insurance Barriers

Cost and insurance pose additional barriers, especially for low-income and uninsured women. More than half of women requiring contraceptive services rely on publicly funded sources, which struggle with rising demand and underfunding.

The Affordable Care Act’s contraceptive provision would lower millions of Americans’ out-of-pocket expenses by covering FDA-approved methods without copays or deductibles. However, many non-compliant employers and insurance plans still impose high cost-sharing.

Extending comprehensive Medicaid family planning services in every state provides a pathway to affordable care for economically disadvantaged women.

Refusals to Provide Contraception

Conscience-based objections create substantial access barriers across Catholic hospital systems, pharmacies, and other care settings nationwide. This results in referral delays or coverage gaps, especially in rural locations that lack alternatives, jeopardizing timely care.

Although ethical exemptions aim to protect the diversity of beliefs, refusal laws should mandate timely referrals and preserve patient access. As religious facility mergers continue, proactive advocacy preserves community contraceptive services.

Strategies for Improving Access and Affordability

While substantial barriers stand in the way, evidence-based strategies also exist to expand affordable access to contraception effectively.

Complying With Contraceptive Coverage Requirements

Full compliance with the ACA’s contraceptive provision enables significant progress by eliminating prohibitive out-of-pocket expenses that deter the use of more reliable methods.

Expanding alternative benefit pathways through Medicaid family planning waivers also connects uninsured individuals with coverage.

Targeted implementation assistance helps newly covered entities meet standards. Supporting Title X and other public funding is equally vital to serve those remaining uninsured under the law.

Confidential Adolescent Services

Preserving confidential services, insurance privacy protections, and consent policies enables adolescents to access care.

Communication with parents or guardians is encouraged as appropriate, but barriers requiring parental involvement should not obstruct access to needed contraception.

Increasing Insurance Supply Dispensing Policies

Extending dispensing limits from single cycles to 12-month supplies improves continuation rates across contraceptive methods.

Updating restrictive formularies also ends improper “fail-first” tiering policies that impede patient choice.

Enabling over-the-counter access further eases barriers, provided accompanying insurance coverage or savings programs keep oral contraceptives affordable.

Same-Day Access to Quick Start Methods

Streamlining initiation by offering same-day device insertion, injection, or oral contraceptive starts during existing visits improves convenience and saves additional travel burdens. Appropriate provider compensation and billing structures support such quick-start models.

Postpartum and Post-Abortion Contraceptive Access

Implementing immediate postpartum long-acting reversible contraception (LARC) insertion during hospitalization after delivery maximizes opportunities when women have existing coverage.

Despite global maternal care bundled payments, Medicare and Medicaid payment models should enable separate cost coverage for LARC devices. Likewise, ensuring comprehensive contraception is seamlessly available during abortion visits reduces gaps in care.

Reduce Sterilization Barriers

Informed consent requirements aim to protect patient rights but pose obstacles to desired postpartum tubal ligations.

Revising outdated restrictions affecting low-income sterilization candidates covered through Medicaid and other government insurance plans establishes equitable access.

Reach the Most Vulnerable Populations

Targeting disadvantaged minority and low-income groups with higher unintended pregnancy rates is paramount, as financial barriers multiply access challenges. Culturally competent education and outreach through trusted local partners make services more approachable and relevant.

Take Charge of Your Family Planning Journey with Raleigh Gynecology & Wellness

Addressing the barriers limiting access and affordability necessitates collaboration between all stakeholders – patients, providers, policymakers, and diverse community partners.

Achieving comprehensive contraceptive care as vital preventive coverage for all women is contingent on dismantling obstacles related to knowledge gaps, high costs, restrictive policies, and systemic roadblocks.

Early investments to establish equitable access create invaluable societal benefits and economic returns that compound across generations.

Everyone has a stake in securing these vital services to support women, families, and healthy communities. Raleigh Gynecology & Wellness provides personalized guidance to ensure contraceptive care options fit your needs and circumstances.

Contact us today at (919) 636-6670 or schedule an online consultation to take charge of your family planning journey.

When it comes to contraceptive care, the choice of birth control method extends far beyond just preventing pregnancy. The impact of different contraceptives on your overall well-being and long-term health should also be considered.

That’s why open communication with your gynecologist is so important when making contraceptive decisions.

By discussing all aspects of various contraceptive options — weighing the potential benefits against possible side effects and risks — you can find the best solution tailored to your lifestyle and medical history.

Getting the complete picture empowers you to take charge of your sexual and reproductive health.

Hormonal vs Non-Hormonal: Understanding the Differences

Hormonal birth control, such as the pill, patch, ring, shot, and implant, all contain some level of artificial estrogen or progesterone. By regulating hormones in your body, these methods prevent ovulation so you cannot get pregnant.

Potential benefits beyond pregnancy prevention include lighter, more regular periods, reduced menstrual cramps and PMS symptoms, clearer skin, and protection against certain cancers later in life.

However, added hormones also come with potential side effects, including nausea, headaches, weight gain, and mood changes in some women.

In some cases, more severe risks, such as blood clots or high blood pressure, may occur. Certain medical conditions, age factors, smoking, and family history can all impact these risks.

Non-hormonal options such as the copper IUD, condoms, diaphragm, and fertility awareness methods avoid artificial hormones altogether.

For women unable or unwilling to expose themselves to added hormones, these alternatives provide birth control without that risk.

The trade-off is that non-hormonal choices typically require more effort on your part for consistent use or come with other side effects, including heavier, more painful periods with the copper IUD. Understanding all the options lets you determine what will work best for your needs.

Permanent Contraception: Is it Right for You?

Tubal ligations and vasectomies represent permanent contraception choices, so counseling about long-term implications is especially important. You must feel confident that you do not desire pregnancy in the future when opting for sterilization procedures.

Even though some sterilization methods may be reversible, they can be complicated, expensive, and unsuccessful. To avoid regret, go into the decision-making process with full awareness.

Your Gynecologist Needs Your Complete Medical Profile

Genetics, personal health conditions, medication usage, and lifestyle factors all weigh heavily when identifying the ideal contraceptive solutions. Be ready to share details on:

• Family history of blood clots, strokes, cancers, or other hereditary conditions
• Your full medical history—especially related to migraines, hypertension, heart/vascular health
• Current prescriptions or over-the-counter medications
• Tobacco usage and alcohol consumption
• Major life events such as childbirth

As circumstances evolve over months or years, update your gynecologist on any changes that could impact contraceptive method safety or effectiveness.

Finding the Right Fit: Lifestyle, Side Effects and Beyond

Ideally, your contraception should align with your day-to-day lifestyle and habits. Factors such as sexual frequency, number of partners, and family plans for the future play a role.

If you frequently travel and do not want to deal with refilling prescriptions, getting shots, or inserting devices while out of town, options can be narrowed.

Or if you work long shifts and tend to forget to take daily medications, methods that do not require consistent action, such as the IUD or implant, may be better.

Be ready to discuss common or expected side effects—both short and long-term—to determine your tolerance levels. Do not hesitate to report any worrisome or severe reactions you experience so adjustments can be made as needed.

Establishing an ongoing contraceptive care plan with check-ins at routine well-woman exams allows you to periodically assess if your birth control selection remains the most appropriate choice as life circumstances evolve.

What’s the Impact on Future Fertility?

A significant consideration for contraception is how soon fertility may return after you discontinue that method. With options such as the birth control pill, patch, ring, and condoms, normal ovulation typically resumes within 1-3 regular cycles after stopping.

The Depo shot can take longer—around six to nine months or more for fertility to reestablish for some women. Coming off longer-acting solutions such as IUDs or implants leads to a quicker return to fertility for most.

However, age factors also come into play as egg quantity and quality decline naturally over time. Older age may be associated with longer delays to return of menses and reduced fertility potential.

Discuss your desired family planning timeline with your gynecologist when making contraceptive decisions.

STD Protection, Sexual Satisfaction, and Other Intimate Considerations

Pregnancy prevention aside, contraceptive options have other intimate impacts worth discussing openly with your gynecologist, too.

Certain barrier methods, such as male/female condoms, protect against sexually transmitted diseases (STDs)—a consideration if you have multiple partners.

Hormonal changes from birth control could negatively (or positively) affect your libido and sexual satisfaction as well. Conditions including endometriosis or polycystic ovarian syndrome also influence contraceptive method selection.

If you eventually hope to get pregnant, preconception planning becomes important, too. Identifying when contraceptive use should cease and prenatal vitamin supplementation should begin can enhance fertility outcomes down the road.

Empower Yourself Through Contraceptive Care from Raleigh Gynecology & Wellness

Fundamentally, establishing open lines of communication with a trusted gynecologist provides immense value when navigating all aspects of sexual health and contraception. No question you have is off-limits.

The Raleigh Gynecology & Wellness team has years of experience empowering women to take charge of contraception. We take a holistic approach—getting to know all aspects of your health and lifestyle to recommend solutions tailored to your unique needs.

Contact us today at (919) 636-6670 or online to become a patient or schedule your annual visit to discuss contraceptive care.

Hormonal contraceptioncan both positively and negatively affect your menstrual health. As such, it is essential to have an open discussion with your gynecologist when considering hormonal birth control options.

This will allow you to make an informed decision based on your medical history, preferences, and goals.

Types of Hormonal Contraception

Several categories of hormonal contraception are available, and the type you choose will depend on a wide range of factors, including your lifestyle preferences, reproductive health goals, and your medical history.

It is a topic you should certainly discuss with your gynecologists, but it’s good to be aware of what is available in advance. Therefore, the different types of hormonal contraception include:

• Combined oral contraceptives or COCs: Also referred to as “the pill,” COCs include estrogen and progestin. They are taken in pill form on a daily or continuous basis.
• Progestin-only pills (POPs): Unlike COCs, POPs only feature progestin with no estrogen. They may be an option if estrogen is contraindicated.
• Intrauterine devices (IUDs): IUDs are small devices that are inserted into the uterus and release either progestin or copper. The Mirena IUD releases progestin, while the Paragard IUD releases copper without hormones.
• Contraceptive implants: These are small plastic rods placed under the skin of the upper arm. They release progestin slowly over several years. The Nexplanon implant lasts up to 3 years.
• Contraceptive injections: Also known as depot medroxyprogesterone acetate (DMPA) or Depo-Provera, these injections contain progestin and are administered every 12 weeks.
• Vaginal rings: The NuvaRing is a flexible ring placed in the vagina for three weeks per month. It discharges estrogen and progestin, similar to COCs.
• Transdermal patches: Patches such as Xulane stick to the skin and release estrogen and progestin transdermally. A new patch is applied weekly for three weeks out of the month.

Discussing Your Medical History

Hormonal contraception may have some risks, depending on what your medical history is, which is why you should tell your OB/GYN about any of the following:

Personal or Family History of Blood Clots

Estrogen found in COCs, patches, and vaginal rings may slightly increase clotting risk. If you have a blood clot history or if it runs in the family, you should use progestin-only methods instead.

History of Migraines with Aura

Migraines with neurological aura symptoms can increase your risk of stroke on combination hormonal birth control. Progestin-only options are considered safer.

Smoking Habits

Smokers over the age of 35 face higher clotting and heart disease risks on COCs; they should avoid estrogen-containing contraception.

Obesity

People with a BMI over 30 kg/m2 may experience lower efficacy and higher health risks on some forms of hormonal birth control.

Other Medications and Supplements

Some medications can interact with hormonal contraception, reducing its effectiveness. Always disclose any medications or supplements you take.

Addressing Menstrual Health Concerns

Hormonal contraception often leads to changes in menstruation. You should inform your gynecologist about any bothersome symptoms. Common concerns include:

• Changes in menstrual flow and duration: It is common to experience lighter, predictable periods on hormonal birth control. Heavier or prolonged bleeding may indicate an underlying problem.
• Irregular bleeding or spotting: Breakthrough bleeding and spotting are common when first starting hormonal contraception. If it lasts longer than three months or is heavy, consult your gynecologist.
• Amenorrhea (absence of periods): Missing periods can occur as a side effect of contraceptive shots, implants, IUDs, and sometimes pills. Rule out pregnancy and inform your doctor of any amenorrhea.
• Dysmenorrhea (painful cramps): Hormonal birth control often reduces menstrual cramps but may worsen pain in some cases. Pelvic exams help identify the causes of persistent cramping.
• Premenstrual syndrome (PMS): Mood swings, breast tenderness, bloating, and other PMS symptoms may improve or persist on hormonal birth control. Track your symptoms.

Potential Menstrual Health Benefits

When used properly, hormonal contraception can:

• Regulate irregular menstrual cycles
• Lessen heavy bleeding and cramping
• Treat gynecological conditions such as endometriosis and polycystic ovary syndrome (PCOS)
• Improve symptoms of premenstrual syndrome (PMS)

For those with painful, heavy periods or irregular cycles, the menstrual regulation from hormonal birth control can vastly improve their quality of life.

Possible Side Effects and Risks

While many tolerate hormonal contraception well, potential side effects include:

• Nausea, headaches, breast tenderness
• Increased or decreased libido
• Weight gain or loss
• Mood changes
• Breakthrough bleeding

In rare cases, serious complications may occur, such as blood clots, stroke, or liver tumors. Cigarette smoking combined with estrogen use significantly increases these major health risks.

Long-Term Considerations

When used over many years, hormonal contraception may impact:

• Bone mineral density: Some evidence suggests DMPA injections may decrease bone mineral density or BMD, leading to osteoporosis risk. Estrogen-containing contraceptive methods maintain BMD.
• Return to fertility: Most people regain normal fertility within months after discontinuing hormonal birth control. It may take longer with DMPA injections.
• Cancer risks and benefits: There is mixed evidence regarding breast cancer risk, which appears slightly elevated on COCs. However, hormonal contraception reduces endometrial, ovarian, and colorectal cancer risks.

Monitoring and Follow-Up

While using hormonal birth control, it is essential to:

• Get regular pelvic exams, Pap tests, and blood pressure checks
• Report any persistent side effects or warning signs
• Discuss alternative options if problems arise

Get Personalized Hormonal Contraceptive Care from Raleigh Gynecology & Wellness

With many hormonal contraception options available, the best choice is dependent on your specific health profile and preferences.

Raleigh Gynecology & Wellness’ caring providers offer personalized consultations to find the right solution for your needs and lifestyle.

Contact us today at (919) 636-6670 or schedule an online consultation for individualized care and compassionate understanding as you navigate contraception options and menstrual wellness.

Almost half of all pregnancies in the U.S. are accidental. This highlights the importance of contraceptive care in giving women the ability to manage their reproductive health.

Correct and consistent usage of contraception is key to reducing the risk of unplanned pregnancy. However, contraceptive care offers many more benefits beyond pregnancy prevention.

Here are five key ways that contraceptive care can empower you to take the reins of your reproductive health:

1. Prevent Unintended Pregnancy

Typically, the risk of pregnancy is high – around 85% over a one-year period – for women who use no contraceptive method. Access to contraceptive care significantly lowers your chances of having an accidental pregnancy.

The full range of contraceptive methods, when used properly and with consistency, work very well at preventing pregnancy.

Long-acting reversible contraceptives or LARCs, such as IUDs and implants, have failure rates of less than 1% with perfect use.

Even shorter-acting methods such as the pill, patch, ring, and shot are over 90% effective with perfect use. And permanent methods such as tubal ligation provide virtually foolproof protection.

Unintended pregnancy can have significant health, social, and economic consequences. It increases risks associated with delayed prenatal care, premature birth, low baby weight, maternal depression, and poor maternal bonding with the newborn.

Unintended pregnancies may prevent women from achieving their educational and career goals. Contraceptive care enables women to prevent unplanned pregnancies so they can avoid these adverse outcomes and have children when the time is right.

2. Space Pregnancies

Health experts recommend that women space their pregnancies at least 18 to 24 months apart. Short intervals between pregnancies negatively impact mom and baby.

For mothers, closely spaced pregnancies increase risks of preterm birth, low birth weight, preeclampsia, and prenatal depression.

For babies, short pregnancy spacing raises risks of preterm birth, low birth weight, and small gestational size – all associated with infant mortality and chronic disease later in life.

By planning pregnancy spacing, contraceptive care promotes optimal health. It empowers women to use birth control to plan the timing between pregnancies.

This enables the body to completely recover and return to pre-pregnancy health before conceiving again. Proper spacing also allows mothers to replenish important nutrients, such as folic acid, that are depleted during pregnancy.

3. Treat Medical Conditions

In addition to spacing births, contraceptive care offers non-contraceptive health benefits. Hormonal birth control methods can treat several conditions unrelated to pregnancy prevention.

For example, combined oral contraceptives (estrogen plus progestin pills) are often prescribed to alleviate menstrual disorders such as heavy or painful periods, irregular cycles, and endometriosis.

The hormones that birth control pills contain can help regulate your periods and reduce symptoms.

Other conditions that can be treated with hormonal contraceptives include polycystic ovarian syndrome (PCOS) and premenstrual dysphoric disorder (PMDD).

Contraceptives may also be used alongside other medications to treat acne, hirsutism, amenorrhea, menstrual migraines, and uterine fibroids.

This demonstrates the range of gynecological conditions that can be managed through contraceptive care when other treatment options prove ineffective.

4. Avoid Dangers of Pregnancy

For women with certain medical conditions, pregnancy can be risky or even life-threatening. Contraceptives allow women to avoid these dangers by preventing pregnancy altogether.

Conditions such as hypertension, diabetes, heart disease, and breast cancer can seriously endanger the health of the mother and baby during pregnancy.

The health risks may simply be too high for pregnancy to be advisable. Women with these conditions require highly effective contraceptive options.

Contraceptive methods such as sterilization, LARCs, pills, patches, rings, and shots provide the level of protection needed. This gives women control over protecting their health by avoiding pregnancy through contraceptive care.

5. Plan Pregnancies

Contraception enables women the time needed to plan and prepare for pregnancy mentally, physically, and financially. It allows women to achieve educational and career goals before having children.

They can plan to conceive when they have a supportive partner and feel emotionally ready. A planned pregnancy leads to improved nutrition and healthcare, such as folic acid intake and stopping smoking or alcohol use before conceiving.

Contraceptive care puts women in control of the timing of pregnancies so they align with personal circumstances.

Women can thoughtfully plan childbearing for when they have the resources and maturity needed for successful parenting. This leads to positive outcomes for both mother and baby.

Seek Expert Contraceptive Care at Raleigh Gynecology & Wellness

Contraceptive care offers women empowerment over their reproductive health. It enables women to prevent unintended pregnancies, space births appropriately, treat gynecological disorders, avoid pregnancy complications, and thoughtfully plan pregnancies.

Each contraceptive method has its benefits when it comes to improving women’s health and well-being. Raleigh Gynecology & Wellness offers patient-centered contraceptive counseling and care.

We work with you to select the contraceptive method that is in line with your goals for your reproductive health and medical needs.

Contact us today at (919) 636-6670 or schedule an online consultation to take control of your reproductive health through personalized contraceptive care.