Contraception Methods: What You Should Know

Many different contraception methods exist. Before you pick a method, be sure you are familiar with everything from an IUD to what birth control doesn’t protect. Women’s Care Florida’s Dr. Ryan Brosch breaks down frequently asked questions about contraception methods.

What form of contraception protects against pregnancy and sexually transmitted infections?

The only reliable form of contraception that protects against both pregnancy and STDs is barrier protection, such as male and female condoms. Other forms of contraception, such as hormonal methods like birth control pills, patch, vaginal ring, implants like NEXPLANON or IUDs only protect against pregnancy, and not sexually transmitted infections.

Any person with multiple partners or with exposure to a partner that has multiple partners should be using barrier protection to protect against sexually transmitted infections. They should also consider using an additional form of contraception to decrease the risk of unintended pregnancy.

What are the failure rates with different forms of contraception?

To truly understand failure rates of contraception, we should know the difference between typical vs. perfect use. Typical use is how the average person will use contraception—occasionally missing doses or not always using the condom correctly for instance. Perfect use means the barrier method or other contraceptive was used in strict adherence to the manufacturer’s recommendations every time.

Average failure rates when using condoms are about 15 out of 100 unintended pregnancies per year. Hormonal methods with typical use have about a five to 10 percent failure rate, with perfect use being only one to two percent. IUDs and NEXPLANON have similar perfect to typical use failure rates of less than one percent per year.

What are the benefits of long-acting reversible contraceptives?

Long-acting contraceptives are the first line of defense for patients’ contraceptive needs, with the greatest benefit being low failure rates. These are implantable devices that once placed, can stay in for years at a time, providing excellent contraception with the minimal daily inconvenience. Certain implantable devices, like NEXPLANON, or progesterone containing IUDs like Mirena or Kyleena, also provide hormonal suppression of the lining of the uterus called the endometrium, which is what sheds during menstruation. Suppressing the lining can cause very light periods or even no periods at all.

What are the potential risks for IUD placement?

The overall risk of IUD placement is low. The procedure itself does require a pelvic exam with a speculum. The procedure usually lasts approximately five minutes. The patient can expect some pelvic pressure and pelvic cramps when the device is inserted that can continue for the first 24 hours. The overall serious complication rate is quite low. Primary concerns are infection ( less than one percent) of the uterus, expulsion after placement (two to 10 percent) and uterine perforation: which only about one in 1000 patients experience this rare complication.

Do IUDs cause infertility?

There is no evidence that any currently manufactured IUDs used in the U.S. cause infertility. Before the FDA regulated medical devices, there were poorly made IUDs that were known to increase the risk of pelvic inflammatory disease and infertility. These were subsequently removed from the market due to these risks. Unfortunately, this stigma has persisted despite robust safety data available about the IUDs currently in use.

IUD Insertion

Did you know a reversible long-term birth control exists that trumps pregnancy prevention over tubal ligation? It’s called an intrauterine device or IUD. Many women prefer IUD insertion over birth control because you don’t have to remember taking your birth control every day, week, month, or even year. Plus, providers can remove IUDs at any time before its expiration date.

Types of IUDs

Two main types of IUDs exist:

Progesterone IUD

Copper IUD

  • Has no hormones and lasts up to 10 years
  • Paragard®

Benefits

An IUD gives many benefits to women who have hormonal side effects. These uncomfortable side effects include headaches, mood changes, and breast tenderness. Types of birth control such as the pill, patch or injection can heighten these side effects. Additionally, an IUD is one of the most effective types of birth control. An IUD’s effectiveness is more than 99 percent.

Progesterone IUDs release a small amount of progesterone locally into the uterus. That means you will have fewer hormones in your body, making hormonal side effects unlikely. The Mirena IUD, which has a little more progesterone, can also decrease your menstrual flow and reduce your menstrual cramping. Furthermore, some women stop having periods.

In addition, some women prefer to keep their regular menstrual cycles and thus don’t want to use hormones. The copper IUD has no hormones and still works by preventing fertilization. A common misconception is that is aborts a pregnancy. This is false as it prevents conception from occurring.

Who should get an IUD?

The IUD is a great option for all women, including teens and women who have never been pregnant. It does not lead to problems with getting pregnant in the future. It also works well for women in the final five to 10 years before menopause. Prior to menopause, periods often become heavier and more painful. The Mirena IUD can ease the transition to menopause by decreasing menstrual flow and pain.

However, some women should avoid using an IUD. They include women who have large fibroids in the uterus.

IUD Insertion

Providers insert the IUD into the uterus as an ob-gyn’s office typically during your period. If you have unpredictable periods, we recommend using reliable birth control for the two weeks leading up to your visit. Expect to have spotting and menstrual-like cramping during the procedure. Take ibuprofen before and after the procedure to help with the cramping. Lastly, you can return to normal activities later that day.

You can also get an IUD inserted immediately after a vaginal delivery or cesarean section. The expulsion risk is a little higher than waiting until your six-week post-delivery visit, but it is worth talking about with your ob-gyn.

Removal

The IUD can be easily removed at the ob-gyn’s office at any time. In the rare instance, the strings are not readily visible, an ultrasound is used to help remove the IUD. After the IUD is removed, you are able to get pregnant without delay.

Risks and side effects

The risks of using an IUD are very low. They include IUD expulsion (usually in the first few weeks after insertion) and incorrect placement outside of the uterus. While the progesterone IUD can decrease menstrual flow, it can also lead to irregular spotting or bleeding.

Contact a Women’s Care Florida provider if you would like to discuss using an IUD.

Smoking and Birth Control: What Happens?

Most people generally know that smoking is bad for your health. It suppresses the immune system and increases the risk of heart disease and lung cancer. However, many don’t know that combining cigarette smoking with birth control can further increase the risk for major health problems due to the effects of nicotine on extra estrogen supplied by most forms of birth control.

Here’s what you should know about the relationship between smoking and birth control.

A lethal combination

So what happens if you smoke while on birth control? Birth control delivers extra estrogen to your system to prevent ovulation and conception. Nicotine is a toxin that increases your blood pressure and heart rate. When the two substances are combined, birth control adds more stress to your blood vessels on behalf of the extra estrogen and increases the risk for stroke, blood clots, and heart attack.

Providers often get asked if light smoking and birth control have the same effect. Naturally, the heavier you smoke, the more you put yourself at risk. However, any nicotine combined with birth control can increase stress on your blood vessels. Therefore, avoid both light smoking and heavy smoking altogether.

Your odds of worsening familiar history conditions such as heart disease and high cholesterol increases. Consult an OBGYN about smoking and birth control risks. In addition, ask about safer birth control options if you smoke and use a form of birth control such as the pill, ring, patch, or shot.

What to do if you smoke and use birth control

If you smoke, make plans to quit as soon as possible so you can lower your risk for health complications and improve your overall wellness. Many ways of quitting exist. These include patches, gum or medication. Also, talk to a physician about smoking cessation programs that can help you quit.

If you don’t want to quit smoking but use birth control, make an appointment with your OB-GYN as soon as possible. Be completely honest with your OB-GYN about your smoking habit. Many patients hold back personal information. Understand that Women’s Care Florida providers do not judge you because they want to help in any way possible. Therefore, both of you can discuss alternate forms of birth control or the possibility of taking birth control pills that lack estrogen.

Women’s Care Florida offers several options for birth control. These include permanent birth control, subdermal implants, and estrogen-free intrauterine contraceptives. Schedule an appointment with WCF today to explore birth control options and receive comprehensive board-certified gynecologic care.