By Dr. Susan Cooper-Morphew, Obstetrics and Gynecology, Christie Clinic
There are so many choices of contraception from which to choose. The key to picking the right form of contraception for you is to know the strengths and weaknesses of each method and your future goals. Are you the type of woman who can remember to take a pill every day? Are you still breastfeeding? Do you want a period every month? When will you want to have another child?
For women who are not planning to have another child for a year or more there are long-acting, reversible contraceptive options. These options include the following:
• The Mirena is an intrauterine device (IUD) that can remain in place for up to five years. It can initially cause irregular bleeding but the longer that it stays in the uterus the lighter a woman’s period becomes. After the first year, 20 percent of women will not have their period until the Mirena is removed. Ovulation will recommence in 2-3 months after removal.
• The Copper IUD is a non-hormonal device that can remain in the uterus for up to 10 years. This IUD will allow the woman to continue to have monthly periods. When removed, ovulation often returns with the next cycle.
• The Nexplanon is a single rod of progesterone that is implanted in the arm and is good for three years. It can initially cause irregular bleeding. Once removed, ovulation can reoccur in 1-4 weeks.
• Depo-Provera is an injection that women can receive every three months. The majority of women don’t get their periods after being on Depo-Provera for one year. Side effects can include irregular bleeding for the first few months, weight gain, and reversible bone loss. Once discontinued, return to ovulation can take 10 to 18 months.
For women who want more month-to-month options there are the following. The return to ovulation with these options are 1-3 months:
• Birth control pills are pills that should be taken every day. There are two main categories of pills: The progesterone only pill is a birth control pill that must be taken at the same hour every day to be effective. If not, the woman can still get pregnant or experience breakthrough bleeding. There are also combined estrogen/progesterone pills that must be taken daily. These pills do not have to be taken at the same time each day.
• The NuvaRing is a device that the woman can insert in her vagina and for three weeks, she can then take it out and have a period. It is good for women who are not good at remembering to take pills daily but want the same effects as birth control pills.
• The patch can be applied once a week for three weeks followed by a patch free week. It is good for women who do not want to take a pill, injection or insertion. It is not as private as the pill or ring because it can be visible.
There are other options available including tubal ligation, female and male condoms, and natural family planning. Before making a decision on which contraceptive choice is right for you, consult your OB/GYN.
Dr. Susan Cooper-Morphew is an OB/GYN at Christie Clinic in Champaign.