Options for Contraception
Depo-Provera is one of the most reliable, reversible contraceptive methods available today. It is a prescription medication that requires an almost painless injection into the upper arm or buttocks by a doctor or other health care provider once every three months. Unlike the “Pill”, it does not need to be taken every day. Depo-Provera contains a hormone similar to the body’s own natural progesterone that stops the release of a mature egg. Depo-Provera is 99.7% effective, and only needs to be taken four times a year.
Oral Contraceptive (The Pill)
The ‘Pill’ is a small prescription tablet which it taken once a day, in sequence, until every pill in the package is used up. There are two types of birth control pills; the combination pill and the minipill. The combination pill contains both an estrogen and a progestin, whereas the minipill contains a progestin only. Oral contraceptives contain hormones similar to the body’s own natural hormones that stops the release of a mature egg. When used exactly as directed, the Pill has an effectiveness rate greater than 99%, however; typical effectiveness is closer to 97% during the first year of use.
Fertility Awareness Methods (two are noted below) are designed to help determine on which days of the menstrual cycle a women is likely to become pregnant.
The Basal Body Temperature Method requires women to take their temperature every morning before getting out of bed. A small rise of less than one degree occurs when the egg is release, which is carefully recorded. Couples must not have sex from the end of the menstrual period until three days after this rise in temperature.
In the Ovulation Method, changes in vaginal secretions during different phases of the menstrual cycle are observed. Following menstruation, vaginal mucus will become increasingly wet and slippery until the time of ovulation when thick, sticky mucus appears. Couples must not have sex for four days after the ‘peak’ day of the mucus is noticed.
The typical effectiveness rate for these methods is only 80%. This is because many women report losing track of their menstrual pattern, or forget to take their temperature every day.
Tubal Sterilization (Female) & Vasectomy (Male)
Female sterilization, often called a tubal ligation or getting “tubes tied”, requires a surgical procedure that closes the fallopian tubes between the ovaries and the uterus.
Male sterilization is known as a vasectomy. A vasectomy requires a surgical procedure that closes the small tubes through which sperm are released. With appropriate anesthesia, a small incision is made near the women’s navel. The doctor seals the fallopian tubes using an electric current, clip or band. Pregnancy cannot occur because the sperm cannot get tot the egg.
During the male’s surgery, the doctor makes one or two very small incisions in the scrotum, while the patient in under local anesthesia. A small section of each tube is removed and the two ends are sealed. Pregnancy cannot occur because there is no sperm being released to fertilize the egg.
Diaphragm or Cervical Cap
A Diaphragm is a flexible rubber or plastic barrier that is intended to fit securely over the cervix. Similarly, the cervical cap is a thimble-shaped rubber or plastic dome. For a correct fit, each require a pelvic examination by a health care provider. Both methods block sperm for entering the uterus and fertilizing an egg. The diaphragm can be put in place up to two hours before intercourse and may be left in for about six hours. The cervical cap may be inserted six hours before intercourse, but it may be left in place for up to 48 hours. The cervical cap cannot be used during menstruation. Each time sex occurs, a small amount of spermicidal cream or jelly should be spread inside and along the rim of the devices. The effectiveness rates of the diaphragm or cervical cap ranges from 72% to 94%, depending upon consistent and correct use. Each must be inserted properly every time to be effective.
A condom is a latex, rubber or ‘lambskin’ sheath that fits over the penis. They are available over the counter with or without added spermicide. A condom prevents pregnancy by containing sperm during intercourse, preventing the sperm from entering the uterus and fertilizing an egg. The effectiveness rate of the condom ranges from 88 to 98% depending upon consistent and correct use. Greater protection against pregnancy is possible when a condom is used with a vaginal contraceptive, such as a spermicide, a sponge, diaphragm or cervical cap. Latex condoms can help protect against sexually-transmitted diseases, including HIV, the virus that cause AIDS.
The Female Condom
The female condom is a birth control device that fits inside the vagina. It is made of pre-lubricated polyurethane, and is available over the counter without a prescription. The female condom prevents pregnancy by containing sperm during sex, so that sperm cannot enter the uterus and fertilize an egg. Insertion is similar to inserting a diaphragm. The closed end covers the opening of the cervix and the open end stays outside of the vagina, held in place by an outer ring. The female condom can be inserted up to eight hours prior to intercourse.
The effectives rate of the female condom ranges from 75% to 87%, depending upon consistent and correct use.
The Vaginal Contraceptive Sponge is a small, disposable plastic (polyurethane) foam device measuring approximately five centimeters in diameter. The sponge can be purchased in a drug store without a prescription.
Prior to sex, the sponge is inserted into the vagina over the cervix, and prevents sperm from entering the uterus and fertilizing an egg. Spermicide, which kills sperm or leaves them inactive, is released from the sponge for up to 12 hours while the sponge is in place.
The effectiveness rate of the sponge ranges from 72% to 82%.
Vaginal spermicides include creams, jellies, foams and vaginal inserts or suppositories. Vaginal spermicides are sold in drug stores without a prescription. Spermicides contain a small amount of a chemical that kills sperm or makes them inactive. This prevents the sperm from entering the women’s uterus and fertilizing an egg. The spermicide is put into the vagina before intercourse.
The effectiveness rate of spermicide ranges from 79% to 97%, depending upon consistent and correct use, and use with another barrier method. The best results are achieved when vaginal spermicides are used with another barrier method, such as a condom, diaphragm or cervical cap.
The intrauterine device (IUD) is a T-shaped plastic device that is inserted into the uterus. The insertion of an IUD is a simple procedure performed in a doctor’s office. IUDs have a thread that hangs down from the uterus into the vagina, which enables women to ensure that the device is still in place after each menstrual period. The IUD contains copper and prevents pregnancy by causing a reaction within the uterus, so that a fertilized egg cannot be implanted. The effectiveness rate of the IUD ranges from 97% to 99.2%, depending upon correct insertion and the type of IUD. Some IUDs can be left in place for up to four years, while others must be replaced annually, or when desired.
Essure is a new method of permanent birth control that is a lower impact approach that is gentler on your body. The Essure procedure involves placing a small, flexible device called a micro-insert into each of your two fallopian tubes (the tubes where your eggs travel from your ovaries to your uterus.) The micro-inserts are made from materials that have been well-studied and used successfully in heart and other surgeries for many years. Once the micro-inserts are in place, your body tissue grows into the micro-inserts, blocking the fallopian tubes. Blocking the tubes is intended to prevent sperm from fertilizing the egg, thereby preventing pregnancy. Your doctor will be able explain the procedure to you in more detail.
Dr. Roy Jackson, Canadian board certified obstetrician gynecologist and pioneer in endoscopic gynecological procedures is currently a consultant to Conceptus Inc. Conceptus Inc. based in California is developing the Essure procedure. This is a medical procedure designed to provide a non-incisional alternative to tubal ligation, the leading form of birth control worldwide. The Essure procedure is a non-incisional permanent birth control method. In the United States it is predicted that in 2003 surgical tubal ligation and vasectomy which combined will account for more than 1 million procedures in the United States.