Since we are in an election year and this always seems to be a hot topic in the media I thought it a good time to revisit contraception. It is a wonderful and amazing option for women and men to be able to choose children, and to me quite disappointing that as a country we cannot come together to promote the ideas of family planning. Because the topic of abortion is so politically charged I think we forget that a secondary casualty of anti-abortion policy is the basic right and access to birth control. Preventing unintended pregnancy is a communal effort, so please pass along any or all information to someone who would benefit from being informed of their choices.
Most of us are familiar with the trusty old birth control pill. There are two main hormones in most birth control pills. Estrogen in the form of ethinyl estradiol and a progestin (a synthetic form of progesterone) of which there are a great variety, and each has a slightly different activity. There are also a variety of choices with the amount of hormones in pills. Some are the same all month long, some get stronger as the month progresses which somewhat mimics our natural rhythm; and then there are some pills which have no estrogen at all and just use the progestin. All these choices give both the patient and the provider a nice variety of options to create a workable match. The major downside of pills are the side-effects (which of course all methods have), and the fact that you have to remember to take it daily.
Some of the newer contraceptive methods have unique deliveryÂ systems, and are invaluable for those who have trouble remembering aÂ daily pill.Â My personal favorite is the NuvaRingÂ (www.nuvaring.com).Â This is a small (2 inch diameter, 4mm thick)Â flexible ring made of an ethylene vinylacetate polymer impregnatedÂ with ethinyl estradiol and a progestin (desogestrel) whichÂ is inserted into the vagina for 21 days and removed for 7.Â ItÂ delivers a steady release of low-dose hormones throughout the 21Â days.Â Side-effects seem to be minimal with complaints of increased vaginal discharge/ irritation, and sexual partners being able to feel it during intercourse.Â Another method which offers a uniqueÂ delivery option is the patch OrthoEvra (www.orthoevra.com).Â TheÂ patch is a nude colored adhesive impregnated with ethinylÂ estradiol and a progestin (norelgestromin).Â With this method oneÂ patch is applied weekly for 3 weeks, and week four is patch free.Â Â Common complaints with this method are irritation/rash at theÂ adhesive site, breast tenderness, and trouble with patch staying fullÂ adhered to the skin.Â This method has the potential for higher estrogen levels than most others, which for some women can be a problem, so consult your provider. The next method is Depo-Provera (www.depoprovera.com).Â This is a progestin-only method; a smallÂ intramuscular injection of medroxyprogesterone acetate is given onceÂ every 12 weeks.Â There are often complaints of irregular bleedingÂ (especially the first 6 months), significant weight gain, depression, andÂ resuming fertility can take up to 18 months after discontinuing use.Â Â The FDA placed a black box warning on this method to inform patientsÂ and clinicians of the risk of bone mineral density loss while usingÂ this method for more than 5 years. Finally, there is once again a contraceptive which can be implanted under the skin via injecting a small rod (3mm by 40mm) into the inner upper arm. Called Implanon (www.implanon.com) this is a 3 year progestin (etonogestrel) only method.
IUDâ€™s (Intrauterine devices) are experiencing a come-back, andÂ the interest in these small T-shaped systems of contraception continues to rise.Â The use of IUDâ€™s were often recommended to women who hadÂ already had children, but new guidelines haveÂ broadened potential recipients.Â Â There are currently 2 typesÂ available.Â The first is the copper IUD (ParaGard, www.ParaGard.com)Â this is a completely hormone free method offering 10 years ofÂ contraceptive protection.Â The second is a progestin only containing IUS (Mirena an Intrauterine System, www.mirena.com) whichÂ offers 5 years of contraceptive protection.Â The IUD/IUS must beÂ inserted into the uterus by a licensed practitioner.Â Most commonÂ complaints are discomfort during insertion, and irregular bleeding. These devices are easily removed in advance of recommended use.
The final birth control option worth mentioning is continuous use birthÂ control.Â Continuous use can be recommended for those who haveÂ problems with heavy bleeding, cramping or other PMS type issues, asÂ well as for athletes and special occasions like a honeymoon. Continuous use can be achieved with some pills or the NuvaRing, andÂ is basically the idea that there is no 7 day break between takingÂ hormone containing pills or changing rings.Â Research shows that thisÂ method of use is safe and effective, as well as FDA approved.Â UsingÂ your contraceptive method in this manner should be done only with theÂ approval of your health care provider.Â For more informationÂ consult with your provider or visit www.noperiod.com.
Now for you men, there is indeed a method for you tooâ€¦vasectomy! And guess what? Federal dollars from the family planning department now include a way for you to receive a free or reduced fee vasectomy, check with your local health department or planned parenthood for details. Yes this is a permanent method. It involves a simple outpatient procedure which severs the vas deferens, stopping semen from exiting during ejaculation. There is still an ejaculatory fluid released, but no sperm. What happens to them? They get stuck at the dead end and are reabsorbed into the blood stream.
As a naturopath I get two common questions regarding birth control. What are the hormone free options and what do I recommend to women taking hormonal birth control? Hormone free options are condoms, diaphragms, ParaGard IUD, vasectomy, and Cycle Beads (these are pretty cool, an easy way to track your fertile cycle days IF you have regular periodsâ€¦check out their website www.cyclebeads.com). Any hormonal birth control method can deplete B vitamins, so I recommend a good multi or B complex vitamin to be taken daily with food.
All of the aforementioned methods have their own risks andÂ necessary screening before use.Â And of course none of these areÂ protection against STDâ€™s (now called sexually transmitted infections, STIâ€˜s); for that use a condom!Â If any of theÂ aforementioned contraceptive methods are of interest to you check into theÂ websites given as well as seeking the guidance of a health careÂ professional versed in their use.Â Two other websites worthÂ mentioning are www.plannedparenthood.org and www.fwhc.org, they bothÂ give a comprehensive overview of the options available. Be thankful for your right to choose!
DO something you love, BE with someone you love, EAT your vegetables, DRINK clean water, BREATHE deeply and MOVE your body EVERYDAY!