LCHM Winter18 - 23
L C M E D S O C .O R G
Contraception is key in preventing unintended pregnancy and promoting safe
motherhood, but choosing the method that
is right for you can be overwhelming. Let's
have a look at some of the most popular birth
THE LONG-ACTING REVERSIBLE
Long-acting reversible contraceptives
include the intrauterine device (IUD) and
contraceptive implant. These methods are
extremely effective and low maintenance.
The IUD is a small, T-shaped insert that
is placed into the uterus by a healthcare
professional. Some IUDs release progestin,
while others are made of copper. The IUD
is a reversible form of contraception that
can last from three to 10 years, depending
on the specific type. When used for its full
lifetime, the IUD is extremely cost-effective
compared to other forms of contraception.
A poorly designed IUD led to increased
risk of pelvic infections during the 1970s,
resulting in decreased use. Research, however,
has verified that today's devices are very
unlikely to cause pelvic inflammatory disease,
regardless of whether women were screened
beforehand for gonorrhea and chlamydia.
An IUD cannot be placed in women with
an ongoing pelvic infection. With these
developments, the rate of IUD use in the
United States quadrupled between 2002 and
2012, and continues to rise.
The implant is a small progestin-releasing
device that is inserted into the upper arm,
providing three years of contraception. The
insertion and removal procedures can be done
in an office with local anesthetic. It is highly
reliable, as less than 0.05% of women using
this method will become pregnant in one year!
IS KEY IN
THE HORMONAL CONTRACEPTIVES
Hormonal contraceptives are delivered
into the body by oral pill, injection, patch,
or ring. They stop pregnancy by thickening
cervical mucus, which prevents the movement
of sperm. They also prevent the release of an
egg during ovulation.
Oral contraceptive pills must be taken daily
and include either a combination of estrogen
and progesterone, or progestin alone. While
pills are said to be 99% effective, there is a 9%
failure rate because effectiveness depends on
taking the pill every single day.
Administered every three months by a healthcare professional, it is a low-maintenance option.
However, failing to get repeat injections on
time contributes to a 6% failure rate. Both
the Depo-Provera and the progestin-only oral
contraceptive pill, also called the "mini-pill,"
do not affect a woman's ability to breastfeed.
The birth control patch and ring continuously deliver estrogen and progesterone. The
patch is placed on an area of the body such as
the abdomen or leg, while the ring is inserted
directly into the vagina. Both the patch and
the ring are replaced monthly, with a failure
rate of 9%.
Increased risk of failure is due to the patch
falling off, improper reinsertion of the ring,
or not replacing either on time.
THE BARRIER METHODS
The barrier methods work by creating a
physical or chemical barrier for sperm. They
include male and female condoms, spermicides,
diaphragm, and cervical cap. The failure rate
of these methods varies, ranging from 18 to
28%, which is significantly greater than the
Male condoms are critical for reducing
the risk of sexually transmitted infections
(STIs), for which the long-acting reversible
contraceptives and hormonal methods are not
effective. While barrier methods are effective in
A benefit of oral contraceptives is that they preventing STIs, they must be used correctly
can be easily started or stopped. Women can every time to reduce transmission of STIs and
start and stop taking the pill while maintain- prevent pregnancy.
ing the same level of fertility as women who
were not on contraceptives. Additionally, the
Combining two contraceptive methods,
formulation can be adjusted if side effects arise. such as a condom with a spermicidal agent
or a barrier method and one of the hormonal
A limitation of the pill is that it cannot be methods, increases effectiveness.
used in women over the age of 35 who smoke
cigarettes, due to increased risk of blood clots.
This Valentine's Day, show some love for
contraception by learning more. Talk with
The progestin hormonal injectable is com- your doctor about the best contraceptive
monly known by its brand name, Depo-Provera. option for you.
More information can be found at
WINTER 2018 | Lehigh County Health & Medicine 23
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