Health & Fitness

Doc Talk: Consult physician for contraceptive advice

Planning pregnancy is much easier and less costly than ever before. Contraceptive methods have improved considerably in recent years, offering more and safer options. Old ideas and rumors still persist about contraception, so it's important to get accurate and up-to-date information before selecting a birth-control method.

When it comes to learning about which type of contraceptive is best, a woman's best source is her physician. While many types of contraceptives carry risks, they also can provide benefits in addition to pregnancy prevention.

First and foremost, remember that contraceptives do not protect against sexually transmitted diseases (STDs), with the possible exception of the condom. Latex condoms, used correctly, may protect against STDs. Condoms made of animal membrane, as well as non-latex condoms, do not protect against STDs. The only 100 percent guarantee against STDs and pregnancy is abstinence.

Aside from the condom, "The Pill" is perhaps the best known form of contraception. Since birth control pills were first developed in the 1950s, they have undergone significant changes. There are two types of pills. One is a combination of the hormones estrogen and progestin. The other type contains only progestin.

These hormones work by preventing the formation of eggs or changing the lining of the uterus so that an egg cannot implant and grow. They are generally considered safe and effective.

Hormones can be delivered through other routes, as well. The Depo-Provera shot contains only progestin and is effective for three months. The Mirena intrauterine device is a progestin-containing hormonal product that is inserted into the uterus and is effective for five years or until it is removed by a physician. Implanon is a small rod, about 1 1/2 inches long, that is inserted under the skin of the upper arm. It also contains progestin and is effective for three years. Mirena and Implanon are inserted at the physician's office.

Contraceptive hormones also can be delivered through skin patches or vaginal rings. These are easily placed and removed at home and provide similar effects as the oral contraceptive pill but require less frequent administration.

There are other benefits other than contraception that these products can provide.

Hormone-based contraceptives can decrease the amount, length, and frequency of menstrual periods and are often prescribed for women who have heavy or painful periods. Some pills can eliminate periods altogether.

In the past, physicians thought eliminating periods was not healthy, but recent studies show there is no problem with eliminating periods.

Hormones, however, can carry risks, especially for women who have high blood pressure, a history of blood clots, stroke or heart attack, women who smoke and those over age 35. Uncomfortable side effects can include, but are not limited to, headaches and mood changes.

For women who want or need to avoid hormonal contraception, there is an alternative to condoms and other barrier contraceptives. The Paragard copper intrauterine device is a nonhormonal intrauterine device that contains copper. This type of IUD does not affect ovulation or the menstrual cycle.

Copper IUDs are thought to work by preventing the sperm from reaching the egg. In addition, if an egg should become fertilized, implantation on the wall of the uterus is prevented because copper affects the lining of the uterus. It is believed that these effects are enhanced by a small but continuous release of copper into the uterus. This type of IUD can be effective for up to 10 years and has a low risk of side effects.

IUDs gained a bad reputation for a short period of time because of an increased risk of infection. Today's IUDs are made very differently and are much safer. They are an effective alternative for many women who want to minimize the systemic effects of hormones and cannot or prefer not to use hormone-based contraceptives.

Other types of contraceptives include the diaphragm and its newer cousin, the cervical cap. Both fit over the cervix and block the sperm from entering the uterus. Both must be used with a spermicide, which is a tablet, foam, cream, jelly or film that kills sperm. These must be fitted for each individual.

Every woman is unique and has different preferences when it comes to birth control. With so many options available, it is likely that she and her doctor can find a method she is comfortable with.