Birth Control

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What is birth control?

Birth control refers to any activity, medication, or equipment used to prevent pregnancy. There are many types of birth control available for women who do not wish to become pregnant. The decision on which method is right for you should be made with your physician, as well as with your partner.
Birth control methods work in different ways to prevent pregnancy, including the following:

-creating a barrier that blocks sperm from reaching the egg
-killing sperm
-preventing eggs from being released by the ovaries
-changing the cervical mucus to hinder sperm from moving into the uterus
-altering the tissue lining the uterus so that a fertilized egg cannot implant
What are the different types of birth control?

Some methods that do not require a prescription from your physician include the following:

abstinence - not having sexual intercourse.
spermicides - foams or creams placed inside the vagina to kill sperm; these may also provide some protection against sexually transmitted diseases, especially when used with a latex condom.
male condoms - a thin tube made of latex or a natural material that is placed over the penis. The sperm is collected in the end of the condom. Latex condoms may provide some protection against sexually transmitted diseases.
female condoms - a liner made of latex or natural material that is placed inside the vagina. Latex condoms may provide some protection against sexually transmitted diseases.
natural family planning - timing intercourse to avoid “fertile” days using various methods of monitoring body temperature, watching for changes in cervical mucus, and the use of ovulation prediction kits. This method, often known as the “rhythm” method, has a high risk for pregnancy.
Some methods that require a prescription include the following:

oral contraceptives (birth control pills) - medications taken daily that prevent ovulation by controlling pituitary hormone secretion. Usually, oral contraceptives contain the hormones estrogen and progestin. Some types are progestin-only.

In addition to prevention of pregnancy, oral contraceptives have several health benefits including regulating menstrual cycles and decreasing the amount and length of menstrual periods. This can help increase iron stores in women with iron deficiency associated with excessive bleeding. Prevention of certain ovarian and endometrial cancers is a significant benefit of the use of oral contraceptives. Some research has found that some benign (non-cancerous) breast diseases, including fibroadenoma and cystic changes, occur less frequently with the use of oral contraceptives. Recent studies have also suggested that oral contraceptive use may reduce the occurrence of severe disabling rheumatoid arthritis.

mini-pill - unlike the traditional birth control pill, the mini-pill has only one hormone, progestin. Taken daily, the mini-pill thickens cervical mucus and prevents the sperm from reaching the egg. The mini-pill also can decrease the flow of your period and protect against PID and ovarian and endometrial cancer.
Norplant/Implants - capsules containing the synthetic hormone levonorgestrel, implanted under the skin in the upper arm of a woman, which continuously prevent the ovaries from releasing an egg for up to five years. Anesthesia is required for insertion and removal of this type of birth control.
Depo-Provera - a progesterone-like drug given by injection to prevent pregnancy by stopping ovulation. The effects last for about three months and another injection must be given to continue birth control effectiveness.
monthly injections - a new type of contraceptive that combines two types of hormones, estrogen and progestin, in a monthly injection. These hormones work to prevent ovulation and continue regular menstrual periods. The injection must be repeated every 28 to 33 days to be effective.
patch - this is a skin patch worn on the body that releases the hormones estrogen and progestin into the bloodstream. It is most effective in women who weigh less than 200 pounds.
diaphragm or cervical cap - a dome-shaped rubber cup with a flexible rim that is inserted through the vagina to cover the cervix. This type of birth control must be inserted prior to having sexual intercourse.
hormonal vaginal contraceptive ring - a ring that is placed inside the vagina around the cervix. The ring releases the hormones estrogen and progestin.
intrauterine device (IUD) - devices placed in the uterus through the cervix by a physician. The IUD works by preventing an egg from being fertilized in the tubes or from attaching to the wall of the uterus. IUDs containing hormones must be replaced annually, while copper IUDs can last up to 10 years.
intrauterine system (IUS) - the IUS is a small T-shaped device that is placed inside the uterus by a physician. It releases a small amount of hormone each day to prevent pregnancy.
Essure- a thin tube is used to thread a tiny, spring-like device through the vagina to the uterus into each fallopian tube. A material in the device causes scar tissue to develop and permanently plug the tubes.
Surgery that results in the inability to become pregnant includes the following:

hysterectomy - removal of the uterus and usually the ovaries and fallopian tube. This is a permanent form of birth control.
tubal ligation or tubal occlusion (”tying the tubes”) - surgery to cut, cauterize, or band the fallopian tubes to prevent the egg from being transported to the uterus. Tubal ligation is designed to be a permanent method of birth control. Although certain types of tubal ligations can be reversed, the reversal procedure may not be successful.
vasectomy - cutting or clamping the vas deferens, the tubes that carry the sperm from the testes - are blocked. The testes still produce sperm, but the sperm die and are absorbed by the body. This is a permanent male birth control measure.
Methods that have been suggested as preventive, but may actually present a high risk for pregnancy include the following:

-withdrawal before ejaculation
-sexual intercourse during menstruation
-standing up immediately after sexual intercourse
-douching after sexual intercourse
Can’t remember to take the pill or need something longer term?

1. Intrauterine Device (IUD)

The intrauterine device, also know as “IUD”, is the most popular form of reversible birth control in the world with more than 85 million women users. An IUD is a soft flexible “T-shaped” plastic device that is inserted into the uterus to be used for contraception. The device is inserted and removed at separate office visits. The IUD is one of the safest, most effective and private methods of birth control.

Effectiveness: IUDs offer a very effective, safe, and hassle free contraception option and they last for a very long time.
Pregnancy: The ability to become pregnant returns quickly when IUD use is stopped.

There are two IUDs currently on the market in the USA:

a) The Mirena® IUD
Offers 99.9% effective birth control for up to 5 years. This device has a small amount of progestin hormone on it that usually makes your period lighter, and in some cases stops your period. Women tend to like these lighter periods on this IUD. Some women may experience irregular and/or heavier periods for the first 3 to 6 months after insertion but this usually resolves with ongoing use.

b) The ParaGard® IUD
Offers 97%-99% effective birth control for up to 10 years. The device is non-hormonal and has a small amount of copper on it. Occasionally women may have heavier periods on this IUD.

2. NuvaRing®
NuvaRing® is a once a month contraception. It is a comfortable, flexible contraceptive ring that prevents pregnancy by releasing a low dose of hormones. The ring need only be replaced once every four weeks - it is left in place for three weeks and taken out for the remaining week each month. Many women who use the vaginal ring have more regular, lighter, and shorter periods.

Effectiveness: Less than 1% of women will get pregnant each year if they always use NuvaRing® as directed and less than 8% will get pregnant each year if they don’t always use NuvaRing® as directed.
Pregnancy: If you decide you want to become pregnant, stop using NuvaRing®.

3. Depo-Provera®
Depo-Provera® is a birth control shot that is administered in the arm and lasts three months so you only have to think about it four times a year (every 12 weeks). The birth control shot does not contain estrogen, another type of hormone that is in many types of birth control, including the pill, patch, and ring. This means the shot can be a good choice for women who cannot take estrogen and for women who are breastfeeding. For most women, periods become fewer and lighter. After one year, half of the women who use the birth control shot will stop having periods completely. Some women have longer, heavier periods. Some women have increased spotting and light bleeding between periods.

Effectiveness: Less than 1% of women will get pregnant each year if they always use the birth control shot as directed and less than 3% of women will get pregnant each year if they don’t always use the birth control shot as directed.
Pregnancy: Because the birth control shot is long lasting, it can take a long time to get pregnant after getting your last shot - anywhere from nine months to more than a year. So, Depo-Provera® is not a good birth control method for you if you are thinking of getting pregnant soon.

For more information check out Savannah gynecologist.

Joe Edwards, M.D. is a Savannah gynecologist who enjoys writing about health issues that affect women. Check out his website Savannah OBGYN.

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Modern Birth Control Methods

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Deciding What Birth Control to Use

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Birth control is an important practice to many people, as without any form of it, there would be no way to prevent unwanted pregnancies. There are over a dozen forms of birth control, and while all have about the same rate of prevention, some methods are much easier to use than others. Every form of birth control has its own advantages and disadvantages, and before deciding on which one to use primarily, all types should be considered.

There is one birth control method that is 100% effective all the time. As you can probably guess, that method is abstinence. It is impossible to get pregnant if you are not having sex, and that truth is as old as the animal kingdom itself. Unfortunately, the point of contraception is to be able to engage in sex without the risk of pregnancy, so abstinence is ultimately not a good path for an adult.

Another method exists which does not involve the use of any special apparatuses. This is the natural family planning method, which involves the woman measuring her body temperature every day and checking for changes in cervical mucus. By finding these values, the time of ovulation can be calculated, and as long as sex does not occur during ovulation, pregnancy will not occur. However, this method is difficult to follow for working adults, and involves a moderate amount of work. It also is not 100% accurate, as many factors can affect body temperature besides ovulation.

The most common and well known form of birth control is condoms. Condoms require no work on the woman’s part, and are instead used each intercourse session by the male. This particular barrier method has come a long way from being simple pieces of latex. There are now several varieties of condoms, and new variations are coming out every year. Makes sense, since condoms are the most popular barrier method, and sales of the product reach tens of millions of dollars a year.

Several devices can be inserted over the cervix to act as barriers to sperm and release spermicide. These include the diaphragm, contraceptive sponge, and cervical cap. All of these devices are similar, but many women prefer some options over others due to personal preferences.

Finally, there are the permanent solutions to birth control. For the male, the common surgery is the vasectomy. In a vasectomy, the vas deferens (which is the sperm transportation route) is severed from the urethra, so when semen is released, there is no sperm present. This is a very effective surgery that rarely has negative side effects, and in the case one decides they do want to have children, the surgery can be reversed.

The female version of a vasectomy is a tubal ligation. In this procedure, the fallopian tubes are closed shut so no eggs can be released in to them. Without any eggs, fertilization and pregnancy cannot occur. In a marriage, there is often debate about whether who should get the permanent surgery, as it is only required that one partner get it.

The male should logically always be the one to get surgery, as the incidences of death or accidents are much lower in vasectomies than in tubal ligation. In any surgery there are risks, and although they are small, it is better to be safe than sorry.

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So What Will You Use For Birth Control ?

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There are two major methods of birth control namely barrier or hormonal. Aside from that, the other types include sterilization otherwise known as surgery, withdrawal, natural family planning and the simplest which is abstinence.

Lets talk about each of them.
The first is the barrier method wherein the male or the female uses a condom to prevent the sperm from ever entering the female uterus. The male condom comes in many brands, color and flavors and is usually made of latex rubber. This is placed over the penis when it is erect prior to intercourse.

The female condom on the other hand is made of polyurethane and is seven inches long. This allows it to protect the cervix, vaginal canal and the immediate areas surrounding the vagina. It is inserted into the womans vagina also prior to intercourse.
Contraception is a term used to prevent pregnancy. There are different types of them around. As Above some are used by men while others are for women.

Another barrier is known as spermicides. It is a chemical designed to kill sperm and this is available as foam, jelly, foaming tablet and as a vaginal suppository.

You also have the diaphragm that is a soft rubber dome which stretches over a flexible ring that contains spermicides in the form or cream or jelly.

This is placed inside the womans vagina and placed over the cervix. Women should take note that this should not stay inside for more than 3 hours prior to intercourse.

The cervical cap is a small cup made of the same material as a condom. It is also filled with spermicidal cream and inserted into the girls vagina and placed over the cervix.

The last is the contraceptive sponge which is a soft saucer shaped device made from the same material as the female condom.

Now that we have discussed the different barriers, it is time to discuss about hormonal birth control methods.

Hormonal devices appear in the form or an implant, patch, pill or shot. They are designed to prevent the woman ovaries from releasing an egg monthly, cause the cervical mucus to thicken so the sperm will have a difficult time penetrating the egg or thin the lining of the uterus which reduces the chances of a fertilized egg from ever implanting on the uterus wall.

Some experts believe that they are very effective but they cannot protect you from sexually transmitted diseases or STD.

Birth control pills can be acquired from your health provider. Depo-Provera is an injection that costs a little bit more than the pill and can prevent pregnancy for 3 months. Something similar to Depo-Provera is lunelle but this can only prevent pregnancy for up to one month.

The Nuva Ring or vaginal ring is a flexible ring that is inserted into the vagina for three weeks before this is removed and replaced with a new one. The ring contains chemicals such as estrogen and progesterone that releases this into the body.

The birth control patch works like the ring as it releases hormones into the body while the IUD is a small plastic device that contains hormones and copper and changes the cervical mucus to decrease the chances of an egg from fertilizing.

Withdrawal is simply removing your penis out of the girls vagina before ejaculation. Sterilization closes the fallopian tubes permanently and this is better known as tubal ligation. Men can have the same thing and this is called a vasectomy.

Natural family planning is simply controlling the number of kids that you want to have.

Abstinence is not engaging in sexual intercourse at all that is perhaps the most effective type of birth control. Contraception is a term used to prevent pregnancy. There are different types of them around. Some are used by men while others are for women.

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