Which birth control is right for me?

When thinking about birth control methods it is important to find something that fits your personality. Are you the meticulous person that will remember to take a pill every day. Or are you the person who needs an implantable device because you would lose your fingers if they weren't attached to your body?

Key things to remember when talking to your health provider:

• Discuss your health issues with the provider; He or she should already be probing into that issue BUT you take control of your healthcare by making sure. In particular, a personal history of blood clots (i.e. deep vein thrombosis), uncontrolled hypertension, stroke, severe migraines with any type of neurologic component, smoker over the age of 35, history of breast or endometrial cancer means stay away from OCP's (oral contraceptive pills)

• Have the provider discuss the full range of birth control options

• Have the provider discuss failure rates of the particular birth control method with you

Here is a quick list of the the more popular birth control types and my preference when it comes to prescribing them to my patients. This is based on failure rate. Failure rate is greatly influenced by how much work the patient has to do.

For the FAILURE rate: the number represents the how many pregnancies will happen in 100 women per year.

IUD (intrauterine device) [Mirena and Paraguard]: These are 5 and 10 year birth control devices (respectively). The Mirena is coated with a type of progesterone and the Paraguard is a cooper based mechanism. The IUD is inserted by your provider in the office. It can be crampy for the first 24 -48 hrs. In addition the device can cause irregular bleeding for about 6wks (on average) but up to 3 -4 mos. FAILURE rate <1

Nuva Ring: This is a contraceptive ring that is inserted by you once a month. The ring stays in the vagina for 3 weeks and then comes out for 1 week to start your menses. The issue I see with some patients is getting over the idea of having something in the vagina. The ring is to be worn at all times (most importantly during sex). If the ring is in the vagina comfortable then it is in correctly. The medicine is released by heat and moisture both of which the vagina has plenty. FAILURE rate 1-2

The patch (Ortho Evra): This a patch much like the smokers wear. It is placed on the skin (avoiding the breasts and waist) and the medication is absorbed through the skin. It needs to be changed weekly for 3 weeks and the fourth week is patch free and when your menses should start. The main complaint with the patch is that of skin irritation. FAILURE rate 1-2

OCP’s: The number of birth control pills available is enormous. The key is finding a pill that doesn’t cause you much breakthrough bleeding. ALL birth control pills help with acne so don’t let that influence your choice. Most women let the provider choose for them which is o.k. FAILURE rate: 1-2

Depo Provera: This is a 3 month injection of progesterone. Patient either hate this or love it. The love it group doesn’t have any side effects and no cycle while on the shot. The hate it group has hair loss, weight gain, and 3 months of irregular/constant vaginal bleeding. FAILURE rate <1>

Male condoms: Well, the condom is only affective as the man using it. The plus side is that condoms reduce your risk of STD exposure. The downside is that the FAILURE rate is 11.

Spermicides: Any of the foams, gels, creams. FAILURE rate is 20 - 50

Pull and pray: Need I say more FAILURE rate 20

Just getting started with the blog thing. If you have questions go to my web site www.horizonswomens.com and drop it off there.