Contraception

Dr. Catherine Wheeler, Gynecologist practicing at St. Mark’s Center for Women’s Health, goes over the important questions concerning birth control. Certain forms of contraception can treat gynecological issues as well as provide birth control. Dr. Wheeler discusses the risks, common concerns and options surrounding contraception.

I think one of the most important things is how sure do you wanna be about not getting pregnant. That’s probably the most important question to ask yourself you also ought to consider the cost ,a lot of people consider how reliable they can beat using a contraception. For a lot of women,they can’t remember to take a pill every day, or they won’t remember to use a condom or some other method while they’re having sex.

So you wanna consider all of those things. You also wanna think about,is there anything else I’m trying to treat with this,for example birth control pills, certain IUDs can treat heavy periods, cramping, in addition to giving good contraception. You also wanna think about methods that have worked well for you in the past. You wanna think about certain health conditions that you might have, that may be a contraindication to certain medication, or that may interact with certain medication.

Birth control pills these days are actually very, very, safe. There are a lot of different types of hormones with different risk factors,but all of them are safer than being pregnant actually. And most women these days don’t know that, The biggest risk of being on hormonal contraception,like birth control pills, is blood clots, but those are extremely rare. About one in every 2,000 women will have one of those events, so really very rare,and if that’s a concern you should talk to your provider about it.

The IUDs that are now available are again,safer than being pregnant,with very low risk for infection or other problems.  The new data on IUDs is that actually, they cause about the same amount of infections or less infections than in the population not using them. So really the old concerns about getting infections that caused infertility are really no longer there with IUDs.

Birth control pills and other hormone contraceptives actually protect fertility.  That is one of the most common concerns I hear,and it’s really surprising to me when I hear it. I think the majority of women think, for some reason, that they’re gonna trouble getting pregnant. But half of women have unplanned pregnancies,which means they didn’t think they would get pregnant, but it tells you how often we get pregnant easily. In fact 85% of us within a year will be pregnant if we don’t use contraception.

After most contraceptives,people are actually fertile immediately,depending on the type of contraception. There are rare types of contraception,such as a shot with progesterone called Depo-Provera,where delays in pregnancy can be anywhere from three months to two years, but the majority of contraceptives, people go off them and they’re immediately fertile.  Well, one of the things you wanna consider is, is there a circumstance in your life, where even though you don’t think you’re gonna have more kids,you might change your mind.

So when we talk about sterilization, whether it’s vasectomy or plugs inside your fallopian tubes, which is called Essure, or tying women’s tubes, those really are considered permanent sterilization,and if you decide to do that,you need to go into that planning I really don’t think I’m gonna have more kids, I’m gonna count on that. Other options include IUDs, and we now have two types of IUDs which are very highly effective.

We also have all kinds of hormonal contraception,meaning there are hormones in them to try to protect you from getting pregnant. And they include certain types of birth control pills,there are patches, there are injections,there are even little cartridges that go underneath your arm and last for three years. When you consider how you’re gonna choose to not get pregnant, I think the most important thing is,what’s most comfortable to me,and how much do I want to try to avoid pregnancy. A lot of women have fears about contraceptives, or they’ve heard things which may or may not apply to them,or may or may not be true,so I really strongly encourage women to have full conversations with their providers about all choices that are available, and the pros and cons.