Contraception: knowing all of your options

More than 95% of Latina women who have ever been sexually active have used some form of birth control[1]. Using contraception to plan your pregnancies and space them apart can improve your health and the health of your children. There are many forms of contraception, and knowing all of your options will help you choose a method that you are able to consistently use. This gives you the best chance of only getting pregnant when you plan to.  Having so many options also means that if one form doesn’t work for you, you and your doctor can find a different one that does. No matter what method you use for birth control, remember that condoms are the only way to prevent the transmission of sexually transmitted diseases. And, if you have unprotected sex or your contraceptive method fails, you can use emergency contraception. You can get emergency contraception pills directly from your pharmacy if you are over the age of 17, or by prescription at any age. The Plan B pill  (over the counter) can be taken up to 5 days after sex but is more effective in the first 3. Ella (prescription only) is fully effective for up to 5 days.

 

1. Permanent Methods are surgical and are >99% effective

• Vasectomy (male)
• Tubal ligation (female)

2. Long-acting reversible contraceptives(LARC) can prevent pregnancy for a long period of time- months or even years- without requiring you to take any additional action. LARC methods are also >99% effective, and are quickly reversible.

• Intrauterine devices (IUDs) – IUDs are small T-shaped devices that are inserted into the uterus during an office procedure by your doctor. They can be used by all women, even those who have never had children and they remain in the uterus and prevent pregnancy for up to 5 years (Mirena) or 10 years (Paraguard) but can be removed at any time.  The Mirena IUD contains a hormone and your periods become shorter and lighter or disappear completely. The Paraguard IUD contains copper, and is less likely to lighten and shorten your periods. These IUDs do not cause infections like pelvic inflammatory disease. However, for the first month after getting one inserted, you are slightly more vulnerable to infection and should use a condom.
• Implant – The implant (Nexplanon) is a small plastic hormone-releasing rod that is inserted under the skin in your upper arm during a short office procedure by your doctor. It can remain in place for up to 3 years but can be removed at any time. The implant can cause some women to have irregular bleeding or spotting, and some women to not have periods at all.

3. Injection. The birth control shot (Depo-provera) is a hormone injection that you get in your doctor’s office every 3 months. If you are able to get every shot on time, the birth control shot is just as effective as the LARC methods. The shot can cause some women to have irregular bleeding or spotting, and some women to not have periods at all.

4. Combined hormonal methods contain two hormones. These methods are slightly less effective than the LARC methods (91-95% for most women)- although if used perfectly are 99% effective.

• Oral contraceptive pills are taken by mouth at the same time every day. Many formulations are available, and you can have periods every month, a few times a year, or never. There are also some pills that contain only one hormone that are safe for women who are breast-feeding.
• Patches are applied to the skin, and you change them every 7 days.
• The Ring is a small plastic ring inserted into the vagina that you change every 3 weeks.

5. Barrier methods are less effective, around 75-85%

• Male condoms must be put on each time you have intercourse, and removed immediately afterwards. Female condoms are inserted into the vagina and you can wear them for several hours before intercourse occurs.
• Diaphragms and cervical caps are reusable devices that are inserted into the vagina and can be worn for hours before intercourse. Diaphragms and caps are specially fitted for you by your doctor.
• Sponges are disposable devices that are inserted into the vagina and an be worn for hours before intercourse

6. Some methods for preventing pregnancy are less effective. These methods have failure rates that are >25% as most people use them

• Withdrawal
• Spermicide (a cream, foam or gel inserted into the vagina before intercourse)
• Fertility awareness (abstinence during fertile parts of your cycle)

For more information, see the following websites, talk to your doctor, or visit a clinic that specializes in reproductive health.

plannedparenthood.org (in Spanish)

bedsider.org

Erin Bulleit biography:

Erin Bulleit is a third year medical student at the University of Rochester. Before coming to the Finger Lakes region, she lived in Baltimore, MD and Madison, WI. She is interested in Family Medicine and providing accessible primary care and women’s health care for diverse urban populations. She is a member of  the Latino Medical Student Association, a national organization whose mission is to educate and advocate for the health needs of the Latino community. LMSA members, including herself, are looking forward to continuing to contribute to CNY Latino and raising awareness regarding the many health issues affecting the Latinos of Central NY and beyond.