In part one of this two-part series, Ann L. Honebrink, MD, Medical Director of Penn Health for Women at Radnor, discussed the pros and cons of two main types of contraception for women.
“I try to help people think through their birth control options, depending on what they feel they can do or are able to tolerate as a trade-off for a really great birth control method,” explains Dr. Honebrink.
Your future pregnancy plans matter, too. “If you know you don’t want any more kids, the conversation might change a little bit to thinking about permanent or long-acting contraception,” says Dr. Honebrink.
Here’s a look at two more forms of contraception to keep in mind when trying to find the best birth control for your lifestyle.
Long-Acting Reversible Contraceptives
Long-acting reversible contraceptives include:
- Intrauterine devices (IUDs)
- Contraceptive implants
IUDs are inserted into a woman’s uterus. They rely on either copper or the hormone progesterone to prevent pregnancy. Both copper and hormone-based IUDs stop any sperm from reaching an egg. But hormone-based IUDs can also keep your ovaries from releasing any eggs in the first place.
Contraceptive implants—which are usually placed under the skin of your upper arm—also rely on hormones to keep you from getting pregnant, explains the ARHP.
Pros Of Long-Acting Reversible Contraceptives
The contraceptive implant can prevent pregnancy for three years, according to Dr. Honebrink.
“Depending on which type you use, IUDs get put in the uterus for anywhere from five to 10 years,” she adds. “If it’s in properly and doesn’t fall out, it works wonderfully to keep you from getting pregnant—you don’t even need to think about it.”
IUDs and implants are worth considering for women who want long-term birth control that can be easily reversed when they decide it is time to have children.
“As soon as you stop using them, you go back to being as able to get pregnant as you would be if you didn’t use them,” says Dr. Honebrink.
Long-term protection against pregnancy might also be a good option for women who are approaching menopause.
“If they got an IUD put in when they were 41—depending on the type of IUD—that will last them until they’re between 46 and 51,” says Dr. Honebrink.
Cons Of Long-Acting Reversible Contraceptives
But—as with all methods of birth control—IUDs and implants might not be the right choice for some women.
“Getting an IUD put in is not a walk in the park,” explains Dr. Honebrink. “It’s uncomfortable for a few minutes, and sometimes people have cramping for a while after,” she explains.
“And with the implant that gets put underneath the skin, some women are going to have unpredictable bleeding,” she says.
Permanent Birth Control Methods
Permanent birth control methods include:
- Tubal ligation (getting your tubes tied)
- Nonsurgical sterilization (Essure)
With tubal ligation, a small incision is made to either burn, partially remove, or clip the fallopian tubes. With Essure, a little tiny slinky is inserted through the vagina into the fallopian tube.
The goal of both methods is to make it so that the tubes are no longer continuous. This will prevent the egg and sperm from joining.
Permanent birth control methods are effective 99% of the time.
Pros Of Permanent Birth Control Methods
Procedures and devices like tubal ligation and Essure are irreversible, which make them a good option for women who are absolutely sure they do not want to get pregnant.
Both tubal ligation and the initial Essure procedure can be performed in an outpatient facility—meaning you can typically go home the same day that you have it done, according to the National Library of Medicine (NLM).
Cons Of Permanent Birth Control Methods
While tubal ligation is typically a one-time procedure that works immediately, Dr. Honebrink says that Essure takes a little more time before it is effective.
“While it’s a little bit less invasive to get it done, you need to wait another six weeks to have a test to make sure the tubes are really blocked before you can count on that for birth control,” she explains.
The Essure procedure has other long-term risks, says the US Food and Drug Administration. For instance, the slinky insert might move from the fallopian tubes to the abdomen or pelvis. It might also puncture the uterus or fallopian tubes.
Both forms of permanent birth control come with the risk of side effects during and after the procedure, especially if it is not successful and a woman gets pregnant afterwards.
Knowing When It’s Time To Rethink Your Birth Control
While each of the different kinds birth control has its own pros and cons, most women can find a method that works for them. If you’re experiencing side effects or difficulties with your current method, talk with your gynecologist about trying another method.
“You don’t have to just put up with things.” Dr. Honebrink says. “There are many methods to keep from getting pregnant.”