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    by Ngozi Osuagwu, MD | August 21st, 2016


    The one that you will use consistently in the way it is supposed to be used.  Typically when we talk of birth control, we talk about the most effective to the least effective. The most effective birth control is abstinence. If you are not having sex, you cannot get pregnant. There are ways to express your love for another without actually having sex.

    After abstinence, there are the long acting reversible contraceptives otherwise known as LARCs. LARCs include intrauterine devices (IUDs) and the subdermal implant. There are two categories of IUDs. The one with hormones and the one without hormones. The IUDs that contain hormones include, Mirena®, Skyla® and Liletta®. The IUD that does not contain hormone is Paragard®. The name of the subdermal implant is Nexplanon®.  These can last from 3 – 10 years and can be removed when you are ready to have a baby. The reason why they are so reliable is that once you come to the doctor to get it placed, you do not have to worry about anything until you are ready to have it removed.

    The next effective birth control is the shot or DepoProvera®. You will need to come to the doctor’s office every 12 weeks to get the shot. It does contain hormones and you do have to make the effort to come to the doctor.

    Next are the pills. The pills can be very reliable if you take it daily about the same time of the day each day. The issue is not everyone takes it diligently and it is not as effective as the LARCs or the shot. We have two major types of pills – the one that contains Estrogen and Progestin and the one that has only Progestin. There are also pills that you can take continuously so that you do not have a period every month.

    Just as effective as the pills are the vaginal ring and the patch. Both contain the same hormones as the one found in the pills, you just have a different way of getting the hormones in the body. The vaginal ring is also known as Nuvaring®. You leave it in the vagina for 3 weeks and then remove it for a week to have a period. You can have sex with the ring in the vagina. The patch is changed weekly.

    The next are condoms. For condoms to work, you need to use it. The good thing is that along with preventing pregnancy, it also protects against sexually transmitted infections (STIs) which the others do not. You can use condoms with all the other birth control options I have discussed. We have male and female condoms. Although most condoms are made of latex, there are non-latex condoms for those allergic to latex. Yes, they are a little expensive.

    We also have the diaphragm and the cervical cap. Again, it works by using it. So if you are in the heat of the moment, you have to stop and put it in before having sex. You should use it with the  spermicidal creams and/or condoms.

    There are the over the counter creams that contain spermicides and the sponge.

    Natural family planning or periodic abstinence is also very good. There are safe days within your cycle when you cannot get pregnant. Your periods have to come regularly to use this method. Your doctor can work with you to find your safe time and there are apps available to help you. Here is the deal -you cannot be spontaneous with this method. You have to be disciplined. I would not advise this for teenagers or young adults.

    Then of course we have withdrawal or the pull-out method. This can be a sure way of getting pregnant. Most men release some fluid from the penis before they fully ejaculate and that contains sperm.

    We also have emergency contraception or the morning after pill. This is available over the counter if you are over 17 years old and is cheaper if you have a prescription. It does not cause an abortion. It just delays ovulation. It should be used within 72 hours of a condom accident or when you have forgotten to use birth control.

    Take home message: There are many options available. What might be good for one person might not be good for another. Do your research and talk with your health care provider so that both of you can find the best form of birth control for you.

    Check out  a previous blog related to this topic:

    April is STI Awareness month




    1. Linda K. Jackson says:

      Good morning! I haven’t received a response to the email that I sent last week. Thank you.

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