Gynecology Specialists of Philadelphia

Birth Control Options

At Gynecology Specialists we will help find the best birth control option for every individual patient based on their lifestyle, medical conditions, and what they have used in the past. We take the time to discuss all of the different options with you at a specific contraceptive counseling appointment or at your annual exam.  Listed below is a little bit of information about all the different birth control options available.

Birth control pills: The pill has estrogen and progesterone hormones and works by preventing your body from ovulating or releasing an egg every month.  It is most effective when taken at the same time every day.   Benefits include lighter and more regular periods, fewer menstrual cramps, improvement in acne, no prolonged delay in return to fertility, and generally low cost.  Risks include increased risk of blood clots, heart attack, stroke, gallbladder disease, liver tumor, and decreased effectiveness when used in combination with certain medications.  Women with certain medical conditions which increase risk of complications such as blood clots should not use the pill, or other methods with estrogen.

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NuvaRing®®: NuvaRing® has the same hormones and works in the same way as the pill. It is a small, flexible ring that is inserted by a woman into her vagina, similar to a tampon. Once inserted, it is left in the vagina for 3 weeks, and then removed for the fourth week to get your period. You can remove the NuvaRing® for up to 3 hours at a time without losing effectiveness. It does not have to be removed to have sex or during your period. Benefits include not taking a pill every day, shorter, lighter periods, fewer menstrual cramps, and improvement in acne. Risks are similar to the pill, with increased risk of blood clot, gall bladder disease, liver tumors, and vaginal discharge. The NuvaRing® generally cannot be felt by you or your partner, and cannot get lost inside of you, but if you are uncomfortable with idea of inserting or removing a vaginal ring, it may not be the best choice for you.

OrthoEvra® Patch: The patch works the same way as both the pill and the NuvaRing®. It is a patch that is placed on the skin and changed weekly. Benefits include shorter, lighter menstrual cycle, fewer menstrual cramps, no need to take a pill daily, and improvement in acne. Risks are similar to the pill, but with a slightly increased risk in blood clots, though the risk is still very small for patients without other risk factors for blood clots.

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Progestin only pill, also known as the “Mini pill”: This pill contains only progesterone and works by thinning the lining of the uterus, thickening the mucus of the cervix, and stopping ovulation. This is a good option for women who cannot be on estrogen and women who are nursing. However, this pill is very time sensitive and must be taken within the same three-hour time window each day to be fully effective; otherwise there is a higher chance of pregnancy. Benefits are that they do not contain estrogen, can be taken while breast feeding, and may lighten period bleeding and cramping.

Depo-Provera®: This method works in the same way as the mini pill, but it is in the form of a shot that is given at a provider’s office every three months. Benefits include low maintenance, no estrogen risks, safe to be used during breast-feeding, less painful periods, and fewer menstrual cycles. Risks may include weight gain, mood changes, temporary bone thinning (for which patients should take a calcium supplement while they are on Depo-Provera®), a possible delay of several months after stopping Depo-Provera® before fertility returns , and a possible increased risk of cardiovascular disease. Patients on progesterone only methods such as Depo-Provera® may not have periods, which is safe and should not be a cause of concern.

Nexplanon®: This works the same way as the mini pill and Depo-Provera®. It is a flexible rod the size of a match stick, which is inserted under the skin of the inner arm. It slowly releases progesterone over a 3 year period. It can be inserted and removed by a healthcare provider in the office with just an injection of local anesthesia to numb the skin Benefits include low maintenance long term birth control, no estrogen risk, lighter menstrual flow, improvement in menstrual cramps, safe to be used during breast-feeding, and no delay in return to fertility. Risks include possible irregular vaginal bleeding and problems associated with insertion such as bruising or insertion too deep beneath the skin.

Mirena® IUD: The intrauterine devices or “IUD” is a T-shaped device inserted into the uterus in the office by your health care provider. The Mirena® is a progesterone releasing IUD which can be used for up to 5 years. It works by thinning the lining of the uterus, thickening the cervical mucus, and suppressing ovulation. An IUD is an option for women who had already had a baby, as well as women who have not yet been pregnant. Benefits include fewer systemic side effects, low maintenance long term birth control effective for up to 5 years, short light periods, fewer menstrual cycles, no estrogen risk, no delay in return to fertility, safe to use while breast feeding, and improvement in menstrual cramps. Risks include problems associated with insertion, mal-positioning, expulsion, irregular bleeding, pain, and pelvic infection within 30 days of the insertion. IUD’s do NOT increase your risk of ectopic pregnancy or pelvic infections related to STD’s. They cannot become “lost” inside the abdomen, as they are intended to sit inside of the uterus.

Skyla® IUD: This is similar to the Mirena®, but a slightly smaller size, which may make it more comfortable to place for a woman who has never had a baby before. It can be used for up to 3 years, and has similar risks and benefits to the Mirena®.

Paragard® IUD: This is a non-hormonal copper IUD that is placed in the uterus in the office by your health care provider. It works by creating an unfavorable environment in the uterus that affects how sperm function and therefore prevents conception. Benefits include no hormones, which may make it a good choice for patients with history of side effects with hormonal birth control, long-term low maintenance birth control effective for up to 10 years, quick return to fertility, safe to use while breast feeding, and maintains your normal monthly cycle. Risks are similar to Mirena® and Skyla®, however it is also possible to experience increased bleeding and cramping with periods. Paragard® cannot be used by women with a sensitivity to copper. Again, IUD’s do NOT increase your risk of ectopic pregnancy or pelvic infections related to STD’s.

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Tubal Ligation: This is considered a permanent birth control method. It is a minor procedure done in the operating room. Through a small incision our surgeons will identify each fallopian tube and cut/tie it so that an egg can no longer travel to the uterus and lead to pregnancy. This will not change your normal menstrual cycle or make you go through menopause.

Essure®: This is considered a permanent birth control method that can be placed in the office. It consists of two small coils that are placed—one in each fallopian tube. They are passed through the cervix and placed with a small camera. An additional birth control method has to be used for the first three months. After three months a study called a hysterosalpingogram is done. This uses x-ray to make sure no dye can pass through the fallopian tubes, which verifies that they are closed. Similar to a tubal ligation, this will not change your normal menstrual cycle or make you go through menopause.