Women find an array of options and innovations

New innovations in contraception, from hormone-based medications to internal devices, are giving women more birth control alternatives that fit better in today’s lifestyles — providing women with nearly effortless methods and safer choices.

But with all this new information and array of choices, what’s a woman to do? Vanessa Dalton, M.D., M.P.H., of the Department of Obstetrics and Gynecology at the University of Michigan Health System offers information to help women unravel the ever-changing options, including a summary of the newest forms of hormonal birth control and the overhaul of the intrauterine device, or IUD.

"When women are choosing or trying to select among many different kinds of birth control, there are a few things that they need to consider," says Dalton. "One of them is whether they have any medical problems that would make some forms of birth control a poor option for them. The other thing they need to consider is what kind of user they would be. Are they someone that can remember to take a pill everyday on schedule; or do they feel more comfortable interrupting sexual activity to use, for example, a diaphragm or condom?"

Hormone-based birth control
New innovations in hormonal birth control, which stop the ovaries from releasing an egg each month, provide many options with a high rate of success.

"In hormone contraceptives there are actually quite a few new advancements. If you consider what we used for birth control pills even 10 years ago, the dosage just keeps getting lower and lower. What that means for women is that the side-effect profiles, such as weight gain, are quite a bit better," says Dalton.

The vaginal ring, which has only been available for a year, is a new hormone medication that is inserted into the vagina by the woman using the contraceptive. Instead of remembering to take a pill every day or even having to insert and remove a contraceptive device multiple times throughout the month, the vaginal ring is inserted only once, delivers hormones throughout the cycle and is then removed at the end of the three weeks.

Unlike oral contraceptives and other hormone medications, the vaginal ring has not been associated with large weight gain problems. And the ring’s effectiveness is extremely high, with only a 1 percent to 2 percent failure rate.

Another new oral contraceptive, called Seasonale, will likely be released later this year with the benefit of extending the "normal" cycle to three months, with menstruation only occurring on a tri-monthly schedule, says Dalton.

Contraceptive Devices
The IUD (intrauterine device) is making a comeback from a bad reputation. Problems with one type, the Dalkon Shield, led the public to perceive that all IUD’s were prone to infection, even though this was not the case.

An IUD is a small T-shaped plastic device containing copper or hormones that must be inserted into the uterus by a physician. Instead of acting as a barrier, the IUD works more like a hormone medication to change the physical environment of the woman’s uterus. This will either prevent the egg from being fertilized or stop a fertilized egg from implanting and growing in the uterus.

The IUD has recently been given a makeover. The new IUD, the Mirena, is different because it delivers a smaller amount of hormone, which affords women the advantage of having lighter menstruation.

"Almost all women by six to nine months report a decrease in their menstruation, and in fact, some women stop having periods all together. For many women, the IUD is not only a contraceptive advantage, but is used very frequently for women who have menstrual irregularities," says Dalton.

For more information:

Department of Obstetrics and Gynecology
http://www.med.umich.edu/obgyn/

U-M Health Topics A-Z: Methods of Contraception
www.med.umich.edu/1libr/aha/aha_contra_crs.htm

U-M Health Topics A-Z: Intrauterine Device (IUD)
www.med.umich.edu/1libr/aha/aha_iud_crs.htm

U-M Health Topics A-Z: Oral Contraceptives
www.med.umich.edu/1libr/aha/aha_contrace_crs.htm

Department of Health and Human Services: Birth Control Guide
www.fda.gov/opacom/lowlit/brthcon.html

Planned Parenthood
www.plannedparenthood.org/bc/