From Oral Contraceptives to Patches and Rings, Your Questions Answered
Confused by all the conflicting information and rumors out there about birth control? You’re not alone. We asked top gynecologists to help you sort fact from fiction about oral contraceptives, patches, IUDs and more...
Most U.S. women of reproductive age use birth control, according to the Centers for Disease Control and Prevention. Between 2006 and 2008, 99% of women who had sexual intercourse used at least one form of birth control, including the rhythm method, oral contraceptives, the patch, vaginal ring, intrauterine device (IUD) and condoms.
But misconceptions and fallacies about types of birth control are as common as contraceptive use itself. Some women think oral contraceptives can cause cancer, or that breastfeeding prevents pregnancy.
What’s the truth? We asked top gynecologists to weigh in on what’s real, exaggerated or just plain wrong.
1. How long could it take to get pregnant after oral contraceptives or patches are stopped?
It’s possible to conceive in your next menstral cycle after going off the pill or patch, says Amy E. Rosenman, M.D., an urogynecologist (specialist in women’s pelvic issues) at St. John’s Health Center in Santa Monica, Calif., and clinical assistant professor at UCLA School of Medicine.
“The pill is a short-acting drug and can be out of the system in days, which is why it’s so important to take it daily,” she says. “[However, doctors] usually recommend having one normal cycle after stopping the pill at the end of a pack to reestablish a normal lining” in the uterus before you conceive.
2. Can an intrauterine device (IUD) or contraceptive ring inserted into the vagina (NuvaRing) fall out during sex?They can, but it’s not likely, says Gregorio Riera, M.D., an ob-gyn at Texas Children’s Hospital Pavilion for Women in Houston and assistant professor at Baylor College of Medicine.
An IUD is inserted inside the cervix, in the neck of the uterus, Dr. Riera explains. Because of its placement, it can’t be affected by penetration, he says.
“The ring doesn’t go up as far as an IUD, but it does go deep into the vaginal area, so it shouldn’t come out during intercourse,” he adds.
It's designed to rest in the same place as a diaphragm, which also is rarely disturbed by intercourse, Dr. Rosenman says.
The ring might be more likely to come out in women who’ve undergone childbirth or have prolapse, where the pelvic floor muscles and ligaments have weakened and can’t support the uterus, she adds. But if it does come out, you can put it right back in, she says.
3. Does the pill really cause weight gain?Many women believe they can put on weight from taking birth control pills, but that’s generally not the reason for weight gain, Dr. Rosenman says.
“In a group of 100 women, some will gain [weight], some will lose and some will remain the same,” she says. When women do gain weight, “it may be a coincidence that they’re on the pill.”
Dr. Riera concurs: “There have been a lot of [clinical] trials over the years looking at weight gain in women taking the pill,” he says. “Some patients do gain weight, but large trials don’t support that [weight-gain theory] in women taking a monthly pill regimen.”
That’s not the case with progestin-only oral contraceptives, which are taken for three months at a time.
Studies have shown that women do gain weight while taking them, Dr. Riera says. That’s why he counsels patients concerned about weight gain to look at other methods of birth control.
4. Do oral contraceptives decrease sex drive?The pill may affect libido in some women, Dr. Rosenman says.
“As oral contraceptives go through the liver, they stimulate production of a protein called sex hormone-binding globulin," she explains. It reduces the function of certain hormones, including testosterone produced by the ovaries.
“In some women, this is enough to cause reduced libido.”
5. Does the pill help improve bad complexions?“Absolutely,” Dr. Riera says.
Most hormonal methods of birth control do such a good job of reducing acne that the Food and Drug Administration (FDA) has allowed the pill to be prescribed specifically for that purpose, Dr. Rosenman says.
6. Can the pill cause cancer?“The research is really clear: The pill does not cause cancer,” Dr. Riera says.
In fact, oral contraceptives reduce your risk of ovarian by almost 30% and endometrial cancers by almost 40%, and may also cut the risk of colon cancer, he says.
Studies on breast cancer have had conflicting results, but overall, the pill doesn’t significantly reduce or increase risk, Dr. Riera says. It does significantly reduce benign breast problems, he adds.
7. Is it safe to use oral contraceptives to change my mensual cycle?“Yes, the time of menstruation on the pill is completely arbitrary and related to the pattern of the pills taken,” Dr. Rosenman says. “So if you take the three-month pill, there will be a period every three months.”
“If you use the normal [monthly pack], but skip the placebo pills, there will be a skipped period,” she says. “There’s even a continuous pill that’s taken every day with no periods at all, and it’s perfectly safe too.”
Changing the schedule of your period won’t harm your chances of becoming pregnant once you stop using oral contraceptives, Dr. Riera adds.
8. Is withdrawal an effective birth control method?Withdrawal – when a man pulls out of a woman’s vagina before he ejaculates – is an age-old method of birth control, but experts say it’s not reliable.
“It’s better than nothing, but the failure rate is pretty high – close to 20%-30%,” Dr. Riera says.
That means that for every 100fertile women who have sexual intercourse using just this method, 20 to 30 of them will become pregnant within a year.
“Any method that has that high a failure rate isn’t something we’d recommend.” Dr. Riera says.
9. Do I need to use birth control when I’m nursing?
Breastfeeding full-time reduces the likelihood of pregnancy because you don’t ovulate. But many women still conceive while nursing because they assume they’re “safe,” Dr. Rosenman says.
“You will ovulate, and may conceive, before the first period returns,” she explains. “Many women have gotten pregnant while nursing with no period between pregnancies.”
Consult your physician to determine which birth control method is best for you during nursing, Dr. Rosenman says.
10. Why don’t more women use the female condom?Unfortunately, female condoms are “cumbersome and annoying,” Dr. Rosenman says.
“Have you seen one? Female condoms are ginormous!” she says. “They involve an internal ring like a diaphragm and an external ring around the labia. I’m surprised anyone uses them at all.”
According to the National Institutes of Health, the female condom may be unpopular for several reasons, including:
- Intercourse may be “less enjoyable or even uncomfortable” because of the reduction in clitoral stimulation and lubrication.
- “Irritation and allergic reactions may occur.”
- “The condom may make noise.”
- 11. What are the pros and cons to consider when deciding between the hormonal patch and oral contraceptives?The patch releases a gradual supply of estrogen and progestin directly through your skin. It’s this delivery method that makes it different from the pill.
“Anything you take orally has to go through the liver,” Dr. Riera says. “The patch goes directly to your blood,” resulting in higher hormone levels.
That can mean increased risk, especially if the woman is a smoker and is over 35, Dr. Riera says.
“The patch has much higher blood hormone levels than most low-dose pills and a higher risk of clots that form in the legs and travel to the brain [stroke] or lungs [pulmonary embolism],” Dr. Rosenman adds. “Most low-dose pills are safer.”
But “compliance with patches is higher than with birth control pills because you only have to remember [to put on] three patches instead of 30 pills a month,” he says. “Better compliance means fewer unwanted pregnancies.”- By Lori Newman/ From WWW.lifescript.com/ Posted by Mags
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