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Family planning options for when you're done having kids

Main Line Health November 21, 2017 Women's Health

If you’ve decided that you’re finished having children, the idea of taking a birth control pill every day might sound like just another item on a long list of things to remember. But there’s good news: there are other (low-maintenance) ways to protect yourself against unintended pregnancy.

Although most methods of contraception are intended for temporary use—like a hormonal pill, hormonal patch or a condom—there are options that can offer long-term protection.

Options for long-term reversible birth control

For women who are interested in continuing to grow their family—but who wish to delay pregnancy for a while—there are birth control options that can provide long-term protection.

“It can be difficult to keep up with daily or monthly birth control maintenance, like the hormonal pill or patch. There are many women who are looking for an option that will prevent pregnancy for a few years as they or they and their partner decide whether or not to expand their family,” says Kathrine Lupo, MD, OB/GYN at Riddle Hospital, part of Main Line Health.

One such option is intrauterine devices, or IUDs, which have gained popularity in recent years for their reputation as an effective long-term, reliable and reversible birth control option.

There are two types of IUDs available for women: a copper IUD and a hormonal IUD. While both affect the way that sperm move to prevent pregnancy, a hormonal IUD also alters the endometrium, and is FDA-approved for heavy menstrual bleeding. And—while both methods are 99 percent effective in preventing pregnancy—a copper IUD can remain in place up to 10 years, while a hormonal IUD offers up to five years of contraception.

A third option, called a subdermal implant, is placed in the upper arm. It offers three years of contraception with a very low failure rate.

Options for permanent birth control

Permanent, non-reversible birth control may be right for you if you’ve decided that you’re finished growing your family. Although the options for permanent birth control are limited, they do allow women the freedom to have sex while substantially decreasing the the risk of an unwanted or unplanned pregnancy.

The most common method of permanent birth control is sterilization, more commonly referred to as a vasectomy (for men) or tubal ligation (for women). While a tubal ligation is immediately effective, a vasectomy does require about three months for a man’s sperm count to drop to zero. In the meantime, alternative forms of temporary birth control, like condoms, should be used.

While both options are outpatient procedures that don’t require an overnight stay, they do involve small incisions and a general anesthetic. However, a non-surgical alternative is available via the Essure birth control implant.

Essure works by creating a barrier against pregnancy. The implant has two small, soft, flexible metal and fiber coils that are inserted through the vagina and placed in the fallopian tubes. Within three months, scar tissue forms around the coils and blocks the fallopian tubes to prevent egg fertilization. Like a vasectomy, the Essure implant also requires a three-month waiting period to ensure it is effective.

Is Essure safe?

Essure is a FDA-approved but, in recent years, many women have come forward to share their experience with the implant, citing pelvic pain, cramping, nausea, dizziness and—in some cases—an unintended pregnancy. With reports like this, many women are left questioning the implant’s safety and effectiveness.

Like all forms of birth control or sterilization, Essure does have uncomfortable side effects and risks. However, it is 99 percent effective and remains a viable sterilization option for women. But—not all women. Post-marketing studies are currently underway to determine the safety of Essure.

If you are experiencing pain as a result of the Essure implant, you can opt to have it removed, but it is not a reversible birth control option.

“It’s important to talk to your OB/GYN before choosing any birth control method or sterilization option. Working with your doctor to determine the right contraceptive option for you can help prevent unwanted side effects and complications,” says Dr. Lupo.

Finding the right option for you

If you’re trying to determine which method of contraception is right for you, make an appointment with your physician.

Main Line Health’s gynecologists provide expertise in a wide range of services, from adolescence through the post-menopausal period. Visit our website to learn more about our women’s health services.