Contraceptive choices: An option for everyone
9/15/2022 by Jennifer Bold, APRN, C.N.P., D.N.P.
Are you considering talking with your clinician about starting a contraceptive method? Women and couples have great options to consider.
To help you select the right contraceptive method, your clinician may ask you these questions at an appointment:
- How long are you planning on being on birth control?
- How often do you want to think about birth control?
- What are your bleeding preferences regarding menstrual periods? Do you desire no periods, lighter periods or monthly periods?
- Do you have any of these medical conditions: personal or family history of blood clots, migraine headaches with aura, tobacco use, history of breast cancer, heart disease or bariatric surgeries?
The American College of Obstetricians and Gynecologists recommends long-acting reversible contraceptive options as the first-line treatment for women planning to delay pregnancy for more than one year. That's because these options are more than 99% effective.
- Etonogestrel implant in the arm — Nexplanon, which is effective for three years.
- Copper IUD — Paragard, which is effective for 10 years.
- Levonorgestrel IUDs, including Mirena, which is effective for eight years; Liletta, six years; Kyleena, five years; and Skyla, three years.
Clinicians trained in inserting IUDs or subdermal implants need to place the long-acting reversible contraceptive methods, so patients need to plan for an appointment.
Patients must take other contraceptive methods regularly. Because of regular dosing requirements, they are only 92% effective. They usually can be started immediately upon receiving a prescription.
These options include:
- Pills taken daily that consist of progesterone only or a combination of estrogen and progesterone.
- Combined hormone patch that is applied weekly to the skin.
- Combined hormone vaginal ring that is exchanged monthly.
If you desire nonhormonal options, you can use barrier methods. Types of barrier methods include male and female condoms, and diaphragms. Condoms are readily available without a prescription and can provide the added benefit of protection from sexually transmitted infections. Diaphragms require appointments and an exam with a health care professional.
You should also discuss emergency contraception options with your health care clinician in case your primary form of contraception fails. Emergency contraception options are available over the counter and by prescription. IUDs also can be used for emergency contraception. These emergency methods can delay ovulation and prevent pregnancy, but they need to be used as soon as possible following unprotected intercourse.
Finally, you can discuss permanent sterilization procedures if you and your partner no longer desire future pregnancies.
Many effective contraceptive methods are available today. Review your contraception goals and questions with your health care clinician to start a contraceptive method that's right for you.
Jennifer Bold, APRN, C.N.P., D.N.P., is a nurse practitioner in the Department of Family Medicine and practices in the Baldwin building and the Primary Care Gynecology Clinic. She is the Primary Care Education supervisor for advanced-practice professionals at Mayo Clinic in Rochester.