In his monthly column, Dr. Kent Herbert answers your questions related to health care matters. Simply submit your question to stefaniw@newfalconherald.com. It’s your chance to ask the doc.Question: My husband and I are interested in birth control. What forms are currently available?Answer: The birth control pill is the most commonly used method of contraception. The pill is ideal for those who want a simple and effective method that is easy to take. But it must be taken every day to be effective. Most pills are considered to be about 97 percent effective if taken correctly.The biggest concerns with birth control pills are the side effects, which can include headaches, weight gain and upset stomach. Fortunately, the average dose of hormones in birth control pills today is less than several years ago, which has reduced the likelihood of side effects but maintained the effectiveness. There are several low dose options available that make them more tolerable. Most pills also give women the option to take them continuously for up to three months without having a period. Because birth control pills contain estrogen, which can cause blood clots, the pill should be used with caution in women who smoke (as smoking can also cause blood clots) and in women over age 35.In addition to pills, a birth control patch is available that contains similar hormones as the pill. It is worn weekly for three weeks, with the fourth week being a placebo patch that allows the wearer to have a period. Additional hormone methods include Depo-Provera, which is a shot given in the doctor’s office every three months, and the Nuvaring, which is a small plastic ring inserted vaginally once a month.For those who want long-term contraception but aren’t ready for permanent solutions, the intra-uterine device (IUD) is a very good option. The IUD is a T-shaped device that is inserted into the uterus during an office visit. It works by blocking sperm as they move through the uterus, and by creating an environment in the uterus that kills sperm. There are two types of IUDs – non-medicated and medicated. The non-medicated IUD works by staying in the uterus and involves no hormones. It is good for those who want to avoid hormones or who can’t take them, but it also can cause periods to be heavier and more painful. For this reason, the medicated IUD has become the more popular method. It looks the same but contains a small amount of progesterone that acts to shrink and stabilize the uterine lining. Because of this, women who use this IUD often have very light or no periods at all. In addition to birth control, it is also used to treat women who have abnormally heavy periods.The IUD can stay in for five to seven years, depending on the type, and can be removed at any time. Alternatively, it can be removed at the end of its lifespan and replaced with a new one. Because the IUD sits in the uterus, it can make infections worse, and should not be used in anyone who may be at risk for a sexually transmitted disease. Once inserted, the IUD is maintenance-free and greater than 99 percent effective.For those who are sure they are done having children, permanent sterilization can be considered. For males, this involves a vasectomy and for females tubal ligation. The vasectomy is a short and relatively simple office procedure where the vas deferens, which carries sperm, is permanently blocked. Most doctors perform the no-scalpel technique, which allows the vasectomy to be done in about 20 to 30 minutes, with minimal recovery time. It is done with local numbing and many doctors will make the patient comfortable with Valium during the procedure. The vasectomy is greater than 99 percent effective and permanent. A tubal ligation is usually done in the operating room and is similar to the vasectomy in effectiveness and technique, but is considered a more complicated procedure because the tubes are located in the abdomen.There are several methods of permanent and temporary contraception available. To choose the right one it is important to consider the advantages and disadvantages of each. All of these, with the exception of tubal ligation, may be available from your primary care provider, so it is worthwhile to make an appointment to discuss them.Dr. Kent HerbertBoard-certified Family PhysicianFalcon Family Medicine7641 McLaughlin RoadFalcon, CO 80831(719) 494-2006(719) 494-8448 faxwww.FalconFamilyMedicine.com
