What's New in Contraception?

The 21st century has brought many new innovations in women’s health care including a new era of contraception. Just in the last few years the choices of contraception have multiplied to accommodate convenience, health issues, and accessibility. Take a look at some of the latest methods to hit the market and also some of the methods that are on the horizon!

Seasonale: This is one of the newest methods of contraception, just approved by the FDA in early September, 2003. Seasonale is the first and only extended-cycle birth control pill, allowing for women to have only 4 periods a year. This pill is made up of the same ingredients as other oral contraceptives, but is taken on a different schedule than other popular hormonal methods. The Seasonale pack contains 84 active pills and 7 inactive pills causing menstrual bleeding to happen only once every 3 months. Studies show Seasonale to have the same side effects and effectiveness rates as other types of oral contraception pills.

• Pros: Convenience, allowing for only 4 periods a year; relief for those women who experience painful menstruation and severe PMS
• Cons: Can cause more spotting and break through bleeding than other oral contraceptives; cost is slightly higher per year than monthly pill packs; women are exposed to slightly higher amount of hormones yearly than with a monthly pill.

Essure: The newest type of permanent birth control method available that is an alternative to tubal ligation. Essure was approved by the FDA in late 2002 after being used in other countries with great success. Essure provides a permanent type of birth control without any type of surgical procedure or incisions. Essure is made of a flexible device called a micro-insert. The micro-insert is inserted into the fallopian tubes, where body tissue will then grow into it, causing blockage in the fallopian tubes. This prevents fertilization by blocking the sperm from reaching an egg. The device can be inserted by your health care provider and it usually takes about 35 minutes for the procedure, followed by a 45 minute evaluation time. Most women can return to normal activities within 24-48 hours of the procedure. Essure has been found to be more than 99% effective in preventing pregnancy in the first 3 yrs of use. The most common side effects are light bleeding, mild cramping, nausea and vomiting following the insertion procedure.

• Pros: Non surgical procedure; permanent method of contraception; contains no hormones; 99% effective; can resume normal activities within 1-2 days; requires no general anesthesia
• Cons: Not reversible; have to use a back up method for at least 3 months after insertion, 1 in 7 women experience a problem with the procedure not working in both fallopian tubes after initial insertion; studies have only been done on effectiveness up to 3 yrs

Ortho Evra Contraceptive Patch: The Patch is a new hormonal alternative to the birth control pill. This thin patch is placed on the body once a week for 3 weeks and then removed for one week to allow for a menstrual period. Hormones are continuously released through the skin into the bloodstream, to prevent pregnancy. The patch seems to have similar side effects as the birth control pill and has a 99% effective rate when used correctly. The patch is available by prescription only.

• Pros: Only have to remember once a week; easy to hide; may cause less nausea and headaches than other types of hormonal contraceptives
• Cons: May be less effective for women over 200 lbs; may cause skin irritation. For more information, see Birth Control Patch

Lunelle Injection: Injections of synthetic hormones are given once a month, every 28-30 days. These shots must be given in a physicians office and they have similar side effects as oral contraceptives. The Lunelle injection is more than 99% effective in preventing pregnancy if injections are given on time.

• Pros: No medication to remember to take; may result in shorter periods; highly effective
• Cons: Have to go to physician’s office once a month for injection; may cause spotting and irregular bleeding. For more information, see Lunelle Injection

Vaginal Ring: The vaginal ring called the NuvaRing, sits in the vagina releasing synthetic hormones and is worn for 21 days and then removed for 7 to allow for a menstrual period. The NuvaRing does require a prescription but does not have to be inserted by a physician. The vaginal ring has similar side effects to that of oral contraception including headaches, breast tenderness and nausea. NuvaRing is 98% effective when used correctly.

• Pros: Only have to insert monthly; does not require a medication or shot
• Cons: Can result in vaginal irritation; requires monthly insertion and removal. For more information, see Vaginal Ring

Mirena Intrauterine Device: The Intrauterine Device (IUD) has been around for decades, but a new twist has been added to allow for more women to able to use this convenient approach to birth control. The Mirena IUD releases a low dose of progesterone into the uterus causing the lining to thin. The Mirena IUD can be left in place for up to 5 years and has an effectiveness rate of over 99%. This progesterone only IUD can cause irregular bleeding for the first 6 months of use, but then seems to taper off resulting in lighter monthly periods. The IUD is only available through a doctor and can be inserted in a short office visit.

• Pros: Lasts up to 5 years; normally leads to lighter or absent periods over time; contains no estrogen; can be used by women who have never been pregnant before
• Cons: Can cause irregular bleeding and spotting; some women experience cramping; women may have hormonal reactions to progesterone.

Lea Shield: The Lea Shield is similar to the diaphragm and cervical cap, but was made to be very user friendly. This dome shaped silicone device covers the cervix, allowing for secretions to exit without sperm entering in. The Lea Shield can be inserted hours before intercourse and is to be left in place for at least 8 hours afterwards. The shield is to be used with spermicide and is available only through a physician. The effectiveness rate is thought to be at about 86-91%, but it has not been on the market long enough for conclusive results to be established.

• Pros: Reusable; can be inserted hours before intercourse occurs; has a loop to aid in insertion and removal
• Cons: Has not been out long enough to have conclusive studies done; can be uncomfortable for some women to insert

The future of contraception seems to be even more innovative than the present! Studies are currently being done on devices that predict fertility, a 24 hour spermicide, a pregnancy vaccine, a new implant device, and a male birth control pill. What will they think of next?