Contraceptive Counseling

Overview

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Our physicians are experts in all available contraceptive methods. They are experienced in counseling women about methods that are used for not just pregnancy prevention but also for other medical purposes.

Methods

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Pill The birth control pill is the most common form of reversible contraception used in the US. The pill has to be taken every day and it comes in either a progestin-only form or a combined form of both estrogen and progestin. The progestin-only form is mostly used in women who have a medical reason to avoid estrogen-containing methods (i.e. just had a baby, history of a blood clot, smoker over the age of 35, etc.). Patch The birth control patch is another combined hormonal method. A woman places a patch on her skin (back, stomach, or arm) once a week for three weeks. Then on the fourth week she does not wear a patch and has bleeding. Ring The birth control ring is also a combined hormonal method. A woman places a flexible ring into her vagina and removes it three weeks later. After seven days, she then places a new ring. During this ring-free week she will bleed. The combined pill, patch and ring will all regulate a woman’s cycle to have a predictable monthly period that is often shorter, lighter and less painful than her normal period. Injection The birth control injection is administered in the office every three months. Patients commonly experience irregular bleeding, but then after multiple injections usually no bleeding at all. Implant The birth control implant is a progestin-only method. The thin, small rod is placed under the skin and prevents pregnancy for up to three years. The side effect is that bleeding is usually lighter and less frequent, but less predictable in its timing. Intrauterine deviceThe intrauterine device (or IUD) is an excellent option for women who want a longer-acting method. There are two types: the five-year progestin-only IUD and the ten-year non-hormonal IUD. The progestin IUD causes periods to be lighter, less painful and sometimes stops bleeding altogether. The non-hormonal IUD can increase the bleeding and pain of periods in some women.

Sterilization

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Sterilization is a permanent form of birth control. We offer both laparoscopic and hysteroscopic methods of sterilization. In order to comply with New York State law, women must sign consent for sterilization 30 days before their procedure. The laparoscopy is performed through two small abdominal incisions under general anesthesia in the operating room. One metal clip is then placed on each of the tubes which causes immediate and irreversible tubal blockage. The hysteroscopy is performed through a small camera placed transvaginally through the cervix and into the uterus. Small coils are placed into each tube which then scar the tube closed over the next three months. Patient must continue some form of pregnancy prevention during that three-month period. After three months, a special X-ray called a hysterosalpingogram (or HSG) is done where dye is injected into the uterus to confirm that the tubes are closed. Non-hormonal barrier methods The diaphragm, cervical cap, cervical sponge, female condom, and male condom are all non-hormonal barrier methods. The diaphragm requires a fitting by a physician to ensure efficacy. All of these methods are less effective in preventing pregnancy than the other mentioned methods, but offer an alternative for women who cannot use the other methods. Emergency contraception Emergency contraception, also known as the morning-after pill, is a type of birth control a woman can take after having unprotected sex. It is effective within five days of unprotected sex, but it is never 100% effective. It is available to anyone 17 years of age or younger without a prescription. However, a woman can often get it paid through her health insurance if she has a prescription from her doctor. Contraceptive Provision All methods of birth control require at least one visit with a provider to discuss options. Not all methods are safe for all women depending on medical history. No method works 100% of the time, so all women are counseled about possible failure. For most methods it is unnecessary to have a pelvic exam. The IUDs, sterilization, diaphragms, and cervical caps will all require an exam. Annual checkups are encouraged to ensure no changes in medical history as well as todiscuss concerns with any of the methods.