Can New Birth Control Choices Work for You?
Sept. 25, 2003 — -- There are dozens of birth control methods already on the market — and now there are four new ones ranging from a hormone-dispensing patch, to a birth control pill that reduces the number of periods a woman has to four a year.
The Berman sisters — sex therapist Laura Berman and urologist Dr. Jennifer Berman — gave Good Morning America the rundown on the latest choices.
"We have come a long way since the 1960s," Laura Berman said. "Women now have a range of options when it comes to contraception. It comes down to this: each woman should find the form of contraception that best fits her lifestyle and personal taste."
Ask yourself some important questions: Are you someone who can remember to take something on a daily, weekly or monthly basis? Are you the hectic woman? The forgetful woman? The woman who is worried about her libido? The woman who wants her period or one who doesn't? Knowing the answers will help guide you in choosing the best birth control, she said.
Ring Makes Good Pill Alternative
One of the new choices is Nuvaring (Organon), which consists of a small, flexible ring that is inserted into the vagina. The ring then delivers low doses of two female hormones, estrogen and progestin, into the woman's body.
It helps prevent pregnancy by suppressing ovulation and thickening the mucus on the cervix. The ring is inserted and left in for three weeks at a time. It is then removed and discarded while the woman has her period. A week later, a new ring is inserted.
"The advantage is this you can place it in and forget it for three weeks," Laura Berman said. "And then take it out for a week. And then put it back in for the next cycle."
The devices also have fewer side effects than with the traditional pill, including less bloating, headaches and sexual side effects like decreased arousal. The thinking is that because the hormones are locally delivered to the reproductive area as opposed to going into the whole body like the traditional pill there are fewer side effects, Berman said.
"The downside is a lot of women are not comfortable with their genitals and to insert and remove something from this area may be a barrier," Laura Berman said. A very small percentage of women and their partners said they could feel the device.
It was approved by the FDA in October 2001 and became available this year. When used properly, it is effective 98 to 99 percent of the time.
Inserted IUD Lasts for 5 Years
Mirena is an Intrauterine Device that is inserted or removed during a doctor visit with no surgical procedure. Mirena (Berlex) does not contain estrogen like other forms of IUDs and therefore there are no estrogen-related side effects or complications.
"You have to have a doctor insert this," Laura Berman said. "IUDs have a bad rap because of past issues with infertility, infection and diseases. This one is made of plastic and has no copper so the company says it is safer, especially for women who want to have kids later on. They can just take it out."
Mirena releases small amounts of levonorgestrel, which makes the cervical mucus thicker and tacky and also gradually thins the lining of the uterus, which may result in less menstrual bleeding over time. Nearly 20 percent of women will have no period at all after one year. Mirena's effects begin immediately, there is no daily action required, Berman said. It can be left in for up to five years, and the company claims it can also be used by mothers who still want to have children later in life.
The Birth Control ‘Patch’
Effectively known among contraceptives as "the patch," Ortho-Evra (McNeil Pharmaceuticals), attaches directly to a woman's skin and contains hormones similar to those in birth control pills. Some women prefer it because it means you do not have to take the pill.
The patch can be applied and removed on one of four places on the body: the buttocks, abdomen, upper torso or upper outer arm. It should be changed once a week and is waterproof. You can swim, bathe or exercise with the patch on.
"It is easy — that is a plus — and it is also more convenient and more tolerated," Jennifer Berman said. "A small amount of hormone is delivered through the skin. It is a fast-growing method and very effective."
But one thing that women do not like about the patch is that it is visible.
"Some may think it is a visual advertisement that they are sexually active," Berman said. "That may not be for everyone."
The manufacturer says it's 99 percent effective, but may be less effective in women who weigh more than 198 pounds.
Seasonale May Surprise Birth Control Users
Seasonale, approved earlier this month by the U.S. Food and Drug Administration, allows women to reduce their menstrual cycles to four times a year, rather than 13. The idea is the same as the traditional monthly "pill," but Seasonale (Maker Barr Laboratories) is a 91-day regimen, delivering estrogen and progesterone in a low level and continuous manner.
Users would take 84 active tablets followed by seven inactive tablets. Taken daily, the regimen does the same job as other pills, with only one cycle of induced menstruation every three months. Though most women would, in theory, love to skip the unpleasantness that goes with their periods, Seasonale has a large psychological barrier to overcome.
"Some women may be hesitant to use this form because it may seem unnatural to have only one period every three months," Laura Berman said. But that feeling is misguided, she says.
"Most women are not aware of the fact that with any contraceptive pill, they do not have a menstrual period," she said. "Their monthly cycle is actually a 'pill-period' or 'withdrawal bleed,' which is not the same as a period."
It is not uncommon for many women to skip their placebo pills, which suggests that it is not the idea, but the product that is new.
"There is a slight increase in the risk of bleeding and it is a matter of trial and error and see if it works for you," Jennifer Berman said. "We know it is safe and effective."
All of the newest birth control methods require a trip to the doctor for a prescription and advice, because all contain hormones.