‘Tis the season


‘Tis the season for procreation, apparently.  Conception rates reach their annual peak in December, with about 9 percent of all conceptions in the United States occurring … now.  Why?  There are several theories out there, but studies show that more than twice as many condoms are sold in the week before Christmas which strongly suggests an acute increase in sexual activity with holiday festivities.  Suddenly contemplating your contraceptive options?

Nearly 50 percent of pregnancies in the US in 2006 were unintended.  One third of these women cited that they felt they could not get pregnant during the time of conception, and therefore did not use any form of contraception.  Another 16 percent of women did not use contraception because of its side effects.  Both of these speak to the need for more education.  There is no perfect birth control.  And it’s not a one-size-fits-all.  Every women is different, has different needs, comfort-levels, desires, beliefs.  But knowing all of your options (and there are lots) may change your mind about contraception and family planning.  And if the fear of weight gain is the reason you have avoided birth control, know that several studies have shown that hormonal contraceptives do NOT cause weight gain (with one exception, the depo injection).

“The pill” is the contraception option with which most women are familiar.  Oral contraceptives are doses of hormones that prevent ovulation and change the vaginal discharge to impede sperm travel.  A woman must take them at the same time every day in order to be reliably effective.  While certainly a viable option (since the 1960s), is it not the only one.

Prefer less frequent pill popping?  Weekly hormone patches, OrthoEvra, may be an option for you.  There is also the vaginal ring, Nuvaring.  It is a circular, flexible plastic that is about 2 inches in diameter that emits hormones (much like the pill).  It is inserted into the vagina for three weeks at a time, then removed to initiate menses.  Once a month birth control, as long as you don’t mind inserting, checking, and removing it.  The depo shot is a progesterone only injection administered once every three months.  And while there is a risk of a 4-pound weight gain over a year, it may be a reasonable option for women who have difficulty remembering to take medication.  As a perk, with continued use of the DepoProvera injection, many women stop having periods.

Want an even lower maintenance form of birth control?  If you are in the market for long-term contraception, but still would like the option for future pregnancy consider an implantable rod or intrauterine device (IUD).  Both are done in the office with very little, if any, downtime.  An implantable rod, Implanon, is a small piece of progesterone-emitting plastic that is inserted just under the skin (usually in the arm).  This match-stick size product offers contraception for up to 3 years.  There are two intrauterine devices on the market, the Mirena and ParaGard.  Both are small T-shaped devices that are inserted into the uterus and provide 5 years and 10 years of contraception, respectively.  The Mirena is plastic and contains progesterone that acts locally to prevent sperm from traveling through the uterus to the fallopian tubes.  A potentially positive side effect of the Mirena?  Most women stop menstruating after a few months (and no, there is no harm in not having a period).  The ParaGard is a copper IUD that does not contain hormones, and is effective for up to 10 years.

Not interested in hormonal contraception or implantable devices?  For centuries women have relied on their own bodies to accurately predict periods of fertility (i.e. natural family planning, NFP).  This form of birth control can be very effective if you are willing to make observations and plan accordingly.  There are several methods available for NFP: the Billings Ovulation Method, Creighton Model and TwoDay Method are just a few examples.  An upside to NFP, it can be used for contraception or for conceiving.  And, yes, there’s an app for that.  Even if you are leery of the NFP, there is value is knowing your body and when you are most fertile and likely to become pregnant (for most women it is between days 8 – 19, with day 1 being the first day of your period).

And last, but not least, barrier methods.  Traditionally, barrier methods are thought to be left to the men in the form of condoms (thank you, Bill Gates for trying to improve them).  But, as a women you, too, should feel empowered to female barriers.  Behold the diaphragm, cervical cap, and cervical shield.  There are also female condoms and sponges.  When used properly these provide effective, hormone-free contraception that you can control.

Permanent sterilization also exists for women who are certain they no longer desire fertility.  There is now an alternative to the invasive, surgical procedure the tubal.  It’s called Essure, and can be quickly and easily done right in the physician’s office.

There are numerous options for women to prevent pregnancy (aside from continuous abstinence).  Get to know your body, your options, and take charge of your womb!


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