CHOOSING THE RIGHT CONTRACEPTION

There are many options when trying to prevent pregnancy. In addition to preventing pregnancy, birth control can help with menstrual dysfunction and help with symptoms PCOS. Each one has a varying level of failure rate, meaning the percentage of people using this method that if they are sexually active will result in a pregnancy. Without a plan or using menstrual awareness (natural family planning) leads to a failure rate of 24 percent.

Oral contraception (OCPs) involves taking a pill every day. Missing pills routinely can lead to pregnancy and irregular bleeding. OCPs vary widely in their doses, but generally include an estrogen and progesterone. Some are progesterone only. They also come in extended cycle packs, meaning that you will only have a menstrual cycle every 3 months. Your doctor will help you pick the right one for you and adjust the dose to minimize side effects. OCPs have a failure rate of 9 percent with typical use.Estrogen and progesterone also come in the form of patches and rings. Biochemically they function the same as OCPs. Patches are changed weekly and rings are changed monthly. With both of these methods, you will go one week without it to facilitate menses. These methods have a failure rate of 9 percent.

Depo-provera is an injectable contraception given every 3 months. Irregular bleeding can occur after 1 to 2 shots. Typically, menses will stop after 2 to 3 injections. Failure rate with this method is 6 percent.

The most effective birth control, with a failure rate less than 1 percent, is a class of implantable long acting and reversable contraception (LARC). These include the arm implant and intrauterine devices (LARC). These have a risk of irregular bleeding in the first few months of use, but usually after 1 year most women do not have menses. Some IUDs are FDA approved to treat heavy menstrual cycles. They can last from 3 to 10 years.

A lot of women are concerned about weight gain associated with birth control. However, there are currently no studies that support that birth control is associated with weight gain. Some progesterones can lead to an increase in appetite, but the result is usually only a few pounds.

If you are certain you are done having children, then you can have a tubal ligation. This can be done through little incision surgery or at the time of delivery. This should be considered permanent and irreversible. Aside from surgical risk, the most common risk is regret. In younger women (younger than 30) the risk is as high as 20 percent. In women older than 30, the risk is lower at around 6 percent. Things that increase this risk is, low number of children, lower socioeconomic status, and relationship status.

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