Because Life’s Full of Surprises, but Pregnancy Doesn’t Have to be One!

by Sarah Mashburn, MD, Lakeside Doctors Gynecology and Obstetrics

From adolescence to menopause, women have a variety of contraception options available today. It’s important to know, there’s no one-size-fits-all approach to pregnancy prevention. When deciding on the best birth control option, visit with your OB/GYN to consider your individual needs, medical history and future plans to determine the best fit for you.

Medical History Matters

Your medical history plays a significant role in selecting a contraception method. Conditions such as a history of blood clots in your legs or lungs, migraines with aura, tobacco use (especially in individuals over age 35), high blood pressure and diabetes should all be considered and discussed with your physician. For example, if you have a history of blood clots you may need to avoid estrogen-containing options and consider progesterone options such as oral progestins, the implant or an intrauterine device (IUD).

Future Pregnancy Planning

Consider your future plans for pregnancy when choosing contraception. If delaying pregnancy for several years is your goal, long-acting reversible contraception (LARC) methods like IUDs or implants may be the best option. These options provide reliable protection without daily upkeep, making them ideal for adolescents or those likely to forget daily pill use or patch changes. We can place IUDs and implants during your office visit and can also provide pain relief options like a one-time dose of medication to help relieve anxiety and local analgesic injections.

Age and Life Stage Considerations

Age and life stage also influence contraception choices. Women approaching menopause may still wish to use birth control to prevent pregnancy and can see improvement in perimenopausal symptoms such as heavy periods and hot flashes with the use of low dose estrogen-containing pills. For those who cannot have estrogen due to medical conditions, alternatives like low-dose or progesterone-only pills, as well as IUDs, can be safe options that also help manage heavy periods.

Permanent Options

For women who are certain about not wanting future pregnancies, permanent sterilization such as tubal ligation may be considered. This is an option whether someone has had multiple pregnancies or none as long as the patient is certain about their decision given that it’s not reversible. This procedure can be performed at the time of a C section, following a vaginal delivery in certain candidates with a small incision underneath the belly button or laparoscopically. When not performed at the time of birth, we recommend waiting six weeks after delivery for the laparoscopic procedure.

Emergency Contraception

Certain contraceptive options like condoms, diaphragms and fertility awareness methods are associated with higher failure rates, so they’re best suited for those who are comfortable with the possibility of a surprise pregnancy. In the case of contraceptive failure, several forms of emergency contraception are available, and are most effective when taken promptly after intercourse. Over-the-counter pills like Plan B contain a high dose of progesterone to stop or delay the release of an egg from the ovary. However, Plan B is less effective for individuals with a higher body mass index (BMI). For those patients, we can place an IUD or prescribe a different type of emergency contraception pill called Ella, so  you should call your doctor as soon as possible after intercourse. If you would like to have a prescription on hand for emergencies, be sure to ask your doctor during your annual exam.

Dispelling Myths

I also tell patients to be aware of birth control myths and misconceptions. Concerns about birth control impairing future fertility are unfounded, with decades of data supporting its safety. Birth control works by temporarily pausing fertility, allowing normal cycles to resume once discontinued.

There are side effects that can be seen with contraception use, but typically if you do not like the first birth control method you try, there are plenty of other options to explore. We recommend giving it three months to allow unwanted side effects to subside. But if you’re unhappy with your method, don’t hesitate to call your provider to discuss alternatives. By having open and informed discussions, we can help you make proactive decisions about your reproductive health.