Birth Control

Careful and consistent use of a recommended birth control method will help prevent an unplanned pregnancy. FPA can help you decide which method is best for you.

FPA provides the following birth control options. Our staff will help you decide which method is best for you.

	Effectiveness	How it is used	Benefits of use	Possible side effects	Possible serious complications
The Pill (many brands) The Patch Ortho Evra®	92-99%	You take 1 pill every day, at the same time every day.	Can help protect against: acne endometrial cancer ovarian cancer excess body hair anemia PMS Can generally make periods lighter and with less cramps.	These symptoms can occur for some women: bleeding between periods breast tenderness headache nausea — rarely, vomiting change in sexual desire depression	These complications are rare, but possible: blood clots in the legs or other parts of the body (more common with the patch than with the pill or the ring) migraine headaches high blood pressure stroke heart attack liver tumors gallstones
The Patch Ortho Evra®	92-99% lower in patients who weigh more than 198 lbs	You use 1 patch per week for 3 weeks in a row. The 4th week is a patch-free week.
The Ring (Nuva Ring)	92-99%	You insert 1 ring vaginally and remove it after 3 weeks.
The Shot (Depo Provera)	99-99.9%	You get 1 shot every 12 weeks (about 3 months).	helps prevent endometrial cancer no pill to take daily	Irregular bleeding (may be less than normal, greater than normal, or not at all) change in sex drive weight gain depression hair loss, or increased hair on the face or body headache temporary decreased bone density	These complications are rare, but possible: liver tumors gallstones ectopic pregnancy
IUC ParaGard® Mirena ®	99%	A clinician inserts the IUC into your uterus	can last up to 12 years long-lasting always there can be used while breastfeeding Mirena may reduce menstrual flow	Spotting between periods Increased cramping during periods ParaGard may increase menstrual flow	Uterine injury or perforation IUC can be expelled Pregnancy with an IUC in place can be dangerous

Other Birth Control Methods Available at FPA

Diaphragm

• A rubber, dome-shaped cup with a spring rim, which is worn deep in the vagina during intercourse.
• Because the vagina of every woman is unique, each must be "sized" for a diaphragm by a physician or trained clinician.
• Used with spermicidal (sperm killing) jelly or cream. It is inserted into the vagina to completely cover the cervix.
• Works as a barrier and holds the spermicide in place.
• The diaphragm must be put in BEFORE intercourse and left in place at least 6 hours after intercourse.

---

Over-the-Counter Birth Control Methods (available at the pharmacy)

Condoms

• A male condom is a thin cover that fits smoothly over the erect penis.
• A female condom is a sheath or pouch with one end that goes into the vagina and the other end that rests on the outside.
• Acts as a barrier to keep the semen (containing millions of sperm) from going into the vagina by holding the semen in the condom.

Spermicide (foam, jelly, film)

Spermicide contains a chemical that inactivates sperm. It is used by the woman and inserted deep into the vagina each time she has intercourse.

• Forms a barrier over the cervix and the kills sperm trying to reach the cervical canal.
• Should be inserted no more than 20 minutes before intercourse and additional foam must be used with each intercourse.

Vaginal Sponge

• A polyurethane sponge containing a spermicide that is placed into the vagina prior to intercourse.
• Works much like the diaphragm by acting as a barrier and spermicide over the cervix.

Morning After Pill or Emergency Contraceptive Pills (ECPs)

Plan B (one brand of ECPs) became available over-the-counter to women 17 years old or older in 2006. Women 16 years old and younger still need to get a prescription for ECPs.

• ECPs have been in use for many years. In February 1997, the FDA acknowledged that ECPs are effective and safe.
• Used when an episode of unprotected sex has occurred.
• For maximum effectiveness, ECPs should be started within 72 hours after the episode of unprotected sex.
• Works by stopping or delaying the release of an egg from the ovary (ovulation) or the lining of the uterus (endometrium) is altered so that the fertilized egg cannot implant.
• Approximately 50% of patients will have menses within one week of taking the ECP. The remaining patients will have menses within 21 days. The first menses may be irregular and light or heavy.
• If there is no menses within three weeks, the patient must return for an examination and pregnancy test.

Existing Pregnancy

The Emergency Contraceptive Pills WILL NOT terminate an existing pregnancy and may be harmful to the fetus. However, we are not aware of any published reports indicating that the ECP causes fetal abnormalities. A patient who is pregnant is not a candidate for the ECP. ECPs will not alter an "ectopic" pregnancy. An ectopic pregnancy is a medical emergency. If symptoms of an ectopic pregnancy occur, you must seek care through your private doctor or emergency room.

Common Side Effects

• Nausea - approximately 50% of patients will experience nausea.
• Approximately 20% of women will report vomiting.
• Some women may also experience breast tenderness, abdominal pain, headache or dizziness.
• Relief of the side effects should occur within a day or two after treatment is completed.

Permanent Birth Control Methods (FPA will provide a Referral)

Essure

• A permanent (non-reversible) method of female sterilization.
• Outpatient procedure in which a doctor inserts coil springs (or microinserts) through the body’s natural pathway into the Fallopian tubes.
• Over the next few months, a tissue plug is formed in the tubes that prevent sperm from passing through. The completion of the plug is confirmed with a special test.

Tubal Sterilization

Tubal sterilization is a permanent (non-reversible) method of female sterilization. It is a surgical procedure in which the surgeon cuts and clips the Fallopian tubes, which prevents sperm from passing through.

Vasectomy

A permanent (non-reversible) method of male sterilization. It is a surgical procedure in which the surgeon cuts the Vas Deferens (through which sperm leave the testes). The success of the surgery is confirmed with a special test.