Our Ob/Gyn Dr. Sara Klevens reports on birth control!
Dr. Sara Klevens is a good friend from Princeton and is now our Ob/Gyn at the illustrious office of Frumovitz, Matsunaga, Daly, Ross, Thordarson Vogel and Klevens in Santa Monica associated with St. John's Health Center. Some think it's weird to have your friend be your Ob/Gyn, but we are thankful for the comfort and honesty! We asked Dr. Klevens to share her expert medical thoughts on birth control. And here they are!
One of the many hot topics addressed in my office on a daily basis is birth control. There are many options out there and lots of misinformation too so I thought I could break things down a little bit and hopefully help people make the best birth control choice for them.
There are nonhormonal barrier methods such as condoms or diaphragms. The hang up with these is actually using them. Diaphragms must be put in with spermacide prior to intercourse and left in place for at least 6 hours after. They both have a failure rates close to 8% which is related to improper use or condom breakage.
Oral Contraceptives (OCP) are the most commonly used birth control in the US and there are many different types and doses. Typically I start a patient on a low dose OCP because the lower the dose, the fewer the side effects. All birth control pills make periods lighter, more regular and less painful. The pill also helps women with acne and moodiness around their periods. Other benefits include a 50% reduction in lifetime risk of ovarian, colon and uterine cancer, if used for five years or more, and there is no established link between OCPs and breast cancer. Weight gain is not a common side effect of low dose OCPs.
Potential side effects include breast tenderness, feeling emotional and bloating. These side effects tend to resolve as your body acclimates to the medication over the course of 1-2 months. The most serious side effect of the pill is blood clots—with low dose pills this is a rare occurrence but very serious if it occurs.
Women who have trouble remembering to take pills or who experience a lot of nausea with the pill may do well on the Nuvaring. This is a round flexible ring that is placed in the vagina and left there for 3-4 weeks at a time. The medication is time released from the ring and the medication is absorbed through the vaginal skin. This has all the same benefits and side effects of a traditional OCP.
Itrauterine Devices (IUD) are another great form of birth control. These are T shaped devices that are placed inside the uterus and they are as effective as getting your tubes tied, but completely reversible. The Paragard IUD is a copper IUD, it has no hormones in it whatsoever and it can be left in for up to 10 years, but removed at any time. The one potential draw back of this IUD is that it can make the periods heavier. The Mirena IUD has a small amount of progesterone in it, no estrogen. This progesterone acts locally on the lining of the uterus and makes it very thin. The benefit to the patient is very light periods or no periods at all.
That covers most options. Always keep in mind that what works for one person may not work for another and there can be a period of trial and error until the perfect match is made.
Please write in with your questions and hot topics you'd like Dr. Klevens to answer!!
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