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Birth Control Briefing

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How well does it work? It’s 99.7 percent effective with perfect use: Only one in a thousand women taking their pill every single day without fail would become pregnant. With typical use (that is, forgetting to take a pill now and then), the pill is 92 percent effective. This means that eight in one hundred women will get pregnant on the pill. (Trust me, it really happens: I’ve delivered babies conceived this way.)

Pros:

  • Safe (Except for women over thirty-five who smoke or who have classic migraines with visual disturbances before the headaches start. The pill is not recommended for these women due to an increased risk of blood clots.)
  • Cuts the risk of ovarian and uterine cancer by half
  • The most popular method of contraception among teens

Cons:

  • You need a prescription.
  • It doesn’t protect against STIs.
  • You have to take your pill every day.
  • It’s associated with an increased rate of cervical cancer (although experts think this increased risk comes from not using condoms and therefore contracting HPV, which is linked to cervical cancer).
  • It can be expensive.

The Ring
Approved in 2001, the Ring is a soft, flexible silicone ring that releases estrogen and progestin and carries about the same low risks as the pill. You remove it after three weeks, then insert a new one a week later. A nice feature of the Ring is that it keeps your hormone levels slightly lower than even the lowest-dose pill. Also, since the medication is absorbed via the vagina, the hormones don’t have to be processed by your liver the way they do with the oral pill. I don’t have many patients using the Ring, because most don’t like the idea of inserting something in their vaginas (funny, isn’t it?). My teen patients who do use the Ring like the fact that they don’t have to remember to take a pills every day—and that it’s a lot easier to hide than a pill container.

How well does it work? It is assumed to be as effective or even more effective than the pill. It’s more than 99 percent effective with perfect use in adult women and 92 percent effective with typical use.

Pros:

  • Safe (same low risks as the pill)
  • Convenient—you only have to think about it twice a month (once when you take it out, once when you put a new one in)

Cons:

  • Hasn’t been formally studied in teens
  • Might cause vaginal discharge or discomfort
  • Doesn’t protect against STIs
  • Can slip out . . . but still works if replaced within three hours

The Patch
This is a skin-colored patch, worn on the stomach, back, arm, or buttocks, that releases estrogen and progestin.

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