Contraception Health Article

Precautions

There are risks associated with some forms of birth control. Some of the risks of each method are listed below:

• Birth control pills—The hormone (estrogen) in birth control pills can increase the risk of heart attack in women over 40 who smoke.
• IUD—The IUD can increase the risk of serious pelvic infection. The IUD can also injure the uterus by poking into or through the uterine wall. Surgery might be needed to fix this.
• Tubal sterilization—"Tying the tubes" is a surgical procedure and has all the risks of any other surgery, including the risks of anesthesia, infection, and bleeding.

Preparation

No specific preparation is needed before using contraception. However, a woman must be sure that she is not already pregnant before using a hormonal method or having an IUD placed.

Aftercare

No aftercare is needed.

Risks

Many methods of birth control have side effects. Knowing the side effects can help a woman to determine which method of birth control is right for her.

• Hormonal methods—The hormones in birth control pills, Depo Provera, and Norplant can cause changes in menstrual periods, changes in mood, weight gain, acne, and headaches. In addition, it may take many months to begin ovulating again once a woman stops using Depo Provera or Norplant.
• Barrier methods—A woman must insert the diaphragm in just the right way to be sure that it works properly. Some women get more urinary tract infections if they use a diaphragm. This is because the diaphragm can press against the urethra, the tube that connects the bladder to the outside.
• Spermicides—Some women and men are allergic to spermicides or find them irritating to the skin.
• IUD—The IUD is a foreign body that stays inside the uterus, and the uterus tries to get it out. A woman may have heavier menstrual periods and more menstrual cramping with an IUD in place.
• Tubal sterilization—Some women report increased menstrual discomfort after tubal ligation. It is not known if this is related to the tubal ligation itself.

There is no perfect form of birth control. Every method has a small failure rate and side effects. Some methods carry additional risks. However, every method of birth control can be effective if used properly.

BOOKS

Osathanondh, Rapin, Michael R. Stelluto, and Karen J. Carlson. "Contraception." In Primary Care of Women,ed. Karen J. Carlson and Stephanie A. Eisenstat. St. Louis: Mosby-Year Book, Inc., 1995.

Osathanondh, Rapin. "Conception Control." In Kistner's Gynecology, ed. Kenneth J. Ryan, Ross S. Berkowitz, and Robert L. Barbieri. St. Louis: Mosby, 1995.

Amy B. Tuteur, MD

KEY TERMS

Fallopian tubes—The thin tubes that connect the ovary to the uterus. Ova (eggs) travel from the ovary to the uterus. If the egg has been fertilized, it can implant in the uterus.

Fertilization—The joining of the sperm and the egg; conception.

Implantation—The process in which the fertilized egg embeds itself in the wall of the uterus.

Ovulation—The release of an egg (ovum) from the ovary.