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Birth Control Methods and Options
The side effects of the ParaGard copper IUD are minimal. IUDs are the most cost effective method or option for birth control available and are used by 160 million women worldwide. Side Effects of birth control pills.
The IUD is used by only 1% of women in the U.S. The ParaGard IUD is a small, "T-shaped" device made of flexible plastic and requires no daily attention. It can be used safely for up to 12 years once inserted and is the most cost-effective method of contraception available.
An intrauterine device is a birth control device also known as an IUD. It is a device placed in the uterus and is the world's most widely used method of reversible birth control. Worldwide, the IUD is used by 160 million women.
Did you know that for 120 hours after sex, you can take emergency contraceptive pills to avoid becoming pregnant? AND for 5 to 7 days after sex, you can have a Copper T 380 A IUD (ParaGard) put in? Emergency postcoital insertion of the Copper T 380 A IUD (ParaGard) is the most effective currently available postcoital contraceptive. Not all doctors are aware of this.
Insertion of a copper-T IUD as emergency contraception is more than 99% effective, making it more effective than emergency (morning after) contraceptive pills.
Since September of 2005, ParaGard IUD is approved for women from age 16 through menopause. ParaGard is also no longer contraindicated for women with a history of sexually transmitted diseases or pelvic inflammatory disease unless a patient currently has acute PID or engages in sexual behavior suggesting a high risk for PID. Finally, mutual monogamy is no longer a user requirement.
Pelvic inflammatory disease (PID) is a general term that refers to infection of the uterus, fallopian tubes and other reproductive organs. It is a common and serious complication of some sexually transmitted diseases (STDs), especially chlamydia and gonorrhea. It is estimated that more than 1 million women in the U.S. experience an episode of acute PID every year. It can be treated with several types of antibiotics.
WHAT ARE THE ADVANTAGES OF AN IUD?
- Copper T IUD (ParaGard) and Levonorgestetrel IUD (Mirena) are the two most effective reversible methods of birth control.
- Copper T 380 A IUD (ParaGard) is effective for at least 12 years.
- Only 1 out of 100 women using a Copper T for 12 years will become pregnant.
- The copper IUD prevents ectopic pregnancies.
- This contraceptive is very cost effective (inexpensive) over time.
- Use of an IUD is convenient, safe, and private.
- All you have to do is check for the strings each month.
- The ParaGard IUD may be used by women who cannot use estrogen–containing birth control pills, patches or vaginal ring including breastfeeding women.
- The IUD may be inserted immediately following the delivery of a baby or immediately after an abortion.
- Some studies of IUDs have shown a decreased risk for uterine cancer. There is also some evidence that IUDs protect against cervical cancer.
WHAT ARE THE DISADVANTAGES OF AN IUD?
- There may be cramping, pain or spotting after insertion.
- The number of bleeding days is slightly higher than normal and you may have somewhat increased menstrual cramping. If your bleeding pattern is bothersome to you, contact your doctor. There are medications which may give you a more acceptable pattern of bleeding and cramping.
- The IUD provides no protection against sexually transmitted infections. Use condoms if there is any risk.
- There is a higher initial cost of insertion. However, after 2 years, it is the most cost-effective contraceptive method.
- The IUD must be inserted by a doctor, nurse practitioner, nurse midwife or physician’s assistant.
- A very small percentage of women are allergic to copper.
- A small percentage of IUDs may be expelled by a woman’s body within the first few months due to an improper fit.
The worst side effect is partial or total perforation of the uterine wall or cervix which may occur with use of the ParaGard T 380A. The rate of perforation in randomized trials of the ParaGard T 380A has been 1 in 1,360.
It is important that the doctor who inserts the IUD is experienced in the procedure. An inexperienced or careless doctor is the major cause of a uterine wall perforation. It is generally believed that perforations, if they occur, are encountered at the time of insertion, although the perforation may not be detected until some time later.
Insertion of the IUD may introduce bacteria into the uterus. The insertion process carries a small, transient increased risk of PID in the first 20 days following insertion. It is very important that the provider use proper infection-prevention techniques during insertion.
If you need help finding a doctor that offers IUDs, visit www.IUD.com. If you are a physician or clinic who provides IUDs to your patients, register with this website.
A recent study in Latin America, Asia and Africa found that factors contributing to discontinuation among 321 copper IUD users were expulsion (3.1 percent) and bleeding and pain (4.5 percent). Researchers also found that women younger than age 20 had higher expulsion rates than older women.
Women should be counseled about side effects and what they mean before an IUD is inserted. If menstrual changes occur during the first few months of use, providers should reassure the woman that these side effects are normal and will usually diminish over time. It is not medically necessary to remove the IUD unless the woman also complains of fever, abdominal tenderness or unusual vaginal discharge -- signs of PID -- or severe pain -- a sign of uterine perforation or partial expulsion. Providers can also help women cope with side effects by prescribing nonsteroidal anti-inflammatory drugs, such as ibuprofen. For example, doctors can recommend 400 milligrams of ibuprofen four times a day until bleeding stops for women with menstrual bleeding problems and pain.
Research suggests that providers may be able to predict removals for bleeding or pain at the one-month follow-up visit. It is ironic and possibly even moronic that more third world women benefit from a superior form of birth control than women in North America.
Even though over one fourth of European women use the copper IUD, only 1% of American women use an IUD, in large part due to negative publicity and law suits against an IUD called the Dalkon Shield used back in the 1970s. It effectively “poisoned the well” against IUDs and doctors became “gun shy” against potential legal problems. Even though it is not exactly rocket science, most doctors in the U.S. have never been trained in med school on how to insert an IUD.
Birth Control Pills
About 40% of women who take birth-control pills will have side effects of one kind or another. Some of these side effects include light bleeding between menstrual periods, skipped periods, nausea, weight change, bloating, increase in vaginal infections and no libido.
The most serious side effect associated with the birth-control pill is a greater chance of blood clots, stroke and heart attack. Women who have the most risk of developing these problems are women who smoke, are over thirty-five and women with other health problems such as diabetes, high blood pressure, heart or vascular disease or blood cholesterol and triglyceride abnormalities. Other serious side effects are worsening of migraine headaches, gall bladder disease, and an increase in blood pressure.
Women who take birth control pills have a slightly increased risk of developing breast cancer early in life, with the risk being greatest for women who use oral birth control before they have their first child. Use of oral birth control was associated with a 19% overall increased risk of breast cancer diagnosed before menopause. But the increase in risk more than doubled among women who took oral contraceptives before a first pregnancy.
In the January 2006 issue of The Journal of Sexual Medicine, researchers have published a study measuring sex hormone binding globulin before and after discontinuation of the oral contraceptive pill. The research concluded that women who used the oral contraceptive pill may be exposed to long-term problems from low values of "unbound" testosterone potentially leading to continuing sexual, metabolic, and mental health consequences.
Sex hormone binding globulin (SHBG) is the protein that binds testosterone, rendering it unavailable for a woman's physiologic needs. The study showed that in women with sexual dysfunction, elevated SHBG in "Oral Contraceptive Discontinued-Users" did not decrease to values consistent with those of "Never-Users of Oral Contraceptive". Thus, as a consequence of the chronic elevation in sex hormone binding globulin levels, pill users may be at risk for long-standing health problems, including sexual dysfunction.
Oral contraceptives have been the preferred method of birth control because of their ease of use and high rate of effectiveness. However, in some women oral contraceptives have ironically been associated with women's sexual health problems and testosterone hormonal problems. Now there are data that oral contraceptive pills may have lasting adverse effects on the hormone testosterone.
The research, in an article entitled: "Impact of Oral Contraceptives on Sex Hormone Binding Globulin and Androgen Levels: A Retrospective Study in Women with Sexual Dysfunction" published in The Journal of Sexual Medicine, involved 124 premenopausal women with sexual health complaints for more than 6 months. Three groups of women were defined: i) 62 "Oral Contraceptive Continued-Users" had been on oral contraceptives for more than 6 months and continued taking them, ii) 39 "Oral Contraceptive Discontinued-Users" had been on oral contraceptives for more than 6 months and discontinued them, and iii) 23 "Never-Users of Oral Contraceptives" had never taken oral contraceptives. SHBG values were compared at baseline (groups i, ii and iii), while on the oral contraceptive (groups i and ii), and well beyond the 7 day half-life of sex hormone binding globulin at 49-120 (mean 80) days and more than 120 (mean 196) days after discontinuation of oral contraceptives (group ii).
The researchers concluded that SHBG values in the "Oral Contraceptive Continued-Users" were 4 times higher than those in the "Never-Users of Oral Contraceptives". Despite a decrease in SHBG values after discontinuation of oral contraceptive pill use, SHBG levels in "Oral Contraceptive Discontinued-Users" remained elevated when compared to "Never-Users of Oral Contraceptives". This led to the question of whether prolonged exposure to the synthetic estrogens of oral contraceptives induces gene imprinting and increased gene expression of SHBG in the liver in some women who have used the oral contraceptives.
Dr. Claudia Panzer, an endocrinologist in Denver, CO and lead author of the study, noted that "it is important for physicians prescribing oral contraceptives to point out to their patients potential sexual side effects, such as decreased desire, arousal, decreased lubrication and increased sexual pain. Also if women present with these complaints, it is crucial to recognize the link between sexual dysfunction and the oral contraceptive and not to attribute these complaints solely to psychological causes."
"An interesting observation was that the use of oral contraceptives led to changes in the synthesis of SHBG which were not completely reversible in our time frame of observation. This can lead to lower levels of 'unbound' testosterone, which is thought to play a major role in female sexual health. It would be important to conduct long-term studies to see if these increased SHBG changes are permanent," added Dr. Panzer.
Oral contraceptives were introduced in the USA in 1960 and are currently used for reversible pharmacologic birth control by over 10 million women in the US, including 80% of all American women born since 1945 and, more specifically, 27% of women ages 15-44 and 53% of women age 20-24 years. By providing a potent synthetic estrogen (ethinyl estradiol) and a potent synthetic progesterone (for example -- norethindrone), highly effective contraception is achieved by diminishing the levels of FSH and LH, thereby reducing metabolic activity of the ovary including the suppression of ovulation.
Several studies over the last 30 years reported negative effects of oral contraceptives on sexual function, including diminished sexual interest and arousal, suppression of female initiated sexual activity, decreased frequency of sexual intercourse and sexual enjoyment. Androgens such as testosterone are important modulators of sexual function. Oral contraceptives decrease circulating levels of androgens by direct inhibition of androgen production in the ovaries and by a marked increase in the hepatic synthesis of sex-hormone binding globulin, the major binding protein for gonadal steroids in the circulation. The combination of these two mechanisms leads to low circulating levels of "unbound" or "free" testosterone.
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