Tag Archives: contraceptive implant

Do Birth Control Pills Cause Breast Cancer? The Latest Study

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Last month, you might have seen headlines warning you that hormonal birth control increases risk for breast cancer. This news came from a study that examined the medical records of nearly 1.8 million Danish women — and the huge sample size lent heft to the findings, several of which stood in stark contradiction to commonly held beliefs about modern hormonal contraception.

Some types of hormonal contraception could increase breast cancer risk, while others may not. But the Pill also reduces risk for endometrial and ovarian cancers.

Birth control comes in two “flavors” — hormonal and nonhormonal. Hormonal contraception is among the most effective, and includes birth control pills, hormonal IUDs, the shot, the vaginal ring, the implant, and the patch. Nonhormonal contraception ranges from very effective, including surgical sterilization and the copper IUD, to the not-quite-as-effective, including condoms, diaphragms, and withdrawal. (With the exception of condoms, birth control does not provide protection against STDs.)

Hormonal contraception is one of the greatest achievements in the history of medicine, and offers those wishing to control their fertility an array of effective options. However, as with all effective medications, there is potential for side effects. And, because many forms of hormonal birth control contain types of estrogen, and exposure to estrogen is a risk factor for breast cancer, many people wonder if hormonal birth control might increase users’ chances of developing breast cancer later in life.

Most birth control pills contain a combination of two hormones: estrogen and progestin (synthetic progesterone). Other hormonal methods, such as the ring and the patch, also use combinations of these two hormones.

There are also pills that don’t contain estrogen, called POPs, or progestin-only pills — aka the “minipill.” Additionally, hormonal IUDs, the implant, and the shot are progestin-only methods.

What Previous Studies Have Shown

The connection between hormonal contraception and breast cancer is murky, because the association is difficult to study properly. There are so many different types of hormonal contraceptives, each with different dosages, different chemical formulations, and different ways of entering the body. We can’t tease these differences apart on the one hand, but make blanket statements about hormonal contraception as a whole on the other hand. But we can look at the available evidence and see where it points. Continue reading →

STD Awareness: Do IUDs and Implants Prevent STDs?

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Highly effective birth control methods, namely intrauterine devices (IUDs) and implants, have received a lot of well-deserved attention in recent years. They are as effective at preventing pregnancy as permanent sterilization, but can be stopped at any time, and can last from three to 12 years. They are the contraceptive of choice for female family-planning providers, who should know a thing or two about choosing an optimal birth control method. They are fantastic options for teenagers and others hoping to delay pregnancy for at least a few years. And the best news is that, for now anyway, these pricey birth control methods are still available at no cost to Americans covered by Medicaid or health insurance.

For the best protection against unintended pregnancy and STDs, combine condoms with IUDs or contraceptive implants.

If IUDs and implants prevented sexually transmitted diseases (STDs), they would pretty much be perfect — but, alas, like most forms of birth control, they don’t protect you from viruses, bacteria, and other bugs that can be passed from person to person through sex. To reduce their risk for STD exposure, sexually active people must employ other strategies, including (1) being in a mutually monogamous relationship with a person who does not have STDs; (2) being vaccinated before becoming sexually active to receive protection from hepatitis B virus and human papillomavirus (HPV), two sexually transmitted viruses; and, last but definitely not least, (3) condoms, condoms, condoms!

A study published this month looked at college students using IUDs and implants and found that most of them didn’t use condoms the last time they had vaginal sex — 57 percent of women who were not using IUDs or implants used a condom, compared to only 24 percent of women who were using IUDs or implants. That’s not too surprising if pregnancy prevention were the only concern, but condoms are an important addition for anyone seeking to reduce their STD risk. Continue reading →

IUDs and Implants: It’s Not Too Late for LARCs

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Access to contraception is coming under attack, and reproductive-health advocates are scrambling to find ways to protect it. In December, Obama did what he could to protect Planned Parenthood from losing its ability to serve Medicaid patients. In New York, the state’s attorney general has moved to ensure that New Yorkers will continue to receive no-copay birth control as part of their insurance benefits, and Massachusetts moved to defend Medicaid patients’ right to use Planned Parenthood’s services in the event of federal interference. And, across the country, people at risk for unintended pregnancy are clamoring for highly effective, long-term birth control to see them through the next four tumultuous years.

IUDs and implants can help you and your uterus make it through the Trump administration.

Tom Price, who was confirmed as secretary of health and human services last month, represents the most immediate threat to our birth-control access. As HHS secretary, Price has the power to declare that contraception is not a “preventive” service insurers must make available to their customers with no copay. In one fell swoop, Price could undo the enormous progress the Obama administration made in expanding access not just to all forms of contraception, but to highly effective forms of contraception that had for so long been out of reach to so many.

Before the Affordable Care Act, long-acting reversible contraception (LARC) methods like IUDs and implants were known to be highly effective — not just cost-effective, but also simply the most effective in terms of preventing pregnancy. However, the high upfront costs closed the door to many potential users. Let’s do some quick-and-dirty math: A copper IUD could set you back anywhere from $500 to $932, but it lasts for 12 years. That means it costs $3.50 to $6.50 per month, compared to the Pill, which can cost $10 to $50 a month out of pocket. Clearly, the IUD makes the most financial sense, but for many of us, a medical bill charging upward of $500 doesn’t fit into our budgets. Better to rely on methods like the Pill, which cost more over time, but aren’t as hard on the wallet of someone living paycheck to paycheck or on an otherwise tight budget. Continue reading →

Let’s Talk Contraception: What Contraception Does Your Doctor Choose?

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IUD in hand croppedHave you ever wondered what birth control method your health provider has chosen to use for her contraceptive? Though it is usually not relevant or ethical for your provider to disclose something so personal, you might find it helpful and reassuring to know this information when you are deciding which contraceptive is a good choice for you.

Thanks to the Affordable Care Act, you might not have to worry about footing the bill for an IUD or implant yourself.

New research by Planned Parenthood has some answers to this question. In a recent study published in Contraception, the official journal of the Association of Reproductive Health Professionals and the Society of Family Planning, Planned Parenthood researchers found that women’s health care providers are three-and-a-half times more likely to choose long-acting reversible contraceptives (LARCs) such as IUDs (intrauterine devices) and implants as their contraceptive of choice. Forty-two percent of providers use LARCs, compared to just 12 percent of women in the general population. The birth control pill is used far less often, by only 16 percent of providers surveyed. Earlier studies have also shown these differences, but the Planned Parenthood study shows an increasing trend of women health care providers choosing LARCs.

The Centers for Disease Control and Prevention also conducts surveys and studies to look at contraceptive usage across the general population. Their surveys have shown an upward trend in LARC use — a five-fold increase in the last 10 years. Most of the women using these methods are 25 to 34 years old. But women in general use LARCs far less often than the percentage of health care providers reporting they use LARCs in the Planned Parenthood study. Continue reading →

Let’s Talk Contraception: How Effective Is My Birth Control?

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According to the Guttmacher Institute, 62 percent of women of child-bearing age (roughly 15 to 44 years of age) currently use a contraceptive method. Most contraceptive users are married and on average would like to have two children. This means that a woman might be using a contraceptive method for more than 30 years.

Studies have calculated that if a sexually active woman is not using any contraceptive method, over the course of a year she has an 85 percent chance of becoming pregnant. Using contraceptives greatly decreases this chance, but there are still some possibilities that her contraceptive method could fail to prevent pregnancy.

To maximize your contraception’s effectiveness, use it as correctly and consistently as possible.

When choosing a contraceptive method, you might want to use the safest and most reliable method available. How likely is it that your choice could fail? With the many types of birth control at your disposal, how do you know which is most effective? And why, with even the most effective contraception around, do women still have unintended pregnancies?

If we rank birth control methods according to most effective to the least effective, how do they compare? How is effectiveness measured?  Continue reading →

Contraception in the Zombie Apocalypse

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The zombie hoard approaches. Photo: Caio Schiavo

The zombie horde approaches. Photo: Caio Schiavo

If you’ve watched a zombie movie with your friends, you’ve probably talked about what kinds of weapons you’d be packing in case of a zombie apocalypse. The Centers for Disease Control and Prevention even has a list of supplies you’ll need for a zombie preparedness kit, which includes smart choices like water, duct tape, and bleach. (I would add toilet paper to that list. How you’ll miss it when you’re on the run!) But how many of you have discussed birth control?

You’ve probably picked out which weapons to use during the zombie apocalypse. But have you chosen a birth control method?

Even if your greatest dream is to have a baby, you must admit that the zombie apocalypse is the worst time to be pregnant, give birth, and raise a child. Fleeing and hand-to-hand combat can be a drag while pregnant, and childbirth can kill you, especially without access to trained personnel or hygienic supplies. And if you do manage to birth a baby into this cruel new world, diapers can distract from more pressing duties, and the infant’s cries can attract undead attention.

When you’re in hardcore fight-or-flight mode, taking a pill at the same time every day might be difficult, and besides, a supply of pills can take up valuable backpack real estate. Plus, even if you find an abandoned pharmacy to raid, birth control pills and condoms come with expiration dates and can be affected by high temperatures. The same goes for contraceptive patches and rings. For these reasons, you need a contraceptive method that’s well suited to the zombie apocalypse. Besides abstinence, what are your options? Continue reading →

Let’s Talk Contraception: Contraceptive Implants

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implantMany of us want a long-term method of birth control, but know we’re not able to reliably take a daily pill or interrupt a sexual experience to use a barrier contraceptive. There are several other options available that offer protection on a weekly, monthly, or yearly basis. A very effective but often underused method is the contraceptive implant, which provides pregnancy prevention for three years. The Guttmacher Institute reports that only 0.3 to 0.5 percent of women who use birth control choose an implant, but it is one of the most effective contraceptives.

The implant protects you from pregnancy for three years and, with a failure rate of 0.05 percent, is the most effective reversible contraceptive.

There are two hormonal implants available in the United States: Implanon and Nexplanon. Both contain only a progesterone hormone, etonorgesterol. This hormone prevents pregnancy by suppressing ovulation, thickening cervical mucus, and thinning the lining of the uterus. Nexplanon is quickly replacing Implanon because it is designed to be seen on an X-ray. This feature helps medical providers be sure the implant is placed correctly and reduces problems due to incorrect insertion. If the implant is placed incorrectly, you can have numbness and it may be difficult to remove.

Nexplanon is a very small flexible plastic rod, about the size of a matchstick. It is inserted by your provider under the skin in your upper arm, where it slowly releases the progesterone hormone into your bloodstream and prevents pregnancy for three years. After three years, it must be replaced with a new one to provide continuous effective birth control. However, it can be removed at any time before three years if desired. Continue reading →