What if the Pill is Not for You? Reversible Contraceptive Choices

Birth control pills are the most commonly used form of contraceptive in the United States, closely followed by sterilization. But what is there for women who want reversible contraception but can't or don't want to take the Pill? Dr. Donnica Moore discusses the different reversible contraceptive options available today. Dr. Moore discusses their various risks and benefits, including how likely they are to prevent pregnancy and sexually transmitted infections. She also offers useful tips to help evaluate your contraceptive options.

Despite the many methods available to prevent pregnancy, about 6 of every 10 pregnancies in the United States are unplanned. This figure is even more alarming in light of the fact that of the 60 million US women or reproductive age, a third do not need contraception because they are sterile, pregnant, trying to become pregnant (apr. 7 million), are virgins, or are not sexually active. A 1995 report by the Institute of Medicine attributed this high rate of unintended pregnancies, in part, to Americans' lack of knowledge about birth control. Perhaps in this area more than any other, knowledge is truly power: the power to plan when or whether to conceive as well as the power to protect yourself from numerous sexually transmitted diseases, many of which are still incurable and a few of which--like HIV/AIDS or hepatitis C-may be fatal.

Nearly two-thirds of reproductive-age women who practice contraception use reversible methods such as oral contraceptives or condoms. The remaining women rely on female (tubal ligation or hysterectomy done for other reasons) or male sterilization (vasectomy). According to the 2000 Gallup Survey of Women's Health and Contraception Methods, nearly 4 out of 10 women ages 18-49 now use some form of long-acting birth control, including sterilization, injections, implants, and IUD's. Female sterilization, the pill, and the condom are the most widely used birth control methods in the US. The Pill is a safe and effective choice for the 16 million American women who use it and it provides numerous other health benefits in addition to its contraceptive protection. Yet there are many women who can not take the Pill. These include women who may be pregnant; who are over 35 and smoke more than 15 cigarettes/day; who have unexplained vaginal bleeding; who have had certain blood clots in the veins or lungs; who have certain liver diseases; or who have estrogen-dependent tumors (e.g. breast cancer). Some women with other medical conditions may be advised by their physicians not to take the Pill. These include some-but not all-women with heart disease; liver disease; uncontrolled high blood pressure or cholesterol levels; uncontrolled diabetes; certain types of migraine headaches; certain types of seizure disorders; or those with a parent or sibling who had a stroke, heart attack, or clots in the lung before the age of 55. There are many women who have been frustrated with side effects of the Pill and others who simply don't want to (or can't remember to) take a hormonal medication every day.

Unfortunately, most of these women are not aware of their many other contraceptive options. There are several different categories of reversible contraceptive options to the Pill. These include: