Gone are the days of limited options for contraception management that left anyone who could not take a pill with the option of condoms. With a wide array of highly effective new pills and new innovative technology, the options for contraception are abundant. Now a big question on prescribers’ minds is how do we choose what is right for our patients.
1. Are hormones right for your patient?
Hormonal options now include pills, patches, vaginal rings (monthly or yearly), progesterone shots, arm implants, and levonorgestrel secreting IUDs. The diversity of options allow for daily, weekly, or monthly applications that meet the varying needs of patients. However, there are significant contraindications to estrogen containing products such as history of blood clots, uncontrolled hypertension and smoking. In these cases, you might consider a progesterone only or non-hormonal option. Non-hormonal options now include condoms, vaginal gels, copper IUDs and tubal ligations. Condoms and gels allow for protection as needed in the moment without having to use something throughout the month.
2. Does your patient need help regulating their cycle?
If cycles are irregular, heavy, or painful, you may consider an estrogen and progesterone combination pill, patch, or ring to help bring cycles to a regular monthly pattern.
3. Does your patient need long term and reversible contraception?
A hands-off approach to reversible birth control in the form of an arm implant or IUD may be the easy solution your patient needs. Implants can last up to 3 years and IUDs can range from 3 to 10 years of protection. Both have excellent rates of return to fertility after removal making them an ideal choice for patients who want to wait awhile before having children.
4. Is your patient done having children?
If the patient is done having children you can consider an IUD or a tubal ligation for more long-term prevention of pregnancy.
With all the new options available, we can find an individualized option that works best for our patients and their lifestyle.