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Birth control options for women - Highlights

Description

An in-depth report on the birth control options available to women.

Alternative Names

Contraception

Highlights:

Birth Control Options

Birth control options for women include:

Hormonal contraceptives, such as birth control pills
Intrauterine devices (IUDs)
Barrier devices, such as condoms, diaphragm, and the cervical cap
Fertility awareness methods
Sterilization

Ortho Evra Warning

The FDA has updated the label for the birth control skin patch Ortho Evra to include results of recent studies warning of increased risks for blood clots for women who use this product.
Recent epidemiology studies have reported that women who use the birth control patch have a higher risk for developing venous thromboembolism (blood clots in the veins) than women who use birth control pills. Venous thromboembolism is a condition that can lead to pulmonary embolism, the blockage of an artery in the lungs.
Ortho Evra is a combination hormonal product that contains the progesterone norelgestromin and the estrogen hormone estradiol. Compared to birth control pills, the patch exposes women to higher levels of estrogen, which increases the risk for blood clots. Women who are older than age 40 or who smoke cigarettes should discuss with their doctors whether the birth control patch is a safe choice.

Nonoxynol-9 Warning

The FDA has ordered manufacturers of stand-alone contraceptive products containing the spermicide nonoxynol-9 to include a warning that this chemical does not provide protection against sexually transmitted disease, including HIV (the virus that causes AIDS).
Contraceptive products that use nonoxynol-9 include gels, foams, films, and inserts that are used as the sole means of contraception.
The FDA also warns that nonoxynol-9 can irritate the vagina and rectum, which may increase the risk of contracting HIV from an infected partner.

Resources

www.nichd.nih.gov -- National Institute of Child Health and Human Development
www.plannedparenthood.org -- Planned Parenthood
http://ec.princeton.edu -- Emergency Contraception Website
www.acog.org -- American College of Obstetricians and Gynecologists
www.guttmacher.org -- The Alan Guttmacher Institute
www.arhp.org -- Association of Reproductive Health Professionals

References

Blythe MJ and Diaz A. Contraception and adolescents. Pediatrics. 2007; 120(5): 1135-48.

Cheng L, Gulmezoglu AM, Piaggio G, Ezcurra E and Van Look PF. Interventions for emergency contraception. Cochrane Database Syst Rev. 2008;(2): CD001324.

Cole JA, Norman H, Doherty M, Walker AM. Venous thromboembolism, myocardial infarction, and stroke among transdermal contraceptive system users. Obstet Gynecol. 2007 Feb;109(2 Pt 1): 339-46.

Collaborative Group on Epidemiological Studies of Ovarian Cancer, Beral V, DollR, Hermon C, Peto R, Reeves G. Ovarian cancer and oral contraceptives: collaborative reanalysis of data from 45 epidemiological studies including 23,257 women with ovarian cancer and 87,303 controls. Lancet. 2008 Jan 26;371(9609): 303-14.

Creinin MD, Meyn LA, Borgatta L, Barnhart K, Jensen J, Burke AE, et al. Multicenter comparison of the contraceptive ring and patch: a randomized controlled trial. Obstet Gynecol.2008;111(2 Pt 1): 267-77.

Erkkola R. Recent advances in hormonal contraception. Curr Opin Obstet Gynecol. 2007;19(6): 547-53.

Hannaford PC, Selvaraj S, Elliott AM, Angus V, Iversen L, Lee AJ. Cancer risk among users of oral contraceptives: cohort data from the Royal College of General Practitioner's oral contraception study. BMJ. 2007;335(7621): 651.

Hov GG, Skjeldestad FE and Hilstad T. Use of IUD and subsequent fertility--follow-up after participation in a randomized clinical trial. Contraception. 2007;75(2): 88-92.

Inki P. Long-term use of the levonorgestrel-releasing intrauterine system. Contraception. 2007;75(6 Suppl): S161-6.

Jick S, Kaye JA, Li L, Jick H. Further results on the risk of nonfatal venous thromboembolism in users of the contraceptive transdermal patch compared to users of oral contraceptives containing norgestimate and 35 microg of ethinyl estradiol. Contraception. 2007 Jul;76(1): 4-7.

Kaunitz AM. Clinical practice. Hormonal contraception in women of older reproductive age. N Engl J Med. 2008;358(12): 1262-70.

Kaunitz AM, Arias R and McClung M. Bone density recovery after depot medroxyprogesterone acetate injectable contraception use. Contraception. 2008;77(2): 67-76.

Kulier R, O'Brien PA, Helmerhorst FM, Usher-Patel M and D'Arcangues C. Copper containing, framed intra-uterine devices for contraception. Cochrane Database Syst Rev. 2007;(4): CD005347.

Lopez LM, Grimes DA, Gallo MF and Schulz KF. Skin patch and vaginal ring versus combined oral contraceptives for contraception. Cochrane Database Syst Rev. 2008;(1): CD003552.

Margolis KL, Adami HO, Luo J, Ye W, Weiderpass E. A prospective study of oral contraceptive use and risk of myocardial infarction among Swedish women. Fertil Steril. 2007 Aug;88(2):310-6.

Meirik O. Intrauterine devices - upper and lower genital tract infections. Contraception. 2007;75(6 Suppl): S41-7.

Nelson AL. Contraindications to IUD and IUS use. Contraception. 2007;75(6 Suppl): S76-81.

O'Brien PA, Kulier R, Helmerhorst FM, Usher-Patel M and d'Arcangues C. Copper-containing, framed intrauterine devices for contraception: a systematic review of randomized controlled trials. Contraception. 2008;77(5): 318-27.

Peterson HB. Sterilization. Obstet Gynecol, 2008;111(1): 189-203.

Polis CB, Schaffer K, Blanchard K, Glasier A, Harper CC and Grimes DA. Advance provision of emergency contraception for pregnancy prevention (full review). Cochrane Database Syst Rev. 2007;(2): CD005497.

Power J, French R and Cowan F. Subdermal implantable contraceptives versus other forms of reversible contraceptives or other implants as effective methods of preventing pregnancy. Cochrane Database Syst Rev. 2007;(3): CD001326.

Prager S and Darney PD. The levonorgestrel intrauterine system in nulliparous women. Contraception. 2007;75(6 Suppl): S12-5.

Roumen FJ. The contraceptive vaginal ring compared with the combined oral contraceptive pill: a comprehensive review of randomized controlled trials. Contraception. 2007;75(6): 420-9.

Rosenberg L, Zhang Y, Constant D, Cooper D, Kalla AA, Micklesfield L, et al. Bone status after cessation of use of injectable progestin contraceptives. Contraception. 2007;76(6): 425-31.

Tolaymat LL and Kaunitz AM. Long-acting contraceptives in adolescents. Curr Opin Obstet Gynecol. 2007;19(5): 453-60.

Reviewed last on: 11/11/2008
Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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