Birth Control Health Center

Not Your Mother's Birth Control

Reading a popular women's magazine the other day, I was startled to discover that what looked like one of those peel-off makeup samples wasn't a makeup sample at all. It was "The Patch," a form of birth control that you slap on your skin once a week. Of course, the magazine sample didn't actually contain the combination of estrogen and progestin that the real patch releases -- it was just to demonstrate how thin and unnoticeable the real thing is.

A few pages later, I found an ad for NuvaRing, an insertable hormonal contraceptive. After decades of little to no exciting news in contraceptives for women, suddenly we're riding a wave of promising new birth control methods.

"This is really unprecedented," says Stephanie B. Tiel, M.D., a clinical instructor of obstetrics and gynecology at Columbia University College of Physicians and Surgeons in New York. "There are four new FDA-approved methods of contraception now on the market."

Tiel calls the new options "the best of both worlds" -- they have the quick reversibility of the pill, should you decide to get pregnant, but they're longer-acting systems that don't require busy women to remember to do something at the same time every day.

"You Don't Have to Think About It"

First on the market was Mirena, an intrauterine device (IUD) that's been used in Europe for over ten years. Mirena releases levonorgestrel, a hormone commonly found in the pill, to create a "hostile uterine environment" and prevent pregnancy. Inserted (and removed) by a physician, Mirena works for up to five years, with a failure rate of less than 1%.

"You don't have to think about it. Once it's in, it's in," says Tiel. "It's just as effective as having your tubes tied, only it's reversible." Another big plus: Mirena causes lighter periods for most women. In fact, some 20% of Mirena users don't menstruate at all. "It's totally normal. The hormone in the IUD thins the ¼ lining [of the uterus] so you still ovulate, but you don't bleed," Tiel explains. Most of the other 80% experience 1-2 days of very light bleeding, a huge relief if you normally have problem periods.

Some women avoid IUDs because of fears of infection and infertility. But those problems were limited to the Dalkon Shield, which had a braided string for the doctor to use in removing the device. The braiding allowed bacteria to grow, unlike the single-filament strings used to remove Mirena (and the other current IUD, the copper-IUD).

As with any birth control method, there are some disadvantages. Mirena has to be inserted and removed by a doctor; it's a simple, painless procedure, but not a do-it-yourself task. It's also expensive, costing about $360 for the device plus your doctor's visit fees, if your insurance doesn't cover it (some plans do).