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Not Your Mother's Birth Control

Women today have a wide array of new and easy birth control options. Just pick your preference!

"You Don't Have to Think About It" continued...

Following on Mirena's heels came Lunelle, a monthly hormonal injection. Unlike Depo-Provera, women still menstruate with Lunelle, which has a ten-day "window" for each new dose. In other words, if you got your last Lunelle shot on October 10, you can get your next one any time from November 5-15 without dampening its effectiveness.

Lunelle's effectiveness, at 98-99%, is equivalent to that of the birth control pill if the woman's compliance is good. And since you have to get the shot only once a month, compliance should be higher than with a once-a-day pill. Disadvantages? Some women don't like shots, and the monthly doctor visits can be inconvenient.

Patching It Up

Tiel predicts that Ortho Evra, the birth control patch, will be immensely popular. Using the same hormones as in the most popular birth control pill, Ortho Tri Cyclen, the patch can be applied anywhere on the body -- the buttocks, the lower back, the abdomen -- except directly over the breast. "It's discreet. People don't have to see it if it's under your underwear," she says. It's changed once a week, and has the same possible side effects as the pill.

The big difference: patch compliance rates are much higher than with the pill, especially for younger women. Teenagers, for example, manage effective pill compliance 67% of the time, but with the patch, they use it effectively 88% of the time. The patch does occasionally come loose -- about 3% of the time -- and users need to check once a day to make sure it's still firmly in place.

Finally, there's NuvaRing, a small, flexible transparent ring about as big as a silver dollar, that a woman inserts directly in her vagina. It's replaced every three weeks, and because it's not a barrier method but acts by releasing hormones, it doesn't need to be precisely placed to be effective. "So as long as it's up in the vagina and exerting influence using the hormones, it's fine," says Dr. Tiel. "You just squeeze it and slip it in, and you don't feel it while it's there."

Like the pill, NuvaRing has a pregnancy rate of less than 1%. NuvaRing, OrthoEvra, and Lunelle also have the same risk factors as the pill -- for example, smokers (especially those over 35) are at increased risk of blood clots, and women who have blood clots, certain cancers, or a history of heart attack or stroke are advised against using these methods.

Tiel doesn't think the new options, as exciting as they are, will replace the pill. "The pill probably is still going to be the mainstay contraceptive for women. The point is that some women will do better with the ring, some with the patch, and so on," she says. "Everybody should have the best chance to have maximum success with their contraception."

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