Long-Term Birth Control: New Implants and Patches
Prevent pregnancy without thinking about it.
Birth control pills aren't for everyone. If you've forgotten your pills too
many times -- or can't take them -- there are plenty of options.
The birth control patch (Ortho Evra), vaginal ring (NuvaRing), and three
types of birth control implants (Mirena, Implanon, and Essure) offer long-term
birth control that is virtually hassle-free for months, years, or forever.
If pregnancy is still a future possibility for you, make your choice
carefully. With Ortho Evra, NuvaRing, and Mirena, fertility returns in one to
two months. With Implanon, fertility will return a bit more slowly than with
Of course, just because fertility returns, pregnancy might not happen
immediately, says Christopher Estes, MD, assistant professor of obstetrics and
gynecology at the University of Miami School of Medicine. "It can take time,
just as with regular old birth control pills."
Only one device -- Essure -- provides permanent sterilization. "So far, it's
100% effective," he notes. "It's great for women who don't ever want to be
Ortho Evra: Birth Control Patch
For freedom from daily pills, many women are trying Ortho Evra. You can wear
this birth control patch on your arm, your belly, or your backside. The patch
is a small, flesh-colored square that is barely noticeable.
It's just as effective as the pill in preventing pregnancy. And it works in
a similar method as birth control pills do. Each patch releases estrogen and
progestin through your skin for seven days. You use a patch each week for three
weeks, then no patch for one week -- and your period occurs.
"You have to remember it less often, so there's less chance for error,"
Estes says. The risks are the same as birth control pills or any combined
hormone method, he adds. There are concerns, however, about higher risk of
complications with the birth control patch.
Two studies of the patch produced conflicting results. Both showed no
increased risk of heart attack, stroke, or death. However, one of the studies
found twice the risk of nonfatal blood clots in the legs and lungs. (Birth
control pills have also been associated with blood clots.)
"The jury is still out on that," Estes tells WebMD. "If you ask my opinion
and that of professionals around the world, we need more information. So far,
it doesn't look like a significantly increased risk of blood clots. It's
something that is still being looked into, but I have not counseled any
patients to stop using the patch because of this."
Estes puts the risk into perspective: "Young, healthy nonsmokers have an
extremely low risk of blood clots," he tells WebMD. "About 1 in 1,000 of those
women will have a blood clot. If they take the pill, it's 3 in 1,000 -- still a
very, very low risk. If the patch doubles that risk, it's still very low."