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Long-Term Birth Control Without Surgery

By Sonya Collins
WebMD Feature

You don’t have to take a pill every day. Several birth control methods last weeks, months, or even years with little effort on your part. They are safe and effective for most healthy women of childbearing age.

“The best method of contraception for any woman is the method that she’s going to use correctly and consistently,” says Elizabeth Micks, MD, MPH. She’s an acting assistant professor of obstetrics and gynecology at the University of Washington Medical Center.

Do you know what's available?

The IUD

An intrauterine device (IUD) is a small, T-shaped device that your doctor places inside your uterus, or womb. It can stay there for 3 to 10 years, depending on its type. Your doctor can easily remove it if you decide you'd like to get pregnant or you no longer want to use it.

Once the IUD is in place, you don’t have to do anything else to prevent pregnancy. IUDs are 20 times more effective than pills, patches, or rings. Fewer than 1 in 100 women get pregnant during their first year on the IUD. This is the same success rate as sterilization.

Most women of childbearing age with a normal, healthy uterus can use this device. Your gynecologist will examine you before placing it.

Hormonal IUDs are plastic and release the hormone progestin. This thickens the mucus in your cervix (lower part of your uterus), which keeps sperm from entering. It also thins the walls of your uterus. This keeps a fertilized egg from attaching to it, which is a part of pregnancy.

Two brands of hormonal IUD are available: Skyla and Mirena. Skyla lasts for 3 years. Mirena, which uses a higher level of hormone, lasts for 5 years. It is also FDA-approved to treat heavy menstrual bleeding. Mirena can reduce bleeding up to 90% after the first 6 months.

“It’s so effective in treating women with heavy bleeding, painful periods, even women with endometriosis [a disorder of the uterus], fibroids [noncancerous tumors], and other problems," Micks says.

The drawback for some women is getting through those first 6 months. “Hormonal IUDs can lead to a lot of irregular bleeding in the beginning, which for a lot of women is really not acceptable,” Micks says. “Women do not like spotting (light bleeding between periods).”

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