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    Do You Know Your Long-Term Birth Control Options?

    By Sonya Collins
    WebMD Feature

    You don’t have to take a pill every day. There are birth control methods that last weeks, months, or even years with little effort on your part - and no surgery. They are safe and effective for most healthy women.

    Which one is best for you?

    “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, an acting assistant professor of obstetrics and gynecology at the University of Washington Medical Center.

    Find out what’s available, what’s involved, and how well each one works.

    The IUD

    This is a small, T-shaped device that your doctor places inside your uterus, or womb, after giving you a checkup. It can stay there for 3 to 10 years, depending on its type.

    Once the IUD is in place, you don’t have to do anything else to prevent pregnancy. They 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.

    Your doctor can easily remove it if you decide you'd like to get pregnant or you no longer want to use 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. Both rely on the same drug, called levonorgestrel. Skyla lasts for 3 years. Mirena, which has a higher dose, 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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