Rings, Rods & Patches: What Will Work Best For You?

In 1975, when Loretta Lynn sang Now I’ve Got The Pill, she rejoiced in gaining control of her reproductive life. Decades later, birth control is still making an enormous difference in women’s lives, and many factors go far beyond simply controlling birth. 

Birth control can also help:

Christina and Dr. Garritano have written about a variety of birth control methods before (click here to read), and they explain several more here. Read on to find out if the vaginal ring, implants, patches, tubal ligations or vasectomies are the best choice for you.

 

Vaginal Ring

The vaginal ring has been in development for over 40 years, trying to solve the challenge of continuously and steadily releasing the correct amount of hormones that the inner lining of the vagina can absorb. NuvaRing, releasing etonogestrel and ethinylestradiol, is the primary vaginal ring available in the United States. 

Very like the Pill, the vaginal ring prevents pregnancy by suppressing ovulation. There is also evidence that the thickened cervical mucus prevents sperm from reaching the egg and that the thinner lining of the uterus prevents any fertilized egg from implanting. A new ring is inserted into the vagina each month and you are unlikely to feel it during intercourse. Your partner may feel it, but few feel it is troublesome. It does not prevent sexually transmitted diseases. 

The ring is about 99% effective in preventing pregnancy when used correctly. You may experience breakthrough bleeding or spotting, increased vaginal discharge or vaginal infection or irritation. Like combination birth control pills, vaginal rings may increase the risk of blood clots, heart attack and stroke. You may also be at increased risk of toxic shock syndrome.

 

Implant

Nexplanon is a matchstick-sized flexible plastic rod is placed under the skin your upper arm, releasing a low, consistent amount of progesterone to suppress ovulation, thicken cervical mucus and thin the lining of the uterus. Nexplanon is implanted with the use of a local anesthetic and works for about 3 years, when it must be removed and replaced. 

Nexplanon’s efficacy is similar to that of an IUD, and unlike a pill or a condom, does not rely on human behavior to work the way it needs to; it doesn’t rely on remembering to take your pill every morning or making sure that condom you are using isn’t expired.

While it is nearly 100% effective in preventing pregnancy, it does not prevent sexually transmitted diseases. You may experience irregular bleeding, particularly in the first 6-12 months after insertion, or amenorrhea, an absence of your period. Decreased sex drive, depression, weight gain or vaginal dryness can occur. We do not currently offer Nexplanon insertion or removals at our office but are happy to direct you to a local provider if you are interested in this birth control method.

 

The Patch

A patch is adhered to the skin releasing estrogen and progestin into the bloodstream slowly and consistently. The patch is changed every week for a total of 21 days. To allow for a period, you’ll go patch-less for a week before applying another.

The hormones released by the patch suppress ovulation, thicken cervical mucus and thin the uterus lining to prevent pregnancy. It is also nearly 100% effective when used correctly. The patch does not prevent sexually transmitted disease. 

Any side effects are similar to other hormonal contraceptives and include an increased risk of blood clots, heart attack, stroke and high blood pressure. You may experience breakthrough bleeding. The patch may also raise estrogen levels higher than the pill, further increasing the risk of blood clots. The patch is not reliable for women who weigh more than 198 lbs. 

 

Tubal ligation

Getting “your tubes tied” is permanent birth control. Your fallopian tubes are ligated to prevent egg and sperm from meeting and causing pregnancy. 

Tubal ligation is a surgical sterilization procedure that requires anesthesia. Typically done laparoscopically, your physician will make a few small incisions in your abdomen and insert small instruments that will cut, tie, clamp, band or seal your fallopian tubes. The incisions will then be closed with a few stitches or glue. You should be able to return home in the company of a caregiver on the day of surgery. If you are having a planned c-section, a tubal ligation can also be done at that time. 

Tubal ligation surgery carries the same risks of infection and side effects as other surgeries, and you will need several weeks to fully recover. You will still get a monthly period.

About 1 in 200 women get pregnant after a tubal ligation, and it does not protect you against sexually transmitted diseases. While it can sometimes be reversed, a reversal is not guaranteed to be successful; you should only elect this option if you feel certain that you do not want to have any more children. 

 

Vasectomy

Permanent birth control for males, the first vasectomy was performed on a dog in 1823. In the 1940’s, it became recognized as a viable means of birth control. Because vasectomy is lower in cost, easier to perform and less stressful for the patient, vasectomy has become a more popular permanent sterilization method than tubal ligations. 

A vasectomy involves cutting the vas deferens, the tube that carries semen from the testicles to the ejaculate out of the penis, to prevent sperm from leaving the penis.

Under local anesthetic, a urologist will make a small opening in the scrotum. They will pull the vas deferen through the opening and cut it. They will tie, cauterize or clip the vas deferens ends and insert them back into the scrotum and close the opening. 

A vasectomy carries the same risks of infection and side effects as other surgeries. A vasectomy does:

Vasectomy does not prevent sexually transmitted diseases. A vasectomy does NOT provide immediate permanent birth control. Men should ejaculate 20 or more times to clear any sperm from semen, and a semen analysis should be done to confirm no sperm are present before having unprotected sex. After semen analysis, vasectomy is incredibly efficient in preventing pregnancy; only 15 in 10,000 couples conceive after surgery and testing. 

Birth control methods are varied and diverse, but Dr. Garritano and Christina are here to help you find the right method for you. Do you have questions about your current birth control method, or about trying something new? Call our office at 203-409-2539 or click here and then click the orange “Book Online” in the top right corner to make an appointment. We are happy to help you find the family planning method that best suits your lifestyle and your goals. 

Did you miss Her Wellness’ first message about birth control? You can click here to read it now!

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