Birth control statistics

How do the artificial hormones in birth control pills work?
Is it mandatory to use another birth control type while on the pill?
Why have my periods stopped?
I forgot to take my pill. What do I do?
Can I use the birth control pill to change the date of my period?
Why have I been spotting and having irregular bleeding?
Can I still get pregnant while taking the birth control pill every day?
I didn't know that I was pregnant and continued taking my birth control pills. Can this hurt my baby?
How long after stopping the pill should I wait to get pregnant?
What are some common side effects and health risks of the pill?
Is there anyone who shouldn't use the birth control pill?
What if I smoke? Can I still use the pill?

About Depo-Provera

About the IUD

What is an intrauterine device?
How does it work?
For how long is the Mirena IUD effective?
How do I know the Mirena IUD is still there?
What are the disadvantages?

About the vaginal ring

What is an vaginal ring?
How do I use the NuvaRing?
How effective is the vaginal ring?
What should I do if the NuvaRing comes out?
What if I leave the NuvaRing in for too long?
How do I remove the vaginal ring?
What are some side effects of the vaginal ring?

About the contraceptive patch

About Plan B

About Implanon

How do the artificial hormones in birth control pills work?

Birth control pills, like Yasmin or Alesse, contain artificial estrogen and/or progestin that copy the hormones your body produces. Your body then reacts to these heightened levels of hormones in different ways, all of which can prevent pregnancy. The primary way the artificial hormones in the pill work is by suppressing ovulation. They also work to thicken your cervical mucus thereby creating a hostile environment for sperm. Both of these methods help to prevent fertilization.

Is it mandatory to use another birth control type while on the pill?

The "pill" and Depo-Provera are thought to work right away as long as you start them on the first day of your period. However, it can take up to seven days before they become fully effective. Most women aren't fertile during this time anyway, but just in case you should use a back-up contraceptive like a condom. Some doctors recommend that an additional form of birth control be used for the first month of taking the pill.

Women who are using the mini-pill (Micronor) will need an additional form of birth control for the first cycle (28 days). More importantly, birth control pills do not protect against sexually transmitted diseases (STDs). Using a condom will help to prevent the transmission of many STDs as well as offer you extra protection against pregnancy.

Why have my periods stopped?

Missing a period is not uncommon for women who use birth control pills. If you have taken all your pills there is a minimal risk of pregnancy. However, it is still a good idea to take a pregnancy test to make sure. If you have forgotten to take a pill or missed two periods in a row, then your chance of pregnancy could be greater. Again, take a pregnancy test. They can be purchased at your local drugstore or you can make an appointment with your doctor.

I forgot to take my pill. What do I do?

If you are taking combination birth control pills (estrogen and progesterone) you should take the missed pill as soon as you remember and then take the next pill at the time you normally would. You may have to take two pills in one day. Eventhough the risk of pregnancy is minimal, it is still a good idea to use a condom or a sponge for the next seven days.

If the missed pill happened during day 15 or 21 of your pill schedule, contact your doctor for instructions. In some cases your doctor may advise you to skip the pill-free/reminder pill week and begin a new package as soon as you finish your current set of birth control pills.

Can I use the birth control pill to change the date of my period?

It is possible to use birth control pills to change the date of your period. This practice can reduce the efficiency of the pill so be sure to speak with your doctor first.

Why have I been spotting and having irregular bleeding?

Experiencing spotting halfway through your cycle is not unusual, especially for new birth control pill users. Increasing the strength of the pill can stop this from happening. Spotting may also be a sign that your pills are not as effective as they should be, therefore an additional form of birth control should be used. However, in some sexually transmitted diseases, spotting is a symptom as well. If you think you may be at risk for a STD, make an appointment with your doctor to get tested.

Depo-provera users often have irregular bleeding. No periods, light periods and lengthened or heavy periods are all normal side effects of this form of birth control. Women who experience heavy or lengthened periods should bring it to the attention of their health care provider.

Can I still get pregnant while taking the birth control pill every day?

Yes! If taken correctly on a daily basis, the pill is as much as 99% effective in preventing pregnancy, but there is still a 1% chance that you could get pregnant. Furthermore, missing a pill or taking a pill a few hours later than normal can decrease the effectiveness. Certain medications like antibiotics are also known to increase the chance of your contraceptives failing.

I didn't know that I was pregnant and continued taking my birth control pills. Can this hurt my baby?

There is no conclusive evidence that exposure to the artificial hormones found in birth control pills will hurt an unborn child. However, it is generally advised that you stop use of the pill if you suspect that you are pregnant.

How long after stopping the pill should I wait to get pregnant?

When she has stopped taking her birth control pills, a woman's body may take a while to adjust back to her normal menstrual cycle. While some women find they return to a normal cycle right away, others can take up to a year. It may be a good idea to wait two to three normal menstrual cycles before trying to conceive. This allows your body the time it needs to adjust to life without the extra hormones, making it able to deal with a pregnancy better.

What are some common side effects and health risks of the pill?

Common side effects for combination contraceptives can be:

• Weight gain
• Nausea and vomiting (felt for the first few cycles)
• Dizziness
• Increase or decrease in acne
• Headaches
• High blood pressure
• Loss of libido
• Depression
• Vaginal infections

Less common serious health risks can be:

• Blood clots in legs, lungs, heart or brain
• Stroke
• Heart attacks
• Possibly cervical cancer

Is there anyone who shouldn't use the birth control pill?

The pill does not suit all women. If any of the following apply to you, you may not be able to use hormonal methods of birth control.

• You are, or suspect that you are pregnant
• Are breastfeeding and / or are less than 6 weeks postpartum
• Are over the age of 35
• Smoke
• Have unexplained vaginal bleeding
• Have active liver disease or a history of liver tumors
• Have a history of heart disease, stroke, high blood pressure or some other condition that puts you at risk of a heart attack
• Have diabetes
• Have breast cancer, history of breast cancer or an abnormal growth in the breast
• Have a history of blood clotting problems
• Have cancer or history of cancer of the reproductive organs
• Have migraines or focal neurologic symptoms

What if I smoke? Can I still use the pill?

Cigarette smoking increases the risk of serious cardiovascular side effects from all birth control use. This risk increases with age and heavy smoking (15 or more cigarettes per day) and is quite high in women over 35 years of age. Women who use birth control pills should be strongly advised not to smoke. More specifically, risks increase for heart attacks, blood clots, stroke, liver cancer, and gallbladder disease, although the risk is very small in healthy women without underlying risk factors.

What is Depo-Provera and how does it work?

The "shot" is an injectable progestin-only prescription method of reversible birth control. It contains a hormone that is similar to the progesterone made by a woman's ovaries to regulate the menstrual cycle. Depo-Provera stops the ovaries from releasing an egg (ovulation), thickens cervical mucus to prevent sperm from combining with the egg and changes the uterine lining, which, in theory, may prevent implantation of a fertilized egg.

How effective is Depo-Provera?

If you take the shot during the first five days of your period, protection is immediate and will last for 3 months. Otherwise, you should use a backup method of birth control, like a condom, for the first week.

Depo-Provera is so effective that out of 1,000 women who use it correctly and consistently, only three will become pregnant during the first year of use. The shot will not protect you from sexually transmitted diseases. Using a condom will help to prevent the transmission of many STDs as well as offer you extra protection against pregnancy.

Can Depo-Provera affect your chances of becoming pregnant?

Depo-Provera is reversible and has no permanent effect on fertility. However, after the last injection there can be a nine-month delay in return to normal fertility. If you are thinking about becoming pregnant in the next year or two, Depo-Provera will not be the right choice for you.

Who can use the shot?

Most women can use the shot. It may be best for you if:

• You want very effective long-lasting birth control
• Cannot take estrogen (Depo-Provera is progestin only)
• Are unable to use other routine barrier methods (like a diaphragm) or take a daily pill

It may not be best for if you have:

• Current serious blood clotting conditions
• High blood pressure
• High risk for heart disease
• A history of severe depression
• Liver disease, such as hepatitis, abnormal results on liver function tests, or a history of liver tumors

Who should not use the shot?

You should not use Depo-Provera if you:

• Cannot put up with irregular bleeding or loss of your period
• Are taking medicine for Cushing's syndrome
• Are or might be pregnant
• Have a known or suspected breast cancer
• Have unexplained bleeding from the vagina
• Want to become pregnant within the next year

Women should not use the shot continuously for more than two years unless no other birth control method is right for them.

What are some possible side effects of Depo-Provera?

In the first six to twelve months, irregular bleeding is the most common side effect for women using Depo-Provera.

• Periods become fewer and lighter for most women, and often stop altogether. The longer a woman uses the shot, the more likely her periods will stop. It may take up to a year for periods to return after a woman's last shot.
• Some women will have longer, heavier periods.
• Some may have increased light spotting and breakthrough bleeding.
• Women who use the shot may have temporary bone thinning.

Less common side effects include:

• Change in libido
• Change of appetite, weight gain
• Depression
• Hair loss, or increased hair on the face or body
• Headache
• Nausea
• Nervousness, dizziness
• Skin rash or spotty darkening of the skin
• Tender breasts

Warning Signs
Serious problems are rare. Tell your physician immediately if you have:

• A new lump in your breast
• Major depression
• Severe pain in the stomach or abdomen
• Unusually heavy or prolonged vaginal bleeding
• Yellowing of skin or eyes

What is an intrauterine device?

Called an IUD for short, it is a small, plastic, T-shaped device with a string attached to the end. The IUD is placed inside the uterus to prevent pregnancy. Placement requires a visit to your doctor. After your IUD is put in place, you may have sex, swim, exercise, and use tampons as soon as you want to. The IUD is stays in your uterus until your doctor removes it.

How does it work?

The IUD slowly releases small amounts of the hormone levonorgestrel (commonly used in birth control pills) into the lining of your uterus. This is thought to thicken your cervical mucous which may make it harder for the sperm to join with an egg.

For how long is the Mirena IUD effective?

The hormonal IUD needs to be replaced every 5 years. You can have your doctor remove Mirena at any time.

How do I know the Mirena IUD is still there?

When you get your period, insert a clean finger in your vagina and check for the string of the IUD. If you can't feel the string or you feel the IUD itself, call your doctor. Either of these could mean that the IUD is not in the correct spot. Call your doctor if you miss your period or if you notice any uncommon fluid or odor coming from your vagina. Have regular check-ups every year.

What are the disadvantages?

For the first few hours after a Mirena IUD is put in your uterus, you may experience cramps and backaches. Some women have bleeding for a couple of weeks after the IUD is inserted, and heavy periods after that. Rarely, the uterus can be injured when the IUD is put inside you.

When you use the IUD there is no protection from AIDS or any other sexually transmitted diseases. In fact, these infections can be more serious in women who have an IUD. The more people you have sex with, the greater your chance of getting an infection if you have an IUD. Therefore, Mirena is best for women who have only one long-term sex partner. You should not use the IUD if you're pregnant, if you're allergic to copper, or if you have abnormal bleeding or cancer of the cervix or uterus.

What is an vaginal ring?

Known as NuvaRing, the vaginal contraceptive ring is inserted into the vagina in order to prevent pregnancy. The ring releases a constant amount of estrogen and progesterone throughout your cycle, therefore supressing ovulation.

How do I use the NuvaRing?

The NuvaRing is pinched between the index finger and thumb and inserted into the vagina far enough that you can't feel it. Position of the ring will not change its effectiveness. There is no risk of the ring being pushed too far or of getting lost in the vagina. Your cervix will stop the ring from going any further than it should.

The NuvaRing resides in the vagina for 3 weeks in a row, and then is removed for 1 week for your period to begin. After 1 week, a new ring is inserted, regardless of whether you still have your period.

How effective is the vaginal ring?

When used correctly and consistently, the NuvaRing is 98-99.9% effective.

What should I do if the NuvaRing comes out?

Most women do not have trouble with the ring coming out. However, the ring may slip out of the vagina while straining with a bowel movement or with severe constipation.

If the ring does come out and you are aware of it within 3 hours, you should still have complete contraceptive coverage. Rinse the vaginal ring with cool water and re-insert as soon as possible. However, if it has been more than 3 hours or you are unsure of how long the ring has been out, you must use a different birth control method for 7 days.

If the ring is lost, you must insert a new ring on the same schedule as you would have used the lost ring.

What if I leave the NuvaRing in for too long?

If you have left the vaginal ring in for an extra week or less, you can simply remove the ring, wait for 1 week and re-insert a new one.

If the ring is left for more than 1 extra week (a total of 5 weeks), you should take a home pregnancy test. If the test is negative, re-insert a new ring and use a back-up contraceptive for 7 days.

How do I remove the vaginal ring?

You can easily remove the NuvaRing by hooking the index finger around the rim of the ring and pulling it out. The ring should be removed 3 weeks after insertion, on the same day of the week that it was initially inserted.

Your period will usually start 2-3 days after removal of the ring.

What are some side effects of the vaginal ring?

Side effects of the NuvaRing are found to be similar to those of the pill and contraceptive patch. These symptoms usually resolve in the first 1-3 months of use.

• Nausea
• Headaches
• Breast tenderness
• Irregular bleeding

Rare problems include blood clots, heart attack, and stroke. You should contact your doctor immediately if you experience any of the following symptoms:

• Sudden abdominal pain
• Unexplained chest pain or shortness of breath
• Severe headache
• Blurred vision
• Severe leg pain (calf or thigh area)
• Weakness in one side of the body

What is the contraceptive patch?

Known as Ortho Evra, it is a small, thin patch that is placed on the skin. The patch releases small amounts of estrogen and progesterone which is absorbed through the skin. By suppressing ovulation, Ortho Evra is 99% effective in preventing pregnancy.

How do I use the patch?

You should apply the first patch on the Sunday following the first day of period. If you start your period on Sunday, apply the patch that day. Don't wait until the next Sunday! You should use another form of birth control for the complete first cycle of the patch.

Ortho Evra can be applied to your buttocks, upper arm, abdomen, or upper torso. DO NOT apply the patch to your breasts. You should apply the patch directly to the skin and press for 10 seconds to make sure it is securely in place. Check the patch daily for placement. The patch is worn for one week, and then removed. A new patch should be immediately placed in a different location. This will decrease the likelihood of skin irritation caused by the patch.

The patch is changed one time per week for three weeks in a row, and then removed for 1 week. This will be the week that your period will start.

How do I use the patch?

The most common side effects are nausea, headache, breast tenderness, and irregular bleeding. These symptoms will usually resolve in the first 1-3 months of use.

You should call your doctor immediately if you have any of the following symptoms:

• Sudden abdominal pain
• Unexplained chest pain or shortness of breath
• Severe headache
• Blurred vision
• Severe leg pain (calf or thigh area)
• Weakness in one side of the body

Will my activities have to change while using the patch?

Ortho Evra will not change your daily activities. You can swim, bathe, shower, and exercise. However, it is possible that your patch could get loose or fall off. Check to make sure the patch is still in place after your more strenuous activities.

What if my patch falls off?

If partial or complete detachment has occurred for less than 24 hours, you should try to re-attach the patch. DO NOT try to use any kind of tape or alternate adhesive! If you have difficulty re-attaching, apply a new patch in the same place. Keep your patch changing schedule the same as you had it before. In this case there is no need for a backup contraceptive.

If partial or complete detachment has occurred for more than 24 hours or you are unsure as to how long detachment has been, you may not be protected from pregnancy. You should remove the old patch and apply a new one. Your patch changing schedule is now switched to the day that you applied the new one. In this case, you will need a backup contraceptive for 4 weeks.

What if I forget to change my patch on my scheduled change day?

If you have forgotten your Ortho Evra patch in:

Week 1

• Use an alternate form of birth control.
• Apply a new patch as soon as possible.
• Adjust your patch changing schedule so that you change your patch one week from application of the forgotten patch.

Week 2 or 3 (and if you are up to 48 hours late in changing the patch)

• Immediately apply a new patch.
• Backup birth control is not needed.
• Apply the next patch on your usual change day.

If you are more than 48 hours late in changing your patch in week 2 or 3, you may not be protected from pregnancy. You should take the following steps:

• Use another form of birth control for 4 weeks.
• Start a new 4 week cycle by wearing a new patch. Consider this day 1 again and continue to change the patch each week for 3 weeks in a row.
• Adjust your patch changing schedule so that you change your patch one week from application of the forgotten patch.

Week 4 (if you forget to remove your patch for your period)

• Remove the patch as soon as possible.
• Keep your patch change day the same as usual.

Never have more than 7 patch-free days. If this happens, you will need to use another form of birth control for 4 weeks.

What is Plan B?

Plan B, or the morning-after pill, is an emergency contraceptive used as a backup method for preventing pregnancy after unprotected sex or failure of another birth control type. For example, if you were using a condom and it broke, if you forgot to take 2 or more of your birth control pills this month, or you were sexually assualted, Plan B may be a good option for you.

It is important to know that Plan B is not RU-486 (the abortion pill). Because Plan B is used to prevent pregnancy, it will not work if you are already pregnant, and it will not affect an existing pregnancy. It is not for routine use.

How does Plan B work?

Plan B contains the hormone levonorgestrel, the same ingredient found in many birth control pills. The difference is that Plan B contains a larger dose of levenorgestrel than the amount found in a single birth control pill. And, unlike many birth control pills, Plan B does not contain any estrogen. There are other morning-after pills that contain both progestin and estrogen. Contact your doctor for more information. The morning-after pill is not a substitute for routine birth control, and will not protect you from HIV and any other sexually transmitted diseases.

How soon after unprotected sex should I take the morning-after pill?

If Plan B is taken within 3 days (72 hours) after unprotected sex, it will decrease pregnancy by 89%. That means 7 out of 8 women who would have gotten pregnant will not get pregnant. The morning-after pill works even better if you take it within the first 24 hours after unprotected sex.

Since unprotected sex might happen when your doctor's office is closed, getting a prescription for Plan B in advance means that it will be there for you, in time, if you ever need it.

What are the side effects of Plan B ?

Side effects can include nausea, abdominal pain, tiredness, headache, menstrual changes, dizziness, breast tenderness, and vomiting. Menstrual bleeding may be heavier or lighter, earlier or later after taking Plan B. If your period is more than one week late, pregnancy should be considered.

Who should not use the morning-after pill?

The morning-after pill should not be used if you are already pregnant (it will not work), if you are allergic to levonorgestrol or any of the ingredients in Plan B, or for regular birth control.

What is Implanon?

Implanon is injected underneath the skin of the upper arm by your doctor. The rod is inserted relatively pain free into the underside of the upper arm after a local anesthetic is used to numb the area. A special applicator is used to insert the rod underneath the skin, taking about one minute. You won't be able to see the rod, but you can feel it with your fingers. Slowly releasing a progestogenic hormone called etonogestrel, Implanon provides highly reliable protection from pregnancy for the course of three years. A regular check-up every 6 months will be required by most doctors.

How does Implanon work?

Implanon contains 68 milligrams of etonogestrel that is released over a three-year period. About 60 - 70 micrograms per day are released in the first year and the amount decreases over time until only about 25 - 0 micrograms per day are released in the third year. After the third year, Implanon will continue to release some hormone, but it will be at ineffective low levels. The etonogestrel thickens cervical mucus, which in turn prevents sperm from fertilizing an egg and from allowing any egg that does happen to get fertilized from implanting itself in the uterine wall. Implanon also completely inhibits the release of eggs from the ovaries during the first two years, and continues to do so during the third year, but less effectively.

How is Implanon removed?

Taking about two minutes, removal of Implanon takes slightly longer than the insertion, but with the use of local anesthetic, most women describe only "mild discomfort." After a tiny cut is made in the skin near the tip of the rod, your doctor then pulls it out from underneath the skin. Once removed the hormone etonogestrel will no longer be in your bloodstream, and fertility returns to normal within one month. You may have a small scar where the rod was removed.

What are the advantages of Implanon?

• While it can be felt it cannot be seen
• It is inserted very simply after a local anaesthetic numbs the area
• The procedure takes just a few minutes
• Depending when in your cycle Implanon is inserted it can be effective immediately or within 7 days of insertion
• After removal a woman’s ovulation, and fertility, returns to normal within 3 weeks
• It is almost 100% effective
• Removal is usually relatively quick and easy

Are there any disadvantages for Implanon?

• Irregular vaginal bleeding
• Acne
• Headaches
• Breast pain
• Possible weight gain