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How does a vaginal ring work?

Vaginal rings are another form of hormonal birth control. They're similar to birth control pills because their contraceptive benefits are derived from estrogen and progestin. However, instead of taking the hormones by mouth as with pills, the hormones in the ring are absorbed directly through the vaginal wall when the woman places the ring in her vagina.

Vaginal rings are left in the vagina for three weeks, and then they are removed for one week. It's during that fourth week that a menstrual cycle occurs.

Vaginal rings are left in the vagina for three weeks, and then they are removed for one week.

The effectiveness of vaginal rings is similar to birth control pills. However, they have the added benefits of a very low rate of breakthrough bleeding, and the woman doesn't have to worry about remembering to take a pill every day. However, I tell my patients that they may notice some increase in their normal vaginal discharge.

Most partners won't notice the ring in the vagina during intercourse. However, if they do, and if it bothers them, the ring can be removed for up to 3 hours without losing its effectiveness.

Is the contraceptive patch safe and effective?

The patch consists of an adhesive swath of material containing estrogen and progestin that is affixed to the skin once a week. It's a convenient method of birth control for those women who don't want to take a daily pill, and its effectiveness is similar to the pill. However, the patch is currently under scientific scrutiny because there are some concerns that those women who use it might experience a higher incidence of blood clots.

How does Depo-Provera work?

Depo-Provera is progestin that is given to a woman via an injection. Depo-Provera has been around for years, and initially it required a visit to the doctor's office every 3 months for an intramuscular injection. However, a newer version has been developed that only requires a routine skin injection. This means that women can now be taught to give themselves the shot, or if they prefer, they can continue to go to the doctor's office for it.

Depo-Provera carries the same side effects as most hormonal methods. However, there are three additional points to keep in mind. First, when a woman begins using Depo-Provera, it's likely that her menstrual cycle will stop completely. Second, when a patient stops using it, her fertility may not return for several months. And third, Depo-Provera has been shown to cause some women to gain weight. In fact, the weight gain can be as much as 15 pounds. (You can imagine the looks I get each time I mention this fact to my patients.)

Nevertheless, it has to be noted that Depo-Provera is a highly effective form of contraception. When used correctly, the effectiveness is greater than 99%. Those are pretty good odds.

What is Implanon?

Implanon was approved by the FDA in 2006. It consists of a flexible rod the size of a matchstick that is placed under the skin of a woman's arm. (You usually can't see it after it's been implanted by a specially-trained health care provider.)

The Implanon rod contains only progestin, and therefore it carries with it the associated side effects of progestin that I mentioned previously. Moreover, it can only be removed in a doctor's office, and there can be persistent spotting and irregular bleeding with this method of birth control. However, Implanon's effectiveness is rated at greater than 99%, its contraceptive effects can last up to 3 years, and it doesn't require taking a pill daily.

Depo-Provera is a highly effective form of contraception. When used correctly, the effectiveness is greater than 99%.

 
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