Guest Author - Denise Howard, M.D., M.P.H.

Birth control is an important concern for women during their reproductive years. This is even more of an issue in older, but reproductive age women. You have completed your childbearing but are still at risk of pregnancy if you are sexually active. The issue can be made more complex by medical conditions or other factors that increase the risk associated with contraceptive use.

With so many options available, selecting the one that is right for you can be confusing. No method is completely risk free. There are pros and cons to each and potential complications and side effects that also exist. In order to select the right option for you it is important to understand how the contraceptive work, the risks, potential side effects and effectiveness.

Birth control methods typically fall into 4 categories: barrier, hormonal, intrauterine devices and sterilization methods. The barrier methods work by blocking sperm from getting into the female reproductive tract thus preventing fertilization. The hormonal methods work in many ways but primarily by preventing the release of an egg from the ovary. If there isn’t an egg available to fertilize then pregnancy will not occur. The intrauterine devices also work in many ways but the main way is by preventing the sperm from meeting the egg and by preventing the lining of the uterus from becoming prepared for implantation. Finally, permanent sterilization methods work by surgically obstructing the passageway of the egg or sperm.

Selecting the method that is right for you depends on many factors. These factors may include your desire for future fertility, your concurrent medical problems, your ability to be compliant, your tolerance of undergoing procedures and your concerns for managing or preventing other problems. Some methods also serve other functions. Barrier methods such as condoms can prevent the transmission of sexually transmitted infections. This is especially important if you are not in a monogamous relationships or don’t trust that your partner is monogamous. Hormonal contraception is also used to control heavy periods, painful periods and to treat conditions such as Endometriosis. There are also other situations where menstrual control maybe desirable.

The next series of articles will discuss in detail the different methods, their effectiveness, risks, potential benefits and possible side effects.