Transcription:

Caitlin Whyte: Hello and welcome to Check-Up Chat with Evergreenhealth. Contraception or birth control is used as planning or prevention of pregnancy, as well as protection against some infections. Between oral contraceptives, condoms, injections, and implants, it can be difficult to determine which birth control method is right for you.

So, we're here with Evergreenhealth OB-GYN, Dr. Alicia Stone-Zipse, to help us break down the different contraceptives and what is the best way of choosing the best method for your needs. Doctor, thank you for joining us today. Now, as I mentioned in my intro, there are a whole list of different contraceptives. So, can you give us a brief overview of the different types?

Alicia Stone-Zipse, DO: So, you know, there are four different types of contraceptives in general. There's what we call the LARCs, which are long-acting reversible contraceptives. There are the different hormonal methods that include pills, injections, patches, rings. There's the different barrier methods. And then, there's the more permanent methods that are considered like sterilization methods.

Caitlin Whyte: Okay. So with all of these options, let's break down each a bit. We'll go through each type of birth control and the benefits of each. So, let's start with what you called LARCs, those long-acting reversible contraceptions, your IUDs or your implants. What are some benefits of those?

Alicia Stone-Zipse, DO: So, those long-acting reversible contraceptives, they are a type of birth control that can be placed and then left in for a long duration. So, there's a lot less that someone needs to do to maintain it. They are very effective and they typically have minimal side effects. The first type is the different IUDs. So, there are two types of IUDs. There's progesterone-releasing IUDs and the copper IUDs. They are inserted during a pelvic exam and sit inside the uterus to prevent pregnancy. The second type is the arm implant called Nexplanon that's also inserted in the office, and can stay in for up to three years.

The IUDs, they can stay anywhere from three to 10 years depending on which type is given. With all of these long-acting methods, they do require an office visit for placement. So for some people, that could potentially be a barrier. Some other things that are important to know about the IUDs is, while they are a procedure, there are various ways that we can make that procedure comfortable for patients, so we can minimize discomfort and pain associated with it.

Caitlin Whyte: Gotcha. This is actually what I have and it's kind of a great set-it-and-forget-it method. But before that, I was on the hormonal methods. You know, those are kind of the classic ones that everyone knows. Your pills, your patches, your injections. Tell us about the different methods of the hormonal option and just some of the benefits or why someone might choose that.

Alicia Stone-Zipse, DO: So, the hormonal options, they include the pills, patch, injection and a vaginal ring. So, those are very easy to start. You know, you don't need a procedure to have them placed. You don't require a pelvic exam to have them. They are something that you kind of have direct control over. So, you know, with the pill, you can take it every day. The patch, you place it weekly. The vaginal rings, there's a ring that can stay for up to a year. There's also a ring that can be changed out monthly. The injections, they do require coming to the office, but it's at an interval of every three months. So, there's a little bit more spacing for that.

Caitlin Whyte: And, you know, you talked about going to the office as being an obstacle for some people. So of course, our traditional barrier methods are a little more accessible. We have male and female condoms, contraceptive sponges and spermicides. Tell us about this option of birth control.

Alicia Stone-Zipse, DO: The big benefit to the barrier forms of contraception is they're the only method that does protect against sexually transmitted infections. And so, that gives you an additional layer of protection. You can get them over-the-counter in terms of male condoms. And, you know, aside from occasional allergies, you know, there's no hormones in them.

Caitlin Whyte: And tell us a bit about the sponges and spermicides, because I think those are a little less familiar.

Alicia Stone-Zipse, DO: Yeah. So, you know, they have to be used every time that you have intercourse. The spermicide, it basically just kind of creates an environment that doesn't allow the sperm to survive. They have a certain level of effectiveness to them. But you know, they are a little bit less effective than the hormonal or the long-acting reversible contraceptive methods.

Caitlin Whyte: Gotcha. And our last option here is definitely the most long term, I guess you would say, is sterilization. So, we have tubal ligations and vasectomies. Tell us about the benefit of these and why someone might go this route.

Alicia Stone-Zipse, DO: Sterilization is a permanent form of birth control. So, it is meant to be irreversible. So, it should be used if someone is absolutely certain that they are not desiring pregnancy or that they are not wanting to get anyone pregnant. It's a surgical procedure that, for males, is typically done by a urologist in their office. For females, it's either done immediately after a delivery or at an interval tubal.

The gold standard now for the female sterilization is what's called a bilateral salpingectomy, where both tubes are removed in their entirety. That also has the benefit of, I guess, increasing the efficacy of it as well as there's data that supports that it reduces someone's risk of ovarian cancer by taking out the entire tubes.

Caitlin Whyte: Oh, wow. I didn't even know that. That's awesome.

Alicia Stone-Zipse, DO: Yeah. But, you know, the barriers to that is that it's a surgical procedure. So, you know, you have to have that kind of time commitment.

Caitlin Whyte: Gotcha. So doctor, we talked about a lot of different methods here and they all have benefits and, you know, some cons just with having to go into the office, you know, the sterilization being a little more surgical. So, how can someone who's considering going on birth control find the right method for them. You know, what to consider, and maybe just weighing the pros and cons of each, what's the best way to kind of determine which ones for you?

Alicia Stone-Zipse, DO: The best thing to do is to, you know, reach out to their OB-GYN or start with their primary care provider. If someone isn't a hundred percent sure, they can always start with a televisit to kind of go over all their options in detail and then get an understanding for what is best for them based on their health, age, their preferences with sexual activity, future plans for pregnancy and just their overall health concerns for themselves, so that they can figure out a method that's safe, effective, and kind of meets all their needs.

Caitlin Whyte: Wonderful. We're wrapping up here, doctor. Is there anything else you want listeners to know about birth control? Any maybe misconceptions or just things you hear a lot in the office as we close out this episode?

Alicia Stone-Zipse, DO: I always want patients to feel comfortable to ask questions and to, you know, not hesitate to really ask so that they can understand what's right for them and to make sure that they're comfortable with their experience.

Caitlin Whyte: Absolutely. Comfort is the most important thing, especially with conversations like this. Well, doctor, thank you so much for your time and for this important information as well as all the work you do.

If you're considering going on birth control, make an appointment with your primary care physician or OB-GYN. For a full list of locations and services, visit evergreenhealth.com/health-service.

This has been Check-Up Chat with Evergreenhealth. I'm Caitlin Whyte. Stay well.