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Talking To Your Provider About Birth Control
Dr. Lisa Patel leads a discussion on how to talk to your provider about your birth control options.
Featured Speaker:
Lisa Patel, MD
Dr. Patel completed her doctor of medicine and internal medicine residency at Rush University Medical College in Chicago, Illinois. During her residency, Dr. Patel served as a Residency Educator, where she facilitated student learning for Rush Medical College clinical work and United States Medical Licensing Exams (USMLE) through tutoring sessions. Transcription:
Talking To Your Provider About Birth Control
VO: Riverside healthcare puts the health and wellness information you need.
Well within reach.
Liz Healy: Hello listeners. And thank you for tuning into the well within reach podcast, brought to you by Riverside health care. I'm your host, Liz Healey and joining me today is Dr. Lisa Patel, who is an internist here with Riverside medical group. Thanks for joining us today, Dr. Patel.
Lisa Patel: Hi, Liz. Thank you for having me.
Liz Healy: Yeah. So, can you tell us a little bit about your background? Kind of how you ended up here at Riverside.
Lisa Patel: Yeah. So I'm at the Riverside medical group. I'm at the Kankakee office in that Westwood medical arts building, just across the street from the hospital and from the pavilion. I did my medical training and residency at rush university in downtown Chicago. I am moved to the community this summer. And I started working here at Riverside in August.
Liz Healy: Oh, great.
We're excited to have you here today and to have you as part of our Riverside medical group. And today we're here to talk about birth control and kind of what you should talk to your doctor about when it comes to birth control. So can you kind of talk to us about what types of things you should consider when choosing a birth control?
Lisa Patel: Yeah. So there are a lot of factors to consider before you choose a birth control. Which is why it's so important to have a conversation with your provider. It's important to think about if, and when you want to have a family. And it's important to discuss multiple options and choose the one that's most convenient and safe for you.
Liz Healy: Okay. So whether like certain questions, obviously you touched on certain things you should think about, but when you go into your provider, should you have pre researched it or. You know, have questions in mind when you go to talk to them or just kind of go in with an open mind.
Lisa Patel: Yeah. So, you know, certain types of birth control are not safe. If you smoke cigarettes, you have a history of breast cancer, blood clots, stroke, or heart disease. And also, you know, you should tell your doctor if you have any of these conditions. Also, if you have migraines with aura, that's an important thing to talk to your doctor about as well.
Liz Healy: Okay, so you mentioned there's different types of birth control. I know. I've heard that there's hormonal and non-hormonal. Can you tell us a little bit about the different types?
Lisa Patel: Yeah, sure. So that's a big question because there's a lot of options. So. I always like to talk about birth control really from what is most effective to what is least. So if we start talking first about the non-hormonal options, really. The most effective is really surgical sterilization. So that's almost a hundred percent effective.
Options include a vasectomy, which is reversible. And while other option is a tubal ligation, which is generally not. Reversible. And then in terms of other options for non-hormonal, there's also the copper IUD. That's almost 99% effective and it can stay in place for 10 years. And then when we're talking about other non-hormonal options,
We always think about barrier methods. So things that are physical limitations, these would include male condoms, female condoms, diaphragms, which are kind of like a saucer shaped silicone cup. And these can vary from. 80 to 90% effectiveness, depending on how well it's used. And then the next options are vaginal gels and spermicides, which vary from 70 to 80%, some of the newer ones on the market.
or closer to 90%. And so those also vary based on how you're using it and how well you're using it. And then last for the non-hormonal options, kind of some of the other options that are kind of the least effective would be cycle tracking where a woman tracks her menstrual cycle, her body temperature.
And her vaginal discharge to kind of predict when she's obsoleting. Rating. And to avoid intercourse during those periods. Now the other options, and these are kind of the more. common ones that we think about are the hormonal options. So these are birth control options that include either combination, estrogen and progesterone, or just progesterone only.
So patients with vascular disease and some of the things that I mentioned before should generally avoid estrogen containing birth control. So some of our progesterone only options. They kind of vary based on how frequently they're exchanged. So. First you think about the progesterone only IUT that's exchange every five years. There's also a progesterone only arm implant. That's changed every three years.
There's an injection that you can get every three months or there's a progesterone only daily pill. And then in terms of our estrogen progesterone combination options, there's a vaginal ring that's changed around every month. There's a patch that you can change every week. And then there's a daily pill as well.
So these, all of these options can be 90 to 95% effective, really, depending on how they're used.
Liz Healy: Okay. You weren't kidding. That is a big, big answer to that question. There are a lot of different types. so in all those types, I assume there's a difference in how long it takes to be effective.
Lisa Patel: Yeah. So, I mean, you can start taking birth control any time. Generally what we say is effective after seven days, that kind of varies depending on your cycle. So you definitely should be using a second method such as some of the barrier options until your birth control is effective.
Liz Healy: Okay. So, when you talk to your doctor about the different types and you decide on one, it's important to ask them what. How long it takes for that specific method.
Lisa Patel: definitely.
Liz Healy: Okay. Are there certain medications? Like I know, I don't know if it's an old wives tale, but there's things that used to say like, oh, if you take, you know, some types of medications that it can cause birth control to be less effective. Is that true?
Lisa Patel: Actually that is true. So there are certain medications that decrease the effectiveness that would include. Certain types of antibiotics, certain types of seizure medications. Certain types of fungal medications. certain types of HIV medications, and then some her herbal supplements actually that can interfere with their birth control. And so that's why it's so important to discuss this with your provider.
Liz Healy: Yes, that does sound like a very important conversation to have. So the other important conversation I would think that you would want to have with your provider is what the side effects could be of. Different types of birth control. Are there certain side effects that are more common with the hormonal versus non-hormonal?
Lisa Patel: Yeah, so. Usually with the Hormonal options there. The most common side effects are either. Spotting or noticing some bleeding between periods, some nausea and headaches. Those are kind of, kind of the most common side effects. And. Usually they go away after a few months, once you get used to the medication.
With the hormonal options. Usually you notice these more with the progesterone only those are kind of the ones that are known to cause more side effects and the combination. And then in terms of, you know, other things to think about with birth control, you know, there is increased risks with birth control. So.
Some of the risks that you should consider are increases in blood pressure and also an increased risk of blood clots, as well as an important risk to know.
Liz Healy: I know that the increased risk of blood clots with something that I've heard about just in conversations with providers about birth control. If a woman was looking to start a family in the near future compared to, you know, five to 10 years down the line. Are there certain options that would be better for them.
Lisa Patel: Yeah, definitely. So if you're looking to start a family in the near future, I would say the easily reversible option such as the pill or the patch or those options might be better for you. If you know, are not planning to start a family for five to 10 years, or even longer than, you know, the implants for the IUD, these are great options in that situation.
Liz Healy: Okay. So I know birth control was obviously originally developed to prevent pregnancy, but are there other health issues that birth control can be used to address?
Lisa Patel: Yeah, definitely. So, birth control definitely helps, you know, from the contraceptive standpoint, but also, you know, it can help in regulating or even reducing your menstrual cycles. Reducing menstrual cramps and reducing, you know, those uncomfortable pre-menstrual symptoms. It can also help in conditions such as endometriosis, which can cause a lot of pelvic pain. And so there, there are other uses besides contraception for birth control.
Liz Healy: Oh, that's great information. Thanks for sharing all of this with us today. Is there anything else that you would like to add Dr. Patel?
Lisa Patel: Yeah. I think it's, you know, really important to know that while birth control can prevent pregnancy. Not all types of birth control per tact from STDs or sexually transmitted diseases. So it's still important to use barrier methods for the prevention of these infections.
Liz Healy: Perfect. Thank you so much for joining us today and thank you for tuning into the well within reach podcast with Dr. Lisa Patel from the Riverside medical group and your host, Liz Healey. Are you looking for a primary care provider? Riverside has over 40 primary care providers to choose from, including Dr. Patel.
Find a provider that fits your needs@myriversidedocs.com or by calling 8 5 5 4 0 4 docs. Again, that number is 8 5 5 4 0 4 3 6 2 7.
Talking To Your Provider About Birth Control
VO: Riverside healthcare puts the health and wellness information you need.
Well within reach.
Liz Healy: Hello listeners. And thank you for tuning into the well within reach podcast, brought to you by Riverside health care. I'm your host, Liz Healey and joining me today is Dr. Lisa Patel, who is an internist here with Riverside medical group. Thanks for joining us today, Dr. Patel.
Lisa Patel: Hi, Liz. Thank you for having me.
Liz Healy: Yeah. So, can you tell us a little bit about your background? Kind of how you ended up here at Riverside.
Lisa Patel: Yeah. So I'm at the Riverside medical group. I'm at the Kankakee office in that Westwood medical arts building, just across the street from the hospital and from the pavilion. I did my medical training and residency at rush university in downtown Chicago. I am moved to the community this summer. And I started working here at Riverside in August.
Liz Healy: Oh, great.
We're excited to have you here today and to have you as part of our Riverside medical group. And today we're here to talk about birth control and kind of what you should talk to your doctor about when it comes to birth control. So can you kind of talk to us about what types of things you should consider when choosing a birth control?
Lisa Patel: Yeah. So there are a lot of factors to consider before you choose a birth control. Which is why it's so important to have a conversation with your provider. It's important to think about if, and when you want to have a family. And it's important to discuss multiple options and choose the one that's most convenient and safe for you.
Liz Healy: Okay. So whether like certain questions, obviously you touched on certain things you should think about, but when you go into your provider, should you have pre researched it or. You know, have questions in mind when you go to talk to them or just kind of go in with an open mind.
Lisa Patel: Yeah. So, you know, certain types of birth control are not safe. If you smoke cigarettes, you have a history of breast cancer, blood clots, stroke, or heart disease. And also, you know, you should tell your doctor if you have any of these conditions. Also, if you have migraines with aura, that's an important thing to talk to your doctor about as well.
Liz Healy: Okay, so you mentioned there's different types of birth control. I know. I've heard that there's hormonal and non-hormonal. Can you tell us a little bit about the different types?
Lisa Patel: Yeah, sure. So that's a big question because there's a lot of options. So. I always like to talk about birth control really from what is most effective to what is least. So if we start talking first about the non-hormonal options, really. The most effective is really surgical sterilization. So that's almost a hundred percent effective.
Options include a vasectomy, which is reversible. And while other option is a tubal ligation, which is generally not. Reversible. And then in terms of other options for non-hormonal, there's also the copper IUD. That's almost 99% effective and it can stay in place for 10 years. And then when we're talking about other non-hormonal options,
We always think about barrier methods. So things that are physical limitations, these would include male condoms, female condoms, diaphragms, which are kind of like a saucer shaped silicone cup. And these can vary from. 80 to 90% effectiveness, depending on how well it's used. And then the next options are vaginal gels and spermicides, which vary from 70 to 80%, some of the newer ones on the market.
or closer to 90%. And so those also vary based on how you're using it and how well you're using it. And then last for the non-hormonal options, kind of some of the other options that are kind of the least effective would be cycle tracking where a woman tracks her menstrual cycle, her body temperature.
And her vaginal discharge to kind of predict when she's obsoleting. Rating. And to avoid intercourse during those periods. Now the other options, and these are kind of the more. common ones that we think about are the hormonal options. So these are birth control options that include either combination, estrogen and progesterone, or just progesterone only.
So patients with vascular disease and some of the things that I mentioned before should generally avoid estrogen containing birth control. So some of our progesterone only options. They kind of vary based on how frequently they're exchanged. So. First you think about the progesterone only IUT that's exchange every five years. There's also a progesterone only arm implant. That's changed every three years.
There's an injection that you can get every three months or there's a progesterone only daily pill. And then in terms of our estrogen progesterone combination options, there's a vaginal ring that's changed around every month. There's a patch that you can change every week. And then there's a daily pill as well.
So these, all of these options can be 90 to 95% effective, really, depending on how they're used.
Liz Healy: Okay. You weren't kidding. That is a big, big answer to that question. There are a lot of different types. so in all those types, I assume there's a difference in how long it takes to be effective.
Lisa Patel: Yeah. So, I mean, you can start taking birth control any time. Generally what we say is effective after seven days, that kind of varies depending on your cycle. So you definitely should be using a second method such as some of the barrier options until your birth control is effective.
Liz Healy: Okay. So, when you talk to your doctor about the different types and you decide on one, it's important to ask them what. How long it takes for that specific method.
Lisa Patel: definitely.
Liz Healy: Okay. Are there certain medications? Like I know, I don't know if it's an old wives tale, but there's things that used to say like, oh, if you take, you know, some types of medications that it can cause birth control to be less effective. Is that true?
Lisa Patel: Actually that is true. So there are certain medications that decrease the effectiveness that would include. Certain types of antibiotics, certain types of seizure medications. Certain types of fungal medications. certain types of HIV medications, and then some her herbal supplements actually that can interfere with their birth control. And so that's why it's so important to discuss this with your provider.
Liz Healy: Yes, that does sound like a very important conversation to have. So the other important conversation I would think that you would want to have with your provider is what the side effects could be of. Different types of birth control. Are there certain side effects that are more common with the hormonal versus non-hormonal?
Lisa Patel: Yeah, so. Usually with the Hormonal options there. The most common side effects are either. Spotting or noticing some bleeding between periods, some nausea and headaches. Those are kind of, kind of the most common side effects. And. Usually they go away after a few months, once you get used to the medication.
With the hormonal options. Usually you notice these more with the progesterone only those are kind of the ones that are known to cause more side effects and the combination. And then in terms of, you know, other things to think about with birth control, you know, there is increased risks with birth control. So.
Some of the risks that you should consider are increases in blood pressure and also an increased risk of blood clots, as well as an important risk to know.
Liz Healy: I know that the increased risk of blood clots with something that I've heard about just in conversations with providers about birth control. If a woman was looking to start a family in the near future compared to, you know, five to 10 years down the line. Are there certain options that would be better for them.
Lisa Patel: Yeah, definitely. So if you're looking to start a family in the near future, I would say the easily reversible option such as the pill or the patch or those options might be better for you. If you know, are not planning to start a family for five to 10 years, or even longer than, you know, the implants for the IUD, these are great options in that situation.
Liz Healy: Okay. So I know birth control was obviously originally developed to prevent pregnancy, but are there other health issues that birth control can be used to address?
Lisa Patel: Yeah, definitely. So, birth control definitely helps, you know, from the contraceptive standpoint, but also, you know, it can help in regulating or even reducing your menstrual cycles. Reducing menstrual cramps and reducing, you know, those uncomfortable pre-menstrual symptoms. It can also help in conditions such as endometriosis, which can cause a lot of pelvic pain. And so there, there are other uses besides contraception for birth control.
Liz Healy: Oh, that's great information. Thanks for sharing all of this with us today. Is there anything else that you would like to add Dr. Patel?
Lisa Patel: Yeah. I think it's, you know, really important to know that while birth control can prevent pregnancy. Not all types of birth control per tact from STDs or sexually transmitted diseases. So it's still important to use barrier methods for the prevention of these infections.
Liz Healy: Perfect. Thank you so much for joining us today and thank you for tuning into the well within reach podcast with Dr. Lisa Patel from the Riverside medical group and your host, Liz Healey. Are you looking for a primary care provider? Riverside has over 40 primary care providers to choose from, including Dr. Patel.
Find a provider that fits your needs@myriversidedocs.com or by calling 8 5 5 4 0 4 docs. Again, that number is 8 5 5 4 0 4 3 6 2 7.