Long-term contraception is a highly-effective, non-permanent method for preventing pregnancy.
Unlike other methods that need to be thought about on a daily, weekly, or even monthly basis, long-term contraceptives are safe, reliable and come in a variety of options.
Christine Masterson, M.D., FACOG, Director of the Women and Children service line at Summit Medical Group, talks about these methods -- their benefits, risks, and precautions -- and how to choose the right one for you.
Selected Podcast
Are You Considering Long Term Contraception?
Featured Speaker:
Dr. Masterson believes that caring for women through many stages of their lives is a profound privilege. Her philosophy of care is to treat patients as a whole to achieve the best health outcomes.
Dr. Masterson is a recipient of the MDx Medical, Inc. Patients' Choice Most Compassionate Doctor Award for her outstanding bedside manner, time spent during patients' visits, courtesy of her office staff, appropriate follow-up care, and overall excellence.
Christine Masterson, M.D., FACOG
Christine Masterson, MD, FACOG, is Director of the Women and Children service line at Summit Medical Group.Dr. Masterson believes that caring for women through many stages of their lives is a profound privilege. Her philosophy of care is to treat patients as a whole to achieve the best health outcomes.
Dr. Masterson is a recipient of the MDx Medical, Inc. Patients' Choice Most Compassionate Doctor Award for her outstanding bedside manner, time spent during patients' visits, courtesy of her office staff, appropriate follow-up care, and overall excellence.
Transcription:
Are You Considering Long Term Contraception?
Melanie Cole (Host): Long-term contraception is a highly effective non-permanent method for preventing pregnancy, and unlike other methods that need to be thought about on a daily, weekly, or even monthly basis, long-term contraceptives are safe, reliable, and come in a variety of options. My guest today is Dr. Christine Masterson. She is director of the Women and Children Service Line at Summit Medical Group. Welcome to the show, Dr. Masterson. Tell us a little bit about what’s going on in terms of long-term contraception today.
Dr. Christine Masterson (Guest): Well, luckily we have a lot of different options now in long-term contraception. There are numerous different things that we can utilize. Some of them are things that are placed in the office, but it really gives patients the freedom not to have to worry about taking a medication on a daily basis and really decreases the risk of forgetting.
Melanie: We’ve all heard so much about the birth control pill for the last 40 years and that is that daily pill that most women don’t like to take. Tell us about some of the options out there for long-term control that are a little bit different than the birth control pill.
Dr. Masterson: Sure. There is a hormonal ring that can be inserted that can deliver the medication. It gets left in place for several weeks and then it gets removed. There’s also intrauterine devices, what we call IUD, and some of them contain hormones. Some other brands are hormone-free. In the right patients who need to avoid hormones, there is an option to have contraception without any hormonal influence. There is also inserts that can be placed under the arm that can also deliver the medication in a similar manner.
Melanie: What are these all called? How do we speak to our doctors about using them?
Dr. Masterson: Sure. The ring is called NuvaRing. The IUDs, one is called Mirena. That is the one that contains progesterone. There’s also a smaller version of that called Skyla, also containing progesterone. The Paragard is the hormone-free alternative. It is a copper form of an IUD and doesn’t contain any medications at all. The insert that goes under the arm is called Nexplanon. All of these would require a conversation with the physician. They are prescription medications or devices that need to be discussed with the physician. Most of them are inserted in the office, although the NuvaRing is a medication you can insert at home on your own.
Melanie: What are the side effects of these types of long-term contraception?
Dr. Masterson: There’s actually a lot of benefits of taking the medications. The ones that contain hormones really can manipulate the menstrual cycle so you can get relief of a lot of heavy or regular bleeding often by using them. Sometimes, the intrauterine devices that contain progesterone do have some spotting, especially the first few days of insert, but overall, most people are very pleased with the cycle control that they attain, and often, you may not even get to see a withdrawal cycle while using an IUD. The copper IUD is a little bit different because it does not have any hormonal medication in it and it contains copper. Sometimes, the bleeding can be a little bit heavier and the cramping can be a little bit heavier especially in the first several cycles. For most people over time, however, the cycles do improve. The implant in the arm, Nexplanon, is hormonal so that too can help control the cycle and often, people will have no bleeding at all. Anytime we use hormones, there’s a risk of headaches, weight changes, skin changes. Sometimes, hormones can affect hair growth. Sometimes people see hair loss. Usually, those are short-lived until the body adjusts to the use of the hormones.
Melanie: These are removable, correct? If somebody changes their mind, do they affect your chances of getting pregnant later on?
Dr. Masterson: They are absolutely removable and the fertility rates go right back to normal once they are removed. The ring can be removed in your own home by yourself. The IUDs do need to be removed in the office as does the implant in the arm.
Melanie: What are the percentages for not getting pregnant with these things? We’ve heard that the pill was 97, 98, different percentages like that. What are the percentages on these ones you’ve been discussing?
Dr. Masterson: With these long-term options, it approaches 99 percent.
Melanie: Wow! That’s amazing. Are women finding these to be a more suitable option because you just don’t have to think about it? Can they move around once you’ve implanted them or the one that we do ourselves? Are these difficult to have in you?
Dr. Masterson: Most people are unaware once the devices are placed. Most people report that they can’t feel anything and they feel just as they did before they were placed. There is a chance that any foreign body could migrate or move its position when it’s in the body. One of the risks with the IUDs is there’s a rare chance it could be expelled or perforate the uterus or push at the uterus. That is very rare. It’s very rare that we see that at all happen. The ring, NuvaRing, is easily removed by the patient in their own home. Most people find they can’t even feel it when it’s in. Most people don’t have any problems with that. Lastly, the implant in the arm, again, that too, because it is a foreign body that we are placing inside the body, there is a chance it could migrate or it could cause local skin changes or irritation. Most people don’t find that. Most people find that they’re very stable. The effectiveness of the contraception is increased because it is something you don’t have to remember every day so you can’t forget to take an IUD because it’s in and it’s working 24/7.
Melanie: Something like the NuvaRing, does that interfere with sex at all?
Dr. Masterson: Most people don’t feel it at all. Again, it is a ring that sits vaginally. There is a chance that either partner could have some perception of it, but that’s not my finding in general. Most people don’t even know it’s there.
Melanie: You’ve mentioned these various forms of long-term contraception. How is a woman to decide which one is best for her?
Dr. Masterson: Well, the first thing is it’s important to speak to your physician and see which would work best for you in terms of your lifestyle, your medical history, what other medications you may or may not be taking and determine which would be the right mode for you. Your physician in the office can help guide you to make the right choice.
Melanie: Do we worry about hormones? Sometimes they can be protective against the endometrial type cancer. Are those benefits going to be something that carry through to the long term or do we receive those benefits just while we’re using that?
Dr. Masterson: There are definite benefits to hormones in terms of uterine cancer and ovarian cancers. The hormones do offer a protective effect. It does go into the long term in terms of offering you protection. When women use hormonal contraceptives, it does help decrease your risk of ovarian cancer in the long run. The questions about breast cancer, we don’t know. Most people believe breast cancer is related to estrogen use and most of these products do not contain estrogen. The progesterone-only IUDs are a good choice for someone that is unable to take estrogen for various reasons. Sometimes, people have a history of a cancer that could be responding to hormones or blood [clot] and you might not be a candidate for hormones at that time. That’s the benefit of the other IUD, the non-hormonal copper IUD.
Melanie: Do any of these methods provide any protection at all against STIs?
Dr. Masterson: They don’t. You still need to consider protecting yourself using barrier methods for STIs. The progesterone does cause a thicker cervical mucus, so there is some thought that that may offer some protection, but to be really safe, you still need to use condoms.
Melanie: If a woman comes in to discuss this with you, whether she’s 18 or 28, what is your best advice that you give them on choosing, because there are so many out there now and then there is the short-term birth control. How do you decide whether long term is for you or short term and what is your best advice?
Dr. Masterson: Well, personally, I usually go through with a patient when she tells me she needs to consider contraception. I go through all the different options including things like natural family planning where you’re monitoring your menstrual cycle, barrier methods like condoms, hormonal methods, and that can include even the long-acting methods as well. We try to make the best choice for her based on her lifestyle and her medical history to see what may work best for her. We also talk about her long-term goal when she may be considering conceiving. Sometimes, if she tells me she may want to consider in the next several months, then a long-term option isn’t the best option for her. We try to make a decision based on what her plans are.
Melanie: Dr. Masterson, in just the last minute here, tell the listeners why they should come to the Women and Children’s Service Line at Summit Medical Group for their care.
Dr. Masterson: Sure. We really try to look at the patients and look at their whole health history and try to really treat them comprehensively. The benefit of coming to our Care Center here is that we are able to access your medical record, see what other providers are treating you with, and make sure that there’s no interactions. We really try to look at a whole woman’s being and treat all aspects of women and the care that they may need.
Melanie: Thank you so much. You’re listening to SMG Radio. For more information, you can go to summitmedicalgroup.com. That’s summitmedicalgroup.com. This is Melanie Cole. Thanks so much for listening and have a great day.
Are You Considering Long Term Contraception?
Melanie Cole (Host): Long-term contraception is a highly effective non-permanent method for preventing pregnancy, and unlike other methods that need to be thought about on a daily, weekly, or even monthly basis, long-term contraceptives are safe, reliable, and come in a variety of options. My guest today is Dr. Christine Masterson. She is director of the Women and Children Service Line at Summit Medical Group. Welcome to the show, Dr. Masterson. Tell us a little bit about what’s going on in terms of long-term contraception today.
Dr. Christine Masterson (Guest): Well, luckily we have a lot of different options now in long-term contraception. There are numerous different things that we can utilize. Some of them are things that are placed in the office, but it really gives patients the freedom not to have to worry about taking a medication on a daily basis and really decreases the risk of forgetting.
Melanie: We’ve all heard so much about the birth control pill for the last 40 years and that is that daily pill that most women don’t like to take. Tell us about some of the options out there for long-term control that are a little bit different than the birth control pill.
Dr. Masterson: Sure. There is a hormonal ring that can be inserted that can deliver the medication. It gets left in place for several weeks and then it gets removed. There’s also intrauterine devices, what we call IUD, and some of them contain hormones. Some other brands are hormone-free. In the right patients who need to avoid hormones, there is an option to have contraception without any hormonal influence. There is also inserts that can be placed under the arm that can also deliver the medication in a similar manner.
Melanie: What are these all called? How do we speak to our doctors about using them?
Dr. Masterson: Sure. The ring is called NuvaRing. The IUDs, one is called Mirena. That is the one that contains progesterone. There’s also a smaller version of that called Skyla, also containing progesterone. The Paragard is the hormone-free alternative. It is a copper form of an IUD and doesn’t contain any medications at all. The insert that goes under the arm is called Nexplanon. All of these would require a conversation with the physician. They are prescription medications or devices that need to be discussed with the physician. Most of them are inserted in the office, although the NuvaRing is a medication you can insert at home on your own.
Melanie: What are the side effects of these types of long-term contraception?
Dr. Masterson: There’s actually a lot of benefits of taking the medications. The ones that contain hormones really can manipulate the menstrual cycle so you can get relief of a lot of heavy or regular bleeding often by using them. Sometimes, the intrauterine devices that contain progesterone do have some spotting, especially the first few days of insert, but overall, most people are very pleased with the cycle control that they attain, and often, you may not even get to see a withdrawal cycle while using an IUD. The copper IUD is a little bit different because it does not have any hormonal medication in it and it contains copper. Sometimes, the bleeding can be a little bit heavier and the cramping can be a little bit heavier especially in the first several cycles. For most people over time, however, the cycles do improve. The implant in the arm, Nexplanon, is hormonal so that too can help control the cycle and often, people will have no bleeding at all. Anytime we use hormones, there’s a risk of headaches, weight changes, skin changes. Sometimes, hormones can affect hair growth. Sometimes people see hair loss. Usually, those are short-lived until the body adjusts to the use of the hormones.
Melanie: These are removable, correct? If somebody changes their mind, do they affect your chances of getting pregnant later on?
Dr. Masterson: They are absolutely removable and the fertility rates go right back to normal once they are removed. The ring can be removed in your own home by yourself. The IUDs do need to be removed in the office as does the implant in the arm.
Melanie: What are the percentages for not getting pregnant with these things? We’ve heard that the pill was 97, 98, different percentages like that. What are the percentages on these ones you’ve been discussing?
Dr. Masterson: With these long-term options, it approaches 99 percent.
Melanie: Wow! That’s amazing. Are women finding these to be a more suitable option because you just don’t have to think about it? Can they move around once you’ve implanted them or the one that we do ourselves? Are these difficult to have in you?
Dr. Masterson: Most people are unaware once the devices are placed. Most people report that they can’t feel anything and they feel just as they did before they were placed. There is a chance that any foreign body could migrate or move its position when it’s in the body. One of the risks with the IUDs is there’s a rare chance it could be expelled or perforate the uterus or push at the uterus. That is very rare. It’s very rare that we see that at all happen. The ring, NuvaRing, is easily removed by the patient in their own home. Most people find they can’t even feel it when it’s in. Most people don’t have any problems with that. Lastly, the implant in the arm, again, that too, because it is a foreign body that we are placing inside the body, there is a chance it could migrate or it could cause local skin changes or irritation. Most people don’t find that. Most people find that they’re very stable. The effectiveness of the contraception is increased because it is something you don’t have to remember every day so you can’t forget to take an IUD because it’s in and it’s working 24/7.
Melanie: Something like the NuvaRing, does that interfere with sex at all?
Dr. Masterson: Most people don’t feel it at all. Again, it is a ring that sits vaginally. There is a chance that either partner could have some perception of it, but that’s not my finding in general. Most people don’t even know it’s there.
Melanie: You’ve mentioned these various forms of long-term contraception. How is a woman to decide which one is best for her?
Dr. Masterson: Well, the first thing is it’s important to speak to your physician and see which would work best for you in terms of your lifestyle, your medical history, what other medications you may or may not be taking and determine which would be the right mode for you. Your physician in the office can help guide you to make the right choice.
Melanie: Do we worry about hormones? Sometimes they can be protective against the endometrial type cancer. Are those benefits going to be something that carry through to the long term or do we receive those benefits just while we’re using that?
Dr. Masterson: There are definite benefits to hormones in terms of uterine cancer and ovarian cancers. The hormones do offer a protective effect. It does go into the long term in terms of offering you protection. When women use hormonal contraceptives, it does help decrease your risk of ovarian cancer in the long run. The questions about breast cancer, we don’t know. Most people believe breast cancer is related to estrogen use and most of these products do not contain estrogen. The progesterone-only IUDs are a good choice for someone that is unable to take estrogen for various reasons. Sometimes, people have a history of a cancer that could be responding to hormones or blood [clot] and you might not be a candidate for hormones at that time. That’s the benefit of the other IUD, the non-hormonal copper IUD.
Melanie: Do any of these methods provide any protection at all against STIs?
Dr. Masterson: They don’t. You still need to consider protecting yourself using barrier methods for STIs. The progesterone does cause a thicker cervical mucus, so there is some thought that that may offer some protection, but to be really safe, you still need to use condoms.
Melanie: If a woman comes in to discuss this with you, whether she’s 18 or 28, what is your best advice that you give them on choosing, because there are so many out there now and then there is the short-term birth control. How do you decide whether long term is for you or short term and what is your best advice?
Dr. Masterson: Well, personally, I usually go through with a patient when she tells me she needs to consider contraception. I go through all the different options including things like natural family planning where you’re monitoring your menstrual cycle, barrier methods like condoms, hormonal methods, and that can include even the long-acting methods as well. We try to make the best choice for her based on her lifestyle and her medical history to see what may work best for her. We also talk about her long-term goal when she may be considering conceiving. Sometimes, if she tells me she may want to consider in the next several months, then a long-term option isn’t the best option for her. We try to make a decision based on what her plans are.
Melanie: Dr. Masterson, in just the last minute here, tell the listeners why they should come to the Women and Children’s Service Line at Summit Medical Group for their care.
Dr. Masterson: Sure. We really try to look at the patients and look at their whole health history and try to really treat them comprehensively. The benefit of coming to our Care Center here is that we are able to access your medical record, see what other providers are treating you with, and make sure that there’s no interactions. We really try to look at a whole woman’s being and treat all aspects of women and the care that they may need.
Melanie: Thank you so much. You’re listening to SMG Radio. For more information, you can go to summitmedicalgroup.com. That’s summitmedicalgroup.com. This is Melanie Cole. Thanks so much for listening and have a great day.