Is It Time to Dump Your Birth Control?

Featured Article, Reproductive Health, Women's Health
on May 1, 2013

Birth control has come a long way, baby. Women have far more options today than they did a generation ago—or even 10 years ago. We can choose to get a shot, wear a patch, take a pill or have a semi-permanent or totally permanent procedure. And the options just keep growing. (Though we’re still waiting for a male birth control pill—but more on that later.)

Even if you’ve happily used the same method of birth control for years, check out the latest developments—whether it’s something all new or an improvement to what you already use.


Intrauterine devices (IUD), which block fertilization from inside a woman’s body, are still available in hormonal (Mirena) and nonhormonal (Paraguard) options. But now you also have an option that is similar to Mirena but remains in place for only three years, instead of five . The low-dose three-year IUD Skyla was just approved by the FDA in January—the first new device of this kind in a dozen years.

“And pretty immediately, fertility returns as soon as you have them removed. That’s a plus,” says Jacki Witt, a women’s health nurse practitioner, and member of the board of directors of the National Association of Nurse Practitioners in Women’s Health.

Though it’s fine health-wise to remove IUDs before the end of their term, they’re most cost-effective if you keep them as long as possible. For that reason, Skyla may appeal to younger women who plan to get pregnant in fewer than five years—especially as doctors no longer advise against IUDs for women who have never had a baby.

“Many young women are getting IUDs without a problem, and they’re doing well,” says Dr. Mary Jane Minkin, a gynecologist, clinical professor at the Yale University School of Medicine and spokesperson for First Response.

The Implant

The implant is a matchstick-sized rod that is inserted into your arm, where it releases the hormone progestin, which prevents pregnancy. You may have heard of Implanon, but now there is a new version of this implantable birth control device called Nexplanon. According to Witt, it’s actually very similar to the older version. “It’s just a little bit different the way they put it in,” says Witt.

The implant is good for up to three years. The most common side effect of an implant is irregular bleeding in the first 6-12 months, but not all women will experience this.

The Pill

When the birth control pill first hit pharmacies, a typical dose contained 100 micrograms of estrogen, a high dose of hormones that put women at risk for complications for stroke and pulmonary embolism. But today, most women take low-dose combination birth control pills that contain anywhere from 20 to 50 micrograms of estrogen. Others opt for a progestin-only minipill.

But the options just keep expanding. While many women prefer the traditional regimen of 21 days of active pills and seven days of inactive pills, others choose a continuous-dosing contraceptive like Seasonale or Seasonique, to reduce their monthly periods to four times per year.

“It’s quite safe,” says Minkin, adding, “Some women get breakthrough bleeding if they go much more than six to eight weeks without a break for a period. If that happens, I’ll let my patients get their period and then get back on the pill.”

Another type of pill, Lybrel, which was approved by the FDA in 2007, is taken continuously and eliminates monthly periods altogether.

Permanent Birth Control

It used to be that women that wanted a permanent birth control solution had two choices: have their partner undergo a vasectomy or opt for surgical sterilization, in the form of a tubal ligation. But now there’s a less-invasive option for women that can be performed in your doctor’s office: fallopian tube occlusion. Essure, which was FDA approved in 2003, permanently blocks the fallopian tubes via a set of flexible inserts. Over time, scar tissue forms around them, preventing pregnancy permanently. But take note: While other types of “permanent” birth control are potentially reversible with additional procedures, Essure is not.

The Pill—For Men

The bad news: It’s not here yet. But while it’s likely still years from the market, a birth control pill for men is closer than ever. This year, the National Institutes of Health awarded a $4.7 million grant to a chemist at the University of Minnesota to help fund her research on a contraceptive method that would slow the speed at which sperm travel—and have fewer side effects than the testosterone-based male birth control methods that have already been tested.