Whether you’re looking to postpone having a baby or are considering a permanent solution, there are multiple birth-control options from which to choose.
To have a baby or not to have a baby, that is the question. If the answer is “no” or “not now,” that leads to a number of decisions, not the least of which is determining which partner will assume primary responsibility for birth control.
For men, the choices are relatively simple: condoms or vasectomy. Condoms, when used correctly, protect against sexually-transmitted diseases and offer a fairly reliable means of birth control. However, condoms are rarely used correctly, resulting in an 82-98% effective rate at preventing pregnancy, according to the National Center for Health Statistics. The second option is vasectomy, a surgical procedure that provides permanent sterilization for men. It’s safe, quick and has one of the lowest complication rates and highest success rates (more than 99%) of any method of birth control.
The pros of vasectomy
Getting a vasectomy is not something most men look forward to. The good news, however, is a vasectomy is not all that complicated – and relatively painless – once the patient gets past the initial anxiety.
At Pacific Medical Centers (PacMed), the surgeon typically uses a no-scalpel technique, which decreases the size of the incision to less than a centimeter. It is performed in a doctor’s regular office using a local numbing anesthetic. The no-scalpel technique is faster than a traditional vasectomy, so the procedure usually takes less than 20 minutes. Patients require minimal pain medication afterward and are back to normal activities at one week. Another form of birth control should be used for at least the next 12 weeks until your doctor has confirmed your sperm count has dropped to zero.
At least once a month, PacMed offers a same-day vasectomy clinic at its Canyon Park clinic on weekends where patients meet with the surgeon for a consultation and then have the surgery performed, all on a Saturday morning. Generally, they’re able to go back to work the following Monday, without taking any days off.
A vasectomy should be viewed as a permanent procedure. While procedures to reverse a vasectomy are available, they are not guaranteed. Also, reversal surgeries are generally not covered by health insurance whereas vasectomies typically are covered by insurance.
New choices in IUDs
If you are a woman deciding between the birth control pill and an intrauterine device (IUD) as a mode of contraception, there is no one right answer. Every woman is unique and may adapt slightly differently to the two modes of contraception.
Since the IUD’s usage is less prevalent today, let’s focus on the advantages of this underutilized device.
The IUD is a small – roughly one inch – plastic “T” inserted into the uterus that hampers the interaction and implantation of the sperm and egg. An IUD is inserted by a qualified medical professional in a doctor’s office. The procedure takes a few minutes and is subsequently monitored through frequent check-ups. IUDs are one of the most effective forms of birth control available – more than 99% effective in preventing pregnancy.
There are three brands of FDA-approved IUDs available in the United States:
- ParaGard® IUD, which contains copper, is the only reversible birth control that’s more than 99% effective and 100% hormone free. ParaGard may be a good option if you want to avoid or can’t tolerate hormones. It lasts up to 10 years.
- Mirena® (levonorgestrel-releasing intra-uterine system) is a hormone-releasing system that lasts up to five years. Mirena is also FDA-approved to treat heavy periods in women who choose IUD birth control.
- Skyla™ is the newest FDA-approved IUD. Like the Mirena, Skyla releases a small amount of progestin each day to keep you from getting pregnant. It’s slightly smaller than the Mirena and lasts up to three years.
IUDs (or IUSs) are safe, inexpensive over time, and provide extremely effective long-term contraception from a single decision. All you have to do is check for the strings each month. If, at any time, you decide you want to try to have child, your healthcare provider can remove your IUD during a routine office visit. Once the IUD is removed, fertility returns rapidly.
Permanent options for women
When you know your family is complete, you may be ready to consider permanent birth control. Any form of permanent sterilization is considered to be irreversible. You should be certain you do not want to deliver more children and will not change your mind.
Along with vasectomy for men, there are two types of permanent birth control procedures for women:
- Laparoscopic tubal ligation is an operation done over general anesthesia. Often the operation is accomplished through using a laparoscope. This instrument is inserted through a small incision in the abdomen. The tubes are visualized so the surgeon can place rings, apply clips or burn the tubes. After this operation your eggs will have no way to get to your uterus, and the man’s sperm will have no way to get to your eggs. This method is effective immediately.
- Essure® permanent birth control is a procedure done via hysteroscopy that works with your body to create a natural barrier to prevent pregnancy. During this quick procedure, a doctor places the soft, flexible Essure inserts into your fallopian tubes through the natural pathways of your vagina and cervix, so no incision is necessary. Over the next three months, your body works with the inserts to form a natural barrier in your fallopian tubes. This barrier prevents sperm from reaching the egg so that pregnancy cannot occur. During this three-month period, you must continue to use another form of birth control. After three months, your doctor will conduct a confirmatory test to verify that the inserts are in place and your tubes are fully blocked.
Which type of birth control is right for you? Multiple factors come into play, including your medical history, which partner wants to take the primary responsibility, surgical risks, possible side effects, and long-term cost or insurance coverage. Any birth control decision, whether temporary or permanent, should involve a discussion between you, your partner and your healthcare provider.
In the United States, almost half of all pregnancies are unintended. If you’re not ready to hear those magical words, “Congratulations, you’re going to have a baby!” now may be the perfect time to explore the latest birth control options available to you.
About the Authors
Michael Y. Han, MD, is a urologist at PacMed’s Canyon Park and First Hill clinics.
Shilpa Desai, MD, conducts practices in gynecology and women’s health at PacMed’s Canyon Park and First Hill clinics.
Michael Y. Han, MD
Shilpa Desai, MD
Pacific Medical Centers is a multi-specialty group that offers birth control options for both women and men. At PacMed, couples can get counseling on current birth control methods and sterilization techniques. For more information and profiles on Dr. Han and Dr. Desai, visit PacMed.org or call 1.888.4PACMED.
Vasectomy Facts vs. Myths:
True: It should be considered a permanent procedure. While procedures to reverse a vasectomy are available, they are not guaranteed. Also, reversal surgeries are generally not covered by health insurance while vasectomies are covered by insurance.
True: It is performed in a doctor’s regular office using a local numbing anesthetic.
True: It has a quick recovery period. Patients require minimal pain medication afterward and are back to normal activities at one week.
Myth: It causes erectile dysfunction. There is no data showing that this is true. Vasectomy does not affect the nerves or the blood vessels of the penis.
Myth: It reduces sexual desire. There is no data that proves a vasectomy reduces sexual desire. Testosterone, men’s main sex hormone, is transported from the testicles in the bloodstream. A vasectomy does not disrupt this process.