Navigating Birth Control: Expert Advice from Dr. Bana Kashani, OB-GYN

In a rapidly evolving landscape of reproductive health, navigating the variety of birth control options can be overwhelming. While the most common forms of birth control include oral contraceptives, like the pill, condoms, IUDs, implants, patches, and rings, there are other options – from hormonal contraceptives to barrier methods and fertility awareness techniques. Bana Kashani, M.D., OB-GYN, reproductive endocrinologist and infertility specialist, explains the efficacy of various methods, empowering individuals to make informed decisions about their reproductive health.

“When choosing a birth control method, it's essential to consider factors such as efficacy, convenience, side effects, and personal preferences. Some individuals may prefer the ease of hormonal contraceptives, while others may opt for the long-term protection offered by long-acting reversible contraceptives (LARCs),” says Dr. Kashani. “Understanding the nuances of different options enables individuals to make choices aligned with their unique needs and preferences."

Dr. Kashani sheds light on various birth control methods in the following Q&A:

What are the different types of birth control methods available?

There are several types of birth control methods, including hormonal contraceptives (pills, patches, rings); barrier methods (condoms, diaphragms); long-acting reversible contraceptives (IUDs, implants); permanent methods (sterilization), and fertility awareness methods, which involve tracking menstrual cycles and abstaining from intercourse during fertile periods.

How effective are hormonal contraceptives in preventing pregnancy?

Hormonal contraceptives, when used consistently and correctly, are highly effective at preventing pregnancy. Oral contraceptives, patches, and rings have failure rates of less than 9%, but effectiveness can vary with inconsistent usage. For example, forgetting to take the pill, taking it at different times each day, and interactions with other medications can influence its effectiveness.

Can using hormonal birth control methods for an extended period affect fertility negatively?

There is limited evidence to suggest that using birth control methods for an extended period negatively impacts fertility. Hormonal contraceptives work primarily by suppressing ovulation and thickening cervical mucus with fecundity (chances of conceiving) returning to normal upon cessation of their use. Recent research indicates that fecundity return among women after discontinuation of any hormonal contraceptive methods was high. Hormonal contraception does not cause us to lose more eggs every month nor does it lower your egg count in the future.

Are LARCs more effective at preventing pregnancy than other methods?

Yes, LARCs such as intrauterine devices (IUDs) and contraceptive implants are among the most effective forms of birth control, rivaling permanent sterilization. They have success rates exceeding 99% and are suitable for individuals seeking long-term contraceptive solutions. Available in hormonal and non-hormonal options, the IUD provides long-term protection against pregnancy, lasting from three to 10 years depending on the type.

Can IUDs cause infertility?

There is little to no evidence to suggest that intrauterine devices (IUDs) cause infertility. IUDs are highly effective contraceptives and are considered safe for most individuals. Once an IUD is removed, fertility typically returns to normal, allowing individuals to conceive if they desire. It's important to consult with a healthcare provider to discuss any concerns or questions about IUDs and their potential impact on fertility.

Are there any long-term side effects on fertility associated with using barrier methods or fertility awareness as a form of birth control?

These methods generally do not have long-term effects on fertility. Barrier methods such as condoms, when used correctly, provide effective contraception without impacting fertility. Inconsistent or improper barrier method use causing STIs can lead to pelvic inflammatory disease if left untreated, scarring the fallopian tubes and risking tubal factor infertility or ectopic pregnancy. Fertility awareness methods entail monitoring menstrual cycles or ovulation to identify fertile days and avoid unprotected intercourse, without impacting fertility.

"No matter which method you choose, I recommend keeping pregnancy tests on hand like First Response Early Result if you think you might be pregnant, especially if you experience irregular periods with birth control use," advises Dr. Kashani. "Concerns about changes in your menstrual cycle or fertility should be discussed with a healthcare provider, who can offer personalized guidance based on individual health factors and reproductive goals.”

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Sarah Haney
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