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Long-Term Birth Control: New Implants and Patches

Prevent pregnancy without thinking about it.

Mirena: The New IUD continued...

Mirena does not contain estrogen, but releases another hormone -- levonorgestrel -- into the uterus, which creates a "hostile uterine environment" that prevents pregnancy. "It's as effective as tubal ligation (tubes tied) in preventing pregnancy," Estes explains.

It also decreases menstrual flow and cramps. "We use it to treat women who have heavy periods," he says. "It's my first-line treatment for heavy bleeding. Some women actually have no periods at all."

"Mirena is a method that is really catching on," Ross tells WebMD. "We're seeing a lot more patients who want the IUD. Women used to be afraid of infection from IUDs, but new data shows that it's not a risk if you're monogamous. It's also good for people who can't afford birth control pills, because once you have it, it's good for several years."

Birth Control Implant: Implanon

Implanon is an implanted device, too, but it goes into your arm. The matchstick-sized plastic rod must be replaced every three years. It works by releasing the hormone progestin, which works in several ways to prevent sperm from reaching eggs.

"It is a great method as well," Estes says. "There is no estrogen, so it's fine for women who have had blood clots before, women who smoke, are over age 35, women who have had a heart attack or have heart defects."

Women who want a continuous method of birth control -- one that is worry-free -- will like Implanon, he says. "Once it's in place, it's in place."

Expect some spotting and bleeding with Implanon, adds Ross. Your period will likely get lighter; you may have no period after awhile. 

Make sure you find a specially trained doctor to insert it. The Implanon web site can help you find a provider by ZIP code or city.

Essure: The Ultimate Long-Term Birth Control

For women who want the assurance of sterilization, "Essure is great," Estes says.

Essure is a way of having your tubes tied (tubal ligation) without the surgery, he explains. The 10- to 20-minute procedure can be performed in a doctor's office, using local anesthesia -- which means that it is less expensive than tubal ligation, and recovery is quicker. Some doctors perform the implant as a hospital outpatient procedure.

Here's how it works: A spring-like device is inserted in each fallopian tube, causing scar tissue to form over the implant. That blocks the tubes and prevents fertilization of egg by sperm. To ensure that Essure is doing its job, you will need a three-month follow-up appointment.

"It's the only sterilization method where we can confirm that you are indeed sterilized," Estes tells WebMD. "So far, it's 100% effective. We can't guarantee, but it seems very reliable."

Because Essure works without hormones, it does not affect the monthly cycle. For women who have troublesome periods, it's possible to have Essure as well as the Mirena IUD, Estes adds.

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Reviewed on December 04, 2007

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