Birth Control at CHOICES

Choices Women's Medical Center is more than an abortion clinic. As a comprehensive women's health care facility, we provide patients with contraception, also known as birth control. Choosing the best birth control is a very personal decision. We understand that every patient is different, and will provide information about and access to many options of birth control methods in order to find the best fit for the patient, including birth control pills, emergency contraception (a.k.a. the morning after pill), IUDs, Nexplanon, and more.
 
The ESP Method
 
When you come to our women's health clinic in Queens, we'll help you choose the method of contraception that is best for you. The most important factors to consider are effectiveness, safety, and personality - what Choices calls the ESP Method
 
Effectiveness: Some methods of birth control are less than 50% effective; others are over 99% effective. The importance of effectiveness to you depends on how important it is for you to avoid pregnancy. 
 
Safety: Every method of birth control has benefits as well as risks, and every patient is affected differently by these benefits and risks. Knowing how your body reacts to side effects is an important part of choosing a birth control method.
 
Personality: Since there is such a wide range of birth control options, Choices takes the time to get to know each patient's personality to help find the best method of birth control to suit the patient's likes, dislikes, and needs.
 
 

Birth Control and Family Planning Methods

Essure is the new non-incisional (no cutting) method of permanent sterilization approved by the FDA in 2002. This is an irreversible method of birth control. Unlike traditional tubal ligation which requires cutting into the abdomen Essure micro-inserts are placed through the bodies natural openings and does not require general anesthesia.

How does Essure work?

Your doctor will use a camera called a Hysteroscope placed in your uterus to place hormone free micro-inserts into each fallopian tube. Then over a three month period your body will naturally fill in the tissue around the inserts causing your tubes to be permanently blocked. You will need to have a special x-ray called HSG to verify that the tubes are blocked and you can no longer get pregnant.

How does Essure differ from traditional tubal ligation?

Traditional tubal ligation requires general anesthesia and must be performed in an operating room. The woman’s stomach is then expanded using special gas and 3 small incisions are made through which using special instruments the doctor can identify the fallopian tubes and either cut, clip or burn them. Essure is minimally invasive meaning it does not require any cuts be made in the body and can even be done with a local and sedation right in the doctor’s office. Because of the ease of insertion, no incisions and no general anesthesia most women are able to go home within 45 minutes and are able to return to normal activities within 1-2 days. Unlike with the traditional tubal they have had major surgery and may require 1-2 weeks to be able to return to work or school.

How much will Essure cost?

Essure is now being covered by most insurance plans. One of our insurance specialists will be able to assist you in determining what if any costs there will be.

What do I have to do to get Essure?

Well first you will need to come in for a standard PAP and STD screening at which time you can discuss with your provider the desire for permanent sterilization and if Essure is an appropriate and viable option for you. There is a 30 day waiting period even after the decision is made. Most importantly you must be absolutely sure that you do not want to have any more children.

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birth control pillsBirth Control Pills are taken every single day. A woman choosing this method will commit to taking ONE pill every day, at approximately the same time every single day. Pills contain two types of hormones: estrogen and progestin. In order to be eligible for Birth Control Pills, you must have a medical exam, including your medical history, internal examination and Pap test. If you choose this method of birth control, a Choices provider will give you a prescription for up to 6 months of pills; you will be required to come for a brief 6-month interval visit.

Effectiveness: 99% effective (if used correctly)

Safety: Birth Control Pills can cause minor discomforts such as breast tenderness, nausea, spotting, nervousness, and/or depression/emotional labiality. These side effects may be experienced during the first few months of taking the pill and then subside. Some women, however, find relief in changing to different brand of Pill; Choices providers will work with you to decrease any discomforts felt. More significant risks, such as stroke, blood clots, or circulatory disorders, have been reported from taking the Pill. The Pill is not right for you if you have a history of liver disease, blood clotting disorders, stroke or uncontrolled high blood pressure. Women who use hormonal birth control methods are strongly advised not to smoke, as smoking increases the risk of side effects. Choices providers will always review with you the warning signs of a serious side effect:

  • Headache
  • Vision Changes/Problems
  • Chest Pain
  • Abdominal/Heartburn Pain
  • Leg Pain (in the calf)

Potential health benefits of taking oral contraceptive pills include a reduced risk of developing cancers of the uterus and ovaries, benign breast disease, pelvic infections, iron-deficiency anemia, rheumatoid arthritis, and a variety of menstrual disorders. The Pill does not protect against HIV or other sexually transmitted infections.

Personality: Effectiveness is very important to you. You like to be spontaneous and to be in control of every situation. You have no problems remembering to take medication. You are a mature individual. With the Pill, you get a monthly menstrual period. 

 

The Nuva Ring is a soft, flexible, transparent ring containing hormones (estrogen and progestin) and is inserted into the vagina once a month. It operates like other hormonal methods (see Birth Control Pills or The Patch) where you will get a monthly menstrual period. To insert the ring for use, it is pressed together between two fingers and inserted into the vagina (to fit around the cervix). The ring is worn for three complete weeks, and then discarded. Following a complete ring-free week, a fresh ring is then vaginally inserted. In order to be eligible for the Nuva Ring, you must have a medical exam, including your medical history, internal examination and Pap test.

Effectiveness: 99% effective (if used correctly)

Safety: The Nuva Ring has risks and side effects similar to other hormonal methods. The Ring does not protect against HIV or other sexually transmitted infections.

Personality: You are comfortable with touching yourself in the vaginal area. You are a non-smoker. The possible side effects associated with hormonal methods do not bother you. You can remember to insert the ring and remove it as required. What you look for is spontaneity and a method that is dealt with less frequently than other hormonal methods. With the Pill, you get a monthly menstrual period.

The Ortho Evra Patch is a small, thin, square "bandaid-like" patch containing hormones (estrogen and progestin) that is worn on the body. It operates like other hormonal methods (see Birth Control Pills or the Ring) where you will get a monthly menstrual period. To use the Patch, you apply one patch on the body and wear it for a full week. That patch is then removed and a new one is applied; this is done for 3 consecutive weeks, then you will have a week without wearing a patch. Following a complete patch-free week, a new one is applied to begin another 3 weeks of wearing. In order to be eligible for the Ortho Evra patch, you must have a medical exam, including your medical history, internal examination and Pap test.

Effectiveness: 99% effective (if used correctly)

Safety: Ortho Evra has risks and side effects similar to other hormonal methods. The Patch does not protect against HIV or other sexually transmitted infections.

Personality: You are a non-smoker. The possible side effects associated with hormonal methods do not bother you. You can remember to replace the patch weekly. What you look for is spontaneity and a hormonal method that is dealt with less frequently than the Pill. With the Pill, you get a monthly menstrual period. 

Depo Provera is a hormonal injection shot that is administered by a healthcare professional every 12-13 weeks (approximately three months). Depo is a hormonal contraceptive method; though unlike pills, the ring or the patch, it only contains one of the hormones (progestin) and is therefore is okay for use in women who cannot take estrogen.

Effectiveness: 99% effective (if used correctly)

Safety: Has possible side effects similar to other hormonal methods. For the first 6 months to a year of use, many women experience irregular menstrual spotting and/or bleeding. Eventually, your menstrual flow may be reduced and for some women may stop entirely. Other possible effects to the injection include weight gain and loss of bone calcium. Depo does not protect against HIV or other sexually transmitted infections.

Personality: Injections do not bother you. You can remember to return regularly for your shot. The risk of side effects does not bother you, including possible spotting, irregular bleeding, or not getting a monthly menstrual period. You are looking for a birth control method that does not have to be dealt with as frequently as other hormonal methods. 

The Paragard IUD is a device inserted into the uterus and can be worn for up to 10 years. A woman choosing this method wants long-term birth control; yet if that changes and pregnancy is desired, the IUD can be removed at any time before the 10 year limit. The IUD is inserted by a healthcare professional during a woman's menstrual period. Most women experience little or no pain/discomfort during the insertion process. In order to be eligible for an IUD, you must have a medical exam, including your medical history, internal examination, Pap test and cervical/vaginal cultures.

Effectiveness: 99% effective

Safety: Paragard in non-hormonal and therefore, does not have any hormone-related side effects. The first several menstrual periods a woman has with an IUD inserted may be heavier and cramping may be experienced. The risks of an IUD include expulsion (the IUD falls out of the uterus) or perforation (the IUD punctures the uterine muscle). IUDs' also carry a small risk of Ectopic pregnancy, PID, bleeding between periods, uterine cramping and unwanted pregnancy. The Paragard IUD does not protect against HIV or other sexually transmitted infections.

Personality: You desire a long-term method of contraception. You are in a monogamous (one-to-one) relationship with your partner. You have never had an ectopic (tubal) pregnancy nor have a history of pelvic inflammatory disease. You do not want a hormonal form of contraception. You enjoy spontaneity and, therefore, are looking for a birth control method that you do not have to think about. 

The Mirena IUD is a device inserted into the uterus and can be worn for up to 5 years. Unlike the Paragard IUD, Mirena contains hormones (progestin). A woman choosing this method wants long-term birth control; yet if that changes and pregnancy is desired, the IUD can be removed at any time before the 5 year limit. The IUD is inserted by a healthcare professional during a woman's menstrual period. In order to be eligible for an IUD, you must have a medical exam, including your medical history, internal examination, Pap test and cervical/vaginal cultures.

Effectiveness: 99% effective

Safety: The first several menstrual periods a woman has with an IUD inserted may be heavier and cramping may be experienced; however, because of the hormone in the Mirena IUD, over time (approximately 9-12 months) a woman's menstrual periods will lighten considerably and may even stop. IUDs carry a small risk of Ectopic pregnancy, PID, bleeding between periods, uterine cramping and unwanted pregnancy. Mirena's risks also include ovarian cysts, deep vein thrombosis and decrease/loss of menstrual flow. The risks of an IUD include expulsion (the IUD falls out of the uterus) or perforation (the IUD punctures the uterine muscle). The IUD does not protect against HIV or other sexually transmitted infections.

Personality: You desire a long-term method of contraception. You are in a monogamous (one-to-one) relationship with your partner. You have never had an ectopic (tubal) pregnancy nor have a history of pelvic inflammatory disease. You are able to use a hormonal form of contraception. You enjoy spontaneity and, therefore, are looking for a birth control method that you do not have to think about. 

The Diaphragm is a cervical barrier method of contraception. It is a dome-shaped device made of latex that is fit into the vagina to provide a snug seal so that sperm cannot enter the cervix. It is used with a spermicidal jelly or cream to add additional barrier protection. The Diaphragm is fitted for your vagina by a healthcare professional. The Diaphragm is a "use-based" type of birth control; you insert it into the vagina for each occasion of intercourse; it is left in the vagina for 6-8 hours following the last time your partner ejaculates (comes) and then it is removed.

Effectiveness: 86% effective (if used correctly)

Safety: Neither you nor your partner are allergic to latex nor the spermicidal cream or jelly used. If the Diaphragm is left in place for too long, risks of urinary tract infections and toxic shock syndrome may increase. The Diaphragm is used for every act of intercourse and therefore, must be inserted correctly for contraceptive protection. The Diaphragm offers very limited protection against some sexually transmitted diseases; however, cannot be relied on for full protection from HIV or other STDs.

Personality: You are comfortable touching yourself in the vaginal area. You do not want a hormonal form of birth control. You do not mind being required to insert the Diaphragm for each occasion of intercourse. You plan to ask your doctor for a prescription for emergency contraception (the "day after" pill), and are comfortable with abortion as a backup in case you become pregnant. You are a mature individual.

Emergency Contraception is the most frequently used method to prevent pregnancy immediately after unprotected sex. Emergency contraceptive pills deliver a specific dose of hormones that is 75% effective in preventing pregnancy IF TAKEN WITHIN 3 DAYS of unprotected sex. Emergency Contraception is not effective in preventing pregnancy more than 3 days after unprotected sex. If more than 3 days has elapsed, you can discuss other options with our staff.

Effectiveness: 75% effective IF TAKEN WITHIN 3 DAYS (72 hours)

Safety: Many women who use emergency contraceptive pills feel nausea and may vomit. Some also feel dizzy or tired and have breast tenderness. These side effects are not serious and usually last for about a day. No serious or long-term complications have been linked to Emergency Contraception pills. If you do not have a period within 21 days of taking emergency contraceptive pills, you should consult our staff for further pregnancy testing. Emergency Contraception does not protect you against HIV/ AIDS and sexually transmitted diseases.

Personality: A mistake has occurred and you do not want to chance a possible pregnancy. Emergency contraceptive pills are meant for emergency protection, and are not used for preventing pregnancy in the long term as a method of birth control. When you visit your physician for Emergency Contraception, you can discuss other options for long-term birth control. 

nexplanonNEXPLANON is a hormone-releasing birth control implant for use by women to prevent pregnancy for up to 3 years.

The implant is a flexible plastic rod about the size of a matchstick that contains a progestin hormone called etonogestrel. It also contains a small amount of barium sulfate so that the implant can be seen by X-ray. Your health care provider will insert the implant just under the skin of the inner side of your upper arm. You can use a single NEXPLANON implant for up to 3 years. NEXPLANON does not contain estrogen.

How it works

NEXPLANON prevents pregnancy in several ways. The most important way is by stopping the release of an egg from your ovary. NEXPLANON also thickens the mucus in your cervix and this change may keep sperm from reaching the egg. NEXPLANON also changes the lining of your uterus.

When the NEXPLANON implant is placed correctly, your chance of getting pregnant is very low (less than 1 pregnancy per 100 women who use NEXPLANON for 1 year). It is not known if NEXPLANON is as effective in overweight women because studies did not include many overweight women.

Your health care provider can remove the implant at any time. You may become pregnant as early as the first week after removal of the implant. If you do not want to get pregnant after your health care provider removes the NEXPLANON implant, you should start another birth control method right away.

Will NEXPLANON be covered by insurance?

NEXPLANON may be covered by your insurance plan. To determine if you have coverage, you should call the customer service number on the back of your insurance card. Ask if NEXPLANON is covered under your policy. You may need to explain that NEXPLANON is an implantable contraceptive. You may also be asked to provide the billing code for NEXPLANON. You can ask your health care provider for the code. If NEXPLANON is covered, ask the customer service representative to send verification of coverage to your health care provider.

Important Safety Information about NEXPLANON (etonogestrel implant)

You should not use NEXPLANON if you are pregnant or think you may be pregnant; have or have had blood clots; have liver disease or a liver tumor; have unexplained vaginal bleeding; have breast cancer or any other cancer that is sensitive to progestin (a female hormone), now or in the past; and are allergic to anything in NEXPLANON. if you have diabetes, high cholesterol or triglycerides, headaches, gallbladder or kidney problems, history of depressed mood, high blood pressure, allergy to numbing medicines (anesthetics) or medicines used to clean your skin (antiseptics). These medicines will be used when the implant is placed into or removed from your arm.

The Skyla IUD available at Choices Women's Medical CenterThe Skyla IUD is a device inserted into the uterus and can be worn for up to 3 years. Skyla contains a low dose of hormones. A woman choosing this method wants long-term birth control; Yet, if that changes and pregnancy is desired, the IUD can be removed at any time before the 3 year limit. The IUD is inserted by a healthcare professional during a woman's menstrual period. In order to be eligible for an IUD, you must have a medical exam, including your medical history, internal examination, Pap test and cervical/vaginal cultures.

Effectiveness: 99% effective

Safety: The first several menstrual periods a woman has with an IUD inserted may be heavier and cramping may be experienced; however, because of the low hormone in the Skyla IUD, over time (approximately 3-6 months) a woman's menstrual periods will lighten considerably and may even stop after a year. The Skyla IUD carry a small risk of Ectopic pregnancy, Sepsis (a rare, but life threatening infection), PID, bleeding between periods, uterine cramping and unwanted pregnancy.