Intrauterine Devices continued...

An IUD may puncture the wall of the uterus when it is inserted. This occurs in 1-3 of 1,000 insertions. Cramping and backache may occur in the first few hours after an IUD is placed. Bleeding may occur for a couple of weeks after an IUD is placed. Some women have increased menstrual pain and heavy periods while using the copper IUD, but these symptoms are decreased in those using the hormonal IUD. Pelvic inflammatory disease is also possible with IUD use if a woman is not in a monogamous relationship and has an increased risk of STD transmission. 

IUDs do not protect against STDs. STDs can be worse in women who have IUDs, and the chance of getting an STD may be higher in women who use IUDs during the first 4 months after they are placed. IUDs are best for women in relationships in which both partners are monogamous.

IUDs are not appropriate for all women.

Hormonal Methods

Birth control pills
 
Birth control pills, also known as oral contraceptives, have been marketed in the United States since 1962. Over the past 40 years, there have been changes in the type of estrogen and progestin (hormones) used in the pills and lower amounts. 
 
According to the Centers for Disease Control and Prevention, the birth control pill is the leading birth control method used by women younger than 30 years (17% use the pill). 
 
Birth control pills today are designed to improve safety and reduce side effects. Lower doses of estrogen are associated with a decrease in side effects, such as weight gain, breast tenderness, and nausea. 

Birth control pills are usually taken by mouth and swallowed with a liquid. In late 2003, the FDA approved a spearmint-flavored chewable birth control pill called Ovcon 35. They contain the same hormones that are in standard birth control pills. You may chew the pills or swallow them whole. If you chew the pill, you should drink 8 ounces of water afterward to make sure the full dose reaches your stomach.
 
Over 30 different combinations of birth control pills are available in the United States. The majority of the combinations of these pills have 21 hormonally active pills followed by 7 pills containing no hormones. A woman begins taking a pill on the first day of her period or the first Sunday after her period has begun. By taking a pill a day, a woman can usually take pills consistently throughout her cycle. 

• Monophasic pills: These have a constant dose of both estrogen and progestin in each of the hormonally active pills.
  
  
• Phasic pills: These combinations can alter either or both hormonal components to try to mimic the natural menstrual cycle. 
  
  
• 91-day pill: The FDA has approved a birth control pill that you take for 12 weeks (84 days) followed by 1 week (7 days) of an inactive pill. A menstrual period occurs during that week, every three months. The pills (known as Seasonale) contain the hormones already approved for other, 28-day birth control pills.