Contraceptive Care

Contraception is a method to prevent pregnancy and there are many different types. Some are more effective than others.

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In general, you should either start taking birth control pills on the first day of your period (the first day you start bleeding) or the first Sunday after the start of your period (not the end), whichever your doctor recommended.

This ensures that you are not pregnant, and helps maintain your period on the pill close to the time it would normally occur. It is very important to take your pill at the same time every day and take every pill. If you ever forget, take it as soon as you remember. If you miss more than one pill, take two pills a day until you catch up, but expect to get some irregular bleeding. If you do not take your pill properly, or need to catch up on pills, you will need to use back-up contraception with a condom. As you finish each pack of pills, make sure you have already received your next pack from your pharmacy so you can go straight from one to the next.

PMG Birth Control Pills New Start Information

While most women expect to have a decrease in their period flow when they are on birth control pills, it is not unusual for the period to get so light that there is no obvious bleeding, even on the placebo pills. If you are taking your pill properly, this is perfectly normal and not a cause for concern. There is no need to “take a break” from the pill to have a period.

Sometimes you may have light bleeding or spotting randomly on birth control pills. This is called “breakthrough bleeding” and is a common side effect with birth control pills. This can be due to irregular pill taking, sickness, stress, other medications, or can happen for no obvious reason. Most of the time, you will go back to normal in one or two cycles. If the bleeding is concerning to you, please contact the office to discuss this issue further.

If you are not taking the pill properly, please use back up contraception (condoms).

In general, you will get one year of refills at the annual appointment. Most pharmacies will dispense your prescription every 3 months. If you are within a year, you should call your pharmacy directly, not the office.

You may request a prescription refill through your Patient Portal account or by contacting your pharmacy to request the pharmacy submit an e-refill request to our office. Prescription refills take up to 72 hours for your physician to approve.

Routine prescription refill requests are NOT emergencies and will not be answered after hours.

Each individual insurance plan has a formulary of covered medications. This information can be located on your insurance website. Many prescription drug plans only cover generic medication. Be prepared that the pharmacist may switch your medication to a generic medication that is covered by your insurance. if you wish to have a specific or name brand medication, please indicate this to your physician so that it can be sent in “dispense as written / no substitutions.”

 

An IUD is a small device shaped like a “T” that is inserted into your uterus (through the vagina) by your physician at the office. This device is extremely effective long-acting reversible contraception. The IUD prevents conception (prevents the sperm from meeting the egg). Depending on the device you select, it can provide contraception from 3-10 years.

Please provide us with your insurance information & the type of IUD you prefer.

PMG OBGYN will check your IUD coverage PRIOR to your appointment. If your IUD selection is covered, you will be notified.

For your convenience, PMG OBGYN stocks Mirena, Kyleena, Skyla and Paragard IUDs at both the Princeton and Plainsboro office locations. You can have an intrauterine device (IUD) inserted during an office visit. Please call 609-924-9300 to schedule your device insertion.

If you have not previously discussed this with your provider, please schedule a telemedicine visit to discuss which IUD is right for you, the insertion process, and whether any premedication is needed for your insertion. Scheduling a discussion before insertion will also allow us to check your insurance benefits in advance of your insertion appointment.

IUD Birth Control | Info About Mirena & Paragard IUDs (plannedparenthood.org)

What’s an IUD insertion like? (plannedparenthood.org)

Types of Intrauterine Devices (IUD)

Changes in bleeding is the most common side effect. With all IUDs, you may have bleeding and spotting between menstrual periods, especially during the first 3 to 6 months. This is extremely common as your body acclimates to the device and is an expected side effect. Depending on the type of device you choose, your bleeding may change.

The paragard (nonhormonal copper) IUD can cause longer, heavier, painful periods. This is an expected change and patients should anticipate this.

The Mirena, Kyleena & Skyla IUDs all contain varying doses of progesterone hormone. These types of IUDs affect the lining of your uterus by thinning and randomly shedding the lining. After insertion, the bleeding is occasionally heavier than usual at first. However, the bleeding usually becomes lighter than usual and may be irregular. It is common for patients to skip periods or for periods to be completely absent with the hormonal IUDs.

Call the office if the bleeding remains heavier than usual or increases after it has been light for a while.

Yes, it is safe to use a tampon while you have an IUD.

No. IUDs do not protect against sexually transmitted diseases. Please consistently use a condom to protect yourself against STDs.

NEXPLANON is a hormone-releasing birth control implant placed in the inner upper arm to prevent pregnancy for up to 3 years. The implant is ONE flexible plastic rod about the size of a matchstick that contains a progesterone hormone called etonogestrel. The implant is placed in the office by PMG OBGYN physicians.

Contraceptive implant – Mayo Clinic

Your progesterone only options include a daily pill called the “mini pill”, an injection of “depo provera” every 3 months, Nexplanon upper arm implant, or an intrauterine device (IUD) that contains no hormone or a small amount of progesterone.

The CDC has published guidelines to advise safety of estrogen-containing contraception in women with various medical conditions. Some examples of common reasons women CANNOT be on estrogen-containing contraception (pills, patch, ring) are history of migraines with aura, smoking, high blood pressure that is poorly controlled, history of blood clots in lungs or legs, and history of heart attack or stroke.

None of these options protect you against sexually transmitted diseases. Only condoms prevent sexually transmitted diseases.

This website is a good resource discussing available options to you.

Progestin-Only Hormonal Birth Control: Pill and Injection | ACOG

Please contact the office at 609-924-9300 if you are interested in any of these options.

A laparoscopic tubal sterilization is an elective surgery. A camera is placed through a small incision in the belly button and another small incision may be placed on your abdomen. An instrument is used to burn or remove the fallopian tubes for permanent (cannot be reversed) sterilization.

Tubal sterilization can also be performed at the time of your repeat cesarean section. During the cesarean section, the fallopian tubes are usually seen and can be removed for permanent sterilization. This procedure usually adds about 10 minutes to the cesarean section. Please discuss with your physician prior to your scheduled cesarean section if you are interested in sterilization at the same time.

A vasectomy is an in-office outpatient surgery performed by a Urologist for permanent sterilization. This is a minor surgery for men and is NOT performed at PMG OBGYN.

There is no established amount of time that it is “safe” to take the pill, and depends entirely on your history and particular circumstances. Your doctor will discuss this with you when you come in for your annual exam.

There is no data that suggests that birth control will cause infertility. We do know that as women get older it can be harder to conceive, so age is more of a factor than being on contraception. If you are thinking about getting pregnant, ask your doctor about when you should come off your contraceptive method. Sometimes it can take 2-3 months to get a regular menstrual cycle if you have been on a contraceptive method for many years which helps reduce your menstrual blood flow.

It is important to note that there are MANY different reasons why women start contraception, not just for prevention against pregnancy. Other very common reasons that your doctor may initiate contraception may be to manage symptoms of heavy menstrual bleeding, pain/cramping with periods, acne, regulating menstrual cycles, improving hormonal profile, managing symptoms of perimenopause, preventing severe anemia, or treating endometriosis.