WLM Winter 2013-14 | Page 21

WLM | Wyoming Woman CONTRACEPTIVE TECHNOLOGY Brings Convenient Options for Women by Travis D. Klingler, MD E ach year, half of all pregnancies in the United States are unintended. And half of those unintended pregnancies – or one in four pregnancies overall – end in abortion (of interest, the abortion rate in the United States is the highest of all Western developed countries and Japan). These statistics speak to the importance of effective, accessible contraception. No single method, however, is universally suitable for all women and many factors affect a woman’s choice of contraception. There are many properties that constitute an “ideal” contraceptive method, including effectiveness, the likelihood of compliance, frequency of intercourse, age, cost, side effects, and many other factors. Discretion is also important to many women, who regard the decision of whether or not to use contraception (and which form to select) as a private matter. There are several good options that have been available for many years. This includes oral contraceptives (often referred to as “The Pill”), and barrier methods (including the use of condoms). Longeracting methods have also been available, including depot medroxyprogesterone acetate (DMPA) injections, subdermal implants, and intrauterine devices (IUDs). Of course there is always the permanent method of tubal ligation (“tubes tied”) when sterilization is desired. More recently, several new contraceptive methods have been approved for use in the United States. These methods provide additional choices to women and their physicians. In addition to being safe and effective, these new options are also intended to be easier to use, resulting in better compliance. A few of the newer options include: • Mirena IUD is an intrauterine device that uses a rate-controlled membrane to ensure continuous release of Levonorgestrel, a highly potent progestin that provides effective treatment when released directly into the uterine cavity. It is approved for five year use, which makes it a very convenient long- \