There are two main categories of contraceptives: hormonal and barrier methods. Overall, hormonal methods are slightly more effective (except for an IUD), but may also pose a greater number of potential risks and side effects. Below each contraceptive method is summarized in terms of advantages, risks, and side effects, according to the American College of Obstetrics and Gynecology.

Hormonal contraceptives can include a pill, injection, implant, skin patch, or vaginal ring option. The implant, pill, and injection are considered 97-99% effective, while the vaginal ring and patch are closer to 92% effective.  (This difference in efficacy could be partially related to improper usage, but should be noted.) Additionally, hormonal contraceptives do not protect against STD’s.

Implant

Advantages:

- Prevents pregnancy for 3 years              -safe for breastfeeding women

-easily removed allowing fertility to return relatively quickly

Risks:

-Ectopic pregnancy can occur, although rare, if pregnancy does occur while implant is in place

Side effects:

-Irregular bleeding          -headache          -weight gain           -acne                 -mood changes/depression

Injection

Advantages:

-Prevents pregnancy for 3 months           -Safe for breastfeeding women

-May reduce risk of endometrial cancer as well as hormonally-triggered migraines

Risks:

-Possible reduced bone density

-Increased risk for cardiovascular disease if additional factors are present (smoking, weight etc…)

Side Effects:

-Delay in fertility of 10 months                   -Fatigue/dizziness                           -Weight gain

-Irregular bleeding (usually during first 6-9 months of use)

Vaginal Ring

Advantages:

-May reduce menstrual pain and migraines         -May improve acne and minimize excess hair growth

-Can be inserted/removed at home

Risks:

-Increased cardiovascular problems, depending on pre-existing risk factors

Side Effects:

-Vaginal infections/discharge     -headaches        -weight gain       -nausea

Skin Patch

Advantages:

-May reduce menstrual pain and migraines         -May improve acne and minimize excess hair growth

-Can be inserted/removed at home

Risks:

-Increased cardiovascular problems, depending on pre-existing risk factors

Side Effects:

-Vaginal infections/discharge     -headaches        -weight gain       -nausea

Barrier methods of birth control are popular options for women who prefer a non-hormonal approach to contraception. They are safe for breastfeeding women, have little to no side effects, and are typically easy to use.

IUD (non-hormonal)

Advantages:

-Safe for breastfeeding women                                -long-term (one-time insertion)                                -non-hormonal                 -99% effective in preventing pregnancy                  -may decrease menstrual bleeding and pain

Risks:

-The uterus could be pierced, but is rare                               -if pregnancy occurs, ectopic pregnancy is possible

-slight increased risk of pelvic inflammatory disease (PID) in some women

Side Effects:

-none reported other than associated risks listed

Spermicide

Advantages:

-Easy to use                        -Inexpensive                     -No hormones                  -Safe for breastfeeding women

Risks:

-No protection against STD’s

Side effects:

-vaginitis or allergic reaction

Condoms

Advantages:

-Easy to use                        -Inexpensive                     -No hormones                  -Safe for breastfeeding women

Risks:

- None

Side effects:

- allergic reaction to latex or polyurethane

Sponge

Advantages:

-Over-the-counter          -No hormones                  -Safe for breastfeeding women

Risks:

-Slightly increased risk of Toxic Shock Syndrome (TSS)

Side effects:

-Allergic reaction to polyurethane, spermicide, or sulfites

Diaphragm

Advantages:

-Safe for breastfeeding women                                -No hormones

Risks:

-Potential increased risk of urinary tract infection

-Spermicide use can increase HIV transmission if partner is infected

Side Effects:

-Allergic reaction to spermicide or polyurethane

Cervical Cap

Advantages:

-Safe for breastfeeding women                                -No hormones

Risks:

-Potential increased risk of urinary tract infection

-Spermicide use can increase HIV transmission if partner is infected

-Toxic Shock Syndrome if used during menstruation

Side Effects:

-Vaginal irritation             -Allergic reaction to spermicide

The American College of Obstetrics and Gynecology website (www.acog.org) has additional information regarding these methods of birth control. Whichever contraceptive option you choose, make sure it is only after discussing with your partner and gynecologist.

As with any medication, testing its effects on a pregnant mother, as well as her baby in utero, is difficult, and faces some ethical concerns. Birth defects have not been frequently or consistently noted in recent research studies, but this is of course a worrisome question when using any pharmaceutical while pregnant. Some studies have indicated low birth weight and/or pre-term birth as effects of SSRI treatment during pregnancy. However, research studies overall have obtained extremely mixed results. The data is not only limited and varied in its results, but in some cases, is based on siutations where women didn’t know they were pregnant and were taking SSRI’s, or in women who were considered infertile and then later became pregnant. These groups do not exactly mimic all potential treatment situations, and so any conclusion drawn from research on these groups of individuals is not necessarily reliable.

This begs the question, “What can I do or take to combat depression if I’m pregnant?” Research indicates that for mild to moderate depression, behavioral-based therapy or counseling improves some cases. Exercise may also assist in easing stress and improving mood. For moderate to severe depression, medication may be considered. However, it is extremely important to have a conversation with your Obstetrician regarding this issue. Pre-natal health and proper infant development are of utmost concern, yet untreated depression may negatively affect birth weight and overall neonatal health. Depression during pregnancy is also a strong indicator of postpartum depression, so identifying and treating symptoms early (during pregnancy) may help stave off tendencies to deeper postpartum depression or a lack of bonding with baby.

The controversy surrounding SSRI treatment during pregnancy will no doubt continue, as more research is needed to confirm its efficacy and safety. In the meantime, share any concerns with your OB/GYN so you can best understand available treatment options.

Irritable Bowel Syndrome is a disorder that causes abdominal cramping and changes in bowel movements, as well as bloating. There is no confirmed cause for IBS, as the bowel itself is not damaged. It simply malfunctions, causing spasms which result in the above mentioned symptoms. Stress is a confirmed aggravator, as it sends increasing signals between the brain and bowel, causing increased spasms. Certain foods, such as dairy or wheat can also trigger similar symptoms.

IBS-like symptoms are important to discuss with your doctor. There is not a blood test, or other simple procedure to test for IBS, so identifying the symptoms is often the best way to confront the issue.  Malabsorption of nutrients and dehydration can result if the problem persists. It is also important to rule out a food allergy, enzyme deficiency, or a more serious condition, such as colon cancer or ulcerative colitis. Moreover, a physician will define the parameters of an IBS diagnosis. For some, the symptoms are accompanied by constipation, while others experience mainly diarrhea. This distinction is important in order to prescribe the appropriate treatment.

Treatment varies greatly, depending on the type and severity of symptoms, and individual response. Pharmaceuticals may provide relief from diarrhea or constipation symptoms. Lifestyle changes, such as avoiding foods that stimulate the intestines (like coffee or soda), may play a part in relieving pain. So far, there is no one medicine or lifestyle change will work for everyone. However, research is ongoing, and new medications are being introduced. The Complete Women’s Practice has recently partnered with Clinical Inquest as a designated research testing site. If you are interested in participating in a study on IBS (compensation available), contact our office for more info at 937-433-6513. A complete list of qualifications is available on our website: www.covaobgyn.com/irritable-bowel-syndrome. Otherwise, be aware of changes in your digestion, and maintain ongoing discussion with your doctor regarding your symptoms and any new treatment options.

You must meet the following qualifications:

-Ages 18-80

-Currently experiencing abdominal pain or discomfort

-Diagnosed with diarrhea-predominant IBS

-No mixed-symptom IBS diagnosis

-No Krohn’s or diverticulitis

If you meet these qualifications, and would like to participate, call our office: 937-433-6513, option 1.

All qualified candidates will be compensated for their time completing the study.

First of all, you are not alone if you are experiencing libido problems. In fact, in a recent University of Pennsylvania study, more women than men reported experiencing sex drive irregularities. There are a variety of factors– physical, mental, and emotional–that can negatively impact libido.

If your energy and/or sex drive is low, rule out medication as a possible culprit first. Pharmaceuticals prescribed for hypertension/high blood pressure, antidepressants such as Prozac or other SSRI’s, and diabetes medications are common intimacy interrupters.

Normal hormonal changes related to pregnancy or menopause can also adversely affect libido, so give yourself time to adjust to these life changes, and find the right treatment option. If hormonal fluctuations continue, there may be an underlying issue. For example, testosterone levels are important to measure, as the small amount women make is vitally important to our sexual health! The possibility of an endocrine disorder is something your doctor can examine.

Finally, do not underestimate the power of sheer exhaustion! The old “I’m too tired” adage is a normal, appropriate response to a habitual bedroom proposition, but prolonged stress and fatigue can more severely depress the libido. Of course the responsibilities of career and parenting can make time for intimacy sparse, but notice if it is a lack of time or lack of desire that is preventing time alone with your partner. If it is mostly a lack of desire, there might be a bigger problem to address.

I read recently that sexual health is a “barometer” for your overall health, which is exactly why a discussion with your doctor is the place to start when libido starts to slip. Here are a few other tips to maintaining sexual health:

Manage stress levels—spend time talking with your partner daily, without the distraction of phones, computers, or TV.

Make sex a priority—put a “date” on the calendar to ensure you and your partner have designated alone time.

Exercise regularly to improve overall circulation and maintain a  positive mood.

Consider eliminating junk food and eating more fresh food to improve energy levels and overall well-being.