Which contraception methods are safest for a 29-year-old?

Question

Hi doctor,

I am 29 years old, not planning to have children for at least three to four years, and currently on combined oral contraceptive pills. I have had breakthrough spotting for the last two months and occasional headaches around my periods. My blood pressure is 132/86 mmHg, and I do not smoke.

Are these symptoms common, or does it mean this pill is no longer suitable for me? Also, what are the pros and cons of switching to an intrauterine device or implant?

I sometimes forget to take my pills, so I am worried about reliability as well. What is the safest and most effective long-term option? I just want something stable without constant side effects, but the choices are overwhelming.

Please suggest.

Answer 1

Hi,

I am glad you chose icliniq.com for your medical-related queries.

I understand your concern.

I am deeply concerned about your worries. If you are planning a long-term family plan, then there are two options for you. The first one is a copper intrauterine contraceptive device (IUCD).

As you know, copper IUCDs can cause complications. Complications of copper IUCD include:

Spontaneous expulsion.
Misplacement of IUCD.
Heavy menstrual bleeding.
Painful menstrual bleeding.
No protection against sexually transmitted diseases (STDs)

So, the best choice for you will be to use a hormonal intrauterine device (IUD) for birth control and the treatment of heavy menstrual bleeding. It is a T-shaped plastic device that releases the hormone Levonorgestrel into the uterus, preventing pregnancy and potentially reducing bleeding.

It can be used for up to eight years for birth control and up to five years for managing heavy bleeding. It contains 52 mg of Levonorgestrel intrauterine system (LNG-IUS) and releases a daily dose of 20 micrograms into the uterine cavity. It provides effective contraception with shorter, lighter, and less painful periods.

There are many types of options available, such as:

IUD containing 13.5 mg, which releases 6 to 10 micrograms per day.
IUD containing 19.5 mg, which releases 17.5 micrograms per day.
IUD releasing 18.6 micrograms per day.

Mechanism of action:

Thickening of cervical mucus
Inhibition of fertilization and ovulation
Prevention of endometrial growth and causing endometrial atrophy

Indications:

Contraception for up to five years.
Heavy menstrual bleeding.
Dysmenorrhea (painful menstrual periods).
Premenstrual syndrome or PMS (emotional, physical, and behavioral symptoms that occur before the start of menstruation).

Contraindications:

Known or suspected pregnancy.
Current or recurrent pelvic inflammatory disease (PID).
Lower genital tract infection.
Cervicitis.
Endometritis.
Cervical polyp.
Cervical cancer.
Endometrial cancer

I would suggest that you use Mirena.

Other options include oral contraceptive pills, which work by:

Thickening of cervical mucus
Inhibiting fertilization and ovulation
Preventing endometrial growth and causing endometrial atrophy

Hope I have solved your query.

I will be happy to help you further.

Thank you.