Which contraceptive method is safe during lactation?

Question

Hi doctor,

I am looking for better birth control options after experiencing a third unplanned pregnancy in the past five years. Clearly, what we are currently using is not working. At the moment, we rely on condoms and withdrawal, but these methods have proven to be unreliable.

I previously tried oral contraceptive pills, but I had difficulty remembering to take them consistently due to my busy schedule managing three children under the age of six. I am concerned about the pain and potential side effects associated with intrauterine device (IUD) insertion, such as irregular bleeding or weight gain.

My partner is unwilling to consider a vasectomy, and I am not ready for a tubal ligation. I am now exploring long-acting birth control options that would be effective, low-maintenance, and suitable for someone with a demanding lifestyle. I would prefer a method that is reversible, in case we decide to have more children in the future.

Additionally, I struggle with anxiety, so I am concerned about the potential hormonal effects on my mood. I am also currently breastfeeding my eight-month-old child, so I would like to know which options are safe during lactation.

What long-acting, low-maintenance, and reversible birth control methods would you recommend for someone in my situation?

Thank you.

Answer 1

Hi,

Welcome to icliniq.com.

I understand your concerns. Based on what you have shared, you had multiple unplanned pregnancies, difficulty maintaining daily pill routines, anxiety about hormonal side effects, and you need a reliable, low-maintenance method. I would recommend considering a contraceptive implant.

This method is particularly suitable for busy individuals like yourself, especially those who are breastfeeding and looking for a long-term but reversible form of contraception.

Mechanism of action

The implant works primarily by inhibiting ovulation and fertilization.
It delays the early proliferative phase of the endometrial lining, making it less receptive to implantation.
It increases cervical mucus thickness, which makes it more difficult for sperm to penetrate and reach the egg.

Advantages

Highly effective- The contraceptive implant is one of the most effective, reversible methods available, with a success rate of over 99 percent in preventing pregnancy.
Long-lasting protection- Once inserted, the implant provides continuous protection for up to three years. There is no need to remember daily pills or schedule regular appointments for injections or patch changes.
No interference with sexual activity- The implant does not disrupt sexual spontaneity or require any action at the time of intercourse, unlike condoms or diaphragms.
Reversibility- Fertility typically returns quickly after the implant is removed, making it an ideal option for women who may consider having more children in the future.
Suitable for breastfeeding- The implant is safe to use while breastfeeding. It contains only progestin (no estrogen), which makes it a preferred option for nursing mothers.
Safe for women with anxiety or those who cannot take estrogen- Because it is estrogen-free, it avoids many of the mood-related side effects that can occur with combined hormonal contraceptives.
Reduced menstrual symptoms- Many users experience lighter periods or no periods at all. Menstrual cramps and related discomfort often improve as well.
Convenience and privacy- The implant is placed under the skin of the upper arm in a quick outpatient procedure. It is discreet, does not require maintenance, and is easy to remove when no longer desired.
Potential improvement in acne- Some individuals notice clearer skin when using progestin-only contraceptives like the implant, although this effect varies.

I hope this information helps you.

Thank you.