Many women stop using the pill (the COC or combined oral contraceptive – estrogen and progesterone) because of negative side effects. Migraines, family history of heart disease, high blood pressure are all medical risk factors that prevent women from using the regular pill.
Decreased libido is also a big non-medical side effect, although one less discussed in gynecologist’s office.
However, there are hormone-based contraceptives that are locally placed, meaning they prevent ovulation but because they go directly to the bloodstream (the patch) or are close to the uterus (Nuvaring) they have to deliver much less hormone. Therefore, women suffering from migraines have had success using the Nuvaring. Or, some women who cannot tolerate the pill, do tolerate the patch.
So, what is available in Israel?
- The Ortho Evra patch (distributed by Jannsen in Israel) can be stuck anywhere on the body, and left on for one week. Three weeks on, one week off, sometimes with a period, and then after seven days, start again.
- The Depo Provera shot is available in Israel (Pfizer Company), and is often used among adolescents or those with cognitive delay who forget to take pills on a daily basis. The shot is needed every three months for complete protection, but one of the benefits is its effectiveness is not influenced by outside factors like other medication, severe diarrhea or vomiting. Unfortunately, Depo Provera got a bad rap in the late 90’s when it was linked with a possible scandal of giving it to women without their knowledge to prevent them from getting pregnant (a long story and feel free to look it up if you’d like) but it is a viable contraceptive option, available in Israel, and works for many women.
- The Nuvaring has been around for a while (distributed by MSD) but has gained slow popularity in recent years, especially among those women who want hormonal protection but have negative side effects from the higher dose pill. The Nuvaring is inserted into the vaginal canal and remains there for three weeks, removed by the woman, who waits a week and then replaces it with a new one. It requires a prescription but does not need to be fitted or inserted by anyone but the woman herself.
So, if you have used these options when you lived in your home country, or are looking for a different method, all of these options are available in Israel with a prescription from a gynecologist (initially) and then the family doctor, and can be purchased in major pharmacies.
Remember: For anyone of us who has teenagers, we know the side affects of hormones. It’s the same with hormonal contraception. Every gynecologist should take a family and personal medical history before prescribing any hormone-based contraceptive; history of heart disease, high blood pressure, blood clotting issues, to mention some. If the doctor does not ask you any of these questions, volunteer that information and then switch to another gynecologist for your next visit.
There are many options for women to use to prevent pregnancy; there is no ideal option, but a woman can find what works for her and her partner, according to age, medical history, need and side effects.
DO ask questions, of your doctor (and your friends if you feel comfortable or facebook, which ladies seem to seek out more these days).
DO remember that not making a decision is also making a decision. If you want to get pregnant, fantastic. Just remember that if you don’t use contraception, you are making a choice to, yes, get pregnant.
DON’T stop using one method without starting something else, thinking ‘well I was covered’ because you are not.
DON’T think that because you are over 45 you will not get pregnant. If you are getting your period, even on an irregular basis, you are still ovulating, and older eggs can still produce babies.
DON’T give up because you experienced unwanted side effects from one method. Often, you must try several options before you find something that works for you, and something that worked for you after the last pregnancy may not be what you need the next time around.
DON’T think that spermicide alone is as effective as other contraception options.
DO go back to your doctor for follow up, for whatever choice you make. Even if you chose to stop using one method, let your doctor know. I often have discussions with gynecologists about side effects connected with certain contraceptive types, and they will tell me, ‘well the woman never complained’, to which I respond, ‘well, did she come back and discuss it with you?’ The feedback is important to the doctor as well as for you.
Previous posts about contraceptive options in Israel: