Contraception

We offer a wide range of contraception and family planning options. These include:

 Oral contraceptives

Oral contraceptives are the most commonly prescribed method of contraception among women in their child-bearing years. There are three different types of oral contraceptives available on the market today. They are:

• Estrogen-progesterone combinations
• Progesterone-only
• Continuous/extended-use pills

While oral contraception is used most often to prevent pregnancy, they may offer therapeutic benefits for other gynecologic conditions. Dr. Chismar will recommend an oral contraceptive based on your medical history, needs and preferences. Oral contraceptives are most effective when patients take them exactly as prescribed. For patients who are using oral contraceptives (for any reason), it is important to receive regular medical care.

 Transdermal patch

A transdermal patch works similarly to oral contraceptives, except that users apply a patch to their skin once per week for three consecutive weeks. The patch contains a combination of estrogen and progesterone, and prevents conception. To permit menstruation, during the fourth week, the user does not apply a patch. With typical use, a transdermal patch is about as effective as oral contraception. As with oral contraception, it is important to receive regular medical care if you use a transdermal patch to prevent conception.

 Depo-Provera injections

Depo-Provera is an injected, long-acting form of the hormone progestin. Women who use Depo-Provera (medroxyprogesterone acetate) will receive an injection four times per year. The injection temporarily suppresses ovulation, and produces other changes in a woman’s cervical mucus that frustrate contraception. It is considered a highly effective form of birth control, but it is not always recommended for use in every patient. Dr. Chismar can help you determine whether Depo-Provera is a good option for you. 

 Vaginal ring

A vaginal ring is a small, flexible vaginal insert that releases a continuous dose of both estrogen and progesterone to discourage conception. Women insert the ring themselves, and it remains in place for one month. Each month, the user must insert a new ring.  Vaginal rings are about as effective as oral contraception or a transdermal patch. They are more effective provided that the patient uses them exactly as directed, and inserts them correctly every time.

 Natural family planning counseling

Natural family planning (NFP) can be an effective means of avoiding conception, but it requires constant observation and interpretation of sometimes subtle signals that a woman is preparing to conceive. Only about 1%-3% of fertile women in the US choose to use a NFP approach to contraception. Some NFP strategies have been shown to be as much as 92% effective in preventing conception. Because NFP strategies rely entirely on individual practice, there is no way to predict its success for any given woman.

 Intrauterine Device (IUD)

An intrauterine device (IUD) is another common approach to contraception. IUDs are T-shaped, flexible plastic (or sometimes copper) devices that are inserted into the uterus (and removed) by a doctor to prevent conception. They are semi-permanent, and release the hormone progestin to discourage pregnancy. On average, an IUD can last 3-6 years, and is about 99% effective in preventing pregnancy.

Some IUDs can help control heavy menstrual bleeding, but they are not recommended for every woman. Women with a history of gynecological cancer, untreated sexually transmitted infections, compromised immune systems, liver cancer or liver disease, or large uterine fibroid tumors should not use an IUD.

Dr. Chismar can help you determine whether an IUD is a good contraceptive choice for you. Currently, Dr. Chismar recommends the following IUDs for his patients:

 Nexplanon

Nexplanon is an etonogestral implant designed to prevent conception. The implant is placed under the skin of your arm by a doctor, and can remain in place for up to three years. It is 99% effective at preventing conception, but it is not recommended for every woman. Women who smoke, have liver disease or liver tumors, or a history of breast cancer should not use Nexplanon. Women with a history of diabetes, high cholesterol or high triglycerides, high blood pressure, kidney problems or a history of depression should discuss these issues with Dr. Chismar before selecting Nexplanon as a contraception method.

 Permanent sterilization

Permanent sterilization is another method of contraception that is considered highly effective for both men and women. Generally, permanent sterilization requires a surgical procedure. It should only be considered by women who are certain that they will never have or want additional children, or who have been advised for medical reasons not to attempt future pregnancies. Permanent sterilization techniques render a woman physically unable to have children and should be considered irreversible.

Dr. Chismar is a trusted healthcare provider in Dover, and offers a wide range of contraception and family planning options for his patients. He will work with you to determine the options that best meet your needs and provide all necessary follow-up care.