Birth-control update

The IUD revisited:

Many doctors hesitate to offer patients the intrauterine device (IUD) because of past experiences with the Dalkon Shield, an IUD withdrawn from the market decades ago after being linked to pelvic inflammatory disease (PID). The newer IUDs -- Paragard and Miren -- pose a slightly increased PID risk only in the first three weeks after insertion, University of North Carolina research shows. Effectiveness 99 percent. Possible side effects Menstrual changes, back pain, spotting.

New Rx products for women who often forget to take the pill:

The NuvaRing is a flexible ring about two inches in diameter that's inserted into the vagina and left in place for three weeks. It's not noticeable to the user or her partner and releases a continuous low dose of the same hormones contained in birth-control pills. (Unlike a diaphragm, the ring's exact position within the vagina doesn't matter.) Removing it brings on a menstrual period, and a new ring is inserted on day five. Effectiveness 98-99 percent. Possible side effects Vaginal irritation, headache, nausea. For more information:

With the hormone-releasing patch Ortho Evra, you only need to remember to apply a new patch to your buttock or lower abdomen once a week for three weeks of your menstrual cycle. Effectiveness 99 percent. Possible side effects Breast tenderness, headaches, skin irritation. Note: not recommended for women weighing more than 198 pounds. For more information: -- Beth Janes

If all else fails

Many women don't know that safe, simple emergency contraception is widely available. For information on the "morning-after pill," call (888) NOT-2-LATE. Or visit, operated by Princeton University's Office of Population Research and the Association of Reproductive Health Professionals. -- Mary Ellen Strote

What not to take with the pill

Saint Johnswort This herbal product that may help relieve mild depression can interfere with the effectiveness of certain drugs, including oral contraceptives. According to Swedish scientists, several women who took Saint Johnswort while on the pill have gotten pregnant. -- M.E.S.

Antibiotics To resolve a longstanding controversy, the American Medical Association recently reviewed studies and found that yes, antibiotics do occasionally lessen the effectiveness of oral contraceptives. The AMA recommends that if you have experienced breakthrough bleeding or unplanned pregnancy in the past while using both birth-control pills and antibiotics, you should err on the side of safety and use another method of contraception while taking antibiotics. -- Nancy Monson

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