Watch: The Mayo Clinic Minute

Journalists: Broadcast-quality video (1:00) is in the downloads at the end of this post. Please 'Courtesy: Mayo Clinic News Network.' Read the script.

"It's the most reliable form of birth control, other than abstinence, that we have," says Dr. Tobias Kohler, a Mayo Clinic urologist and men's health expert.

He says roughly 15 to 20 percent of American men have vasectomies.

"Vasectomy is a procedure we do in the clinic where we take the vas deferens, which is the tube that connects the testicle to plumbing downstream, and we cut it in the clinic so that sperm can't travel downstream and cause a pregnancy," says Dr. Kohler.

The procedure takes about 10 minutes, and the recovery time is quick.

"If you have the procedure done on a Friday, you'd be back to work Monday for certain," says Dr. Kohler.

You might have some slight swelling or pain initially, so Dr. Kohler advises to take it easy.

"Use ice to the area. Avoid any kind of [vigorous] activity. And watch some TV."

And what about fears that vasectomies might cause problems with a man's sexual performance or testosterone levels?

"They do not," says Dr. Kohler.

Even though 6 percent of men eventually will have their vasectomy reversed, the procedure should be considered permanent.

"This is not one of those things where you want to do spur of the moment," says Dr. Kohler. "You want to make sure that this is absolutely what you want to do."

Learn more about vasectomy services.

The post Mayo Clinic Minute: Why vasectomy is a great option for birth control appeared first on Mayo Clinic News Network.

On this week's Mayo Clinic Radio program, Dr. Stephen Kopecky, a Mayo Clinic cardiologist, will discuss heart disease and the cholesterol lowering medications known as statins. Also on the program, Dr. Margaret Long, a Mayo Clinic gynecologist, will explain birth control options, including a mobile medical app that's been approved by the Food and Drug Administration as a form of birth control. And Dr. Tobias Kohler, a Mayo Clinic urologist, will share a warning: Beware of bogus treatments for erectile dysfunction.

Here's your Mayo Clinic Radio podcast.

The post American Heart Month / birth control app / bogus treatments for erectile dysfunction: Mayo Clinic Radio appeared first on Mayo Clinic News Network.

On the next Mayo Clinic Radio program, Dr. Stephen Kopecky, a Mayo Clinic cardiologist, will discuss heart disease and the cholesterol lowering medications known as statins. Also on the program, Dr. Margaret Long, a Mayo Clinic gynecologist, will explain birth control options, including a mobile medical app that's been approved by the Food and Drug Administration as a form of birth control. And Dr. Tobias Kohler, a Mayo Clinic urologist, will share a warning: Beware of bogus treatments for erectile dysfunction.

To hear the program, find an affiliate in your area.

Miss the show? Here's your Mayo Clinic Radio podcast.

Use the hashtag #MayoClinicRadio, and tweet your questions.

Mayo Clinic Radio is on iHeartRadio.

Access archived shows or subscribe to the podcast.

Mayo Clinic Radio produces a weekly one-hour radio program highlighting health and medical information from Mayo Clinic.

The post Mayo Clinic Radio: February is American Heart Month appeared first on Mayo Clinic News Network.

On the next Mayo Clinic Radio program, Dr. Stephen Kopecky, a Mayo Clinic cardiologist, will discuss heart disease and the cholesterol lowering medications known as statins. Also on the program, Dr. Margaret Long, a Mayo Clinic gynecologist, will explain birth control options, including a mobile medical app that's been approved by the Food and Drug Administration as a form of birth control. And Dr. Tobias Kohler, a Mayo Clinic urologist, will share a warning: Beware of bogus treatments for erectile dysfunction.

Learn more about ED (erectile dysfunction) services

To hear the program, find an affiliate in your area.

Miss the show?  Here's your Mayo Clinic Radio podcast.

Use the hashtag #MayoClinicRadio, and tweet your questions.

Mayo Clinic Radio is on iHeartRadio.

Access archived shows or subscribe to the podcast.

Mayo Clinic Radio produces a weekly one-hour radio program highlighting health and medical information from Mayo Clinic.

The post Mayo Clinic Radio: American Heart Month / birth control app / bogus treatments for erectile dysfunction appeared first on Mayo Clinic News Network.

DEAR MAYO CLINIC: My husband and I are both in our early 20s and would like to wait about five years to begin our family. What type of birth control would you recommend? Does using birth control for a long time make it harder to conceive down the road?

ANSWER: A wide variety of safe, effective birth control options are available, and sometimes it can be tough to decide which one is the right choice. For someone in your situation — who wants to get pregnant in a few years — long-acting reversible forms of birth control (also called contraception) are likely the best option. There are several to choose from, and none affect your ability to conceive once you decide you’d like to become pregnant.

Long-acting reversible contraceptives give you consistent, reliable birth control without needing to think about it regularly, as is necessary for some other options, such as birth control pills, condoms, natural family planning or contraceptive sponges. There are three basic types of long-acting reversible contraceptives: intrauterine devices or IUDs, implants and injections. All require a prescription from your health care provider.

An IUD is a small device placed in the uterus by a health care professional during an office visit. There is a hormone-free IUD that works by preventing sperm from fertilizing an egg. There also are IUDs that contain the hormone progesterone. They work by thinning the uterine lining, thickening cervical mucus, and preventing sperm from fertilizing an egg.

Depending on the type you choose, IUDs can be left in place for three, five or 10 years. For typical use, IUDs have a failure rate of less than one pregnancy in 100 women per year. As soon as the IUD is removed, your natural fertility is restored.

A contraceptive implant is placed just beneath the skin on the inside of your upper arm. It’s a flexible plastic rod that is about the size of a matchstick. The implant releases a low, steady dose of a hormone that prevents pregnancy by suppressing ovulation, thinning the uterine lining and thickening cervical mucus. The implant can prevent pregnancy for up to three years. After that, it needs to be removed and replaced.

Implants are as effective as IUDs, with protection against pregnancy higher than 99 percent. An implant must be removed by a health care provider. You can have it taken out at any time. You return to your natural level of fertility as soon as the implant is removed.

A contraceptive injection is birth control you receive in the form of a shot once every three months. The injection, which contains the hormone progestin, prevents pregnancy in a manner similar to the contraceptive implant — by suppressing ovulation to keep your ovaries from releasing an egg, as well as thickening cervical mucus to keep sperm from reaching the egg.

If you always get your injections on schedule, every 12 weeks, the reliability of this birth control method is as high as an IUD or implant. If you wait longer than 13 weeks between injections, its effectiveness goes down significantly. So if you choose the injection, you must be willing to visit your health care provider every three months. You can continue receiving the injections for as long as you'd like. When you decide to stop getting the injections, there can be a short delay in the return of your fertility and ovulation. However, eventually your fertility will return to normal.

Each of these long-acting reversible forms of birth control has specific risks and benefits, and they aren't all appropriate for every woman. Your family health history, personal medical background and individual preferences must be considered. Talk to your health care provider about the pros and cons of each, based on your situation, to help decide what's right for you. — Dr. Megan Wasson, Medical and Surgical Gynecology, Mayo Clinic, Scottsdale, Arizona    

The post Women’s Wellness: Using birth control before starting a family appeared first on Mayo Clinic News Network.

If you take the birth control pill (oral contraceptive), you're probably happy with its convenience and reliability. Still, you may have questions about how birth control pills could affect your health, the benefits and risks of birth control pills, and newer options available.

Can I use birth control pills to delay or stop my period?

Yes, you can. Birth control pills were once only packaged as 21 days of active hormone pills and seven days of placebo pills. While taking placebo pills, menstrual period-like bleeding occurs.

Today women have many more options — from regimens with 24 days of active pills and four days of placebo pills to regimens that are all active pills.

Some extended-cycle pill regimens have active hormone pills every day for three months, followed by a week of placebo or low-dose estrogen pills. You experience menstrual bleeding during that week. Newer extended-cycle regimens involve taking active pills continuously for one year and can stop all menstrual bleeding.

Continuous or extended-cycle regimens have several potential benefits. They prevent hormone changes responsible for bleeding, cramping, headaches and other period-related discomforts. It can be convenient to skip a period during important events or trips. For women who experience iron deficiency due to heavy menstrual bleeding, using continuous regimens can reduce bleeding and there is less chance of developing iron deficiency.

Unscheduled bleeding and spotting often occur during the first few months on this type of regimen. It usually stops with time, but it continues in some women long after using the pills.

Do I need special pills or can I use ordinary birth control pills to prevent having a period?

There are birth control pill regimens designed to prevent bleeding for three months at a time or for as long as a year. But it's possible to prevent your period with continuous use of any birth control pill.

This means skipping the placebo pills and starting right away on a new pack. Continuous use of your birth control pills works best if you're taking a monophasic pill — with the same hormone dose in the three weeks of active pills.

If I plan to have a baby, how soon after stopping the birth control pill can I conceive?

Most women ovulate again about two weeks after stopping the pill. As soon as you ovulate again, you can get pregnant. If this happens during your first cycle off the pill, you may not have a period at all. Check a pregnancy test if you've had unprotected intercourse and your period hasn't returned.

Is there an advantage to waiting a few months after stopping the pill before trying to conceive?

Doctors were once concerned that if you conceived immediately after stopping the pill, you had a higher risk of miscarriage. However, these concerns have proved to be largely unfounded. The hormones in birth control pills don't remain in your system.

Most women start periods again a few weeks after they stop using the pill. However, if your periods were infrequent before you started taking the pill, they will likely be that way again after you stop the pill. Some women find that it takes a couple of months before they return to regular ovulation cycles. After stopping the pill, if you're not ready to conceive, then you may want to consider using a backup form of birth control.

What happens if I stop taking the birth control pill and my period doesn't come back?

If you don't have a period for several months, you may have what's known as post-pill amenorrhea. The pill prevents your body from making hormones involved in ovulation and menstruation. When you stop taking the pill, it can take some time for your body to return to normal production of these hormones.

Your period typically resumes within three months after you stop taking the pill. But some women, especially those who took the pill to regulate their menstrual cycles, may not have a period for several months.

If you don't have a period within three months, take a pregnancy test to make sure you're not pregnant and then see your doctor.

Will a pregnancy test be accurate if I'm taking the birth control pill?

You can get accurate results from a pregnancy test while you're on the pill. Pregnancy tests work by measuring a specific pregnancy-related hormone — human chorionic gonadotropin (HCG) — in your blood or urine. The active ingredients in birth control pills don't affect how a pregnancy test measures the level of HCG in your system.

What happens if I take birth control pills while pregnant?

Don't worry if you kept taking your birth control pill because you didn't know you were pregnant. Despite years of this accident happening, there's very little evidence that exposure to the hormones in birth control pills causes birth defects. Once you learn that you're pregnant, stop taking the birth control pill.

Can I use several birth control pills at once for emergency contraception?

It's possible to use standard estrogen-progestin birth control pills for emergency contraception, but check with your doctor for the proper dose and timing of the pills.

Certain types of pills are specifically designed to keep you from becoming pregnant if you've had unprotected vaginal intercourse. These medications are sometimes referred to as the "morning-after pill." Levonorgestrel pills (Take Action, Next Choice One Dose, and levonorgestrel .75) are available over-the-counter for women age 17 years and older. Younger women need a prescription for these medications.

Plan B One-Step — a single-dose regimen — is available over-the-counter for women of any age and should be used within 72 hours of unprotected intercourse. Plan B — a two-dose regimen — is available over-the-counter for women age 18 and older; those age 17 and younger need a prescription. These emergency contraceptives are available at drugstores, as well as health clinics and Planned Parenthood.

Ulipristal acetate (ella) is another type of pill approved for emergency contraception. It's a nonhormonal medication that prevents the effects of the body's natural hormone progesterone. It's available only by prescription. This medication is taken as a single dose for up to 5 days after unprotected intercourse.

This information is written by Mayo Clinic Staff and can be found with other health and medical information on mayoclinic.org.

The post Women’s Wellness: Birth control pill benefits, risks and choices appeared first on Mayo Clinic News Network.

ANSWER: A wide variety of safe, effective birth control options are available, and sometimes it can be tough to decide which one is the right choice. For someone in your situation — who wants to get pregnant in a few years — long-acting reversible forms of birth control (also called contraception) are likely the best option. There are several to choose from, and none affect your ability to conceive once you decide you’d like to become pregnant.

Long-acting reversible contraceptives give you consistent, reliable birth control without needing to think about it regularly, as is necessary for some other options, such as birth control pills, condoms, natural family planning or contraceptive sponges. There are three basic types of long-acting reversible contraceptives: intrauterine devices or IUDs, implants and injections. All require a prescription from your health care provider.

An IUD is a small device placed in the uterus by a health care professional during an office visit. There is a hormone-free IUD that works by preventing sperm from fertilizing an egg. There also are IUDs that contain the hormone progesterone. They work by thinning the uterine lining, thickening cervical mucus, and preventing sperm from fertilizing an egg.

Depending on the type you choose, IUDs can be left in place for three, five or 10 years. For typical use, IUDs have a failure rate of less than one pregnancy in 100 women per year. As soon as the IUD is removed, your natural fertility is restored.

A contraceptive implant is placed just beneath the skin on the inside of your upper arm. It’s a flexible plastic rod that is about the size of a matchstick. The implant releases a low, steady dose of a hormone that prevents pregnancy by suppressing ovulation, thinning the uterine lining and thickening cervical mucus. The implant can prevent pregnancy for up to three years. After that, it needs to be removed and replaced.

Implants are as effective as IUDs, with protection against pregnancy higher than 99 percent. An implant must be removed by a health care provider. You can have it taken out at any time. You return to your natural level of fertility as soon as the implant is removed.

A contraceptive injection is birth control you receive in the form of a shot once every three months. The injection, which contains the hormone progestin, prevents pregnancy in a manner similar to the contraceptive implant — by suppressing ovulation to keep your ovaries from releasing an egg, as well as thickening cervical mucus to keep sperm from reaching the egg.

If you always get your injections on schedule, every 12 weeks, the reliability of this birth control method is as high as an IUD or implant. If you wait longer than 13 weeks between injections, its effectiveness goes down significantly. So if you choose the injection, you must be willing to visit your health care provider every three months. You can continue receiving the injections for as long as you'd like. When you decide to stop getting the injections, there can be a short delay in the return of your fertility and ovulation. However, eventually your fertility will return to normal.

Each of these long-acting reversible forms of birth control has specific risks and benefits, and they aren't all appropriate for every woman. Your family health history, personal medical background and individual preferences must be considered. Talk to your health care provider about the pros and cons of each, based on your situation, to help decide what's right for you. — Dr. Megan Wasson, Medical and Surgical Gynecology, Mayo Clinic, Scottsdale, Arizona

The post Mayo Clinic Q and A: Using birth control before starting a family appeared first on Mayo Clinic News Network.

In this Mayo Clinic Minute, Dr. Petra Casey talks to reporter Vivien Williams about birth control and when it is appropriate for most healthy women to stop taking it.

Watch: The Mayo Clinic Minute

Journalists: Broadcast-quality video pkg (0:57) is in the downloads. Read the script.

The post Mayo Clinic Minute: Birth control and perimenopause appeared first on Mayo Clinic News Network.

Birth control is often something women, perhaps in their forties or early fifties, stop worrying about a little too soon. Mayo Clinic gynecologist Dr. Petra Casey says, "We find that in most of the research, by the time a woman reaches the age of 55, she is 95 percent likely to have gone through menopause. Menopause is defined as one year of no periods. If you reach 11 ½ months of no periods, then have a period, the clock starts all over again and you’re still not in menopause."

The article below is written for the Office of Women's Health by Dr. Casey.

Do I still need birth control? 

Wondering when you’re menopausal and can safely stop birth control? What birth control is best for women over age 35 or 40? Can you still get pregnant in your 40s and 50s?  These are common questions women ask of their gynecologists, women’s health physicians and other health care providers.

Overall, almost half of all pregnancies and 75 percent of pregnancies in women over 40 years of age are unplanned. ^1,2 Also, some pregnancy complications and risk of miscarriage go up with age. So, if you don’t want to become pregnant, using effective birth control until you are truly menopausal is very important.

Watch: Dr. Casey discusses birth control for women approaching menopause.

Journalists: Broadcast-quality sound bites with Dr. Casey are in the downloads.

Depending on your medical history, your health care provider will talk with you about the best options for you. If you are at a healthy weight, don’t smoke, don’t have high blood pressure or history of blood clots, you can probably continue the oral contraceptive pill, patch or ring well into your 50s. ³

Other great options which don’t contain the hormone estrogen include IUDs, implants, shots and minipills.  Some IUDs contain the hormone levonorgestrel, a kind of progestin, which helps decrease or even eliminate heavy menstrual bleeding,  a common problem for women in their 40s. These types of IUDs last 3 to 5 years.  Another kind of IUD is made of copper, does not contain hormones and can last up to 10 years.  Both types of IUD and the contraceptive implant, a small flexible rod which is inserted under the skin of your arm for 3 years of birth control, are collectively called long-acting reversible contraception (LARC). They are more effective than pills, patch or ring, don’t contain the hormone estrogen (so women who cannot use estrogen can use these), and can protect you against pregnancy for several years. ⁴

Just in case you had unprotected sex and you don’t wish to become pregnant, there are also several kinds of emergency contraception, previously known as the morning after pill. There are pills called Plan B One-Step which you can get at your local pharmacy without a prescription. They contain the hormone levonorgestrel and delay ovulation or release of an egg. They do not interfere with an established pregnancy or cause a miscarriage. Plan B should be taken as soon as possible after unprotected sex but must be taken within 72 hours. Another option which is more effective, especially if you are heavier, is Ella. Ella is effective in decreasing the risk of pregnancy up to 5 days after unprotected sex but requires a prescription. A copper IUD inserted within 5 days of unprotected sex is the most effective option for emergency contraception but requires an appointment with a health care provider. The advantage of the IUD is that you can keep it for birth control for up to 10 years (and about 80% of women do). ⁵

Once you have missed your period for a year, you are considered menopausal and may safely stop birth control. About 90-95% of women will be menopausal by age 55 and may stop birth control then. Sometimes lab tests are also performed to confirm menopause,  but most women don’t need them. Even before the final period, many women experience menopausal symptoms such as hot flashes and trouble sleeping. You can start on menopausal hormone therapy using an estrogen patch to help manage symptoms and use one of the progestin-only birth control options for contraception and to protect the uterine lining from growing too much with the estrogen.  The progestin-containing  IUD, implant, shot or minipill all work well for this. If you have had a hysterectomy, you can take estrogen alone. ⁶ If you would like to avoid hormones as you transition into menopause, you can use the copper IUD, barrier methods like condoms, cervical cap, diaphragm or sponge, or have a minor surgical procedure to tie or block your fallopian tubes. Your health care provider can help guide you in choosing the best birth control option for you during the menopausal transition.

References:

1. Finer LB,. Zolna, MR Declines in Unintended Pregnancy in the United States, 2008–2011.N Engl J Med 2016; 374:843-852March 3, 2016DOI

2. https://www.acog.org/-/media/NewsRoom/MediaKit.pdf

3. Shifren, JL, Gass, ML, for the NAMS Recommendations for Clinical Care of Midlife Women Working Group. The North American Menopause Society Recommendations for Clinical Care of Midlife Women Menopause: The Journal of The North American Menopause Society Vol. 21, No. 10

4. ACOGCommittee Opinion no. 450: Increasing use of contraceptive implants and intrauterine devices to reduce unintended pregnancy.American College of Obstetricians and Gynecologists Committee on Gynecologic Practice.; Long-Acting Reversible Contraception Working Group..Obstet Gynecol. 2009 Dec;114(6):1434-8

5. Zhou, L., Xiao, B. Emergency contraception with Multiload Cu-375 SL IUD: a multicenter clinical trial.Contraception. 2001;64:107–112

6. Long ME, Faubion SS, MacLaughlin KL, Pruthi S,Casey PM. Contraception and hormonal management in the perimenopause. J Womens Health (Larchmt). 2015 Jan;24(1):3-10.

The post Women’s Wellness: Do I still need birth control? appeared first on Mayo Clinic News Network.

Here's the Mayo Clinic Radio podcast.

The post Immunotherapy / Melanoma / Birth Control: Mayo Clinic Radio appeared first on Mayo Clinic News Network.