Family planning is important to your relationships, career, and personal goals. Dr. Holley and Teresa offer you a variety of contraceptive options, hormonal and non-hormonal, short term and long term.


The first step is a comprehensive examination including your health history, current mediations, family history, relationship status, and reproductive plans. Some contraceptive methods are inappropriate for women at risk for blood clots or pelvic infections. Your needs and desires may change as you mature and your situation changes.


Some women prefer the month to month flexibility of birth control pills. They come in several varieties, some with a planned menstrual period each month, others with scheduled bleeding every three months, and others that result in no monthly period at all. Most birth control regimens are prone to “breakthrough bleeding” or unscheduled bleeding at unpredictable intervals. Generally this bleeding is light, but it can be heavy and associated with cramping. It is managed with short courses of hormones to supplement the birth control pill.


Some contraceptive measures are useful for control of other medical problems, for example the use of the pill to control excessive vaginal bleeding or menstrual cramping. As long as you have no serious contraindications, you may be able to control your periods very effectively using the pill.


Many women find that they are unable to remember to take the pill properly; even one missed dose can result in an unplanned pregnancy. For those women, a long acting reversible contraceptive method may be more appropriate. One option is the Depo-Provera injection given once every three months. Another is Nexplanon, an implant of etonorgestril that is placed under the skin of the arm and releases low doses of a progesterone hormone over the space of three years. Both of these options may cause some unpredictable unscheduled bleeding that tends to go away after 6-9 months of use.


For those who would prefer not to have increased levels of hormone in their blood, there are two versions of the IUD available. One is a progesterone secreting IUD that fits in the uterus and releases hormone only in the uterus and pelvic area. Only tiny amounts of hormone are circulated in the blood. Paragard is a non-hormonal IUD that fits in the uterus and prevents pregnancy without using any hormone at all. Both types of IUD present some risk of infection and you should be closely monitored.


Other non-hormonal methods of contraception include the diagram, which uses a barrier in combination with a spermicide to prevent conception, or the condom, which does not require a prescription. The condom requires the cooperation of the male partner, but it is the only method that reduces (but does not eliminate) the risk of sexually transmitted disease. Both of these methods have higher failure rates than the other methods mentioned above.


The contraceptive methods with the lowest failure rates are male and female sterilization. These procedures should be considered only by those who are sure they have completed their families. They should not be done because of pressure from a family member or mental healthcare provider; since they are difficult or impossible to reverse if conditions change in the future.


The male sterilization method is the vasectomy, a minor office procedure done by a urologist or general surgeon. It is done under local anesthetic with few complications and low total cost. A sperm count should be done several weeks after the procedure to ensure that it is effective.


Female sterilization is a surgical procedure done in the operating room. Dr Holley does not perform surgery and we are happy to refer you to an appropriate surgeon for this procedure. The comfort of knowing you are protected from an unwanted pregnancy is important to most women and their families.


The comfort of knowing you are protected from an unwanted pregnancy is important to most women and their families. Contraceptive needs change as you mature and your family changes. We are ready to counsel you about your options for family planning and facilitate your choices to achieve your goal of a healthy family.