contraception

please advise what would be the best, most secure form of contraception for female runners? How effective is the coil? Is there a chance of it penetrating in the womb?

[Elaine Brown, MD]

Hi!

A couple of thoughts--

First,
I'm going to assume that by "coil" you mean an intrauterine contraceptive device (IUD)--
and those are usually considered to be 99% effective.  They are very convenient and low maintenance--depending on the type they can last 5-10 years or even longer. They can also be removed with prompt return of fertility.  The risk of perforation of the uterus is low if you have the device inserted by someone with lots of experience.  Once they are in place it is very rare for them to migrate--so in other words, if it doesn't penetrate the womb when it is inserted, it is unlikely to do so later on.

Second thought--I don't know how much running you do, but if it is enough to cause amenorrhea ( your period goes away because of running) you may need to consider bone density.  Some of my very athletic patients actually end up with stress fractures and low bone density because they are so active that their cycles shut down and their estrogen levels drop.  If that is true for you, oral contraceptives can help to maintain bone density because of the hormones they contain.  They have a little higher failure rate in terms of birth control than the IUD.

Hope this helps!

Dr B