New options in the world of contraceptives offer birth control without as much hassle as the traditional pill.

Lunelle, Mirena, Nuvaring and Ortho Evra have hit the market in the last year and offer women the freedom of not having to remember a daily pill.

“The more options you have, the better,” said Dr. Garth F. Essig, associate professor of OBGYN and clerkship director.

The Nuvaring and Orth Evra drugs are both similar to the pill with the hormones, estrogen and progestrin, that are administered and the physical and emotional side-effects, said Johathan Schaffir, M.D., clinical assistant professor of OBGYN.

The side effects are generally similar to the pill, which include temporary breast tenderness, nausea, cramping and irregular bleeding, Schaffir said.

Nuvaring, a flexible, vaginal ring is inserted by the woman and left in for three weeks. On the fourth week, the ring is removed. Occasionally, vaginal irritation is reported, Schaffir said. The ring should not interfere with sexual intercourse, but if necessary it can be removed for up to three hours.

Patients can control when they want to start and stop using birth control with this device, said Dr. Geri Hewit, assistant professor in the department of OBGYN and pediatrics.

The ring is about as easy to insert and remove as a tampon, Essig said.

Ortho Evra is a transdermal patch which admits hormones directly to the bloodstream through the skin.

The patch can be worn on the buttocks, abdomen, upper torso, excluding the breasts, and upper outer arm.

A new patch is placed on the body each week for three consecutive weeks, followed by a patch free week.

“The patch is not indicated for women over 90 Kg because of the extra body fat,” Schaffir said.

Local irritation and the patch falling off are two complaints reported by patients, Schaffir said.

Patients seem most interested in the patch and the adhesive complaints have been low, Hewitt said.

“I think more women find the patch more acceptable than the ring,” Essig said.

Lunelle, a monthly injection, has recently been recalled by the Pharmacia Corporation because they cannot guarantee that the pre-filled syringes are potent enough to prevent conception, Hewitt said. This form works similarly to the Nuvaring and Orth Evra, but it must be administered by a healthcare professional each month, adding to the cost.

Originally, the company talked about a patient administered version, but it is a long way off, Hewitt said.

Women can take any of the three birth control devices for four straight weeks if they want to avoid a period that month, Schaffir said.

“I don’t think anybody sees this as harmful,” Essig said. It is reasonable not to do this for more than three months in a row because a woman wouldn’t know if she has gotten pregnant in that time.

Cost varies little between the new methods and the pill. All three of the contraceptives range in price between $35 and $40 per month, Essig said.

Mirena is an intra-uderine device that must be inserted by a doctor.

One IUD ranges between $350 and $400, plus the additional cost of a doctor’s visit, but it also lasts up to five years, Schaffir said. IUDs have been around for a while, but Mirena contains hormones to make periods lighter.

It is not recommended for women unless they are in a mutually monogamous, long term relationship because if the woman gets an infection, Mirena increases the risk of taking the infection inside and creating serious problems, Schaffir said.

Mirena is not typical for college students, Hewitt said.

It is also recommended to women who have had at least one child because it makes insertion of the device easier, Schaffir said.

Many side effects, such as breast tenderness, nausea and cramping can be avoided with Mirena because unlike the other forms of birth control, this system provides hormones directly to the area instead of introducing the hormones into the blood stream, Schaffir said.

Irregular bleeding and pain of insertion are two possible side effects, he said. There is also a small risk of infection. It is possible that the uterus could be perforated upon insertion of the IUD. An increased risk for pelvic inflammatory disease is also a possibility, Hewitt said.

A woman can try one method and if it doesn’t work well for her, she can switch to another method, Essig said.

Emotional irregularity is less of an issue with the four new contraceptives.

With the pill, women experience an emotional peak through each day because they take a pill each day, but the new methods work like a sponge and the hormone is slowly dissolved so that emotional highs and lows are not as likely, Essig said.

Smoking is discouraged for any woman taking any of these contraceptives because it increases the risk of blood clots, heart attack and stroke.

The risk of getting pregnant remains consistently low through all new methods. Effectiveness rates are 99 percent, but may be a little higher in Mirena because the woman does not have to remember to take it, Schaffir said.

“The effectiveness is all pretty much the same if used correctly,” Schaffir said.