Choosing a birth control method

Dear Dr. Donya,

I have some questions regarding the correct birth control.

1. Which one is the best birth control method: monthly injection, three monthly injection or the pill?

2. What are the side effects associated with vasectomy and tubal ligation? Is it true that it will accelerate female menopause as well as reducing libido in both men and women.

3. If I want to get pregnant to have a baby girl, can we arrange it based on counting the days of fertility?

4. Do I need to check my blood before getting pregnant? During my first pregnancy, I had a medium level of cytomegalic and toxoplasma.

Thanks so much.

-- Jennifer

Dear Jennifer,

1. Hormonal birth control is an individual preference. They consist of hormone estrogen and progesterone. Oral birth control has the advantages of no pain and you can stop usage at any time, particularly if there is a complication. The disadvantage is, you have to take it on a regular daily schedule.

Injection is associated with pain and it cannot be taken out of your system if there are any side effects. In this case you will have to wait until the body discharges it. Its main advantage is convenience.

The side effects of using birth control are thromboembolism, cancer of the genitals or breasts, liver disease, unwanted pregnancies and abnormal bleeding of the vagina. History of your period and your body shape can guide your doctor to recommend what kind of birth control you should use.

There is an information folder on the possible side effects of these drugs and they are too numerous to list.

Another possibility is the IUD which is put in place by a doctor and is periodically checked to make sure it is in place. It does not have the percentage of reliability that the drugs do but it is associated with much less risk of unwanted side effects.

2. Vasectomy and tubal ligation do not affect your sexual activity. Ovaries produce estrogen and testes produce testosterone and these are the hormones that effect sex drive. Although sexuality has also been proven to be psychological, there is always the possibility of a mental block occurring.

3. Establishing the sex of the child is a possibility if you use the selective sperm process, which is where the X sperm is selected and injected into the egg, which is called IVF. The following are some recommendations which have no scientific support:

* Sex should be had before or two days after ovulation

* Sexual intercourse should not be aggressive

* Deposit as much sperm in the vagina as possible, by drawing back before ejaculation.

* Foods; meat, milk and egg may play a role

4. I would suggest that you take the test in case the infection reoccurs which can affect the child.

-- Dr. Donya