Back to Family Planning

Contraception refers to a number of methods which prevent conception or impregnation. Some of these are artificial means and some natural. Contraception or birth control is employed for various reasons: to prevent pregnancy or to plan a family. Only condoms can be used to ensure “safe sex”: to prevent sexually transmitted diseases or STDs. It is essential that both you and your partner are aware of the kinds of contraceptives available and the kind of protection they offer.
Choosing the right method for yourself can depend on a number of things: age; health; the kind of lifestyle you are living; if you and your partner are planning a new family; whether the both of you are responsible for birth control or if you simply do not want children. It is important that you know the efficacy of the birth control route you choose. Once familiar with all the options available, it is best to consult a doctor who can then guide you to your final decision.

Types of Contraception Available to Women
Some of the contraceptive methods for women contain synthetic hormones that mimic those already present in your body: oestrogen and progesterone. These prevent you from getting pregnant by stop your body’s natural reproductive cycle from working effectively. All hormone based contraceptives work by the ovaries from releasing an egg; thickening the cervical mucus thus making it difficult for sperm to enter your womb and thinning the lining of the womb in order to prevent an egg from implanting.

The Pill
The most commonly used contraception by women is the pill: these contain either one hormone or two and are 99% effective if used correctly. The combination pill contains oestrogen and progestin; the other is a progestin only pill.
The combined pill is available in packs of 21 pills, one taken once every day for 21 days, followed by a 7 day break in which you would get a withdraw bleed. You will have to start a new pack the day after your 7 day break ends. If you miss a pill, you need to read the literature that comes with the pack.
The progestogen-only-pill also known as POP or the mini pill is slightly less effective than the combined pill. The mini pill however, is a better choice for smokers, women over 35 and lactating women. These are taken every day with no break. Missing the pill means you will need to use other contraception for the next two days.
A FAQ on contraceptive pills might make it easier for you to understand and be at ease about your choice.

Emergency Contraceptive Pills
Also known as the morning after pill: these are not used as a regular means to prevent pregnancy and are only used when another contraceptive fails. These can work up to three days after but works best the earliest it is taken.

Injection
These contraceptive hormone injections are intramuscular, which means, they are injected into your buttocks or arm by your doctor or a nurse. This injection is repeated every eight to twelve weeks.

Contraceptive Patches
These small hormone-release patches need to be applied on a non hair area on the skin and should be replaced every seven days. Like the pill, after three weeks of using the patches, you take one week off where you get a withdrawal bleed. Unlike the pill, if your patch comes off and is replaced within 2 days you are still protected against pregnancy.

Vaginal Ring
This is a pliable plastic ring, 4 mm thick and 5.4 cm in diameter, which can be inserted in your vagina on your own or after demonstration from your doctor or nurse. Insert the vaginal ring on the first day of your period and remove after 21 days, followed by a 7 day break after which you insert a new ring.

Implant
A flexible progesterone implant will be inserted in your upper arm, under the dermis. Done under local anesthesia, this inch long rod can remain in your arm for as long as three years. It can be taken out earlier if need be.

Intrauterine System or IUS
This T shaped plastic device prevents pregnancy by continuously releasing progestogen. Fitted using a simple procedure, the IUS can remain inside for 5 years and can be removed when desired.
Important: As with any medication, all hormonal contraceptives have side effects and can interfere or rendered ineffective if you are taking other medication. Please consult the medical literature and the doctor.

Non Hormonal Contraceptives

The Female Condom
Made from polyurethane, these are to be inserted inside your vagina before having sex. This can be done by gently squeezing the small ring at the closed in and inserting into the vaginal cavity. The open outer ring should cover the area around the vaginal opening. The female condom should be carefully disposed off immediately after having sex.

Intrauterine Device
Also known as the coil, this copper and plastic device is inserted into the womb by your doctor or nurse. IUDs come in different types and sizes which determine how long it can last. Ranging from three to ten years, an IUD is effective as long as you choose to keep it. An IUD works by not allowing the sperm to survive in the cervix, fallopian tubes or womb.
Using IUDs come with several risks like ectopic pregnancy or pelvic infections.

Sterilization
Female sterilization involves blocking the fallopian tubes and is an irreversible procedure. This is a minor operation, where you would have to undergo general anesthesia and will face normal post surgery recovery as well as minor risks that all surgeries carry. After the surgery, extra contraception is needed for four weeks and then no other forms of contraception will be needed.

Types of Contraception Available to Men
Fewer contraception options are available to men; but in combination with female contraception can provide extremely effective birth control.

Condoms
A male condom is a protective latex sheath that is fitted over the erect penis before penetration. Condoms made from different materials and in different sizes are available in most pharmacies. Like the female condom, you must dispose of it immediately after sex.
Condoms are liable to leaks and tears and a close eye must be kept for either, in which case, emergency contraception should be sought.

Vasectomy
This safe and simple vasectomy operation seals or blocks the tubes that carry the sperm from the testicles to the penis.

Useful guides and resources on contraception:

• NHS.uk: a presentation of statistics on Effectiveness of different types of contraception
• Beltina.org: tabulates different types of contraception in the US; their availability over-the-counter and their efficacy.
• ThinkContraception.ie: provides a non intimidating overview of contraceptive methods.
• Contraception.co.uk: a female friendly website that helps you chose a contraceptive according to your lifestyle.
• Bupa.co.uk: provides brief, informative expert summaries on hormonal contraceptives.
• Bpas.org: an online wealth of resources and help for women; contraception and pregnancy.