Female Contraceptives: Are Women Aware Of All The Options?

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When it comes to female contraceptives, there are a lot of options. However, this also means that there is a lot to consider when deciding which birth control is best for you. The first thing you should do when looking into your options is to visit a gynaecologist.  You need to weigh your options and decide what method suits you best.  This includes sharing your medical history because it is important when it comes to settling on an option. Issues like your smoking history, any medication you are on, and weight are factored in. You should also read up on the latest information about the options you are thinking about.

Female contraception options include;

The Intrauterine Device (IUD)

This is a small T shaped device that goes into the uterus. There are two types; the copper and the hormonal IUD. The copper IUD is non-hormonal and has a copper coil wound around it. Copper creates a hostile environment for the sperm thus limits their mobility. This reduces the chances of fertilization. The hormonal IUD is made of plastic and contains progestogen. The IUD releases a small dose of this hormone which thickens the cervical membrane. This ensures that the sperm does not enter the uterus or, if fertilization does occur, it prevents the egg from implanting onto the wall of the uterus.

The device is considered to be 99% effective with 1 out of 100 women getting pregnant in a year. It is known to prevent pregnancy from 5-10 years. The procedure of insertion is non-medical and takes about 5-10 minutes. Once it is inserted, you should not be able to feel it. Your partner should also not be able to feel it during sex. If he does, it means it has moved and is no longer effective. Once you are ready to get pregnant, you can have it removed even before the 5-10 years are over.

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IUD contraceptives. Image from https://cdn.vox-cdn.com

Advantages

  • It is an effective method of contraception
  • It is long lasting so you do not have to keep making hospital visits.
  • The procedure is reversible and you can get it removed anytime you want to have children.
  • The copper IUD can be used as an emergency contraceptive. It can prevent pregnancy if used in the first 5 days after having sex and then continues to protect you even after.
  • The copper IUD does not contain any hormones so it does not affect your body.
  • The hormonal IUD helps with period bleeding and pain. You may notice a little bleeding or have no periods at all.

Disadvantages

  • The hormonal IUD may cause side effects such as; having irregular periods.
  • The copper IUD causes heavy bleeding and painful cramping during periods in some women.
  • The IUD can sometimes fall off though that is rare.
  • It does not protect you from contracting Sexually transmitted diseases.

The contraceptive implant

There are two types of implants. Implanon which has been upgraded into Nexplanon in the United States, and Jadelle. Implanon is a 40mm rod about the size of a matchstick inserted just underneath the skin on the inner side of your upper arm. It provides about 3 years of protection. Insertion requires the use of a local anaesthetic. The Jadelle implant is basically two rods implanted on the inner side of the upper arm. It provides protection from pregnancy for up to 5 years.

The Implanon releases a hormone called etonogestrel while the Jadelle releases the levonorgestrel. Both these hormones prevent pregnancy by thickening the mucus of the cervix making it difficult for sperm to penetrate and get to the ovum. Additionally, they also work to inhibit the release of an egg from the ovary. Both implants are 99% effective. However, if used beyond their stipulated time period, the efficiency goes down since the implants release very little hormones.

If you need to get pregnant, the implants can be removed at any time before their due date. However, a study conducted revealed that both implants may be less effective in overweight women.

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Implant. Image from https://www.heraldlive.co.za/news/2014-05-27-contraceptive-implant-an-instant-hit/

Advantages

  • The implants are highly effective contraceptives.
  • They are a low maintenance form of contraception.
  • They are reversible and one can take them out if they want to get pregnant. There is no delay in return of fertility.
  • They reduce menstrual flow and pain.

Disadvantages

  • They do not protect you from STI’s.
  • They may cause irregular periods. Though there is little to worry about since pregnancy is not likely.
  • In some women, they cause heavy bleeding or spotting.
  • There are reported cases of weight gain in some women.

Contraceptive injections

There are three types of injections; Depo-Provera, Sayana Press and Noristerat. The first two protect you for up to 13 weeks while the last one protects you for 8 weeks. Noristerat is however not commonly used in some countries.

They are 99% effective if administered the right way. If you miss an injection and have unprotected sex, you are likely to get pregnant. The injections work to thicken the mucus of the cervix reducing sperm mobility. They also prevent the ovaries from releasing an egg. If you need to get pregnant, simply skip the next dose of your injection. It might take a while before your fertility is back to normal though.

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Image from http://4mat.ulb.ac.be

Advantages.

  • They are highly effective methods of contraception.
  • The Sayana Press injection is made in a way it is safe for self-injection. So you do not need to go a medical centre.
  • It reduces heavy periods and menstrual pain.
  • They are relatively low maintenance and you do not need to go to a medical clinic in about 2-3 months.
  • It does not affect breastfeeding for new mums.
  • Sayana Press and Depo Provera are quite affordable all going for less than KSHS 100.

Disadvantages

  • Both the Depo Provera and Sayana Press may affect your bones since the natural oestrogen produced causes thinning of the bones.
  • The injections cannot be removed from your body so if you want to get pregnant between those 13 weeks, you will have to wait until the period is over.
  • They do not protect you from sexually transmitted diseases.
  • Once discontinued, fertility can take up to 1 year to go back to normal.
  • Some women report experiencing side effects such as spotting, weight gain, and decreased libido.

The patch

The contraceptive patch is a thin plastic beige square that looks like a band-aid. You stick it on the medically prescribed areas such as the upper outer arm, back, butt and stomach. You are required to change it every week except the week you are on your period. However, once the period is over, you should stick it back onto your skin. It is also advised that you alternate the area of attachment. If the week before was the back, the next week should be the stomach. Always do a daily check to ensure that it has not fallen off.

The patch is 91% effective. It works by delivering progestin and oestrogen through the skin to the bloodstream. It then works to suppress ovulation and also thickens the mucus of the cervix so it is harder for sperm to pass through. Additionally, it also causes thinning of the uterine wall so no implantation can occur.

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image from https://www.stayathomemum.com.au/wp-content/uploads/2016/10/13_01_pu_02.gif

Advantages

  • It is simple to use so one can do it from the comfort of their home.
  • If used properly it is highly effective.
  • Its presence can be verified by sight.
  • It helps reduce period bleeding and cramps.

Disadvantages

  • It has higher oestrogen levels than any other contraceptive and that may cause issues.
  • You need to change it every week which can get tedious and one can forget.
  • It is known to interact with some medications such as rifampin, anticonvulsants etc. So it is important that you share information about any medication you are using with your doctor.
  • It does not protect you from sexually transmitted diseases.
  • Fertility may be delayed for a month or two after usage is discontinued.

Contraceptive Pills

Birth control pills are oral medication taken to prevent pregnancy. There are various kinds of pills. The combined pill contains oestrogen and progestin. They are considered to be 99% effective if administered properly. This means ensuring that you take a dose every day and at the same time to complete the 24-hour cycle. The pill may also be ineffective in case you experience diarrhoea or vomiting.

There are three types of combined pills;

  • Monophasic pills used in one-month cycles and provide the same dose of hormones.
  • Multiphasic pills used in one-month cycles and provide different types of hormones.
  • Extended life pills which are used in 13-week cycles. As a result, you can have your periods 4 times a year.

There is also what we call a mini pill for people who are affected by the man-made oestrogen. It only contains progestin and is 95% effective, unlike standard pills. The hormones in the pills work to thicken the cervical membrane preventing sperm from getting through. They also work to hinder ovulation.

There is also the emergency contraceptive pill which should be taken right after sex or in the next 5 days (this depends on the pill). There are different kinds of pills which contain the hormone levonorgestrel which temporarily stops your ovum from releasing an egg. They are not a long-term contraceptive method (you shouldn’t use them more then a couple of times a year – if you find yourself having to use them a lot, you need to consider using other types of contraceptives).

Advantages

  • Highly effective when administered properly.
  • Simple and easy to use.
  • May reduce menstrual flow and cramping as well.

Disadvantages

  • You have to ensure that you swallow one every day without fail.
  • There is a risk of getting blood clots which can potentially lead to stroke.
  • May have side effects such as mood swings, weight gain, headaches, depression, high blood pressure etc.
  • They do not protect you from STI’s.

Diaphragm

A diaphragm is a shallow cup shaped like a little saucer that’s made of soft silicone. It is bent in half then inserted into your vagina to cover your cervix. For maximum results, it is used alongside a spermicide which is a gel or cream that kills sperm. Right before intercourse apply the spermicide onto the diaphragm before you insert it to cover the cervix. You must leave it in for 6 more hours after you have had sex.

Additionally, if you have been wearing the diaphragm 3 hours prior to having sex, you need to use additional spermicide before proceeding to have intercourse. If inserted and used properly, it is 96% effective. The spring in the rim of the diaphragm forms a seal against the vaginal walls. This then works to prevent sperm from entering the uterus.

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Diaphragm – image from https://www.drugs.com/cg/images/en3312930.jpg

Advantages.

  • You only need to wear it before having sex.
  • It is highly effective when used correctly
  • There are no long lasting side effects associated with its use.
  • You need to put it on before sex so your partner can easily know if you are using protection.

Disadvantages

  • In the heat of the moment, you may forget to put it on.
  • It may be uncomfortable to insert and remove.
  • If not cleaned well, it can cause issues such as bladder infections. You should clean it with water-based or silicone-based lubricant. Do not use detergent or other things to clean it.
  • The spermicide may cause irritation for you and your partner.

The rhythm method.

This method is a natural birth control method. It includes using a combination of methods such as coitus interruptus and symptom-based fertility awareness. This is being aware of the changes the body goes through when you are most fertile. The major part of the rhythm methods includes using calculation to figure out when your fertile days start and end.

You should be able to have sex the first day after your fertile days are over and not get pregnant. To use this method, you need to compile data for 6 of your monthly cycles so you may have somewhat accurate results. It is also not possible to use this method if all your cycles are below 27 days. This is considered to be 96-97% effective.

 

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Image from https://upload.wikimedia.org/wikipedia/commons/8/85/SDM-circle2.gif

Advantages

  • It requires no use of medication or other gadgets.
  • The method has no side effects.

Disadvantages

  • The method can only predict your safe days. It is hard to get accurate data because your cycle changes.
  • Sperm can live up to 7 days in a woman’s womb so you may not be completely out of the woods.
  • It does not protect you from STI’s
  • It requires you to keep track of your cycles to get accurate data which you may get wrong or forget to keep a tally.

The NuvaRing

This is a small bendable ring that you insert into your vagina.  It contains hormones oestrogen and progesterone. These hormones thicken the mucus of the cervix thus sperm cannot move around and fertilize the egg. They also make the lining of the uterus thinner to deter implantation. Additionally, they are absorbed into the vagina to prevent ovulation.

You should insert the ring after every period then  take out when on your period. The ring is 98-99% effective if inserted and used properly.

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Image from https://www.obgynecologistnyc.com/wp-content/uploads/2016/09/Nuvaring-Birth-Control-Vaginal-Ring.jpg

Advantages

  • It is an effective method of contraception if used properly.
  • It is a simple method that one can do in the comfort of their home.
  • You do not have to think about it every day.
  • It may help reduce menstrual blood flow and period pain.

Disadvantages

  • It may be uncomfortable to insert and remove.
  • It may cause side effects such as nausea, breast tenderness, mood changes etc.
  • The ring may cause spotting in the first few months of use.
  • It does not protect you from STI’s.

Female Condom

The female condom is made from a soft plastic called polyurethane and is worn in the vagina to prevent semen from getting into the womb. It needs to be placed into the vagina before sexual intercourse and removed afterwards. It should not be reused. If used correctly, it is 95% effective. You should not use a female and male condom at the same time. The friction between them can cause the condoms to tear or burst.

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Female condom. Image from https://www.healthlinkbc.ca

Advantages

  • It is the only method of female contraceptives that protects you from STI’s.
  • The female condom has no side effects
  • It is simple to use.
  • It is highly effective if used properly.
  • Your partner can verify if you have it on.

Disadvantages

  • It may be uncomfortable to insert and remove especially if it goes deeper than it should.
  • One may forget to insert it in the heat of the moment.
  • It reduces the natural feeling of having.

And what are the contraceptive options for men? Male Contraceptives: What Are The Available Options And What Are Their Advantages and Disadvantages?

Have you had any side effects from using contraceptives? What types of contraceptives are you using?

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