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Planning our families is absolutely essential and has become second nature to us. And it is very embarrassing to be caught on the wrong foot in this regard, not to mention the medical consequences.
It is obvious that there is no perfect or best method for anyone. Each one has different needs, preferences and medical challenges. In order to be able to select the best option for contraception for us, we need to know a few facts about each method.
We list out to you the options available and a few details of each method so you can find your pick.
Condom:
- Easily available, does not need doctor’s assistance
- Has to be used with every act of intercourse
- Have to rely on male partner
- Failure possible due to user errors
- Protects from sexually transmitted diseases
Every man must know the technique of using condoms correctly. Incorrect usage is the commonest reason for an unintended pregnancy.
Intrauterine contraceptive device (IUD):
A small plastic device containing copper which can be inserted into the uterine cavity where it prevents implantation of the forming embryo.
- Time tested, but associated with menstrual irregularities and pain in many cases
- Effective for 3, 5 or 10 years depending on brand
- Not suitable for women who have yet to have a baby or those who have pelvic infections
- Needs medical assistance to insert, insertion mildly painful
- Failures possible
- Needs to be checked every month by the user
This method is very useful for women who cannot remember to take the pill or whose partners would not want to use the condom. It certainly gives you a sense of freedom from having to remember to use protection always.
The Mirena is a special type of IUD which releases the hormone progesterone within the uterus. Mirena users experience less flow during their periods compared to other IUD users and it is therefore more acceptable than the routine copper devices. It is also used to treat many gynaecological conditions where the patient suffers from heavy periods.
The pill:
With the market being flooded with newer contraceptive pills, there is a lot of confusion in the minds of women today about which pill to take for which situation.
Whereas the doctor is the best judge of which pill is best for you, every woman must know the basics.
Broadly, one may categorize pills as :
- 1. Birth control pills ( e.g. MalaD or any of the 21 tab or 24 tab packet tablets) which contain two hormones, Estrogen and Progesterone or Progesterone alone.
- 2. The emergency contraceptive pill ( e.g. I pill , Unwanted 72, Pill 72 among others )
- 3. The Abortion pill
The birth control pills are the true contraceptive pills as they prevent pregnancy .They need to be taken daily as per instructions and are more than 99% effective if taken correctly.
A host of combinations of hormones in varying doses available today allows a woman to pick up the pill best suited to her needs (as per doctor’s advice).
For e.g. the latest ultra dose pill with drospirenone ( Crina20, Dronis20, Yamini, etc. ) has improved greatly the safety of the pill and thus can be used longterm and makes it most suited to the 35 plus woman and even women with special medical needs, whereas the progesterone only pill caters to the unique needs of the breast feeding mother.
The emergency pill is to be used only in case of an emergency i.e. rape or when an unexpected unprotected act of intercourse has taken place. It needs to be taken within 72 hours, preferably 12 hours ... the sooner the better. It is about 90% effective within the first 48 hours and efficacy goes down with time elapsed.
The abortion pill is to be taken after the diagnosis of pregnancy is already established and the pregnancy is less than 49 days from the last menstrual period. The success rate is about 90%. In case of failure, a surgical abortion must be carried out. Medical abortion is a legal matter and comes under the purview of the MTP Act, 1971. It must be carried out under the guidance of a registered medical practitioner as per the guidelines of the Act.
Needless to say, the wise would rather prevent than go for an abortion. Women’s education is the only answer to curb the increasing trends in abortion.
Contraceptive injections:
These injections are to be given every 2 months (60 days) or 3 months (90 days) and they release the hormone progesterone within the body which prevents pregnancy.
There are two formulations available –
DMPA or Depot Provera Contraceptive (3 monthly injections) and
NET – EN (2 monthly injections)
These injections have the following features:
- Highly effective if taken correctly
- Can cause some weight gain esp in the first year of use
- Menstrual irregularities are very common and the main reason for discontinuation in most cases
- Return of fertility is delayed (you may take some time before you can conceive again after stopping injections)
- Some metabolic problems are possible making you more prone to developing diabetes mellitus or high blood pressure
They are not very popular mainly because of the disturbance caused to the menstrual cycle.
Vaginal spermicides:
These are chemicals applied locally in the vagina to destroy the sperms or to make them immotile thereby preventing pregnancy.
The most popular of the spermicides used is TODAY. TODAY is a vaginal tablet which has to be inserted into the vagina by the woman before intercourse. It is effective from 10 min to 1 hour and a new tablet has to be used with each act. It is not as effective as the other options and failures are relatively common, however it is an option for women who find other methods unsuitable.
NuvaRing:
This is one of the latest advances in the world of contraception. It is a vaginal ring which releases the hormones estrogen and progesterone and works just like the birth control pill with the same combination. The ring has to be inserted by the woman herself within the first five days of her period (she need not wait for the period to get over) and left in place for three weeks and reinserted after an interval of one week, during which she would get her next monthly cycle.
The side effects and mode of action are the same as that of the birth control pill, except that a few women may experience problems of expulsion or vaginal irritation or discharge.
The main advantages the ring would offer would be:
- Freedom from having to remember to pop the pill everyday
- Regular menstrual cycles
- Highly effective (failure rate very low)
Since it is new in the market, it is yet to become more popular.
What we offer at Gyneguide:
Group Counselling or Individual Counselling for about an hour followed by Q & A session, discussing the following:
- Different methods of contraception in details with advantages and disadvantages and risks
- Suitable animations to explain IUD, condoms and ring
- Suitability of each option for women with special medical challenges
We offer contraceptive education to couples also as a part of our Premarital Counselling Package