Contraception

Healthylife Pharmacy|12 February 2018|3 min read

Types of contraception
Deciding which conctraceptive

Contraception methods are used to prevent pregnancy. Finding the best method for you can require a little bit of research. The only contraceptive that prevents sexually transmitted infections (STIs) are male condoms –so sometimes two forms of contraception are required.

Things to consider when making a choice:

How effective it is in preventing a pregnancy
Limitations due to health issues
Side effects
Cost and availability
Ease of use
Reversibility
Protection against STIs
Benefits other than contraception

Types of contraception

Condoms (male and female)

Condoms are a form of barrier contraception. When a male condom is worn during penetrative sex (vaginal or anal) it collects semen –the fluid that contains sperm. They are used once and then thrown away. Another major benefit is that they provide protection against STIs, including HIV, and stop infection from being passed on.

Condoms have a 2%-18% failure rate but if used correctly can provide a very high level of protection. There are no side-effects, other than if you are allergic to latex rubber or the lubricant. However, non-latex polyurethane condoms can be used as an alternative.

Female condoms are soft plastic pouches that are inserted inside the vagina. They work in very much the same way as a male condom and provide a similar level of protection against STI’s and pregnancy.

Combined contraceptive pill

The combined contraceptive pill, usually just referred to as the pill, contains synthetic versions of the female hormones oestrogen and progesterone. The main way the pill works is by preventing an egg from being released each month, which means a pregnancy cannot begin. The pill is usually taken to prevent pregnancy, but it can also be used to treat:

painful periods
heavy periods
premenstrual syndrome
endometriosis
acne

With perfect use the pill is 99.7% effective but with typical use the rate is less effective at 91%. There are multiple reasons why some people cannot take this medication and there are side-effects such as nausea, headaches and an increased risk of blood clots.

Progestogen-only contraceptive pill

The progestogen-only pill, sometimes called the ‘mini pill’, doesn't contain any oestrogen. It is an option for women who can't use the combined contraceptive pill, such as those over 35 years old and those who smoke.

It works by making the mucous at the entrance to the uterus thicker, so that sperm cannot pass through to meet an egg. In some women it stops the release of an egg each month. It is around 99% effective in preventing a pregnancy. Side-effects include irregular vaginal bleeding, loss of menstruation, weight gain, depression, headaches, bloating and skin changes.

Contraceptive implants and injections

Contraceptive implants and injections are long-acting, effective, reversible and progestogen-only methods of contraception. They are over 99% reliable in preventing pregnancy. The injection is given every 12 weeks and the implant lasts for 3 years. One major side-effect is changes to the pattern of vaginal bleeding.

Diaphragms and caps

Diaphragms and caps are barrier methods of contraception used by women. They cover the cervix and stop the sperm from joining an egg. If used correctly they are 94% effective in preventing a pregnancy.

Vaginal ring

The vaginal ring is a small, soft plastic ring that is about 4mm thick and 5.5cm in diameter. It’s placed inside the vagina on the first day of a woman's period and is removed after 21 days. Seven days later a new ring is used. Vaginal rings contain oestrogen and progesterone and work in a similar way to the combined oral contraceptive pill. It therefore has similar side-effects and disadvantages.

Emergency contraception

A woman can use emergency contraception to prevent pregnancy after having unprotected sex, or if a method of contraception has failed.

There are two types of emergency contraception:

the emergency contraceptive pill (or the morning-after pill)
the copper intrauterine device (IUD)

Intrauterine devices (IUD)

An intrauterine device (IUD) is a small, T-shaped contraceptive device made from plastic that fits inside the uterus. It's a long-acting and reversible method of contraception, which can stay in the womb for 5-10 years depending on the type.

The progesterone IUD works by slowly releasing a very low dose of progestogen hormone into the uterus.

Periods usually become lighter or may stop when using a hormonal IUD. Instead of releasing hormones the copper IUD has copper wrapped around its stem. Unfortunately, it can make periods heavier as a side-effect. Both forms of contraception are 99.8% effective.

Vasectomy

Vasectomy is an operation to permanently sterilise a male. It involves cutting the tubes that allow sperm to leave the testicles. After a vasectomy, the chances of pregnancy are around one in 1,000 but a simple follow-up after the operation will help to confirm the operation a success. Having a vasectomy does not affect a male’s ability to produce hormones, enjoy sex or reach orgasm. Although the operation may able to be reversed it is a big decision to make and all factors should be taken into consideration.

Female sterilisation

Female sterilisation is an effective form of contraception that permanently prevents a woman from being able to get pregnant. There are two forms:

Tubal ligation: this usually involves cutting or placing clips on the fallopian tubes during an operation
Tubal occlusion: a tiny, flexible device is placed into each fallopian tube

The fallopian tubes carry eggs from the ovaries to the womb (uterus). These procedures prevent the eggs from reaching the sperm and being fertilised. It's a fairly minor operation and many women can return home the same day.

Natural family planning

Natural family planning is when natural signs, such as body temperature, are used to identify when a woman is at her least and most fertile during each menstrual cycle, to help either avoid or plan pregnancy. Devices or test kits that predict ovulation can help pinpoint fertile days more accurately. Natural family planning is estimated to be around 75% effective but there are no side-effects and costs involved.

Deciding which conctraceptive

Your doctor can provide the best advice for choosing the most appropriate contraception. To purchase contraceptive devices or to receive accurate information visit your local pharmacy or family planning clinic.