Contraception
You have many choices.
Your choice depends on:
How long you require contraception.
The effectiveness of the contraceptive.
The side-effects of the contraceptive.
Some Tips:
Most contraceptives are given or started on the 5th day of the menses to ensure there is no pregnancy.
All methods described are reversible.
Some may cause fertility to return slightly later.
If 100 couples are trying for a baby 85 will get pregnant in 12 months.
Some will get pregnant at the start of the year, others at the end.
If 100 couples have stopped a contraceptive that delays fertility and try for a baby,
85 will get pregnant in 18 months.
Some will get pregnant in the first few months, others at the end of the 18 months.
Long-Acting Reversible Contraceptives
The implant (Implanon)
How is it used?
lasts for 3 years.
A 4cm thin flexible rod is inserted in your arm in the clinic.
It releases hormones.
Effectiveness
1 to 2 women in 1000 will get pregnant in 5 years.
Advantages
Fertility returns once it is removed.
Side Effects (Disadvantages)
Acne may occur or worsen.
irregular periods for 6 months.
Hormonal Intrauterine Contraceptive Device (Mirena)
How is it used?
lasts for 5 years.
It is inserted in the uterus in clinic during an intimate examination.
It releases hormones locally.
Effectiveness
10 women in 1000 will get pregnant in 5 years.
Advantages
Periods usually become lighter, shorter and sometimes less painful.
Fertility will return once removed.
Side Effects (Disadvantages)
Irregular period for 6 months.
Insertion can be uncomfortable.
Lower abdominal pain for a few days.
May move from its place.
Non-Hormonal Intrauterine Contraceptive Device
How is it used?
Can stay in 5 to 10 years depending on the type of the device.
It is inserted in the uterus in clinic during an intimate examination.
It works once inserted.
Effectiveness
20 women in 1000 will get pregnant in 5 years.
Advantages
Doesn’t produce hormones.
If fitted after 40 it can stay in place until the menopause.
Side Effects (Disadvantages)
Periods may be heavier or longer and more painful.
Insertion can be uncomfortable.
Lower abdominal pain for a few days.
May move from its place.
Combined Hormonal Contraceptives
There are many types of Combined Hormonal Contraception Including:
Combined oral contraceptive pills.
Vaginal ring.
Combined injectable contraceptive.
They are used differently but they all have the same advantages and disadvantages (side effects).
Combined Oral Contraceptive pills
How is it used?
In the first cycle it is started on the fifth day of menses.
Most types are taken 21 days then a seven day gap then the pills are restarted irrespective of the period.
Few types have a different pattern of use.
Effectiveness
50 women in 1000 will get pregnant in 5 years.
Vaginal ring
How is it used?
A small flexible ring is inserted in the vagina.
Lasts for 1 month. Must be removed on the third week.
It may be left in place or removed before intercourse.
Effectiveness
50 women in 1000 will get pregnant in 5 years.
Combined Injectable Contraceptive
How is it used?
An injection is given every month.
The first cycle is started on the 5th day of menses.
Effectiveness
50 women in 1000 will get pregnant in 5 years.
Advantages of all Combined Hormonal Contraceptives
Usually makes periods regular, lighter and less painful.
Reduces risk of cancer of the ovary, uterus and colon.
Suitable for healthy non-smokers up to the age of 50.
Side Effects (Disadvantages)
Not suitable for overweight women or smokers over 35 years.
They slightly increase the risk of breast cancer.
Not suitable for use during breastfeeding.
Can have temporary side-effects such as headaches, nausea, mood changes and breast tenderness.
Progesterone Only Contraceptives
Progesterone Only Injectable
How is it used?
An injection is given every 8 to 12 weeks.
Effectiveness
10 women in 1000 will get pregnant in 5 years.
Advantages
Can be used by women who cannot use estrogen.
Can be used by women who smoke and are over 35 years of age.
You can use it if you are breastfeeding.
Side Effects (Disadvantages)
Periods may stop, be irregular or last longer.
Periods and fertility may take time to return after stopping the injection.
Some women gain weight.
Progesterone only pill
How is it used?
A pill is taken every single day nonstop.
The first pill is usually started on the fifth day of menses on the first cycle only.
It Must be taken at the same time every day.
Effectiveness
50 women in 1000 will get pregnant in 5 years.
Advantages
Can be used by women who cannot use estrogen.
Can be used by women who smoke and are over 35 years of age.
You can use it if you are breastfeeding.
Side Effects (Disadvantages)
Periods may stop, be irregular, or last longer.
May have temporary side-effects such as acne, breast tenderness, weight change and headaches.
Other Methods
Male Condoms
How is it used?
Placed over the penis before intercourse and before touching the women’s genitals.
Effectiveness
150 women will get pregnant out of 1000 in 5 years.
Advantages
No hormones.
No female side effects.
Side Effects (Disadvantages)
May slip off or split.
Man needs to withdraw as soon as he has ejaculated and before the penis goes soft.
being careful not to spill any semen.
Natural Methods
How is it used?
Combine a:
schedule of fertile days.
core temperature.
Cervical secretions monitoring.
Effectiveness
Between 50 to 250 women will get pregnant out of 1000 in 5 years.
Advantages
No physical side effects.
May help when planning for a baby.
Side Effects (Disadvantages)
Takes 3 to 6 cycles to learn well.
A longer period of abstinence from sex.