Contraception (Birth Control)
Planning our families is absolutely essential in today’s day. With abortion laws becoming more stringent, women have fewer choices after getting pregnant.
It is obvious that there is no perfect or best method for anyone. 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.
The 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) also known as Copper T:
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 (a simple task)
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. It is, however, much more expensive and it reduces the flow during periods over time. In fact, most women stop getting periiods about 6 months after Mirena insertion. It is not harmful though.
In fact, the Mirena is used to treat certain conditions which cause uterine bleeding such as heavy periods, endometriosis, adenomyosis and uterine hyperplasia.
The contraceptive 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 :
- Birth control pills ( e.g. Mala D or any of the 21 tab or 24 tab packet tablets) which contain two hormones, Estrogen and Progesterone or Progesterone alone.
- The emergency contraceptive pill ( e.g. I pill , Unwanted 72, Pill 72 among others )
- The Abortion pill
The birth control pill is the true contraceptive pills as it prevents pregnancy. It needs to be taken daily as per instructions and is more than 99% effective if taken correctly. Today various pills are available in the market and women need to consult their gynaecologist to find out which works best for them. In olden days, the pill was not considered safe as the dosage of hormones used was high and hence the risk of stroke and breast cancer was high, especially in older women and smokers. Today’s pills use better hormones in lower quantity which makes the pill a safe option for long term birth control as well.
A special progesterone only pill (Tab Cerazette/Zerogen) is available for use by breastfeeding mothers. It does not harm the milk and does not cause any significant side-effects.
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 of intercourse … the sooner the better. It is about 90% effective within the first 48 hours and more you delay, less effective it becomes.
The abortion pill is to be taken after you become pregnant. It is most effective for pregnancies less than 7 weeks. 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.
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 spermicidal:
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. The ring has to be inserted into the vagina by the woman 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.