Contraceptives: Be in control

Proper planning and use of contraceptive methods helps couples plan their life better

woman on bedside with husbandFor the modern society, contraception is not just the responsibility of a woman, but also of the man. Ideal contraception should be effective, safe, convenient, reversible, cheap, acceptable and devoid of any side-effects. Most importantly, it should provide protection against sexually-transmitted infections. Out of the many methods available, a couple should choose the contraceptive option depending on their need at a particular time and their choice.

Which contraceptive method you choose depends on the frequency of intercourse, woman's age, choice and completion of family.

Natural methods of contraception

  • Rhythm method or calendar technique: It requires the woman to record the length of a menstrual cycle for several months. And then subtract 19 days from the shortest cycle and nine days from the longest cycle. This period determines her fertile period. Abstinence from intercourse during this period prevents pregnancy.
  • Basal body temperature: Body temperature is recorded by a special thermometer. After ovulation basal body temperature rises by 0.5 – 1 degree F. Women are advised to avoid sex from periods till three days post ovulation. This method is cumbersome and may fail in
    20 – 30 per cent cases.
  • Coitus interruptus or pull-out method: This involves withdrawal before ejaculation. Although this method is easy to use, doesn't need any special devise, requires no prescription and has no side-effects, it could be unsatisfying to both partners. Also, if not careful, there is a high failure rate.

Oral contraception

The development of oral contraceptive [OC] pill was a major breakthrough in the 20th century. Usually, an OC pill contains two drugs—oestrogen and progesterone. The ideal OC pill is the one with lowest hormonal dose and minimal side-effects. OC pills are helpful in regularising periods, preventing ovarian cysts, reducing pain and bleeding during periods and also decreasing ovarian and womb cancers.

However, side-effects like nausea, vomiting, and breast tenderness is a major reason for discontinuation. These effects subside by three months of using the pills.

Research shows that the use of OC pills is not associated with weight gain, which clears the air surrounding the use of OC pills and weight issues.

It is best to consult a qualified doctor before considering an OC pill as there are certain conditions where OC is contraindicated like history of brain disease, migraine, epilepsy, heart disease, clotting problems, liver problems, suspected breast cancer or pregnancy.

Combined OC pill [contain oestrogen and progesterone] should not be taken by women who breast feed. Such women can opt for progesterone only pills [POP].

If used properly, OC pill is an effective method of contraception.

Injections

This method is highly effective and the effect lasts for 2 – 3 months. There are two forms of injections, which need to be taken two or three months apart. In some women, these injections cause irregular periods and may delay the return of fertility, after discontinuation. Other side-effects are weight gain, cramps, depression, leg cramps and feeling being bloated.

Intrauterine devices [IUD/ IUS]

An IUD is a device—usually a coil—is inserted straight into the uterus. It can last for 3 - 10 years. Copper-containing coils are cheaper and more widely used in India. However, side-effects like heavy bleeding, pain, risk of infection, and ectopic pregnancies occur with their use.

A new and effective coil in use today is MIRENA [IUS], which has a drug that slowly releases progesterone into the uterus. This is effective in preventing pregnancy and is an expensive method devoid of any side-effects.

Barrier method

Male condom is the most widely used barrier method of contraception. This method prevents the risk of sexually transmitted diseases. It is cheap and, if used properly, is also effective. Female condoms too are available in the market; but they are less popular and some women find the insertion cumbersome.

Sterilisation

This is a permanent method of contraception. It is important to realise that reversal of these procedures can be difficult and may not become successful.

Male sterilisation [vasectomy] is relatively a simple procedure compared to female sterilisation. Female sterilisation is by laparoscopic ligation of both tubes and should be performed by a qualified doctor.

Emergency contraception

These are tablets with higher dosage of hormones. Two tablets are taken with a gap of 12 hours, soon after unprotected intercourse, preferably before 72 hours. Emergency contraception is relatively safe, but has a failure rate between 20 – 30 per cent. Nausea and vomiting are common side-effects. It is important to note that this is not a substitute for planned contraception.

Contraceptives can help you plan your life the way you want, if chosen wisely. Choose one with mutual consent.

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