Sexual Health: Guide & Facts You Should Know About Contraception

Contraception helps the people to plan their pregnancy. Delaying or spacing and stopping babies reduces pregnancy-related risks and unwanted pregnancies for girls, young  & older women. Many teenagers are very much sexually-active and it is important for them to be equipped with the facts on contraception.

Before deciding on contraception, you should consult a physician who would advise the best contraception methods for you. Most people prefer methods which are comfortable, affordable and effective in preventing pregnancies and sexually transmitted diseases.

Two main categories of contraception:

• Non-hormonal
• Hormonal

 

Non-hormonal:

Non-hormonal contraception methods create a barrier between the sperm and the egg.

(a) Abstinence:

• It is the act of not having any form sexual activity, oral, vaginal or anal.
• It has 100% effectiveness because there is no opportunity for the sperm to fertilize the egg.
• Although it has 100% effectiveness, it can be quite challenging to control the sexual desire and requires a very strong determination.

(b) Coitus interrupts (Withdrawal)

• A method of withdrawing penis from the vagina before ejaculating.
• 96% effective with perfect use, 78% effective with typical use.
• This method can be very tricky and needs a lot of self-control and determination in male partner. It can interfere with sexual pleasure of both couple too.
• Risk of pregnancy is increased if he ejaculates before he manages to fully pull out or ejaculates right outside the vagina.

(c) Barrier methods:

• Male condom
• Female condom
• Diaphragm, cervical cap
• Spermicidal
• Intrauterine Contraception Device

1. Male condom
   
   • 98% effective with perfect use, 85% effective with typical use.
   • The condom act as a physical barrier by trapping the semen in the condom so that it will not be able to fertilize the egg and prevents sexually transmitted disease too.
   • It should be applied on the erect penis before penetration happens.
2. Female condom
   
   • Looks like a larger male condom with small ring at closed end and a larger ring at the open end.
   • 95% effective with perfect use, 79% effective with typical use.
   • It functions as a cover in the vaginal canal and collects semen before, during and after ejaculation, preventing sperm from entering vagina.
   • It can be tricky to insert correctly and the outside ring may slip into the vagina during intercourse.
   • Not as easily available as the male condom.
3. Diaphragm, cervical cap
   
   • Diaphragm is a reusable flexible soft rubber cup to be inserted inside the vagina that covers the cervix.
   • 94% effective with perfect use, 88% effective with typical use.
   • You will need to consult a doctor to determine the right size and learn how to use them.
   • Usually spermicide is added for better protection.
   • It can be inserted few hours before intercourse.
   • It needs to be cleaned after use and requires careful storage.
4. Spermicide
   
   • Spermicide lubricants, gels or foams work by killing the sperm or make the sperm unable to move towards the egg.
   • 82% effective with perfect use, 72% effective with typical use.
   • Spermicide is applied inside the vagina before sexual intercourse.
   • Should be used with a barrier method like diaphragm, condom for higher effectiveness.
5. Intrauterine Contraception Device (IUD)
   
   • IUD a long-acting reversible contraceptive is a small T-shaped device that is introduced into the uterus by medical personnel in a clinic setting. Likewise the removal of IUD requires medical expertise in a clinic.
   • More than 99% effectiveness.
   • It changes the lining of the uterus to prevent a fertilized ovum from implanting to the wall of uterus.
   • Progestin releasing IUDs last 3-5 years, copper T IUDs last 10 years

 

 

Hormonal

Hormonal birth control refers to birth control methods that contain synthetic forms of hormones.

(a) Oral contraceptive pill

• Two types of oral contraceptives available: Combined oral contraceptive (COC)- contains both oestrogen and progestin and Progestin-only Contraceptive (POC).
• The woman takes a pill every day at about the same time for 21 days, then stops for 7 days to get her period.
• The pills prevent ovulation thus preventing pregnancies.
• Users have to remember to take the pills every day, or it will be not effective in preventing pregnancies.

(b) Depo-Provera injection

• Hormonal progestin intramuscular injection given every 3 months during the first five days of a woman’s period.
• The hormones thicken the mucous at the uterine opening so that sperm won’t pass through.
• It also thins out the lining of the uterus to prevent pregnancy.

(c) Hormonal implant

• Progestin containing implant to be inserted under the skin by a medical professional over inner side of forearm.
• The implant releases small amounts of hormone over next 3-5 years to prevent ovulation, thicken the mucous and thin out uterus lining.

(d) Hormonal patch

• A patch which contains hormones will be adhered on the upper arm once a week for three weeks.
• No patch will be used on the 4^th week to trigger menstruation.
• It is easy to use and non-invasive.

Emergency Contraception

Reasons for choosing EC, a contraceptive method to prevent pregnancy after a non-protected intercourse:

• Missed birth control pill, patch or injection.
• No contraception was used.
• Sexual assault.
• Condom slipped, broke or leaked.
• Error in calculation of fertility period.

There are two main types:

(a)Emergency contraceptive pills or also known as the ‘morning-after-pill’.

• Pills which contain the combination of oestrogen and progestin will be taken for five days after the unprotected intercourse.

(b) Intrauterine Contraception Device

• A copper intrauterine device can be inserted within 5 days of unprotected intercourse and removed at the next menstrual period to prevent implantation.
•  It benefits by preventing the rate of unplanned pregnancies and abortions.

 

 

Permanent contraception

(a) Vasectomy for male:

• Vasectomy is a permanent surgical procedure to close or block the vas deferens (the tube which carries the sperm).
• Another form of contraception is needed until a semen analysis shows no sperm.

(b) Tubal-ligation for female:

• Female sterilization by tubal ligation is a permanent surgical procedure where the fallopian tube (which carries egg from the ovary) will get disconnected.
• Through a laparoscope, doctor will make small incision over the abdomen to either clip, burn or remove the fallopian tube.
• Abdominally, during caesarean section, doctor can assess the fallopian tube to clip or remove them.

 

Efficacy of birth-control method:

A patient’s choice of contraceptive method involves factors such as efficacy, safety, benefits, cost and personal consideration. The choice of contraception may vary over time, depending on your lifestyle and circumstances. Consult with a physician to find the best contraceptive method which suits you.

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References

1. What is contraception? [Internet][cited 2019 Jan 28] Available from:

https://www.nhs.uk/conditions/contraception/what-is-contraception/

2. [Internet][cited 2019 Jan 28] Available from:

http://www.myhealth.gov.my/en/contraception/

3. Hormonal contraceptive. [Internet][cited 2019 Jan 28] Available from:

https://blog.bulletproof.com/non-hormonal-birth-control/

4. Birth control. [Internet][cited 2019 Jan 28] Available from:

https://www.webmd.com/sex/birth-control/default.htm

 

Tags

• contraception
• fertility
• MensHealth
• pregnancy
• women's health