What is contraception?
Contraception is a way to prevent pregnancy. Although different methods of contraception work in different ways, in general, contraception prevents sperm from reaching and fertilizing an egg as a pregnancy begins.
Do all methods of contraception work the same?
Some forms of contraception are more effective than others, some being 99% helpful in preventing pregnancy, especially long-acting reversible contraception (LARC) methods.
Your doctor or nurse can discuss with you how to make sure your method of contraception is as effective as possible; for example, taking a hormonal birth control pill every day without a monthly break.
Does contraception stop sexually transmitted infections?
Only condoms and internal condoms provide protection against STIs as well as pregnancy. They must be used correctly and used every time you have sex. Other methods only protect against pregnancy.
How do you know which methods to use?
Different methods suit different people. The choice of contraceptive method may change depending on your age, health and the state of your relationship.
The nurse or doctor will ask about your health and the health of your family, so that they can recommend the safest contraception.
What are the different types of contraception?
There are many different types of contraception, but not all types are suitable for all situations. The most appropriate method of combating childbirth depends on the general health of the individual, age, frequency of sexual activity, the number of sexual partners, the desire to have children in the future and the family history of certain diseases.
Long-acting reversible contraception (LARC)
An intrauterine device (IUD), also known as an intrauterine system (IUS), is a small, T-shaped device that is inserted into the uterus to prevent pregnancy. A healthcare provider inserts the device. An IUD can stay in place and work efficiently for many years.
After the recommended period of time or when the woman no longer needs or wants contraception, a health care provider removes or replaces the device.
A hormonal IUD or IUS releases a progestin hormone (levonorgestrel) into the uterus. The hormone released causes the cervical mucus to thicken, inhibits sperm from reaching or fertilizing the egg, thins the uterine lining and can prevent the ovaries from releasing eggs.
The failure rate of a hormonal IUS is less than 1%; however, a small percentage of women may experience expulsion of the device, which must be reinserted.
Some research also suggests that these IUDs remain effective up to one year beyond the recommended period of use.
This method can also be used to treat heavy menstrual bleeding because the hormone often reduces or eliminates uterine bleeding.
A copper IUD prevents sperm from fertilizing the egg and can prevent the egg from attaching to the womb. If the fertilization of the egg takes place, the physical presence of the device prevents the implantation of the fertilized egg in the lining of the uterus. The failure and expulsion / reinsertion rates of a copper IUD are similar to those of a hormonal IUD.
Copper IUDs can remain in the body for 10 years. A copper IUD is not recommended for women who may be pregnant, have pelvic infections, or have had uterine perforations during previous IUD insertions. It is also not recommended for women who have cervical cancer or uterine cancer, unexplained vaginal bleeding or pelvic tuberculosis.
Implants are implantable rods. Each rod has match dimensions, it is flexible and made of plastic. The method has a failure rate of less than 1%. A doctor surgically inserts the rod under the skin of the woman’s upper arm. The stem releases a progestin and can remain implanted for up to 5 years.
Short-acting hormonal methods
Hormonal methods of combating childbirth use hormones to regulate or stop ovulation and prevent pregnancy. Ovulation is the biological process in which the ovary releases an egg, making it available for fertilization.
Hormones can be introduced into the body through various methods, including pills, injections, skin patches, transdermal gels, vaginal rings, intrauterine systems and implantable rods.
Depending on the types of hormones used, these methods can prevent ovulation; thickens the cervical mucus, which helps block sperm from touching the egg; or thin lining of the uterus. Healthcare providers prescribe and monitor hormonal contraceptives.
Short-acting hormonal methods (eg injections, pills, patches, rings) are extremely effective if used perfectly, but in typical use, they have a number of failure rates.
Injectable birth control
This method involves injecting a progestin, Depo-Provera® (depot medroxyprogesterone acetate [DMPA]), given into the arm or buttocks every 3 months. This method of combating childbirth can cause a temporary loss of bone density, especially in adolescents.
However, this bone loss is generally recovered after discontinuation of DMPA. Most patients who use birth control should eat a diet high in calcium and vitamin D or take vitamin supplements while using this medicine.
Progestin-only pills (POPs).
A woman takes one pill daily, preferably at the same time every day. POPs can interfere with ovulation or sperm function. POPs thicken the cervical mucus, which makes it harder for sperm to swim in the uterus or enter the fallopian tube.
POPs alter normal cyclic changes in the uterine lining and can lead to unscheduled or progressive bleeding. These hormones do not appear to be associated with an increased risk of blood clots.
Combined hormonal methods
Combined hormonal methods contain a synthetic estrogen (ethinyl estradiol) and one of many approved progestins. All products work by inhibiting ovulation and thickening the cervical mucus. Medicines combined with estrogen / progestin can be given with pills, a patch or a vaginal ring.
Combined hormonal methods have some medical risks, such as blood clots, which are associated with the synthetic estrogen in the product. These risks were not observed with progestin-only hormonal methods, such as birth control, hormonal POP or LARC.
Your healthcare provider can introduce you to risk factors and help you select the most appropriate method of contraception for you.
Combined oral contraceptives (COC, “pill”).
COCs contain a synthetic estrogen and a progestin, which work to inhibit ovulation. A woman takes one pill daily, preferably at the same time every day. Many types of oral contraceptives are available, and a health care provider helps determine the type that best meets a woman’s needs.
This is a thin, plastic patch that sticks to the skin and releases hormones through the skin into the bloodstream. The patch is placed on the lower abdomen, buttocks, outer arm or upper body.
A new patch is applied once a week for 3 weeks and no patch is used in the fourth week to allow menstruation.
The ring is thin, flexible and has a diameter of about 2 centimeters. It provides a combination of ethinyl estradiol and a progestin. The ring is inserted into the vagina, where it continuously releases hormones for 3 weeks. The woman removes it for the fourth week and reintroduces a new ring 7 days later.
The risks for this method of contraception are similar to those for combined oral contraceptive pills. A vaginal ring may not be recommended for women with certain health conditions, including high blood pressure, heart disease or certain types of cancer.
Designed to prevent sperm from entering the uterus, barrier methods are removable and can be an option for women who cannot use hormonal methods of contraception. Failure rates for barrier methods differ depending on the method.
The types of barrier methods that do not require a visit to a healthcare provider include the following:
- Male condoms
The condom is a thin sheath that covers the penis to collect sperm and prevent it from entering the woman’s body. Male condoms are generally made of latex or polyurethane, but a natural alternative is lambskin (obtained from the intestinal membrane of lambs), many okporn actors use condoms differently.
Latex or polyurethane condoms reduce the risk of spreading sexually transmitted diseases (STDs). Male condoms are discarded after a single use.
- Female condoms
These are thin, flexible plastic bags. A portion of the condom is inserted into a woman’s vagina before intercourse to prevent sperm from entering the uterus. The female condom also reduces the risk of sexually transmitted diseases. Female condoms are discarded after a single use.
- Contraceptive sponges
These are soft, disposable foam sponges full of spermicide. One is inserted into the vagina before intercourse. The sponge helps block sperm from entering the uterus, and the spermicide also kills sperm cells.
The sponge should be left in place for at least 6 hours after intercourse and then removed within 30 hours of intercourse.
A spermicide can kill sperm cells. A spermicide can be used alone or in combination with a diaphragm or a cervical cap. The most common spermicidal agent is a chemical called nonoxynol-9 (N-9).
It is available in several concentrations and forms, including foam, jelly, cream, suppositories and film. A spermicide should be inserted into the vagina near the uterus no later than 30 minutes before intercourse and left in place for 6 to 8 hours after intercourse to prevent pregnancy. Spermicides do not prevent the transmission of STDs and can cause allergic reactions or vaginitis.
Methods that require a visit to a health care provider include the following:
Each diaphragm is a shallow, flexible cup of latex or soft rubber that is inserted into the vagina before intercourse, blocking sperm from entering the uterus. Spermicidal cream or jelly should be used with a diaphragm. The diaphragm should remain in place for 6 to 8 hours after intercourse to prevent pregnancy, but should be removed within 24 hours.
Traditional latex diaphragms must be the right size to function properly, and a healthcare provider can determine the correct fit. A diaphragm must be replaced after 1 or 2 years.
Women should also be measured for a new diaphragm after giving birth, performing pelvic surgery, or gaining or losing more than 15 pounds.
These are similar to diaphragms, but are smaller and stiffer. The cervical cap is a thin silicone cup that is inserted into the vagina before intercourse to block sperm from entering the uterus. As with a diaphragm, the cervical cap should be used with spermicidal cream or jelly.
The lid should remain in place for 6 to 8 hours after intercourse to prevent pregnancy, but should be removed within 48 hours. Cervical caps have different sizes, and a health care provider determines the appropriate fit. With proper care, a cervical cap can be used for 2 years before replacement.
Emergency contraception can be used after unprotected sex or if a condom breaks.
Copper IUDs are the most effective method of emergency contraception. The device can be inserted within a maximum of 120 hours from unprotected intercourse. The method is almost 100% effective in preventing pregnancy and has the added benefit of providing an extremely effective method of contraception as long as the device stays in place.
There are very few contraindications to the use of copper IUDs and there are no weight or obesity issues associated with the effectiveness of the method.
Emergency Contraceptive Pills (PCAs)
These are hormone pills, taken as either a single dose or two doses 12 hours apart, which are intended for use in case of unprotected sexual contact. If taken before ovulation, the pills may delay or inhibit ovulation for at least 5 days to allow the sperm to become inactive.
It also causes thickening of the cervical mucus and can interfere with sperm function. ECPs should be taken as soon as possible after exposure to semen and should not be used as a regular method of contraception. Pregnancy can occur if the pills are taken after ovulation or if the woman has unprotected sex in the same cycle.
Sterilization is a permanent way to control birth that either prevents a woman from becoming pregnant or prevents a man from releasing sperm. A healthcare provider must perform the sterilization procedure, which usually involves surgery. These procedures are not reversible.
A sterilization implant is a non-surgical method for permanent blockage of the fallopian tubes. A healthcare provider inserts a thin tube through the vagina and uterus to place a soft and flexible insert into each uterine tube.
No incisions are required. Over the next 3 months, scar tissue forms around the insertions and blocks the fallopian tubes so that sperm cannot reach an egg.
After 3 months, a health care provider performs tests to make sure that the scar tissue has completely blocked the fallopian tubes. A backup method of contraception is used until tests show that the tubes are completely blocked.
Tubal ligation is a surgical procedure in which a doctor cuts, ties or seals the fallopian tubes. This procedure blocks the path between the ovaries and the uterus. Sperm cannot reach the egg to fertilize it, and the egg cannot reach the uterus.
Vasectomy is a surgical procedure that cuts, closes or blocks blood vessels. This procedure blocks the path between the testicles and the urethra. Sperm cannot leave the testicles and cannot reach the egg. It can take up to 3 months until the procedure is completely effective. A backup method of contraception is used until tests confirm that there is no semen.