Birthcontrol: an overview of reliable contraceptives

To prevent pregnancy different reliable methods are available.  Only one method, the condom, involves men. So it seems that contraception is a woman’s responsibility. Maybe sadly but now she can take matters in her own hand.  A lot of new contraceptive methods have been introduced the last few years. So for every woman it’s possible to choose contraception suitable to their personal needs and lifestyle.

Obviously reliability is crucial but women also want easy and user-friendly form of contraception. Also important are no side effects and protection against sexually transmitted diseases. The only reliable method against sexually transmitted diseases is the condom which means men have a role to play. Hormonal contraception is highly reliable but until recently women could only choose the pill. In recent years, however, a number of alternative hormonal contraceptive methods have been introduced. These are as reliable as the pill, but you do not need to take them daily. This means you don’t have to think about contraception every day. And last but not least women also want methods which are easy to quite in case they want to become pregnant (immediately).

All methods involving hormones are highly reliable (>99%). You can distinguish the different methods on how many times action is required. So there are methods which require daily action, once in a week, once in month, once in a quarter of a year and once in several years. Based on your needs and lifestyle you can choose from:

Daily use: The contraceptive pill

The combination (classical) pill.

The Pill is a tablet containing two female hormones – an estrogen and a progestin. These two hormones stop you from ovulating each month. In addition, the hormones thicken the secretions round your cervix, making it more difficult for sperm to get through. Also, they make the lining of your womb thinner, so that it’s less receptive to an egg.  Pros are that the contraceptive pill is highly reliable and can make the monthly periods lighter.  Cons are you have to take them every day (for 3 weeks), the pill is not suitable for women over 35 who smoke and reliability can be affected by gastrointestinal problems.

The estrogen-free pill

Because the pill doesn’t contain estrogen it’s very suitable for breastfeeding women and for women who have side effects related to the estrogen in the classical pill. The estrogen-free pill prevents ovulation consistently.  Pros are that the pill is very reliable, it does not contain estrogen, can be used by breastfeeding women and can also be used by women who do not tolerate estrogen.

contraceptive pill

Some more information on the contraceptive pill can be found in my article Birth control: Facts and fables of the contraceptive pill.

Weekly use: The contraceptive patch

The contraceptive patch is the only weekly hormonal contraceptive method. Like the combined pill the patch contains both estrogen and progestin. The patch (4.5 x 4.5 inches) can be applied easily to a clean and dry skin. The contraceptive patch can be applied on the abdomen, buttocks, upper arm or upper back but not on the breasts. The patch is replaced every seven days. After three weeks there will be one week without patch in which menstruation will occur. The hormones in the contraceptive patch will pass through the skin into the bloodstream. The working of the contraceptive patch is otherwise the same as with the pill. Advantages are that you only once a week have to think about contraception and the contraceptive patch is as reliable as the pill. Also gastrointestinal problems do not affect the reliability. Disadvantages are that it can irritate the skin and the patch is off course visible.

Monthly use: The contraceptive ring

You can insert the flexible contraceptive ring into the vagina like a tampon. The exact location of the ring in the vagina is not important to its effectiveness. The contraceptive ring remains three weeks in the vagina and is then removed. A week later a new ring is inserted. The contraceptive ring is soft and flexible and is therefore comfortable to wear. The vaginal ring provides continuous low doses of the hormones estrogen and progestin. The working of the hormones is the same as with the pill. Advantage is that you have to think about contraception only once a month. It is also easy to use, as reliable as the pill and the hormone doses are low.  A disadvantage is the feeling that there is a foreign object in your body.

Quarterly use: The contraceptive injection

The contraceptive injection contains a relatively high dose of progestin. The hormone is usually injected in the buttock. After injection the hormone is gradually released into the bloodstream. Every three months the injection has to be repeated. Pros are that you do not have to think about contraception for a larger period and it can be used by lactating women. A disadvantage is that the injections must be given by a physician. Also important to know is that it may take longer for fertility to return.

Protection for 3 years: The contraceptive implant

The contraceptive implant protects women against pregnancy for three years. It is very reliable. It contains a progestin called etonogestrel and no estrogen. The implant is a stick/rod which is about 4 inches long and 2mm thick. The stick is inserted under the skin of the upper arm during a minor operation. Once inserted the rod can sits in the upper arm for three years. But it can be removed earlier if desired. Advantage of this contraceptive method is that you are protected against pregnancy for three years. Furthermore it is a very reliable method, the doses of hormones are very low and it is suitable for women who do not tolerate estrogen. Also important is that it is immediately reversible. Disadvantage of the contraceptive implant is that it possible changes the menstrual pattern. Menstruation is often irregular. It is also not suitable for women with acute thrombosis, embolism or severe liver diseases.

Protection for 5 years: The hormone spiral

The hormone spiral contains the hormone progestin. It protects women from pregnancy up to five years. The spiral is inserted directly into the uterus with a special applicator. The spiral can last up to five years in the body. During these five years the hormone spiral provides the body continuously with small amounts of the hormone progestin. Because the spiral is for a longer time in your body a physician should regularly control if the spiral is still in place. Advantage of the hormone spiral is that the contraception is very effective for about five years. Also the doses hormones are very low and it is immediately reversible. Disadvantage is that annual monitoring by a physician is required.

Contraceptive Choices For Woman

In Our Control: The Complete Guide to Contraceptive Choices for Women
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