Methods of Contraception
Progesterone only or ‘mini-pill’
This works mainly by preventing sperm getting through the cervix. It is 96 – 98% effective if taken correctly and at the same time every day. Additional contraceptives are required if the tablet is taken more than three hours late. It is suitable for breastfeeding mothers and for women who cannot take oestrogen.
Progesterone injection
This works in a similar way to the progesterone only pill and prevents ovulation (99% effective). The injection is given every 8 – 12 weeks and is effective immediately. It can be safely used while breastfeeding. It is also suitable for women who do not like or forget to take pills.
Vaginal ring
This is a flexible ring that slowly releases contraceptive hormones into the vagina and is left in place for three weeks and it is then removed. There is a break for one week after which a new ring is inserted. It is 99% effective.
Patch
The contraceptive patch is worn on the skin. The hormones are absorbed into the skin and then into the bloodstream. A new patch is used every week for three weeks. No patch is worn on the 4th week. It is 99% effective if it is used correctly.
Intrauterine contraceptive device (IUCD)
A copper based coil (IUD) or the more popular progestasert system (IUS) is inserted into the womb during a woman’s period and it is effective for 3 – 5 years. Fertility returns quickly after it is removed. It is suitable for women who want a long term method of contraception or who cannot take oestrogen. It is also suitable for women who are breastfeeding and it is 98 – 99% effective.
Implants
An implant is a small flexible rod which is placed just under the skin, usually in the upper arm and contains progesterone only. It is 99% effective and lasts for three years and is suitable while breastfeeding.
Barrier methods
These include spermicidal products, diaphragms, cervical caps, male and female condoms. They work by preventing the man’s sperm from entering the womb and are less reliable than hormonal methods. Diaphragms and caps need to be fitted by a doctor or nurse and require practice to be used effectively. Condoms are the only method that protect against STIs (sexually transmitted infections).
Natural methods
Natural methods of contraception involve learning how to recognise the fertile and infertile time in your menstrual cycle. It can be used to achieve or avoid a pregnancy and therefore you can be in control of your own fertility. It is called ‘natural’ as it does not interfere with any of the normal physiological processes of the body.
Methods include the calendar method, basal body temperature method (BBT), cervical mucus method (Billings Method), muco-thermal method, symptothermal method and ovulation awareness monitors.
The Billings Method can be used while breastfeeding (lactational amenorrhoea) as breastfeeding delays the return of ovulation after birth. The successful use of this method demands full breastfeeding day and night without the addition of other milk, juice, solids or the use of soothers. It should only be used during the first six months after giving birth, providing that menstrual periods have not returned.
Special instructions should be sought for all natural family planning methods.
Surgical methods
These include a vasectomy for men and tubal ligation for women; these must be considered permanent. Therefore, couples should be counselled in all aspects of sterilisation before a final decision is made.
Emergency contraception
Usually called the ‘morning after pill’, this prevents pregnancy in the event of unprotected sexual intercourse or failure of a birth control method, such as a condom breaking or slipping or forgetting to take the pill. It is available over the counter in pharmacies and must be taken within 72 hours of sexual intercourse but earlier if possible. It is 75% – 95% effective. It should not be used regularly as it is only intended for emergency use.
Remember, women should not wait until the return of their menstrual period before starting contraception as ovulation occurs before menstruation making pregnancy possible. Please discuss with your GP or local family planning clinic.