Contraceptive Choices: Exploring Temporary and Permanent Family Planning Options - Dr Simi Haris
Contraceptive methods are used to prevent pregnancy, delay pregnancy and space pregnancies. Choosing contraception is a complex decision. Medical providers have an important role not only in providing medical information, but also in supporting patients through contraceptive counselling.
Ideal contraception should be safe, effective, long-lasting, acceptable and affordable. Also, one needs to look into the preferences of the patients regarding child bearing, privacy, convenience, medical conditions, control of menstruation and also on cultural and social issues. Basically, there are two types of contraception, temporary and permanent.
Temporary methods include barrier methods, IUDS, hormonal and emergency contraception. Permanent methods include male and female sterilization. Barrier methods include male and female condoms, diaphragm spermicide.
Barrier Methods
Condoms are the most extensively used, which is cheap, easily available, protects from sexually transmitted diseases like HIV and so on. It also has a high failure rate of around 13%, which ideally should be less than 1%.
Intrauterine Devices (IUDs)
IntraUterine Devices (IUDS) are implanted to prevent pregnancy. The commonly used ones are
- Copper T (CUT): Non-hormonal, long-lasting, reversible, and highly effective with a failure rate of less than 1%. Can be used for 3, 5, or 10 years.
- LNG (MIRENA): Hormonal IUD, effective for 4 to 5 years, with a failure rate of less than 1%.
Hormonal Contraceptive Pills
Hormonal contraceptive pills, which are a combination of estrogen and progesterone pills, have an efficacy of 4 to 7%. It should be taken regularly without fail. One should consult a doctor before starting the pill to rule out medical conditions.
Other uses of hormonal pills include cycle control, dysmenorrhea, cancer protection and menopausal symptoms.
Locally acting hormonal contraceptives can cause heavy menstrual bleeding, dysmenorrhea, endometriosis, adenomyosis etc.
Other Hormonal Methods
- Transdermal Contraceptive Patches: Transdermal contraceptive patches which are available in some countries need to be applied weekly and are user-friendly with less gastric irritation.
- Vaginal Rings: Vaginal rings with hormones are available. It has to be inserted on a monthly basis and has systemic side effects, but with no gastric irritation.
- Implants (Progesterone Rod): Implants containing progesterone rod need to be kept inside the skin. It is long-lasting, highly effective, with failure rate less than 1%.
- Injectable Contraceptives (Inj DMPA): Inj DMPA is an injection which should be taken once in three months. It is highly effective, but can cause irregular bleeding and weight gain.
Emergency Contraceptive Pills
These pills prevent pregnancy if taken within 72 hours after unprotected sex.
Permanent Contraceptive Methods
- Male Sterilization (Vasectomy)
- Female Sterilization
With a wide variety of contraceptive options available, it’s essential to choose wisely based on health conditions and personal preferences. Consulting with a healthcare provider ensures the best decision for each individual.