Family Planning - Contraception

The choice of a particular method of contraceptive depends on an individual's age, health, frequency of sexual activity, number of sexual partners, plans for future pregnancy, and certain medical conditions.

It is necessary to know that most birth control methods prevent pregnancy. However, no method of birth control offers protection against sexually transmitted diseases.

Discuss with your doctor the choices of birth control available for your particular situation.

Barrier Methods

It is one of the most common contraceptive methods and involves forming a physical barrier to obstruct the sperm from entering a woman's uterus.

Barrier methods include the use of

• Male Condom - The male condom is a thin covering made of latex or polyurethane that is rolled over an erect penis before sexual intercourse to prevent the sperm from entering a woman's vagina
• Female Condom -The female condom is a polyurethane (plastic) tube that has a flexible ring at each end and is inserted into the vagina before sexual intercourse.
• Diaphragm -The diaphragm is a flexible dome that covers the cervix inside the vagina
• Cervical Cap - The cervical cap is a smaller cup made of latex rubber or plastic. These should be used in conjunction with a spermicidal gel and are placed in the vagina before sexual intercourse.
• Spermicides - Spermicides are chemicals that inactivate or kill sperm and are available as foams, suppositories, and jellies
• Contraceptive Sponge - The sponge is a soft, round barrier device made of polyurethane foam

Hormonal Methods

These methods work by preventing ovaries from releasing eggs for fertilisation. They also thicken the mucus around the cervix, making it difficult for sperm to penetrate. They also thin the lining of the womb decreasing its ability to accept a fertilised egg.

In this method, synthetic hormonal preparations containing oestrogen and progesterone can be administered

• Oral Contraceptive pill (OCP), the mini-pill,
• Implanted under the Skin – Implanon,
• Implanted intrauterine device (IUD) - Mirena
• Injected into the muscle (injections) – Depo Provera
• Placed in the vagina (vaginal rings) – NuvaRing

Implanon

This is a contraceptive implant inserted in the arm under local anaesthetic. It is a highly effective contraceptive and lasts for up to three years. It is an ideal method for young women leading busy lifestyles requiring safe and effective contraception. Implanon is the brand name for the contraceptive implant containing the hormone progestogen?

Implanon is a small flexible rod, which is inserted under the skin of the upper arm. It slowly releases progestogen (a hormone similar to the hormone progesterone, which is naturally produced by the female body) into the bloodstream to prevent pregnancy for up to three years.

The implant works by preventing ovulation (egg release from the ovary), preventing thickening of the mucus of the cervix so that sperm cannot enter the uterus (womb), and changing the lining of the uterus, making it unsuitable for pregnancy.

Implanon is at least 99.9% effective. This means that if 1,000 women use Implanon for a year it is possible that 1 woman could become pregnant. Some medications can reduce the effectiveness of Implanon. It is important to inform doctors you have an Implanon when another medication is prescribed

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Intrauterine Device (IUD) - Mirena IUS

This is an intrauterine device that is a highly effective form of contraception with minimal hormonal side effects. It lasts for up to five years and like Implanon has the advantages of being a 'fit and forget method of contraception.

The intrauterine device (IUD) is a small device made of plastic that is inserted into the uterus. It can be non – hormonal Copper and hormonal Mirena or Kyleena.

Hormonal IUD works by thickening the mucus around the cervix and by thinning the womb lining, making it difficult to accept a fertilised egg. It can to a certain degree suppress ovulation – this is age-dependent.

Copper IUD makes a hostile environment in the uterus not allowing implantation but also acting as a spermicide.

Depo Provera Injections

Intramuscular injections containing large dose Progesterone and lasting 12 weeks.

Natural Family Planning Method

Natural family planning (NFP) or fertility awareness does not require medication, physical devices, or surgery to prevent pregnancy.

This method relies on the woman's body physiology to know the time of ovulation. This method involves monitoring different body changes such as basal body temperature or cervical mucus variations.

The woman then abstains from unprotected sex for approximately 7 to 10 days when she may have ovulated.

• Withdrawal - The withdrawal method involves the complete removal of the penis from the woman's vagina before ejaculation.
• Abstinence - Abstinence means not having sexual intercourse. It is the only birth control method that is 100% effective in preventing pregnancy as well as sexually transmitted diseases.

Surgical Methods

Sterilisation is a permanent solution and is meant for men and women who do not intend to have children in the future.

• Male sterilisation - involves vasectomy, a surgical blocking of the vas deferens, the tubes through which sperm pass into the semen.
• Female sterilisation - involves a tubal ligation, a surgical procedure that blocks the fallopian tubes which carry the eggs from the ovaries to the uterus.