Contraception

Contraception

Condoms:

Condoms are a popular form of barrier contraception used to prevent unwanted pregnancy and reduce the risk of sexually transmitted infections (STIs). Here are some key points to understand about condoms:

  • Definition and Types:
    • Condoms are thin sheaths made of latex, polyurethane, or natural materials (such as lambskin) that are worn over the penis during sexual intercourse or inserted into the vagina (known as female condoms).
    • Male Condoms: These are the most common type of condoms and are designed to fit over the erect penis.
    • Female Condoms: These are inserted into the vagina before sexual intercourse.
  • Effectiveness:
    • When used correctly and consistently, condoms are highly effective in preventing pregnancy and reducing the risk of STIs.
    • Male condoms have a typical use failure rate of around 13% for pregnancy prevention. However, with correct and consistent use, the failure rate can be as low as 2%.
    • Female condoms have a slightly higher typical use failure rate of around 21% for pregnancy prevention. With correct and consistent use, the failure rate can be reduced to around 5%.
  • Mechanism of Action:
    • Condoms act as a barrier, preventing direct contact between sexual fluids (such as semen and vaginal secretions) and the partner’s genitals.
    • They help prevent sperm from entering the vagina or reaching the cervix, reducing the chance of pregnancy.
    • Condoms also provide a barrier against skin-to-skin contact, reducing the risk of transmitting or acquiring STIs.
  • Proper Use:
    • Check the expiration date and ensure the condom is not damaged or expired before use.
    • Condoms should be used from start to finish of sexual intercourse, ensuring complete coverage of the penis or inserted into the vagina.
    • Use only water-based lubricants, as oil-based lubricants can weaken latex condoms and increase the risk of breakage.
    • After ejaculation and before the penis becomes flaccid, hold the condom at the base and carefully withdraw to prevent slippage or leakage.
    • Condoms should be stored in a cool, dry place, away from direct sunlight and extreme temperatures, to maintain their integrity.

Oral contraceptives

Oral contraceptives, also known as birth control pills or simply “the pill,” are medications taken orally to prevent pregnancy. Here are some key points to understand about oral contraceptives:

  • Mechanism of Action:
    • Oral contraceptives contain synthetic hormones, typically a combination of estrogen and progestin or progestin alone. These hormones work by:
      • Preventing ovulation: They inhibit the release of an egg from the ovary.
      • Thickening cervical mucus: They make it difficult for sperm to reach the egg.
      • Altering the uterine lining: They make it less receptive to implantation.
  • Types of Oral Contraceptives:
    • Combination Pills: These contain both estrogen and progestin. They are available in various formulations, including monophasic pills (with the same hormone levels throughout the pill pack) and multiphasic pills (with varying hormone levels).
    • Progestin-Only Pills (Mini Pills): These contain only progestin and are typically used by women who cannot tolerate or are advised against using estrogen-containing pills, such as breastfeeding mothers or women with certain medical conditions.
  • Effectiveness:
    • Oral contraceptives must be taken daily and on time for maximum effectiveness. Missing pills or taking them late may result in pregnancy.
    • Cycle control also depends on taking the pills regularly. If you miss pills or take them late you can experience breakthrough bleeding, cramping or other side effects.
  • Benefits:
    • Contraception: Oral contraceptives are primarily used to prevent pregnancy.
    • Menstrual cycle control: They can help regulate the menstrual cycle, reduce menstrual cramps, and lighten menstrual flow.
    • Acne management: Some oral contraceptives are FDA-approved for managing acne in certain individuals.
    • Reduced risk of certain conditions: Long-term use of oral contraceptives may offer protective effects against ovarian cancer, endometrial cancer, and ovarian cysts.
  • Side Effects and Considerations:
    • Common side effects may include breast tenderness, nausea, breakthrough bleeding, and mood changes. These symptoms often improve over time.
    • Oral contraceptives are generally safe for healthy women, but they are not suitable for everyone. Certain medical conditions or risk factors may require individual evaluation and discussion with a healthcare provider before starting oral contraceptives.
    • Oral contraceptives do not protect against sexually transmitted infections (STIs). The use of barrier methods (such as condoms) are necessary for STI prevention.

Nexplanon®

Nexplanon® is a contraceptive implant that provides long-acting and highly effective birth control. Here are some key points to understand about Nexplanon:

  • Implant Description:
    • The implant is a small, flexible rod about the size of a matchstick that is inserted under the skin of the upper arm.
    • It contains etonogestrel, a synthetic form of the hormone progesterone, which is gradually released into the bloodstream over a period of up to three years.
    • The implant is radiopaque, meaning it can be detected on an X-ray, which helps with its proper placement and removal.
  • Effectiveness:
    • Nexplanon® is one of the most effective forms of contraception, with a failure rate of less than 1%.
    • It provides continuous pregnancy protection for up to three years, making it a convenient option for those who prefer long-acting birth control without the need for daily pill administration or frequent visits for injections.
  • Mechanism of Action:
    • The implant primarily works by preventing ovulation, the release of an egg from the ovaries, thereby inhibiting pregnancy.
    • It also thickens cervical mucus, making it difficult for sperm to reach the egg, and thins the uterine lining, reducing the likelihood of implantation.
  • Insertion and Removal:
    • The Nexplanon® implant is inserted by a healthcare provider during a simple outpatient procedure. Dr Williams has special training and expertise in inserting and removing the implant.
    • Local anesthesia is used to numb the area before the implant is placed just under the skin of the inner side of the upper arm.
    • Removal is also performed by a healthcare provider and involves making a small incision to locate and remove the implant.
    • The procedure is relatively quick and straightforward, usually taking only a few minutes.
  • Benefits and Considerations:
    • Highly effective contraception: Nexplanon offers reliable and reversible birth control.
    • Convenience: Once inserted, there is no need for daily administration or frequent visits for contraceptive maintenance.
    • Reversibility: Fertility generally returns quickly after the implant is removed.
    • Side effects: Common side effects include changes in menstrual bleeding patterns, such as irregular bleeding, spotting, or even absence of periods. Other possible side effects include headaches, mood changes, breast tenderness, and weight changes.

IUD

An intrauterine device (IUD) is a small, T-shaped contraceptive device that is inserted into the uterus to prevent pregnancy. It is a highly effective and long-lasting form of birth control. Here are some key points about IUDs:

  • Types of IUDs: There are two main types of IUDs available:
    • Copper IUD: This type of IUD is made of copper and does not contain hormones. It works by creating an inhospitable environment for sperm, preventing fertilization. Copper IUDs can be used for up to 10 years, depending on the specific brand.
    • Hormonal IUD: This type of IUD releases a progestin hormone called levonorgestrel. It works by thickening cervical mucus, thinning the uterine lining, and sometimes suppressing ovulation. Hormonal IUDs are effective for 3 to 8 years, depending on the brand.
  • Both copper and hormonal IUDs are highly effective at preventing pregnancy. Their effectiveness rates are over 99%, making them one of the most reliable forms of contraception available.
  • IUD insertion is typically done by a healthcare provider during a pelvic examination. The procedure is usually quick and can cause some discomfort or cramping. Local anesthesia may be used to minimize discomfort, if needed.
  • Depending on the type of IUD, it can be left in place for several years. Copper IUDs can be used for up to 10 years, while hormonal IUDs can be effective for 3 to 8 years. After the recommended duration, the IUD should be removed or replaced.
  • While IUDs are generally safe and well-tolerated, some women may experience certain side effects, including:
    • Irregular bleeding or spotting: This is common during the first few months after IUD insertion, but usually resolves over time. Hormonal IUDs may also lead to lighter periods or even stop menstruation in some cases.
    • Cramping and discomfort: Some women may experience mild to moderate cramping or discomfort after IUD insertion. This typically subsides within a few days.
    • Expulsion: In rare cases, the IUD may be expelled from the uterus. It is important to check the position of the IUD periodically to ensure it is still in place.
    • Perforation: Rarely, during insertion, the IUD may perforate the uterus. This is a serious complication but occurs very rarely.
    • Infection: IUD insertion slightly increases the risk of pelvic infection, particularly in the first few weeks after insertion. This risk is minimized with proper insertion techniques and following post-insertion guidelines.
  • In addition to pregnancy prevention, hormonal IUDs may have non-contraceptive benefits such as reducing menstrual cramps, improving symptoms of endometriosis, and reducing the risk of certain uterine conditions.

It’s important to discuss all of your options with a healthcare provider to determine which is the right contraceptive choice for you.