2. How to decide
⢠Do you need to protect against STDs?
⢠How important is convenience?
⢠What about effectiveness? Only abstinence is
100% effective, but other methods come close.
With so many options, choosing
a form of contraception can be
daunting. Begin with a few
questions:
3. Fertility awareness
Fertility awareness - Also called natural family
planning, fertility awareness means avoiding
sex when the woman is most fertile.
The most reliable way to do this is to watch
for changes in cervical mucous and body
temperature. To use this method correctly,
it's best to get training from a health care
professional.
ADVANTAGE:No medications or devices.
DISADVANTAGE: Limits spontaneous sex, less
reliable than pill or sterilisation.
4. Spermicide
Frequent use may cause tissue irritation,
increasing the risk of infections and STIs.
Spermicides are most often used along with
other contraceptive methods
ADVANTAGE: Easy to use.
DISADVANTAGE: May increase the risk of STIs,
best used with backup method.
Spermicide contains a chemical that kills sperm. It comes in the
form of foam, jelly, cream, film, sponge or pessary that is
placed inside the vagina before sex. Some types must be put in
place 30 minutes ahead of time.
5. Male condom
The latex condom is the classic barrier
method. It prevents sperm from
entering the woman's body
protecting against pregnancy and
against STDs.
Condoms are about 85% effective but
can be up to 99% effective with proper
use.
ADVANTAGE:Widely available,
protects against STIs.
DISADVANTAGE: Only effective if used
correctly every time. Canât be reused.
6. Female condom
The female condom is a thin plastic pouch that
lines the vagina and can be put in place any
time before sex but before the penis comes
into contact with the vagina or genital area.
Users grasp a flexible, plastic ring at the
closed end to guide it into position. It's
somewhat less effective than the male
condom.
ADVANTAGE:Widely available, some
protection against STIs, conducts body heat
better than a male condom.
DISADVANTAGE: Can be noisy, five out of 100
users get pregnant, not reusable. Should not
be used with a male condom, to avoid
breakage.
7. Diaphragm
The diaphragm is a rubber dome that is
placed over the cervix before sex. It is
used with a spermicide.
If used correctly, they are estimated to be
92-96% effective in preventing pregnancy.
ADVANTAGE:One device can last two
years.
DISADVANTAGE: Must be fitted by a
doctor, no STI protection. Can't be used
during your period due to a risk of toxic
shock syndrome.
8. Cervical cap
A cervical cap is similar to a diaphragm,
but smaller.
The cap slips into place over the cervix,
blocking entry into the uterus. It is used
with spermicide. The success rate is
similar to that of the diaphragm.
ADVANTAGE:Can stay in place for up to
48 hours.
DISADVANTAGE: Initially must be fitted
by a doctor, no protection against STIs.
Canât be used during your period.
9. Contraceptive sponge
The contraceptive sponge is made of foam
and contains spermicide. It is placed
against the cervix up to 24 hours before
sex. The sponge is around 90% effective,
but unlike the diaphragm or cervical cap,
no fitting by a doctor is required.
ADVANTAGE:No prescription, effective
immediately.
DISADVANTAGE: Difficult to insert
correctly, no STI protection. Can't be used
during your period.
10. Contraceptive pill
The most common type of contraceptive pill
(combined pill) uses the hormones oestrogen
and progestogen to prevent ovulation.
The other type of pill is the progestogen-only
pill (POP). When taken on schedule, the pill is
over 99% effective at preventing pregnancy.
ADVANTAGE:More regular, lighter periods or
no periods, depending on the type of pill. Less
period pain.
DISADVANTAGE: No STI protection. May cause
side effects, including breast tenderness,
spotting, serious blood clots and raised blood
pressure. Some women should not use
contraceptive pills.
11. Contraceptive patch
Women who have trouble remembering a daily
pill could consider the contraceptive patch.
The patch is worn on the skin and changed only
once a week for three weeks with a fourth
week that is patch-free.
The patch releases the same types of hormones
as
the contraceptive pill and is just as effective.
ADVANTAGE:More regular, lighter periods with
less period pain, no need to remember a daily
pill.
DISADVANTAGE: May cause skin irritation or
other side effects similar to contraceptive pills.
Doesn't protect against STIs.
12. Vaginal ring
The vaginal ring is a soft plastic ring that is
worn inside the vagina.
The ring releases the same hormones as
the pill and patch and is just as effective It
is removed every 21 days and replaced a
week later following a "ring-free" week.
ADVANTAGE:Lighter, more regular periods,
only replaced every month.
DISADVANTAGE: May cause vaginal
irritation or other side effects similar to
pills and the patch. Doesnât protect against
STDs.
13. Contraceptive injection
The contraceptive injections, known as Depo-
Provera and Noristerat, are hormonal
injections.
Depo-Provera protect against pregnancy for
up to 12 weeks, and Noristerat protects
against pregnancy for up to eight weeks.
Both Noristerat and Depo-Provera are 99%
effective in preventing pregnancy.
ADVANTAGE:Only injected a few times a
year, highly effective.
Cons: May cause spotting and other side
effects. Doesn't protect against STIs.
Prolonged use of Depo-provera may increase
risk of osteoporosis.
14. Contraceptive implant
The contraceptive implant is a matchstick-
sized rod that is placed under the skin of the
upper arm.
It releases the same hormone thatâs in the
contraceptive injection, but the implant
protects against pregnancy for three years.
It is highly effective.
ADVANTAGE:Lasts three years, highly
effective.
DISADVANTAGE: May cause side effects,
including irregular bleeding. Doesn't protect
against STIs.
15. IUDs and IUSs
IUD stands for intrauterine device, a T-
shaped piece of plastic that is placed inside
the uterus by a doctor.
IUDs contain copper and can remain in the
uterus for five to 10 years. An IUS, or
interuterine system, is a similar T-shaped
device that contains the hormone
progestogen. It can remain in place for up to
five years. Both types make it more difficult
for sperm to fertilise the egg and are 99%
effective.
ADVANTAGE: Long-lasting, low-maintenance.
DISADVANTAGE: Side effects can include
painful or heavy periods.
16. Sterilisation - Tubal ligation
If you're sure you won't want biological
children in the future, you may be ready
for permanent sterilisation.
The traditional method for women is
called tubal ligation or "having your
tubes tied." A surgeon closes off the
fallopian tubes, preventing eggs
from making their journey out of the
ovaries
ADVANTAGE:Permanent, nearly 100%
effective.
DISADVANTAGE: Requires surgery, may
not be reversible. Doesn't protect
against STDs.
17. Sterilisation - Tubal implants
A newer procedure makes it possible to
block the fallopian tubes without surgery.
Small implants of metal or silicone are
placed inside each tube. Scar tissue
eventually grows around the implants
and blocks the tubes. Once an X-ray
confirms the tubes are blocked, no other
form of birth control is needed.
ADVANTAGE:Permanent, no surgery,
almost 100% effective.
DISADVANTAGE: Takes a few months to
become effective. May increase the risk
of pelvic infections, irreversible.
18. Vasectomy
Besides condoms, a vasectomy is the
only birth control option available to
men.
It involves surgically closing the
vasdeferens â the tubes that carry sperm
from the testes, through the
reproductive system. This prevents the
release of sperm but doesn't interfere
with ejaculation.
ADVANTAGE:Permanent, almost 100%
effective.
DISADVANTAGE: Requires surgery, not
effective immediately, may not be
reversible.
19. Emergency contraception
Emergency contraception works after
unprotected sex to help avoid pregnancy.
This is an option if a woman has had
unprotected sex or suspects her usual
method failed.
Though it is often called the "morning
after pill", the Levonelle (prescription-
only) or Levonelle One Step (over the
counter levonorgestrel) pill can be taken
up to 72 hours (up to three days) and the
ellaOne pill (prescription âonly) up to 120
hours (up to 5 days) after unprotected sex
or contraception method failure.
The IUD (coil) can be fitted up to five days
after unprotected sex or contraception
method failure as emergency
contraception.
20. Withdrawal
Pulling out before the man ejaculates,
known as the withdrawal method, is not
a foolproof method of birth control.
Some ejaculate (fluid that contains
sperm) may be released before the man
actually begins to climax.
In addition, some men may not have the
willpower to withdraw in time.
ADVANTAGE:Free, no need for devices or
hormones.
DISADVANTAGE: Hard to do correctly. No
protection against STIs.
