Contraception is the prevention of conception or
pregnancy by using various methods, devices, drugs or surgical
procedures. Contraception allows us to enjoy sexual life without
worrying about an unwanted pregnancy. Due to the research and
resulting medical discoveries and inventions, there are presently
many ways to prevent a pregnancy. You should seek professional
advice for the best of choice, as the method chosen will be depend
on individual's health, social life style and interval to her next
pregnancy. All contraceptive methods are created based on two
concepts; prevents fertilization or embryo implantation.
Let us have a look on the contraceptives available. Thanks
to contraceptive, we enjoy recreation without procreation.
- This OCP contains synthetic estrogen and
progestogen (progesterone-like hormone).
- It stops ovulation, makes endometrium (lining
of the womb) thin so that embryo implantation is unlikely to occur
and the cervical mucus thick so that it is difficult for the sperm
to swim through the mucus into the uterine cavity.
- It tends to make menses very short in duration
and scanty in amount.
- It may produce headache, sensation of nausea
and slight weight gain during the initial period of usage.
- It is taken around the same time everyday for
21 days continuously, followed by a 7-day break (that's when menses
usually occurs). After the 7-day break, a new course of pill begins.
- This OCP can be bought at the pharmacy or
clinic.
- Examples are: Nordette, Microgynon,
Marvelon, Mercilon and Gynera.
- Failure rate: 0.1%
(ii) Progesterone-only pills (mini pills)
- Mini pills contain progesterone hormone
only
- It makes the endometrium thin and the cervical
mucus thick. Sometimes it stops ovulation as well.
- The menses will be very short and scanty. The
menstrual cycle will be very irregular. This makes the mini pills
unpopular among OCP users.
- It is considered a "milder" pill, freer of
major side-effects, but is less effective compared to combined oral
contraceptive.
- It is taken every single day of the year
without break in between.
- Post coital pills are used for pregnancy
prevention after unprotected sex, forced intercourse or suspected
contraceptive failure such as ruptured condom.
- It is taken within 72 hours (3 days) after
sexual intercourse.
- It is not as effective as ongoing
contraceptives.
- It should not be used as regular contraceptive
because of its high failure rate.
- Example: Postinor
- Failure rate: 5%
- An alternative way of emergency contraceptive
is by insertion of IUCD in the first 4 days after unprotected
intercourse.
IUCD is a small device (3cm in length), which is placed inside the
womb to induce an inflammatory reaction in the adjacent
endometrium so that no embryo implantation occurs.
The IUCD insertion is best done immediately after menstruation has
stopped, at the same time following termination of pregnancy or
during postnatal examination (1 month after delivery).
There are 2 types of IUCD
(i)
Copper IUCD
- It
contains copper which helps to inhibit the sperm from entering the
Fallopian tubes.
-
Its effectiveness is best for 3 years after insertion.
-
The menstrual flow will be heavy and prolonged for few months
after insertion.
-
Failure rate:< 1%
(ii) Progestogen IUCD (Intrauterine Contraceptive System)
- It
contains Levonorgestel (progesterone-like hormone) which makes the
cervical mucus thick and forbids the sperm from entering the womb.
-
Its effectiveness is best for 5 years after insertion.
-
Its advantage over the copper IUCD is that the menstrual flow will
be lighter and less cramping.
Implanon is a
small white matchstick-like rod contains etonogerstel which is
inserted under the skin of upper arm.
It is inserted by
trained doctor under local anaesthesia
It stops
ovulation, makes endometrium (lining of the womb) thin so that
embryo implantation is unlikely to occur and the cervical mucus
thick so that it is difficult for the sperm to swim through the
mucus into the uterine cavity.
It is effective
for 3 years. At the end of the 3 years, it is renewed under local
anaesthesia.
The menstrual flow
will be light and less cramping.
It may lead to
irregular cycle or amenorrhea (no menses for a few months)
This injection contains progesterone-like hormone
which prevents woman from ovulating (release mature egg).
It is injected at the buttock at 2 months
interval between the first and second dose and subsequently every 3
months.
It will make the menses short and scanty which
may lead to irregular menstrual cycle or amenorrhea (no menses for a
few months). This is a common reason for discontinuation of usage.
Vasectomy is minor surgery which blocks the vas deferens (the
tubes that carry man¡¯s sperm from testis to urethra) by cutting
and tying off the vas deferens.
It
is a day care procedure and is done under local anaesthesia.
There will be some pain or discomfort for several days in the
scrotum area post-vasectomy. Firm supporting underwear will help
to relieve the discomfort.
Contraception is not immediate. You will need to use an
alternative contraceptive method until your semen is free of
sperm. Semen analysis is done 3 months after the surgery to
confirm that the semen is free of sperm.
Vasectomy does not affect sex drive or ability to enjoy sex. The
semen produced is slightly reduced.
It
is less expensive and causes fewer complications compared to tubal
ligation on the female.
It
is an irreversible contraceptive. You must ensure that you do not
plan to have additional children and will not change your mind on
this.
Based on the assumption that the egg's capability
to be fertilized lasts for only 24 hours (1 day) after it is
released from the ovary and the sperm's capability to fertilize the
egg lasts for only 72 hours (3 days) after deposited in the vagina.
This method is only applicable to those ladies
who have regular 28 to 30 days menstrual cycle.
Ovulation (releasing of the mature egg) occurs
between Day 12 and Day 16 of a regular 28 days menstrual cycle. So,
the potential fertile period is between Day 9 (=12-3) and Day 17
(=16+1) of the cycle. In other words, you should avoid sexual
intercourse from Day 9 until Day 17 to prevent an unwanted
pregnancy. (Day 1 is the first day of menses)
During the fertile period (Day 9 to Day 17),
condom can be used during sexual intercourse.
An attempt may be made to pin-point the time of
ovulation by:
(i) recording the basal body temperature (BBT)
immediately after wake up every morning. A rise in temperature of
about half a degree Fahrenheit suggests that ovulation has occured.
(ii) noting the changes of your cervical mucus.
The mucus becomes less viscous, more watery and stingy around
ovulation time.
Breast feeding has contraceptive effect by
delaying ovulation and menstruation.
It is effective when you are exclusive breast
feeding (without supplement feeding to your newborn) for the first 6
months after delivery and before the menses returns.
It is unreliable after the first 6 months when
the baby starts to take solid food.
