Family Health Diary

Avoiding an unplanned pregnancy
Today there is a wide range of different contraceptive methods to choose from, each with different benefits. Choosing the correct contraception is best done with professional advice from your GP or Family Planning Clinic.

Contraceptive choices
A condom is a mechanical latex barrier which is rolled over the erect penis to form a physical barrier between the penis and the vagina, preventing sperm from entering the vagina. Condoms are also necessary for “safe sex” practice in situations that may expose a person to the possibility of a sexually transmitted infection such as chlamydia, herpes or HIV. A new condom must be used for each act of intercourse, and must be applied to the  penis before there is any contact between the penis and vagina in order to prevent pregnancy or infection.

Condoms are 98% effective when used as recommended, but have a higher failure rate in the first year of use. While they are a convenient, non-invasive and affordable form of contraception, some men complain of reduced sensitivity when using a condom.

Diaphragm and Cervical Cap
Diaphragms and Cervical Caps are both barrier methods of contraception in which a rubber device is fitted into the vagina prior to intercourse and left in place for several hours after sex. The diaphragm is a dome-shaped cup with a flexible rim, which fits over the cervix and rests behind the pubic bone, preventing sperm from reaching the uterus. The cervical cap is a smaller rubber device resembling a large thimble, which is fitted over the neck of the cervix, creating a barrier against sperm. Both devices should be used with spermicide.

Intrauterine Contraceptive Device (IUD)
An IUD is a small device made of plastic together with either a band of copper or synthetic progestogen, which is inserted into the uterus by an experienced doctor. It can be changed after five years or removed at any time to allow conception, which is not delayed at all. The IUD has a fine string attached to it by which it is removed. The IUD prevents conception by preventing fertilisation, or by interfering with the ability of a fertilised egg  to embed into the lining of the uterus.

The Oral Contraceptive Pill (OC)
Over 60 million women around the world use this form of hormonal contraception. The combined pill contains two hormones, oestrogen and progestogen, in varying combinations. The pill prevents pregnancy by preventing ovulation. The advantages of the pill include a high efficacy rate of 98%, regular and often lighter periods, and convenience. A disadvantage of the pill for those not in monogomous relationships is its inability to prevent STIs. In these instances, a condom must be used in conjunction with the pill.

The Mini Pill (progestogen only pill)
This contraceptive pill contains progestogen only and works by thickening the cervical mucus making it inhospitable to sperm. Unlike the OCP the mini pill must be taken within 3 hours of the same time of day to guarantee effectiveness of about 95%. Cycle irregularity can be a problem with erratic bleeding or no period. The mini pill is suitable for use during breastfeeding, and is useful for women for whom the OCP is not suitable.

Male and female sterilisation
This permanent form of contraception involves surgery, and in the case of female sterilisation, a general anaesthetic. Sterilisation is not easily reversible and the failure rate is less than 1%. In male sterilisation (vasectomy), the sperm-carrying tubes are cut to stop the sperm leaving the  testes. It is a minimally invasive procedure involving local anaesthetic and full recovery is within a couple of days. Long-term side-effects are rare with vasectomy. For women undergoing tubal ligation, clips are put on the tubes between the ovaries and uterus. In the long-term, tubal ligation may result in heavier and more painful periods for some women.

Contraceptive implants
This form of contraception involves a doctor implanting two small, soft, plastic rods under the skin of the upper arm. The rods contain progestogen (active ingredient levonorgestrel) which is released in tiny doses and the implant is effective for five years.

Your doctor will use a local anaesthetic as a small incision needs to be made to insert the rods. The local anaesthetic means you should not feel any pain.
The implant can be removed at any time, but this must be done by a doctor. Contraceptive implants are almost 100 per cent effective at preventing pregnancy.

The implant works by preventing ovulation, by thickening the mucus of the cervix, which prevents sperm from entering, and by thinning the lining of the uterus which makes implantation of an egg less likely.

Implants are among the most effective contraceptive methods. When used correctly the chance of becoming pregnant is very low and is estimated at less than 1 per cent.

Less popular forms of contraception
Other forms of contraception include hormonal injections, and those with a higher failure rate such as natural family planning, coitus interruptus (or withdrawal) and spermicidal creams, gels and foams. Abstinence is also used by some couples.

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