Friday, 30 March 2012

Contraception choices (continued)

Aside the Top 5 Choices of Contraception there are still plenty of alternatives. In this article I will continue to discuss the choices ranked in popularity by netdoctor.co.uk.

Coitus Interruptus (Withdrawal Method)

The withdrawal method is a frequently contested method of contraception. It often has a failure rate of 15-28% resulted in more unwanted pregnancies compared to using medical contraceptives (including devices), it also does not protect against STIs either.

There is a lot of contention as to whether sperm is contained in the pre-cum of a man, however in the past studies have shown that it can exist but then another will disprove that fact. This may be one of the reasons for a high failure rate, along with experiencing poor timing and leaving small amounts of ejaculate in the women.

The withdrawal method can often be frustrating for both partners as they have to constantly think about when it is the right time to pull out. This can often cause a lot of emotional tension in a relationship so in a modern society where there are plenty of alternatives it would be wise to use them.

Contraception Resources

Contraception: Your Questions Answered
Contraception: A History

Rhythm Method or Fertility Awareness

This method is not a reliable form of contraception but can be useful with couples trying for a baby. This form helps to identify the stages of a women's menstrual cycle and recognize when she is at her most fertile. However, if her cycle is irregular then it will be less reliable in both instances. Also bear in mind that it does not protect against STIs either.

There are a few methods used in family planning but I will not go into any great detail on them:
  • The calender method: helpful in determining phases of a women's cycle
  • The temperature method: identifies when a women is ovulating as her temperature will increase by half a celsius
  • The mucus test: mucus will change in consistence depending on where a women is in her cycle
  • Ovulation tests: either through urine or saliva to try and identify a surge of estrogen
  • Persona: test the urine and glows green for 'go ahead' or red for 'don't have sex'
To find out how each method is used you can find more information from netdoctor or the NHS. 

Resources

Clearblue Fertility Monitor Test Sticks - 20 Pack
Cyclotest Temperature Fertility Monitor
Taking Charge Of Your Fertility: The Definitive Guide to Natural Birth Control, Pregnancy Achievement and Reproductive Health: The Definitive Guide to ... Pregnancy Achievement and Reproductive Wealth
The Fertility Awareness Handbook: The Natural Guide to Avoiding or Achieving Pregnancy

Implants and Injections

These are long-lasting effective (99%) forms of contraception. Both types work in the same way by releasing progesterone which stops ovulation, thickens the cervix mucus and thins the womb lining. These forms are great if you want to prevent pregnancy (they do not protect against STIs) and your fertility will return after you stop using them. However, some women experience headaches, weight gain, nausea and disrupted periods.

Although this form of contraception is widely used it may not be suitable for you if you have had, or still have some health problems; heart disease, liver disease, blood clots, breast cancer, migraines, diabetes, cirrhosis or osteoporosis. 

Implants

The only form available in the UK is know as Nexplanon. Implants are small (4cm) thin flexible tubes that contain progesterone that is inserted in the upper arm by a Doctor or nurse. It can be used for up to three years or if you are older you may reach menopause by which time you can have it removed.

Injections

These are normally given in a muscle in your bottom or upper arm. There are currently two types of injection on the market at the moment:
  • Depo-Provera - effective for up to 12 weeks
  • Noristerat - effective for up to 8 weeks
It is important to get you injections done at the same time everyday otherwise it will not be as effective.

Resources

The Pill and other forms of hormonal contraception: The Facts
Your Guide to Contraceptive Injections
Long Acting Injections and Implants (Advances in Delivery Science and Technology)

Contraceptive Patch

This device is a 5x5cm patch that sticks to a women's arm and releases estrogen and progesterone into the blood stream. It is over 99% effective, however does not protect against STIs. The patches are replaces every week and on every fourth week you do not wear a patch so you can have a withdrawal bleed.

The patch may not be suitable for the following women with these health conditions:
  • Over 90kg (14 stone)
  • Might be pregnant
  • Breast feeding
  • Smoke and are over 35 years old
  • Blood clots
  • Heart problem
  • Migraines
  • Breast cancer
  • Liver or gall bladder disease
  • Diabetes
The patch will also not be effective if you take antibiotics, St Johns Wort or medicines used to treat epilepsy, TB or HIV.

More Information


Diaphragms and Caps

Both of these devices are barrier methods that stop sperm from reaching an egg. The diaphragm is a dome  that fits inside the vagina: caps are similar just smaller.

When used in combination with spermicide (and left in for the recommended six hours after sex) these methods can be 92-99% effective and they do offer some protection from STIs.

Products


Vaginal Ring

The ring is inserted on the first day of a women's period and lasts for 21 days. This form of contraception is 99% effective and works by continually releasing estrogen and progesterone into the bloodstream. However, it does not protect against STIs. As with the patch there are certain factors that will prevent some women from using it (see above).

Products

So that covers the methods and devices used to prevent pregnancy and to also help prevent (in some cases) STIs. However, there are often times when there will be unprotected sex or when the contraceptive has failed, in this instance Emergency Contraceptives are available.

Emergency Contraceptives

There are two methods to prevent against unwanted pregnancy after unprotected sex:
  • The morning after pill
  • The copper intrauterine device

Morning After Pills

There are two types of pill available:
  • Levonelle: can be taken up two 3 days and is available free of charge on prescription or bought from your local pharmacy
  • ellaOne: can be taken up to 5 days and is only available on prescription
The effectiveness of emergency contraception decreases over time; within 24 hours it prevents 95% of pregnancies.

Copper Intrauterine Device (IUD)

Most women can use this as emergency contraception particularly if you cannot take hormones or are on certain medication such as epilepsy drugs.

What You Always Wanted To Know About Emergency Contraception

So that concludes my posts on contraceptive options and I hope they have been some use.

Related links:

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