Know Your Contraception Options
Few people talk about sex in our society, and even fewer talk about contraception, or birth control. But understanding contraception options has many benefits for women, from giving you more control over your body to clearing your skin and much more.
We tend to think of contraceptive methods as being used to prevent pregnancy. This is, of course, an important reason why many women use it, but it’s not the only one: Certain types of contraception can help control acne, reduce period cramps and bleeding, protect against ovarian and uterine cancers, manage polycystic ovary syndrome (PCOS) and endometriosis in addition to preventing pregnancy.
Whatever your reason, it’s important to use the method right for you. We spoke to Dr. Bilsi Mittal, a gynaecologist in Mumbai, who helped us understand contraception options available in India. Here, we introduce them to you. But as always, consult your personal gynaecologist before starting any medication.
HORMONAL VS. NON-HORMONAL
Birth control options come in two broad categories: those that involve hormones, and those that do not. Hormonal methods, which use synthetic hormones progestin (progesterone) and/or estrogen, cause your body chemistry to mimic pregnancy for the three weeks between menstruation, thereby preventing actual fertilization and implantation of an egg. Hormonal methods (namely ‘The Pill’) prevent pregnancy, but can also manage certain medical conditions by regulating progesterone and estrogen levels and counterbalancing other hormones.
The advantages of hormonal methods lie in their ability to treat certain conditions as well as to potentially lower your risk for some cancers. But there are also potential downsides; certain medication can interfere with the effectiveness of the hormones, so advise your doctor of any other medication you may be taking. Different hormones affect people uniquely, so what doesn’t cause side effects for a friend may have side effects for you; with your doctor’s guidance, you may need to try multiple methods over time to find the right one for you. And long-term use of hormonal birth control is linked to increased risk of cervical, breast and liver cancers. Finally, hormonal methods don’t protect against sexually transmitted diseases.
Non-hormonal contraception is just that—sans hormones. These methods work either by creating a physical barrier or hostile environment to sperm, thus preventing fertilization. Their sole purpose is to prevent pregnancy. The most common method is the condom, the only method of birth control that also guards against STDs.
This is one of the most common contraceptive methods and it requires a prescription from a doctor. “The Pill” is a series of tablets containing small doses of hormones, which you take at the same time each day. There are two types of pills – monophase, in which the hormone dosage remains the same over the 21-day course, and multiphase, in which the hormone levels increase slightly throughout. With a monophase pill, you can skip a period by starting a new pack after three weeks. Otherwise, there are no clear advantages or disadvantages to either type; discuss what’s right for you with your doctor.
The pill is also the most commonly prescribed type of contraception to treat conditions described above.
Effectiveness at preventing pregnancy: 99.7% when taken properly.
The vaginal ring is a thin, soft, flexible ring of plastic, about 2 inches across, that you insert into the vagina yourself. It stays in your body for 3 weeks, releasing hormones into your tissue, and is removed for one week for your period. Like the monophasic pill, if you want to delay or skip a period, you can replace the ring with another at the end of the 3 weeks. The ring requires a prescription.
Effectiveness at preventing pregnancy: 99+% when taken properly.
Hormone injections abbreviated as DMPA contain progestin. You get one DMPA injection from a doctor every 12 to 14 weeks, which means you will have roughly four periods a year. These shots do have one drawback other hormonal methods do not: Women who want to get pregnant may take several months to conceive after stopping the injections.
Effectiveness at preventing pregnancy: 94-99%.
IUDs (intra-uterine devices) are small, T-shaped devices inserted in the uterus by a trained doctor. You’ll meet with the doctor twice: Once for insertion, and the second time a few weeks later to make sure the device has not shifted. Over the course of 3 to 5 years, the device releases hormones that inhibit sperm mobility, egg fertilization and implantation. You may or may not continue to have your period while using the hormonal IUD; if you do, it may reduce cramps and bleeding. If you want to get pregnant, a doctor can remove the IUD at any time.
Effectiveness at preventing pregnancy: 99.9%.
Commonly known as a Copper-T, the copper IUD is also inserted into your uterus by a trained doctor, with a follow-up appointment to check its positioning. Copper ions, which mix with uterine fluids, are toxic to sperm (but otherwise safe). Copper IUDs can remain in the body for up to 10 years, which means you don’t have to worry about taking pills, changing rings, or getting shots. You will continue to have regular periods while using the Copper-T (though it may make them heavier or more painful for the first few months). If you want to get pregnant, a doctor can remove the IUD at any time.
Since copper is an element foreign to the body, there is a slight risk of infection for the first few weeks after insertion, making the typical follow-up after IUD insertion extra important.
Effectiveness at preventing pregnancy: 99+% over 10 years.
Condoms act as a physical barrier to the uterus. Their main benefit is that they provide protection against STDs—no other form of birth control does. Condoms are made of latex (most commonly), polyurethane, and lambskin. If you or your partner has a latex allergy, the latter two are the ones to use. But note that lambskin condoms do not protect against viral STDs like HIV and herpes.
Effectiveness at preventing pregnancy: 98% when used properly.
The sponge is a small, flexible, foam disc that contains spermicide. Like the vaginal ring, you can insert the sponge into your vagina yourself. It can stay there for up to 24 hours, preventing pregnancy regardless of how many times you have sex. It prevents pregnancy in two ways: The sponge itself acts as a physical barrier to the uterus and the spermicide kills sperm. While you can buy a sponge without a doctor’s prescription, discuss it with your doctor first, particularly if you are allergic to sulphites or are nursing.
Effectiveness at preventing pregnancy: 90% when used properly by women who have not given birth; 80% when used properly by women who have given birth.