Thursday 7 July 2011

Choosing a Contraceptive Method

There is no single form of birth control that is ideal for all women of all ages. The best form of birth control really depends on the individual.

For example, the priorities of women in their late teens vary greatly from women in their thirties. Women in stable relationships are usually less likely to be at risk of contracting sexually transmitted diseases (STDs) in contrast to younger, single women, therefore their preferred method of birth control may differ.

When choosing a method of contraception, the most important aspect to be sure of is that it works well for you and your lifestyle. If your chosen form of birth control is easily integrated into your life, the risk of complications or inconveniences is greatly reduced. Often, women practice several forms of birth control throughout their fertile lives because their lifestyles change.

It is always recommended to speak with your doctor, family planning consultant and partner before starting any new form of contraception.



Barrier Methods of Contraception


Barrier methods of contraception refer to objects which put a physical impediment between the sperm and the female reproductive track. Of all the barrier methods available, male condoms are most popular. Condoms are latex or polyurethane sheaths which are placed over the penis prior to intercourse. The less popular female version of the condom is also made of polyurethane and has one flexible ring at each end. One of these secure behind the pubic bone to hold the condom in place and the other stays outside the vagina.

Other forms of female barrier contraceptives are cervical barriers, contraceptive sponges and cervical caps. Cervical barriers are contained within the vagina and contraceptive sponges are kept in place over the cervix.

The smallest cervical barrier is the cervical cap. Normally, the cap stays in place by attaching itself to the cervix or vaginal walls using suction. Diaphragms fit behind a woman’s pubic bone. They have a flexible ring which helps keep it in place against the vaginal walls. For extra protection, spermicide may be placed inside the vagina before intercourse when using diaphragms. Spermicide may also be used alone, without a diaphragm, to create a chemical barrier or in conjunction with another physical barrier.


Hormonal Contraceptives

Hormonal contraceptives come in many forms and are generally made up of of synthetic oestrogens and progestins (synthetic progestogens). The most common of these include oral contraceptive pill (‘the pill’), the patch, the contraceptive vaginal ring (‘NuvaRing’) and a monthly injection such as Lunelle, which is not currently available for use in the USA.

Other forms of hormonal birth control only contain a progestin (synthetic progestogen). The progesterone only pill (also know as POP or ‘minipill’) is one of the most popular among these types of birth control. The progesterone pill differs from the ‘the pill’ in that it must be taken at much more precise times in order to be effective. Other common forms of progestin contraceptives include tri-monthly injections (Depo Provera, which is a depot formulation of medroxyprogesterone acetate adminstered as an intramuscular injection), Noristerat (Norethindrone acetate administered as an intramuscular injection every 8 weeks) and contraceptive implants. These forms of progestin-only contraception may cause irregular bleeding.


Intrauterin Methods - The Coil

Intrauterin methods refer to contraceptive devices which are placed inside the uterus and are usually shaped like the letter ‘T’. The arms on of the ‘T’ hold the device in place. Frame-less intrauterin devices (IUDs), such as GyneFix, are also available and are less likely to cause complications. The two main types of IUDs are those that release progestin (a synthetic progestogen) and those that contain copper.

Because there are ten types of copper IUDs in the UK and only one in the US, the terminology to describe these devices differ between the two countries. In the United States, all devices placed in the uterus to prevent pregnancy are referred to as intrauterine devices (IUDs) or intrauterine contraceptive devices (IUCDs). In the UK, only copper containing devices are referred to as IUDs (or IUCDs). Hormonal intrauterine contraceptives are called Intra-Uterine System (IUS).


Coitus Interruptus

'Coitus Interruptus’ literally translates to ‘interrupted sexual intercourse’ and is also referred to as the withdrawal or pull-out method. Coitus Interruptus is accomplished by ending sexual intercourse (pulling out) before ejaculation and involves certain risks. First, the man may not complete the maneuver on time or he may do it incorrectly. Concern has been raised in the past concerning the risk of pregnancy from pre-ejaculate sperm, but several small studies have failed to find any viable sperm in the fluid.


Lactational Amenorrhea Method (LAM)

The Lactational Amenorrhea Method (LAM) can only be practiced by new mothers who are currently lactating. In order to save the strength of a new mother, the body was designed to switch off fertility after birth so the new mother could breast feed the child without the added stress of periods.

According to a Planned Parenthood study conducted in 2005, for women who meet the following criteria, LAM is 98% - 99.5% effective during the first six months after pregnancy.

  • The infant must obtain all of its nutrients (or almost all) from breastfeeding.
  • Pumping instead of nursing and feeding formula to infants reduce the effectiveness of LAM.
  • The infant must be breastfeed every four hours during the day and every six hours at night.
  • The infant must be less than 6 years old.
  • The mother must not have had a period for 56 days after giving birth (when determining fertility, bleeding prior to 56 days postpartum can be ignored).


  • Fertility Awareness for Contraception

    Like LAMs, Symptoms-based Fertility Awareness Methods (FAM) are natural ways to practice contraception. FAMs involve a woman observing and monitoring her body’s fertility symptoms in order to determine the fertile and infertile days of her cycle. In order to monitor correctly, a women must record the fertility signs manually or by using software.

    When a women measures her basal body temperature in combination with an additional indicator of fertility, she is implementing what is known as the ‘symptothermal’ method of contraception.

    Many women choose to employ the assistance of contraceptive monitors when practicing this form of contraception. Contraceptive monitors are tiny computers which identify the fertile and non-fertile phase of a woman’s cycle by measuring body temperature or analysing urine.

    Contraception is also practiced using calender-based methods such as the standard days method and the rhythm method. These practices use the length of past menstrual cycles to predict the likelihood of fertility.

    In order for FAM to work as an effective form of contraception, many people choose to abstain from unprotected sex or use physical barrier methods of contraception, such as condoms, during their fertile periods.

    Natural Family Planning (NFP) is often associated with FAM, and specifically refers to forms of contraception permitted by the Roman Catholic Church.

    FAMs are often used by those practicing NFP in order to identify their fertile and non fertile phases of their cycle.




    Conclusion

    Now that you have a better understanding of all the different forms of contraception available, choosing the one that’s right for you should be less challenging. Remember that there are many things to consider before choosing a method of contraception and you should always consult your doctor before starting any kind of regime.

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