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Family planning: talking contraception after marriage
Words Ebun Lufadeju
"Where can I go to get contraception?" "Which method of contraception is best for me?"
Around the world, people are resorting to dangerous, ineffective methods to prevent pregnancy, such as vinegar, alcohol, sponges, plastic bags, laundry soap, to name a few. These unsafe methods are an indication of the enormous need for family planning access and education.
Starting a family can be exciting as well as nerve-wracking for women. My role as a Pharmacist involves answering questions and providing practical information. This guide will aim to answer some of the most common questions.
What is contraception?
Birth control, also known as contraception, is a method, medication or device used to prevent pregnancy. It has been used since ancient times, but effective and safe methods of birth control only became available in the 1900s.
Using no contraception, typically 85 in 100 women will get pregnant in one year. Every woman has a different reason for wanting to use contraception and the question of whether to use contraception and which one to use is always down to the individual. It is always important to weigh the advantages and disadvantages, to see what method suits best.
What types of contraception are available?
Condoms
Advantages
The only way to protect yourself against sexually transmitted infections (STIs) is to use a condom every time you have sex.
A male condom is 98% effective, and a female condom is 95% effective if used correctly.
Generally, there are no medical side effects from using condoms.
Disadvantages
Condoms are very strong but may split or tear if not used properly, this can lead to an unplanned pregnancy.
Some people may be allergic to latex, which can cause an allergic reaction.
Latex condoms can cause vaginal dryness, having sex with condoms can be uncomfortable for women.
Caps/Diaphragms
Advantages
If a diaphragm is correctly inserted with spermicide, it is 92-96% effective at preventing pregnancy.
You can insert a diaphragm or cap at a convenient time before having sex, using extra spermicide if you have it in for more than 3 hours
Disadvantages
A diaphragm or cap does not provide reliable protection against sexually transmitted infections (STIs)
It can take women time to learn how to use it and is only effective when used correctly.
It can interrupt sex and the latex can cause allergic reactions/irritation
Combined Pills
Advantages
The pill can usually make period bleeds regular, lighter and less painful
The combined pill can help with the management of symptoms of polycystic ovary syndrome (PCOS), endometriosis and premenstrual syndrome.
There is a reduced risk of ovarian, endometrial, and colorectal cancer for some women.
It has been shown to reduce acne.
Disadvantages
The pill has been linked to an increased risk of blood clots and breast cancer.
The pill must be taken every day and missing pills make the combined pill less effective, increasing the risk of pregnancy.
It may not be suitable for women who are 35 and older and women who smoke.
Progesterone-only Pills
Advantages
The POP is 99% effective if taken correctly.
You can take the progestogen-only pill if you are over 35, unlike the combined pill.
The progestogen-only pill is safe to use if you are breastfeeding or intend to breastfeed.
Disadvantages
Some common side effects may include spotty skin, mood changes, headaches and breast tenderness, although these should clear up within a few months.
You may not have regular periods while taking the POP.
Natural Family Planning
Advantages
If followed correctly, family planning can be 99% effective.
You do not have to use a device or remember to take any medication.
There are no physical side effects
Disadvantages
Fertility signals can be affected by factors such as illness, stress, and travel.
Family planning takes a lot of commitment and can be much less effective than other methods of contraception if it is not followed correctly.
Women who choose family planning must keep a daily record of fertility signs.
IUD/IUS
The IUD is a small copper coil. The IUS releases the hormone progestogen.
Advantages
The IUD/IUS devices can last up to 3-5 years.
When used correctly, the devices are 99% effective.
You and your partner should not be able to feel the device during sex.
Disadvantages
There is a chance of infection after the devices are fitted.
There is a risk of pain and vaginal bleeding associated with the devices.
Periods can be irregular and may stop completely.
There is a small risk of rejection after the device has been fitted.
Contraceptive Implant
Advantages
The implant is 99% effective if used correctly.
Once placed in the arm it can last 3 years without having to remember about it every day.
You can have it removed at any time and fertility will return to normal.
Disadvantages
A procedure is needed to insert the implant.
The implant can cause acne or make acne worse.
The implant can cause irregular bleeding.
Contraceptive Injection
Advantages
If the injection is used correctly, it can be more than 99% effective.
The injection can last 8 – 13 weeks, depending on the brand used.
The injection is not affected by other medicines.
It is safe to use when breastfeeding.
Disadvantages
Side effects can include weight gain, headaches, mood swings, irregular periods, breast tenderness and irregular bleeding.
It can take up to 1 year for fertility to return to normal, so it may not be suitable if you plan to have a baby soon after starting the injection.
The injection does not protect from STIs.
Contraceptive Patch
Advantages
If the patch is used correctly, it is 99% effective.
You do not have to think about it every day. Each patch lasts for a week. You change the patch every week for 3 weeks then have a week off without the patch.
The patch may reduce the risk of ovarian, womb and bowel cancer, fibroids, ovarian cysts and non-cancerous breast disease
Disadvantages
It can be noticeable on the arm and can cause itchiness and irritation.
It can be hard for some women to remember when to take the patch.
There is a risk of blood clots and some cancers associated with the use of the implant.
Always remember that what works for everyone is different. This is not an exhaustive list, neither is it medical advice. There are side effects and risks associated with each form of contraception2. Please speak to your doctor or sexual health nurse for more information, especially if you have any medical conditions or you are taking medication.