How To Choose A Contraceptive Method

With so many choices of birth control available, it can be a daunting task to decide on the best choice for you. No single method of contraception (birth control) is suitable for everyone as each type of birth control has its pros and cons. With the help of your healthcare professional, your choices can be narrowed down based on your medical background, lifestyle, and any family planning goals you might have.

Contraceptives, when used correctly, are a safe way to prevent pregnancy. Some contraceptives, such as birth control pills (oral contraceptives) offer added benefits, including regulating your periods and easing menstrual cramps. 

By reducing rates of unintended pregnancies, contraception also reduces the need for unsafe and traumatic abortions.

Which Contraceptive Is Right For You?

Deciding which contraceptive method is right for you is an important part of managing your reproductive health. It can be a tough decision though, as there are many methods available to help prevent pregnancy. Issues to consider when choosing the most suitable birth control method include sexual lifestyle, costs, future pregnancy plans and side effects.

To avoid both unwanted pregnancies and sexually transmitted infections (STIs) it is important to choose the right contraceptive or combination of contraceptive methods. Some birth control methods are less effective than others and can fail for several reasons, including incorrect use and failure of the medication, device, or method itself.

Which Are The Most Effective Methods Of Contraception?

Certain birth control methods, such as intrauterine devices (IUDs), implants and birth control pills (oral contraceptives) have the lowest risk of failure. This is because they are the easiest to use correctly. These are the best methods to use if you want the lowest chance of getting pregnant. However, if you are not in a committed relationship, it is important to protect yourself from STIs by also using condoms.

Birth control methods that are designed for use at or near the time of sex, such as condoms and diaphragms, are usually less effective than IUDs, implants, or birth control pills. Condoms, however, remain an effective way of protecting yourself from getting STIs if used correctly.

Factors to consider when choosing a birth control method include:

• Future plans - if and when you want to have children someday
• Medical history - if you have any health conditions, such as epilepsy or heart disease, that could limit your choices
• Your sexual patterns - how often you have sex
• Your sexual lifestyle - how many sex partners you have and if you need protection from HIV and other STDs
• Efficacy of the birth control method
• Possible side effects of the contraceptive or method
• Ease of use – you should be able to use it correctly every time

Contraception Choices

Birth control options typically include barrier methods (such as condoms), intrauterine devices (IUDs), hormonal methods (such as the pill or implant) and emergency contraception. Based on your preferences, medical history and lifestyle, your healthcare professional can advise you on your most suitable choices.

Barrier Methods

Barrier methods work by preventing the sperm from entering your womb (uterus) and reaching the egg. Male and female condoms specifically are very effective at preventing HIV and reducing the risk of other STDs when you use them correctly every time you have sex. Common barrier methods include:

• Condoms – male and female condoms
• Birth control diaphragm and cervical cap (placed inside the vagina)
• Birth control sponge (placed inside the vagina)
• Spermicide - a gel that stops sperm from reaching an egg 

IUDs (Intrauterine Devices)

An intrauterine device, also known as a coil, is a small, T-shaped birth control device that is inserted into the uterus to prevent pregnancy. IUDs are a very effective, long-acting and reversible birth control method. They are more than 99% effective. Once it has been fitted you will not feel the IUD. There are 2 kinds:

• Copper IUDs release a small amount of copper to prevent sperm from fertilising an egg. It can last for up to 10 years. Because the copper IUD is hormone-free, it does not have many side effects. Occasionally, copper-releasing IUDs can cause cramps, longer and heavier menstrual periods, and spotting between periods.
• Hormonal IUDs, such as the Mirena, release a small amount of hormone to prevent pregnancy. Hormonal IUDs last from 3 to 6 years.

If you want to get pregnant, a doctor or nurse can easily remove the IUD.

Hormonal Methods

Most hormonal methods of birth control work by preventing a woman’s ovaries from releasing an egg during her monthly menstrual cycle. They also cause other changes, such as producing thick cervical mucous, that make it less likely for sperm to reach the egg.

Some hormonal methods are more effective or more convenient than others. A contraceptive implant, for example, lasts for up to 3 years, whereas the contraceptive pill needs to be taken daily.

Hormonal methods include:

• Hormonal IUD - brands such as Mirena prevent pregnancy for up to 8 years. Hormonal IUDs should not be used by women with liver disease, or breast cancer, or who are at high risk for breast cancer.
• Implant (a small rod placed under the skin) - can last for 3 years. Women with a history of serious blood clots, heart attack, stroke, liver tumours or a history of breast cancer should not get the implant.
• Injection - lasts for 8 or 13 weeks (depending on which injection you have). The injection is a good choice if you cannot use oestrogen-based contraception. It is also not affected by other medicines. This might not be the right choice if are planning to fall pregnant as it can take up to 1 year for your fertility to return to normal after the injection wears off.
• Transdermal Patch - worn on the skin and replaced once a week, with 1 week off every month. The patch, which contains both oestrogen and progestin hormones, is a safe, simple and affordable birth control method.
• Vaginal Ring - a small soft, plastic ring that you place inside your vagina. It releases a continuous dose of the hormones oestrogen and progestogen to prevent pregnancy.
• Birth Control Pills - contain the hormones progestin and oestrogen, or only progestin, and must be taken orally once per day. Birth control pills should not be taken by someone with a family history of polycystic ovary syndrome. 

Fertility Awareness Methods

Fertility Awareness Methods (FAMs) are also called natural family planning. With FAMs, you avoid having sex on days you are more likely to get pregnant (usually when you are ovulating). FAMs work best for women who have regular periods but are still not as effective at preventing pregnancy as other contraceptive methods, such as IUDs or hormonal methods.

Emergency Contraception

Emergency contraception is usually used when you miss a pill or injection or if a condom breaks. There are 2 options for emergency contraception:

• Copper IUD — A doctor will need to place this inside your uterus within 5 days of unprotected sex.
• Emergency Contraception Pills (morning-after pill) – needs to be taken within 5 days of unprotected sex.

Sterilisation

Sterilisation is a permanent method of birth control that is suitable for those who are 100% sure they do not want any more children. These methods comprise:

• Vasectomy (in men) -  cutting or blocking the tubes that carry sperm to the outside of the penis.
• Tubal Ligation (in women) -  cutting or blocking the tubes that carry eggs into the uterus. 

Choosing A Contraceptive

Choosing the right method of contraception is a personal decision that depends on various factors such as lifestyle, future plans, medical history, efficacy, and side effects. With the guidance of a healthcare professional, you can navigate through the wide range of options available to find the most suitable birth control method for you. It's important to remember that no single method is universally perfect, and each method has its advantages and limitations. By using contraception consistently and correctly, we can prevent unintended pregnancies, reduce the need for unsafe abortions, and protect ourselves from sexually transmitted infections. Ultimately, taking charge of our reproductive health empowers us to make informed choices and enables us to plan our families according to our desires and circumstances.