The purpose of contraception is to prevent pregnancy, which is why it is also called birth control. Contraception tries to prevent fertilisation by keeping the egg and sperm apart.
Birth control options typically include barrier methods (such as condoms), intrauterine devices (IUDs), hormonal methods (such as the pill or implant) and emergency contraception.
There are many different contraceptive options for women, but relatively few for men. Because women bear greater consequences, should contraception fail, the task is usually set upon them to make sure they have a dedicated method of contraception in place.
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 is suitable for everyone and each type has its pros and cons.
Finding the right contraception that fits into your life is an important part of managing your reproductive health, but there are so many options available that it can be an overwhelming decision. Your healthcare team can advise you on the most suitable choices based on your preferences, medical history, lifestyle, and family planning goals.
Which Contraceptive Is Right For You?
Choosing the right contraceptive can help you avoid both unwanted pregnancies and sexually transmitted infections (STIs). Some birth control methods are less effective than others and can fail when they are used incorrectly or when there is an unforeseen interaction with other medications that you might be on.
Here are some questions for you to consider when choosing a birth control method:
- What are your future plans? Do you want to have children someday and when will you want to have them?
- Do you have any health conditions, such as epilepsy or heart disease, that could limit your choices of birth control? Your doctor will discuss the limitations of the different methods with you before they prescribe the medication.
- How often do you have sex?
- What benefits are you hoping to get from your contraception? Protection from pregnancy, protection from STI’s, help with regulating your period – to name a few.
- What is your sexual lifestyle like and how will your contraception affect this?
- How effective is your chosen birth control method?
- What are the possible side effects?
- You should be able to use your contraception correctly every time. How easy is your chosen method to use?
Barrier methods work by preventing the sperm from entering your uterus and reaching the egg. Male and female condoms specifically are very effective at preventing HIV and reducing the risk of other STIs when you use them correctly every time you have sex. Common barrier methods include:
- Condoms – male and female
- 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
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 contraceptives do not protect you or your partner from STIs.
Hormonal methods include:
- Hormonal IUD: Brands such as Mirena prevent pregnancy for up to 5 years. Hormonal IUDs should not be used by women with liver disease, breast cancer, or who are at a 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: Oral contraceptives contain either both progestin and estrogen or just progestin, and they need to be taken once a day, usually at the same time every day. They also have the added advantage of regulating menstrual cycles, lowering the chances of developing endometrial and ovarian cancer, as well as offering protection against acute pelvic inflammatory disease and ectopic pregnancies.
Non-Hormonal Copper IUDs
Copper IUDs are a good option for people who prefer non-hormonal methods or cannot use hormones for medical reasons.
Copper has an impact on the movement of sperm, hindering their ability to reach and fertilise an egg. It also causes the cervical mucous to thicken, making it more challenging for sperm to access an egg and an embryo to implant itself in the uterus.
Fertility Awareness Methods
Fertility Awareness Methods (FAMs) are also called natural family planning. With FAMs, you track your ovulation cycle and only have sex on days you’re less likely to get pregnant. Cycle-tracking methods work best for women who have regular periods but are not as effective at preventing pregnancy as other contraceptive methods, such as IUDs or hormonal methods.
Emergency contraception is usually used when you miss a pill or injection or if a condom breaks. There are 2 options for emergency contraception:
- A doctor can place a copper IUD inside your uterus within 5 days of unprotected sex.
- Emergency contraception pills (morning-after pill), which need to be taken within 5 days of unprotected sex.
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:
- A vasectomy involves cutting or blocking the tubes that carry sperm to the outside of the penis.
- Tubal ligation involves cutting or blocking the tubes that carry eggs into the uterus.
Frequently Asked Questions
The progestogen-only pill is particularly suitable for women who cannot use contraception that contains oestrogen. It is also a good choice if you have high blood pressure, have had previous blood clots, are overweight or smoke after the age of 35.
Hormonal IUDs such as Mirena or non-hormonal IUSs such as the copper coil can prevent pregnancy for as long as 5 - 10 years.