What is contraception?
Contraception, commonly known as birth control, is the adoption of preventive measures to avoid pregnancy. Contraception techniques prevent the sperm from fertilizing the egg (ovum) and forming a fetus in the uterus.
So-called “natural” methods rely on behavioral and scheduling changes in your sex life, predicated on exceptional self-control skills. For these reasons, behavioral methods of birth control are the least effective available, according to the U.S. Centers for Disease Control.
What is the importance of contraception?
Voluntary birth control has become globally significant with the rapid increase in population. Contraception helps prevent the risk of unsafe abortions due to unwanted pregnancies. Effective control over reproduction may also contribute to a woman’s physical and mental well-being, and her ability to pursue her personal goals.
What are the different types of contraception?
For centuries, people have tried various methods to avoid pregnancy after vaginal intercourse. For example, Egyptologists translated a vaginal pessary contraception recipe from 1850 BCE including crocodile dung and fermented dough. Contraception has evolved to be less dangerous and more effective since then, falling into five primary categories:
- Natural methods: These involve behavioral adaptations and periodic abstinence.
- Mechanical barriers: The use of physical barriers such as condoms to prevent the sperm from reaching the ovum.
- Hormonal methods: This technique involves the use of hormones by the woman to:
- Intrauterine devices: Intrauterine devices are implanted inside the uterus and work by releasing small amounts of hormones or by triggering the immune system to make the environment hostile to the sperm and the fertilized egg.
- Permanent contraception: This method involves a minor surgical procedure to
- Sever the fallopian tubes in women to prevent the mature eggs from reaching the uterus.
- Sever the vas deferens in men to prevent the sperm from getting into the semen.
What are the natural contraception methods?
Natural contraception methods are perhaps the safest way of avoiding pregnancy, but involve periodic abstinence. It requires consistent self-control and some of the methods have a high failure rate. Advantages of natural contraception are:
- No need of any devices
- No costs
- No hormonal or surgical interference with the body
There are three types of natural contraception:
Coitus interruptus is the technique of withdrawing the penis from the vagina before ejaculation.
- Efficacy: Efficacy depends on the man’s capability to withdraw in time. Failure rates are approximately 4% in the first year with perfect use and 22% in typical use.
- Disadvantages: It requires perfect awareness and enormous self-control.
Vaginal intercourse may not result in pregnancy for about six months after the birth of a child, while the mother breastfeeds the baby and is yet to start periods. This method of contraception requires:
Breastfeeding the baby in four-hour cycles during the day and six-hour cycles during the night.
Avoidance of other supplemental food and formula milk for the baby.
During lactation, the body naturally suppresses ovulation by reducing the levels of luteinizing hormone, which helps in egg maturation and release. The period of ovulation absence depends on the frequency and duration of breastfeeding, and the length of time after childbirth.
Efficacy: Failure rate is 0.5% with perfect use and 2% with typical use in the first 6 months after childbirth.
- Uterus involution (return to normal size) is rapid.
- Suppresses menstruation.
- Helps with postpartum weight loss.
- Time of fertility return is uncertain.
- Frequent breastfeeding without other supplements may be difficult.
- This method cannot be used if the mother has human immunodeficiency virus (HIV) infection.
Natural family planning
- Calendar method: Ovulation usually occurs 12 to 16 days before the next period. The abstinence period is 18 to 11 days before the forthcoming period, based on the assumption that the ovum and sperm are viable for 24 and 48 hours, respectively.
- Cervical mucus method: This method is an attempt to quantify the cervical mucus discharge, which increases during ovulation.
- Symptothermal method: The woman’s basal temperature is relatively lower before the egg matures and rises 0.2-0.5 C after ovulation. Temperature rise after ovulation indicates the end of fertility period.
A combination of the above three methods may be required to predict the fertility period, after first recording about six menstrual cycles to calculate the approximate ovulation time.
Efficacy: The failure rate in typical use is about 25%.
Advantages: For certain couples, this may be the only method available for cultural or religious reasons.
- Suitable only for women with regular and predictable cycles.
- Requires complete abstinence during ovulation.
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Birth Control Pill vs. Shot (Depo-Provera): Similarities and DifferencesBirth control pills (oral contraceptives) and the Depo-Provera shot are two hormonal methods of birth control. Both methods work by changing the hormone levels in your body, which prevents pregnancy, or conception. Differences between "the pill" and "the shot." Birth control pills are available as combination pills, which contain the hormones estrogen and progestin, or mini-pills that only contain progestin. In comparison to the Depo-Provera injection, which prevents pregnancy for three consecutive months. Both methods of birth control are very effective in preventing pregnancy. Both the combination pill (if you take them as directed) and shot are up to 99% effective in preventing pregnancy. While the mini-pill is only about 95% effective in preventing pregnancy. Both methods cause weight gain, and have other similar side effects like breast pain, soreness or tenderness, headaches, and mood changes. They may lead to decreased interest in sex in some women. There are differences between the other side effects of these methods (depending upon the method) that include breakthrough bleeding or spotting, acne, depression, fatigue, and weakness. Both oral contraceptives and the Depo-Provera shot have health risks associated with them, such as, heart attack, stroke, blood clots, and cervical cancer. Birth control pills appear to increase the risk of cervical cancer. Talk with your OB/GYN or other doctor or health care professional about which birth control method is right for you.
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DVT and Birth Control Pills (Oral Contraceptives)
Deep vein thrombosis (DVT) is a blood clot that has traveled deep into the veins of the arm, pelvis, or lower extremities. Oral contraceptives or birth control pills can slightly increase a woman’s risk for developing blood clots, including DVT.
DVT symptoms and signs in the leg include leg or calf pain, redness, swelling, warmth, or leg cramps, and skin discoloration. If a blood clot in the leg is not treated, it can travel to the lungs, which can cause a pulmonary embolism (blood clot in the lung) or post-thrombotic syndrome, both of which can be fatal if not treated immediately.
Increased risk factors for DVT and birth control pills include over 40 years of age, family history, smoking, and obesity. Other medical problems that increase the risks of blood clots, for example, lung or heart disease, or inflammatory bowel disease or IBD (Crohn’s disease and ulcerative colitis (UC).
Other options for preventing pregnancy include IUDs, birth control shots, condoms, diaphragms, and progestin-only oral contraceptives.
Hormonal Methods of Birth ControlThere are several different hormonal methods of birth control. The hormones can be estrogen and/or progesterone. The hormones can be taken by mouth, implanted into body tissue, absorbed from a patch on the skin, injected under the skin, or placed in the vagina. Common types of hormonal birth control include: "The Pill" (oral contraceptives), injection (Depo-Provera, Lunelle), the patch (Ortho-Evra), and the vaginal ring (Nuvaring).
IUD (Intrauterine Device for Birth Control)
An IUD (intrauterine device) is a birth control method designed for a woman. The IUD is a small "T" made of molded polyethylene plastic coated with barium so that, if need be, it can be seen on X-ray.
There are two types of IUDs 1) Intrauterine contraceptive device (IUCD) including the ParaGard, Copper 7, and Mini-7; and 2) Intrauterine system (IUS) including Progestasert and Mirena.
Side effects of the IUD include spotting, infection, infertility, pelvic inflammatory disease, and heavy menstrual bleeding. Risks and complications of the IUD are miscarriage, ectopic pregnancy, pelvic inflammatory disease, and increased menstrual bleeding.
Natural Birth ControlNatural methods of contraception are considered "natural" because they are non-mechanical and non-hormonal. Fertility awareness methods (FAMs) are based upon knowing when a woman ovulates each month. Natural methods of birth control include: the calendar rhythm, basal body temperature, mucus inspection, symptothermal, use of an ovulation indicator testing kit, withdrawal, lactational infertility, douching and urination, and abstinence.
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Birth Control: Surgical SterilizationSurgical sterilization is considered a permanent method of contraception. In certain cases, sterilization can be reversed, but this is not guaranteed. For this reason, sterilization is meant for men and women who do not intend to have children in the future. Types of surgical sterilization include: vasectomy, tubal ligation, STOP (selective tubal occlusion procedure), and hysterectomy.