How to Choose a Contraception?
Before you choose a contraception, you need to take into consideration several issues listed below. Your doctor will go through with you these issues.
- General consideration : Your age, number of children, smoking cigarette and occupation
- Sexual relationship: Are you in a monogamous relationship / have several sexual partners?
- Gynaecology history: Do you have painful / heavy / irregular menses. Do you have previous history of fibroid, ovarian cyst, endometriosis or ectopic pregnancy? When do you plan to get pregnant? Previous experience with contraception method
- Medical history : Any history of blood clots, stroke, hypertension, heart attack?
What features is important for you in a contraception? Decide which is more important for you.
- Needs to be very reliable / you don’t mind falling pregnant at some time
- Compliance issue. Do I need to take it every day?
- Cost. How much does it cost? In general, those contraception that do not need to be taken daily is more expensive.
- Side effect
- Breast feeding
- Permanent / Temporary method of contraception
- Does it affect the return of your fertility
Below is a list of all contraceptive method available to make your decision easier:
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Type
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Method
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Advantages
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Disadvantages
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Breast Feeding
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Permanent or Temporary method
|
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Combined oral contraceptive Pill (COCP)
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Hormonal pill to be taken every 21 days / month
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Improves your skin appearance. Could reduce your acne problems.
Makes your menstrual cycle regular.
Makes your menstrual flow lighter with less abdominal cramping.
May improve the symptoms associated with premenstrual syndrome.
Reduces cysts on the ovaries, fibrocystic disease of the breast and endometriosis.
If used for many years, it could reduce your chances of developing cancer of the ovary and uterus.
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Could not be taken by every woman especially if they have contraindication to COCP
Needs to be taken almost daily
May be associated with some side effects
|
May be associated with reduced breast milk
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Temporary
|
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Progesterone Only Pill
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Hormonal pill to be taken everyday
|
Suitable for breast feeding
Suitable for women who have contraindication to using COCP
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May be associated with irregular vaginal bleeding, acne, breast tenderness or breast tenderness
Need to be taken every day almost at the same time or less than 3 hours difference
|
Suitable for breast feeding
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Temporary
|
|
Intrauterine Device
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Inserted into the womb
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Could last up to 3- 5 years
Highly effective
Convenient
Does not require compliance Fertility is reversible promptly after removal
Relatively cheap
Is it not affected by any medications
|
Could affect the menses making it heavier, prolonged and painful in some women.
It does not protect you from sexually transmitted disease.
There is some small risk of pelvic infection especially the first 20 days after insertion.
Spontaneous expulsion of the IUD from the uterus could happen.
Uncommonly, the IUD could perforate through your uterus and require surgical removal
|
Suitable for breast feeding
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Temporary
|
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Hormonal Implant
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Hormonal implant Inserted underneath the skin in the arm
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Could last up to 5 years
Could affect the menses making it heavier, prolonged and painful in some women.
It does not protect you from sexually transmitted disease.
|
It causes changes in your menses: Irregular, spotting, heavy and prolonged or in some women no menses at all.
Tender breasts, acne, changes in mood and sex drive.
Costly.
Requires a small procedure to have it inserted and removed
|
Suitable for breast feeding
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Temporary
|
|
Hormonal Intrauterine
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Hormonal device Inserted into the womb
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Could last up to 5 years
Does not require compliance. You do not need to take daily or monthly pills or injections.
Keeps your hormone levels steadier and lower compared to the birth control pills.
Improves your period making it lighter, shorter and less painful.
Your fertility will return promptly as soon as the IUS is removed.
Women due to underlying medical contraindications that could not take the estrogen hormone contained in the combined oral contraceptive pill, could use this type of contraception.
It is not affected by medication, vomiting or diarrhea.
IUS could be used safely during breast feeding and does not affect your supply.
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Your period may change: Irregular, minimal spotting and in some women no menses at all.
Side effects: Headache, breast tenderness or acne.
Some women develop small little cysts in the ovaries. Majority of these cysts do not need any treatment and resolve on its own.
It does not protect you against sexually transmitted disease
|
Suitable for breast feeding
|
Temporary
|
|
Depo Provera
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Injected intramuscularly every 3 months
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Requires only 3 monthly injections. You do not need to take it every day.
Does not affect sexual activity.
Causes lighter period and in some women no menses at all.
Does not contain the estrogen hormone.
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Requires intramuscular injection which could be painful.
Cause changes in your menstrual cycle. It could either be irregular, scanty or heavy and prolonged. Sometimes, you do not have any menses at all.
Does not protect against sexually transmitted disease.
May cause a delay in return of fertility or menses after ceasing the Depo-provera.
Usually, your ovulation returns within 3 – 6 months. However, in some women it could be delayed up to 12 – 18 months.
Side effects such as nausea, breast tenderness, dizziness, weight gain of up to 2 -3kg in one year, acne, reduced sexual drive
|
Suitable for breast feeding
|
Temporary
|
|
Vaginal Ring
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Inserted vaginal ring every week with rest one week / month
|
Requires less compliance as you need to replace the ring every month
Does not interrupt sex
Reasonable price
The efficacy of the vaginal ring as a contraception is not affected by vomiting and diarrhea.
Your menses will be regular, lighter and less painful.
May help with premenstrual symptoms.
|
Bleeding in between menses
Some women may feel uncomfortable inserting and removing the vaginal ring.
Side effects such as breast tenderness, nausea, headache or mood changes
|
Temporary
|
|
|
Natural Rhythm Method
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Uses the natural physiological changes of your body
|
Do not involve any hormones. Hence, there is no side effects
It is cheap
Allows you to control you fertility naturally
It is perhaps more acceptable – culture / religious
|
If do not use appropriate method – high chance of failure
Do not protect against sexually transmitted disease
Requires cooperation from your male partner to abstain from sexual activity
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Suitable for breast feeding
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Temporary
|
|
Male Condom
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Sheath to cover the male penis during sexual intercourse
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Do not involve any hormones. Hence, there is no side effects
It is cheap
|
If do not use appropriate method – high chance of failure
Requires cooperation from your male partner to abstain from sexual activity
|
Suitable with breast feeding
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Temporary
|
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Vasectomy
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Operation to cut the males’ tubes
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Places more on male partner for fertility control
Does not involve any hormones
Procedures may be done under local anaesthetic
|
May be associated with side effects such as pain, swelling or bleeding after procedure
Reversal of fertility may not be successful
|
Suitable for breast feeding
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Permanent
|
|
Tubal Ligation
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Operation to cut the females’ tubes
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Permanent method
Could be done as a day procedure
Highly effective
|
Requires the women to go under general anaesthetic
Reversal of the procedure may not be successful. Hence, should only be done in a stable relationship and older women.
|
Suitable for breast feeding
|
Permanent
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