There are many types of contraception available today, each with its own unique benefits and issues.
Birth control pills
Birth control pills, often referred to simply as “the pill,” are an oral form of hormonal contraception. It’s one of the most popular forms of birth control. They primarily work by stopping ovulation, the release of an egg from an ovary.
How to use: The pill is typically taken once a day, at the same time each day.
Success rate: When used correctly, the pill is around 99% effective at preventing pregnancy. But considering human error (like forgetting to take the pill), the effectiveness drops to about 91%.
Issues: The pill is typically taken by the woman and can lead to all sorts of side effects, such as mood swings, an irregular cycle, or more. Plus, it’s easy to forget to take them. The pills must be taken consistently every day, and missing doses can significantly decrease their effectiveness. This puts additional responsibility on the female in the relationship.
Condoms are a form of barrier contraception. They prevent pregnancy by stopping sperm from meeting an egg. Condoms are the most commonly used form of contraception worldwide. They’re popular due to their availability, affordability, and the fact they protect against sexually transmitted infections (STIs).
How to use: A condom is worn over the penis during sexual intercourse. It must be used every time you have sex to be effective.
Success rate: With perfect use, condoms are 98% effective. However, with typical use, they’re around 85% effective due to factors such as breakage or incorrect use.
Issues: Condoms, while convenient, are not infallible. They can break or slip off during sex, and their effectiveness is significantly reduced if not used properly. Latex allergies can also be a problem for some users.
The diaphragm is a dome-shaped cup made of silicone that you insert into your vagina. It covers the cervix and prevents sperm from reaching an egg. Typically, you use the diaphragm with a spermicide to kill any sperm that may come into contact with it.
How to use: Apply the spermicide inside the diaphragm and along its edges, then fold and insert it into your vagina to cover your cervix. You should put it in place before sex and leave it in for at least 6 hours after but don’t leave it in for more than 24 hours.
Success rate: When used correctly and consistently with spermicide, the diaphragm is 88% effective.
Issues: Diaphragms can potentially cause urinary tract infections and vaginal irritation. They can be dislodged during sex, which reduces their effectiveness. In rare cases, they can cause toxic shock syndrome if left in for more than 24 hours. They must also be fitted by a healthcare provider, and the size might need to change after childbirth, pelvic surgery, or significant weight change. Diaphragms don’t protect against STIs.
Intrauterine devices (IUDs)
An IUD is a small, T-shaped device that is placed inside the uterus by a healthcare provider. There are two types: hormonal IUDs and copper IUDs. Hormonal IUDs release progestin, a hormone that prevents ovulation and thickens cervical mucus to stop sperm from reaching an egg. Copper IUDs release copper, which is toxic to sperm. IUDs are growing in popularity due to their long-term effectiveness and convenience.
How to use: Once inserted by a healthcare provider, an IUD can stay in place and prevent pregnancy for several years (3-10 depending on the type).
Success rate: IUDs are over 99% effective at preventing pregnancy.
Issues: IUDs can cause side effects such as irregular bleeding, cramps, or discomfort during sex. In rare cases, the IUD can get dislodged or pierce the uterine wall, requiring immediate medical attention. There’s also a small risk of infection during insertion. Furthermore, copper IUDs can lead to heavier and longer periods, while hormonal IUDs might lead to spotting between periods. Like other methods, IUDs do not protect against STIs.
The contraceptive implant is a small, flexible rod that is inserted under the skin of your upper arm by a healthcare provider. It releases progestin, stopping ovulation and preventing sperm from reaching an egg.
How to use: Once inserted, the implant works for up to 3-5 years, depending on the type.
Success rate: The contraceptive implant is over 99% effective.
Issues: Implants can cause side effects like changes in menstrual bleeding, weight gain, mood changes, and headaches. There’s also a risk of infection at the insertion site or the implant moving from its original position. In rare cases, the implant can be difficult to remove. They also don’t protect against STIs
Birth control shot
Also known as Depo-Provera, the birth control shot is an injection of the hormone progestin, a hormone that prevents ovulation and thickens cervical mucus to stop sperm from reaching an egg.
How to use: You get a shot from a healthcare provider every three months.
Success rate: The shot is 94% effective with typical use, but it can be 99% effective with perfect use.
Issues: Birth control shots can cause side effects such as irregular periods, weight gain, headaches, and mood changes. Some women also report bone loss with long-term use, but this typically reverses after discontinuing the shots. In addition, it can take up to 10 months or more to become pregnant after stopping the shots. The birth control shot also does not protect against sexually transmitted infections.
A vasectomy is a permanent method of male contraception that involves a surgical procedure to cut or seal the tubes that carry a man’s sperm from his testicles. It is usually carried out under local anesthetic.
How to use: A vasectomy is a one-time procedure performed by a healthcare provider. It doesn’t take long and most men can return home the same day. However, it’s important to note that it takes several months for the semen to become sperm-free, so another method of contraception should be used during this time.
Success rate: Vasectomies are over 99% effective at preventing pregnancy. However, they do not offer protection against sexually transmitted infections (STIs).
Issues: As with any surgical procedure, there are potential risks such as infection or complications due to anesthesia. Moreover, vasectomies are usually permanent, so they may not be the best choice for men who might want to have children in the future. Reversal procedures are available but are not always successful.
Remember, it’s important to discuss your contraceptive options with a healthcare provider. They can help you weigh the pros and cons of each method, taking into consideration your lifestyle, health history, and family planning goals.
Dr. Sirichet Anekpornwattana (Fertility doctor) (1 June 2023)