News& Information

What You Need to Know about Birth Control

Author:Dr.Irena Mehandjiska Shumanska

Contraception is the use of artificial methods to prevent pregnancy.

One or both members of a couple can use contraception to prevent pregnancy temporarily or sterilization to prevent pregnancy permanently.

Few methods have been used for contraception through the years.

The earliest contraception method is coitus interruptus (withdrawal method), and barrier contraception methods were developed later. In the 1920s, research confirmed the timing of ovulation and the role of the ovarian hormones, estrogen, and progesterone in reproduction, and this led to the development of the rhythm method of contraception that is based on the woman’s monthly variation in body temperature and also helped for the development of the contraceptive pill.

The use of contraceptive pills widely started in the 1960s.

Different types of contraceptive methods

Nowadays, standard contraception methods are oral contraceptives, condoms, withdrawal methods, periodic abstinence(natural family planning), spermicides, diaphragms, progestin injections, progestin subdermal implants, and intrauterine devices (IUDs). These birth control types can be divided into two groups- coitus(sexual intercourse) related methods and methods that are unrelated to coitus.

The first group are the diaphragms, condoms, spermicides, and withdrawal and are more likely to fail. The second group of contraceptives is oral contraceptives, emergency contraception(the morning after pill), intrauterine devices (IUDs), progestin injections, and sub-dermal implants considered more effective.

How do the contraceptive methods work?

The barrier contraceptive methods like condoms, diaphragm, cervical cap, vaginal cream, foam, and suppositories are making a barrier between the sperm and cervix(the opening of the womb) that is how they stop the interaction between the sperm and female eggs. The hormonal contraception methods such as contraceptive pills, IUDs, progestin injections, and sub-dermal implants contain hormones that inhibit the process of ovulation (prevention of the release of an egg), thicken the cervical mucus, and make the endometrium of the uterus thinner and by doing that they are preventing the sperm from fertilizing an egg.

Most common contraceptives used by women

The most commonly used contraceptive methods are oral contraceptive pills and IUDs (intrauterine devices). The pills are usually a combination of synthetic estrogen and synthetic progestin(types of female hormones). These tablets are taken every day for 3 weeks then are not taken during the 4th week to allow for withdrawal bleeding.

The usual dose is 20 to 35 of Ethinyl estradiol(estrogen), and every woman should start with low dose formulations not higher than 35µgr in the beginning.

The IUDs are inserted into the women's uterus and can stay in the womb for 5-10 years, depending on the IUD type. They can be progesterone releasing and copper-bearing IUD. The progesterone releasing makes the inner lining of the womb thin and the cervical mucus thick, preventing the sperm from reaching an egg. The second type is made of copper and plastic. The copper acts as spermicide-prevents the sperm from surviving in the womb.

Common side effects and benefits

The combined contraceptive pills can cause side effects like headaches, nausea, breast tenderness, mood swings, abdominal cramps, weight gain, acne, and vaginal discharge as temporary effects, and that is a sign that the oral contraceptives are not suitable for the individual and they need to be replaced with another type of contraceptive pills. IUD's common side effects are bacterial contamination of the womb, spontaneous abortion, and perforation of the womb, which are infrequent side effects. Besides the side effects, there are benefits of using contraception, especially oral contraceptive pills. They can decrease the risk of endometrial and ovarian cancers by 50 % and reduce the incidence of abnormal bleeding, iron deficiency anemia, benign breast disease, and ovarian cysts.

What should you know about emergency contraception?

Emergency contraception, or the “morning-after pill,” is a type of contraceptive pill that needs to be taken within 72 hours of a single act of unprotected mid-cycle coitus.

If you consider using one of the contraception methods, always make sure to see your GP or gynecologist to discuss the possible ways to prevent pregnancy according to your personal medical history.

Sources:

1. The Merck Manual-7th edition-Section, Family Planning;

2.https://www.nhs.uk/conditions/contraception/what-is-contraception/