Contraceptive options for young couples
Let’s start by explaining what contraception is. Contraception also known as birth control is a deliberate or intentional use of methods to prevent conception and child birth (contra, meaning against and –ception, a short form of the word conception), while contraceptive is a drug or object used to aid the process of contraception.
But why will newlyweds need contraceptives?, Well many newlyweds would rather get their homes and career in order before they start making babies, some couples are enrolled in one post graduate program or the other and would rather finish these programs before having children, and some would rather spend some quality time with their partners before kids come and ruin the fun.
There are several methods of contraception available; both temporary and permanent. This blog post is directed towards newlyweds, so we’ll stick to the temporary methods.
The methods of contraception can be divided into 4 major groups, in no particular order
1. Barrier method (condoms, diaphragm, spermicide)
2. Hormonal method (oral contraceptives, hormonal patches, vaginal rings, emergency pills)
3. Natural method (withdrawal – coitus interruptus, “safe period”)
4. Intrauterine Device
As you can see there are several methods of contraception, boasting of effectiveness from as low as 73% for the withdrawal method to as high as 99% for the oral contraceptives. We would say therefore that it shouldn’t be such a herculean task to find one that suits you, but all these methods as effective as they may be have their various advantages and disadvantages and different methods fit different life styles. This blog post will be as a guide, helping you understand how each method works and aiding your decision. This post is not a substitute to professional medical advice, you should see your doctor especially if you decide to use the hormonal method.
This is also known as “coitus interruptus” – coitus meaning sex and interruptus meaning to interrupt, it is simply the interruption of sex before the man ejaculates, this method is theoretically only about 73% safe and some people don’t even consider it at all,because it largely depends on the man’s self-knowledge and self-control, some people even argue that there is sometimes a form of pre-ejaculate that the man might not be aware of and this pre-ejaculate might contain active sperm cells. In essence this method is the least reliable even though it is inexpensive and doesn’t require any extra materials. Some people also prefer this method because it avoids any side effects the hormonal methods might have and it doesn’t require any doctor’s consultation. If you plan on doing strict birth control this is not the method for you.
Safe period (FAM – fertility awareness method)
Also not completely considered as a method of contraception and like the withdrawal method has one of the least effectiveness and is quite subjective, it involves good knowledge of a woman’s menstrual cycle and having intercourse only at periods when it is least likely for conception to occur. The period from the week before ovulation to the week after ovulation is considered the fertile period, anything outside this period is “safe”. If this method is used with the method of withdrawal explained above or with condoms it can prove high effectiveness. If you don’t know how to calculate your cycle you can consult your health care provider or download apps that can help. Just like the withdrawal method, if you plan on strict birth control this method is not for you
Condoms, diaphragms, sponge and spermicide
These are all barrier methods and will be discussed together because they work in similar fashion; this method does the job of stopping the sperm from getting to the egg. Condoms are generally made out of latex and are worn over the penis (for the male variant) or inserted into the vagina (for the female variant), they are the most commonly used form of contraception boasting of about 95-97% effectiveness with proper use, they are cheap and relatively easy to use and also has the added advantage of protection against Sexually Transmitted Diseases (STD). Disadvantages include reduction of sensation (therefore interfering with sexual pleasure), improper use or breakage of condoms can really reduce its effectiveness and also some women are allergic to latex.
Diaphragms and sponges are barrier methods that work like condoms, they contain spermicide and have effectiveness of about 96%, they are worn over the cervix like a cap and so do not protect against STD. they have the advantage of not interfering with sexual pleasure. Some sponges are even made to feel and look like the cervical wall and the woman and her partner might not notice they are there.
Spermicides are substances that kill sperm; they are available in form of cream and gel. Used alone they have an effectiveness of about 83%, they can be applied to condoms to increase their effectiveness and they are usually used with diaphragms and sponges. They do not protect against STDS.
Hormonal method (oral contraceptives, hormonal patches, vaginal rings)
The hormonal method is a very popular method, almost as common as barrier method, it works by simulating the body’s hormone system. They work by preventing ovulation; no ovulation means no eggs to be fertilized by the sperm. It also thickens the cervical mucus thereby making it difficult for the sperm to swim through to the egg and finally it modifies the uterine wall making it difficult for implantation to occur.
Oral contraceptives are the most used in this category; there are two types: progestin only pills or minipills and COCP – combined oral contraceptive pills (estrogen and progestin containing) , they work basically in the same way but differ slightly in their side effects. If you are using the COCP you should be concerned about its cardiovascular effects especially venous thrombosis. The main advantage of the oral contraceptives is their high level of effectiveness – almost 99%, they also make the menstrual periods lighter and less painful. Disadvantages range from its side effects to its method of use; one tablet has to be used every day for 21days (bleeding will occur for 7 days and pills are resumed on the “29th day”), the 28 days contraceptives usually contain 7 placebo or sugar pills (they are not active pills) this helps the woman get used to taking a pill daily as opposed to the 21 days pill where she might forget to resume after the 7th day. Oral contraceptives require high level of compliance; missing the pill for as little as 12 hours may require a visit to your health care provider, use of other method of contraception i.e. condoms or abstinence from sex for some days. Interactions with other drugs e.g rifampicin can reduce the effectiveness of the pill. Pay a visit to your health care provider to understand the full extent of side effects and drug interactions and to decide what pills are best for you.
The patch works like the COCP and shares its side effects. Its advantage over the COCP is you don’t need to take a pill or change the patch every day. The patch is changed weekly, after 7 days, on the 4th week no patch is used and bleeding will occur that week just like in the oral contraceptives. The patch is applied to the buttocks, arm or abdomen depending on how it suits you, but avoid applying the patch on the same spot weekly to avoid irritation.
The ring works the same way as the COCP and the patch,it is inserted into the vagina like the diaphragm and remains there for 3 weeks, it is removed on the 3rd week and bleeding occurs
Emergency contraceptives are drugs taken few hours after unprotected sex or in the case of broken condoms or slip offs, they can also be taken if you miss your oral contraceptives. They contain hormones and act by preventing or delaying ovulation, the disadvantage is that they do not work after ovulation or fertilization and they cause disruption of menstrual cycle, they should not the used as the main birth control method.
As mentioned earlier get proper medical advice if you decide to opt for any of the hormonal methods. While using this method seek immediate medical attention if you experience any of the following (ACHES): “A”- abdominal pain, upper right side, “C” – chest or arm pain, shortness of breath, coughing up blood, “H” – headaches, severe and not relieved by aspirin or Tylenol, “E” – eye problems, blurred vision, flashing lights, double vision, blindness, “S” – swelling, redness, numbness, tingling or pain in the legs
Intrauterine Device (IUD)
There are two types, the copper and the hormonal IUD. The hormonal IUD contains progestin in very small doses and acts like the hormonal contraceptives discussed above, it however has lesser side effects. When inserted into the uterus it can remain there for aslong as 3-5years. For the copper IUD they do not contain any hormones but rather modifies the uterine secretion making it toxic to sperm and prevents implantation therefore they can be used as an emergency contraception, inserting it within 4-5 days of unprotected sex, it can stay in for as long as 10 years but has been reported to cause heavy and painful menstrual bleeding.
The IUDs are relatively the easiest to comply with as they can be left in the vagina for years without worries, however but they share the disadvantage of needing a health provider to insert or remove them when required. Rarely they can slip out, perforate the uterus or cause transient pelvic inflammatory disease.
This post serves as a guide that will help you decide on the best method for you, once the decision is made, you should do more research and discuss with your health care provider.