Contraception
What are the many methods of contraception available?
Contraception comes in a variety of forms, but not all of them are suited for all situations. The best birth control technique is determined by a person’s overall health, age, sexual activity frequency, number of sexual partners, desire to have children in the future, and family history of specific disorders.
Intrauterine Procedures
A small, T-shaped device called an intrauterine device (IUD) or an intrauterine system (IUS) is put into the uterus to prevent pregnancy. The gadget is inserted by a medical professional. An IUD can be left in place for years and still function properly. A health care provider removes or replaces the device after the appropriate period of time has passed, or when the woman no longer requires or prefers contraception.
The progestin hormone (levonorgestrel) is released into the uterus through a hormonal IUD or IUS. The hormone secreted thickens cervical mucus, prevents sperm from accessing or fertilising the egg, thins the uterine lining, and may stop the ovaries from producing eggs. A hormonal IUS has a low failure rate of less than 1%; however, a small percentage of women may have device ejection and need to have it reinserted. According to some studies, these IUDs can last up to a year after they’ve been used for the required amount of time. Because the hormone often lowers or eliminates uterine bleeding, this approach can also be used to treat severe menstrual bleeding.
A copper IUD keeps sperm from reaching the egg and fertilising it, as well as preventing the egg from adhering to the womb. If the egg is fertilised, the physical presence of the device inhibits the fertilised egg from implanting into the uterine lining. Copper IUD failure and expulsion/reinsertion rates are similar to hormonal IUD failure and expulsion/reinsertion rates. Copper IUDs can last up to ten years in the body. Women who are pregnant, have pelvic infections, or have had uterine perforations from previous IUD insertions should not use a copper IUD. It’s also not advised for women who have cervical or uterine malignancy, unexplained vaginal bleeding, or pelvic TB. At the moment, ParaGard is the only copper IUD that has been authorised by the FDA.
Implants:
Implants are rods that can be inserted into the body. Each rod is the size of a matchstick, is flexible, and is made of plastic. The failure rate of the approach is less than 1%. The rod is surgically implanted under the skin of the woman’s upper arm by a doctor.
The progestin-releasing rod can be inserted for up to 5 years. The only implanted rods available in the out of the indian countries especially in united states are Implanon and Nexplanon, which release etonogestrel. JadelleImplant, a two-rod technique that delivers levonorgestrel, is FDA authorised but not currently available in the United States. Sino-implant (II), a novel levonorgestrel-releasing two-rod technique, is now in clinical trials.
Hormonal Methods:
Hormonal Treatments with a Short Acting Time:
Hormonal birth control uses hormones to prevent conception by regulating or stopping ovulation. The biological process through which the ovary releases an egg for fertilisation is known as ovulation. Pills, injections, skin patches, transdermal gels, vaginal rings, intrauterine systems, and implanted rods are just some of the ways hormones can be delivered to the body. These treatments can inhibit ovulation, thicken cervical mucus, which helps restrict sperm from accessing the egg, or thin the uterus lining, depending on the hormones employed. Hormonal contraceptives are prescribed and monitored by health care practitioners.
Short-acting hormonal therapies (e.g., injectables, pills, patches, rings) are highly effective when administered precisely, but they have a wide range of failure rates when utilised in everyday situations.
Injectable birth control is a type of birth control that is administered through injection.
Once every three months, a progestin called Depo-Provera (depot medroxyprogesterone acetate [DMPA]) is injected into the arm or buttocks. This type of birth control, especially in teens, can result in a temporary reduction of bone density. However, after stopping the usage of DMPA, most of the bone loss is reversed. While using injectable birth control, most patients should consume a calcium- and vitamin-D-rich diet or take vitamin supplements. Sayana Press, a new self-injectable DMPA formulation, has been approved in the United Kingdom and is anticipated to be approved more broadly soon. Because this subcutaneous injectable medicine has fewer hormones, it may be more acceptable to some consumers.
Pills that only contain progestin (POPs):
A lady takes one pill every day, preferably at the same time. POPs have the potential to disrupt ovulation and sperm function. POPs cause cervical mucus to thicken, making it difficult for sperm to reach the uterus or fallopian tube. POPs disrupt the uterine lining’s natural cyclical changes, which can lead to unexpected or breakthrough bleeding. There is no evidence that these hormones are linked to an increased risk of blood clots.
Hormonal Combination Procedures:
A synthetic oestrogen (ethinyl estradiol) and one of the various progestins permitted in the United States are used in combined hormonal treatments. The products all operate by stopping ovulation and thickening cervical mucus. Pills, patches, and vaginal rings can all be used to deliver the combined estrogen/progestin medicines. Because of the synthetic oestrogen in the product, there are potential medical hazards linked with the combination hormonal therapies, such as blood clots. Progestin-only hormonal treatments, such as injectable birth control, POPs, and hormonal LARCs, have not been linked to these concerns. Your doctor can talk to you about your risk factors and help you choose the best contraceptive technique for you.
Oral contraceptives in combination (OCCs, “the pill”). OCCs contain a synthetic estrogen as well as a progestin that prevents ovulation. A lady takes one pill every day, preferably at the same time. There are many different forms of oral contraceptives, and a health care practitioner can help a woman figure out which one is right for her.
Oral contraceptives in combination (OCCs, “the pill”). OCCs contain a synthetic estrogen as well as a progestin that prevents ovulation. A lady takes one pill every day, preferably at the same time. There are many different forms of oral contraceptives, and a health care practitioner can help a woman figure out which one is right for her.
Patches for contraception:
This is a tiny, plastic patch that adheres to the skin and distributes hormones into the bloodstream through the skin. The patch should be applied to the lower abdomen, buttocks, outer arm, or upper body. For the first three weeks, a new patch is put once a week, with no patch applied on the fourth week to allow for menstruation. Ortho Evra is now the only FDA-approved patch.
Ring around the Vaginal Canal:
The ring is thin, flexible, and has a diameter of around 2 inches. It has a progestin and ethinyl estradiol mixture. The ring is placed in the vaginal canal and delivers hormones continuously for three weeks. For the fourth week, the woman takes it out and replaces it with a new ring seven days later. The risks associated with this type of contraception are comparable to those associated with combined oral contraceptive pills. For women with specific health conditions, such as high blood pressure, heart disease, or certain types of cancer, a vaginal ring may not be indicated. The NuvaRingis now the only FDA-approved vaginal ring. Clinical trials are under underway for a novel contraceptive vaginal ring that can be worn for up to 13 cycles.
Barrier Procedures:
Barrier techniques, which are designed to block sperm from entering the uterus and are detachable, may be an alternative for women who are unable to utilise hormonal contraception. Barrier method failure rates vary based on the method.
The following are examples of barrier approaches that do not necessitate a visit to a health care provider:
The following are examples of barrier approaches that do not necessitate a visit to a health care provider:
Male Condoms:
This condom is a thin sheath that surrounds the penis and collects sperm to keep it out of the woman’s body. Male condoms are often constructed of latex or polyurethane, although lambskin is a natural alternative (made from the intestinal membrane of lambs). Condoms made of latex or polyurethane limit the spread of sexually transmitted infections (STDs). STDs are not prevented by lambskin condoms. After one use, male condoms are discarded.
Female Condoms:
These are plastic pouches that are thin and flexible. Before intercourse, a part of the condom is put into a woman’s vagina to prevent sperm from entering the uterus. STD risk is also reduced by using a female condom. After one use, female condoms are discarded.
Contraceptive Sponges:
These are spermicide-filled foam sponges that are soft and disposable. Before intercourse, one is put into the vaginal canal. The sponge aids in preventing sperm from accessing the uterus, while the spermicide kills sperm cells. After intercourse, the sponge should be left in place for at least 6 hours before being removed within 30 hours. The TodayVaginal Contraceptive Sponge is currently the only FDA-approved sponge.
Spermicides:
Spermicides are chemicals that harm sperm cells. Spermicides can be used alone or in conjunction with a cervical cap or diaphragm. A substance called nonoxynol-9 is the most prevalent spermicidal agent (N-9). Foam, jelly, cream, suppository, and film are some of the concentrations and forms available. To prevent pregnancy, a spermicide should be injected into the vaginal canal near to the uterus no more than 30 minutes before intercourse and left in place for 6 to 8 hours following intercourse. Spermicides don’t stop STDs from spreading and can induce allergic reactions or vaginitis.
Diaphragm:
The following methods necessitate a visit to a health care provider:
Before intercourse, each diaphragm is a shallow, flexible cup made of latex or soft rubber that is put into the vagina to prevent sperm from accessing the uterus. A diaphragm should be used with spermicidal cream or jelly. To avoid pregnancy, the diaphragm should be left in place for 6 to 8 hours after intercourse, although it should be removed within 24 hours. Traditional latex diaphragms must have the correct size to function correctly, and this can be determined by a health care professional.
After 1 or 2 years, a diaphragm should be replaced. After giving birth, having pelvic surgery, or gaining or decreasing more than 15 pounds, women should be measured for a replacement diaphragm. Newer diaphragms, such as Caya, are designed to fit most women and do not require a medical professional’s fitting.
Before intercourse, each diaphragm is a shallow, flexible cup made of latex or soft rubber that is put into the vagina to prevent sperm from accessing the uterus. A diaphragm should be used with spermicidal cream or jelly. To avoid pregnancy, the diaphragm should be left in place for 6 to 8 hours after intercourse, although it should be removed within 24 hours. Traditional latex diaphragms must have the correct size to function correctly, and this can be determined by a health care professional.
After 1 or 2 years, a diaphragm should be replaced. After giving birth, having pelvic surgery, or gaining or decreasing more than 15 pounds, women should be measured for a replacement diaphragm. Newer diaphragms, such as Caya, are designed to fit most women and do not require a medical professional’s fitting.
Cervical Caps:
They’re comparable to diaphragms, except they’re smaller and less flexible. The cervical cap is a tiny silicone cup that is put into the vaginal canal before sexual activity to prevent sperm from accessing the uterus. The cervical cap, like a diaphragm, should be worn with spermicidal cream or jelly. To prevent pregnancy, the cap must be worn for 6 to 8 hours after intercourse; however it must be removed within 48 hours. Cervical caps come in a variety of sizes, and the right fit is determined by a health care specialist. A cervical cap can last for two years with adequate care before needing to be replaced. FemCap is the only cervical cap currently approved by the FDA.
Emergency Contraception:
After unprotected intercourse or if a condom breaks, emergency contraception can be utilised.
Copper IUD:
The copper IUD is the most effective emergency contraceptive option available. Within 120 hours of unprotected intercourse, the device can be inserted. The procedure is approximately 100 percent successful at preventing conception and also serves as a highly effective form of contraception for as long as the device is in place. There are very few contraindications to using a copper IUD, and there are no concerns with the method’s effectiveness connected to weight or obesity.
ECPs (emergency contraceptive pills) are hormonal pills that are given as a single dose or two doses 12 hours apart in the event of unprotected sexual activity. The pills can postpone or prevent ovulation for as least 5 days if taken before to ovulation, allowing the sperm to become dormant. They also cause cervical mucus to thicken, which can interfere with sperm activity. ECPs should be used as quickly as feasible following semen exposure and not as a regular means of contraception. If the pills are taken after ovulation or if the woman has unprotected sex during the same cycle, pregnancy can occur.
ECPs (emergency contraceptive pills) are hormonal pills that are given as a single dose or two doses 12 hours apart in the event of unprotected sexual activity. The pills can postpone or prevent ovulation for as least 5 days if taken before to ovulation, allowing the sperm to become dormant. They also cause cervical mucus to thicken, which can interfere with sperm activity. ECPs should be used as quickly as feasible following semen exposure and not as a regular means of contraception. If the pills are taken after ovulation or if the woman has unprotected sex during the same cycle, pregnancy can occur.
Sterilization:
Sterilization is a long-term method of birth control that prohibits either a woman from becoming pregnant or a male from releasing sperm. The sterilisation operation, which commonly entails surgery, must be performed by a health care provider. The majority of these surgeries are not reversible.
Tubal ligation (TOO-buhl lahy-GEY-shuhn) is a surgical technique in which the fallopian tubes are cut, tied, or sealed. The route between the ovaries and the uterus is blocked with this surgery. The sperm are unable to fertilise the egg, and the egg are unable to reach the uterus.
Tubal ligation (TOO-buhl lahy-GEY-shuhn) is a surgical technique in which the fallopian tubes are cut, tied, or sealed. The route between the ovaries and the uterus is blocked with this surgery. The sperm are unable to fertilise the egg, and the egg are unable to reach the uterus.
Sterilization Implant:
The fallopian (pronounced fuh-LOH-pee-uhn) tubes can be permanently blocked by a sterilisation implant, which is a nonsurgical procedure. 11 A health care provider inserts a soft, flexible insert into each fallopian tube using a tiny tube that is threaded through the vaginal canal and into the uterus. There are no incisions required. Scar tissue builds around the inserts and closes the fallopian tubes over the next three months, preventing sperm from reaching an egg. A health care practitioner performs testing after 3 months to check that scar tissue has completely shut the fallopian tubes. Until the tubes are completely blocked, a backup method of contraception is employed.
Vasectomy (va-SEK-tuh-mee):
Vasectomy (va-SEK-tuh-mee) is a surgical technique in which the vas deferens is cut, closed, or blocked (pronounced vas DEF-uh-renz). The passage between the testes and the urethra is blocked with this technique (yoo-REE-thruh). The sperm are unable to leave the testes and reach the egg. It could take months for the treatment to fully take effect. Until tests show that there is no sperm in the sperm, a backup method of contraception is utilised.