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Contraception - which method is best for you?

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As many as 30-40% of pregnancies in the UK are unplanned.

In 2011, there were around 200,000 abortions, and recently concerns have been raised that more and more women are having abortions repeatedly as a form of contraception.

This is despite the fact that more forms of contraception are available than ever before. Here, TNS gives you a concise guide to contraceptive options, to help you decide which method is right for you.

The Condom

One of the most widely recognisable forms of contraception, condoms have existed in various guises for hundreds of years. Now available for both men and women, they are highly effective – male condoms are around 98% effective, with female condoms offering 95% protection. As well as preventing pregnancy, they are also viewed as the best way to prevent the spread of STDs. Considering that they are relatively inexpensive and available without potentially embarrassing trips to the doctors, condoms are one of the most widely used forms of contraception.

Disadvantages include the possibility of holes in the condom and a loss of sensation for either partner. There’s also precious few things less romantic than struggling to open a condom packet in the middle of the moment.

The Pill

The pill, sometimes viewed as one of the most significant medical advances of the 20th century, is used by over 100 million women worldwide. If used correctly, with the women taking the pill at the correct time each day they are required to, it is over 99% effective, making it one of the most effective forms of contraception. They offer no disruption or loss of sensation during sex, and often make periods lighter, less painful and more predictable. There are a variety of different pills available, as side effects can differ greatly for different women. Other known benefits include reducing the risk of ovarian and endometrial cancers, and even helping to reduce acne.

The aforementioned side effects, however, can often be unpleasant. Some of the most common side effects include depression, weight gain through increased appetite, headaches, ‘spotting’ at random times of the month and a decreased libido. They are also not recommended for smokers over the age of 35, can sometimes cause high blood pressure and offer no protection against STDs. There is also the problem of actually remembering to take it at the same time each day, and the protection rate being affected by missing pills, vomiting and the antibiotics rifampicin and rifabutin.

The Patch

Containing the same hormones as most pills, the Patch works in the same way by preventing egg release. For three weeks, women must wear a patch on either their upper arm, bottom, belly or thigh, and then spend a week without wearing it. It only needs to be changed once a week, is just as effective as the pill and shares many of its other effects, include regulating and lightening periods.

However, it also shares a lot of the negative side effects too, including breast discomfort, nausea and headaches. Though these tend to disappear within the first few months, skin irritation around the patch and a change in libido can remain. Depending on where it is worn, there’s also the issue of it being outwardly visible, and it won’t stop an STD.

The Vaginal Ring

Exactly what it says on the tin, a vaginal ring requires minimal maintenance and is 99% effective if used properly. After inserting a plastic ring into the vagina (generally against the cervix), it doesn’t have to be removed for three weeks. There are no pills to remember and it usually doesn’t interfere with the sensation during sex for either partner if inserted correctly.

It still needs to be left out for a week to allow a period, though, and it may take a while to learn how to insert it properly. It also isn’t recommended for women with high blood pressure. If removed for sex, it has to be reinserted within three hours to remain effective, and does nothing to stop STDs.

The Diaphragm/ Cap

Inserted into the vagina to provide a barrier between sperm and the cervix, a diaphragm needs to be used alongside spermicide. It doesn’t affect a woman’s natural cycle, and has no ‘wait time’ after discontinuing use for women to be able to conceive again. It has to be inserted prior to sex, but this can be done hours in advance, meaning that sex is uninterrupted. When used correctly and with spermicide, it is 92-96% effective, and can even protect against some STDs which affect the cervix.

Sex isn’t always down in the diary, however, so you may well have to interrupt things in order to insert. It can also lead to a urinary tract infection, and women will probably have to go to the doctors to be fitted for the right size. Spermicide is also generally messy.

The Implant

The implant is a more long-term method of contraception. Once inserted under the skin of the upper arm, the small plastic tube releases hormones that prevent egg release. It lasts up to an impressive three years, and as well as lightening periods, it can even stop them all together. It’s over 99% effective, fertility returns to normal as soon as it’s removed and there’s no chance of reducing effectiveness by missing a pill.

But the implant can come with a lot of issues. The chief of these is irregular bleeding during the first year. Though it can stop your periods all together, it also might result in bleeding for months at a time. As well providing no protection against STDs, it also shares many of the common side effects of the pill, and needs to be inserted and removed by trained healthcare professionals.

The Coil

More accurately known as an IUD, or Intrauterine Device, the coil is the most effective form of birth control that doesn’t make use of hormones. It provides long lasting protection of up to 10-12 years, and fertility returns to normal as soon as it is removed. A device that is inserted into the uterus, the coil is 98-99% effective depending on the model. It can even be used as a form of emergency contraception – it is far more effective than the Morning After Pill, and works effectively up to 5 days after intercourse.

The main problem with the coil for many women is that it results in heavier, longer, and more painful periods. It can also be expelled from the uterus after it has been fitted, and mistakes from doctors inserting the device can lead to perforating the womb. It also won’t offer any protection from STDs.

IUS

Similar to an IUD, an Intrauterine System works by using the hormone progestogen instead. 99.8% effective, an IUS is also inserted into the womb, and works for up to five years. It makes periods lighter, and can stop them all together eventually. Fertility also returns to normal as soon as the system is removed.

As with an IUD, however, it doesn’t protect from STDs and can be expelled from the womb. It may also lead to ovarian cysts, though these usually disappear by themselves after a few months. It of course needs to be inserted and removed by trained professionals.

The Injection

The progestogen injection is required every twelve weeks and is one of the most effective forms of contraception. With no need to worry about pills and no interruption to sex the injection requires minimal effort, with booking a follow up injection every three months being the only thing to worry about. It even decreases the risk of some cancers, and the chance of seizure in people with epilepsy.

However, it generally takes 8-10 months for women to become fertile after ending their injections, and 18 months before fertility returns to normal. It can affect menstrual patterns in the first few months of use and some side effects include depression and weight change. Side effects won’t stop immediately with ending the injections either, which could a problem if they are serious. It also offers no protection against STDs.

And if you’re really serious...

Sterilisation

Methods of sterilisation vary for both men and women. Common examples include a vasectomy for a man, preventing sperm from entering ejaculated semen, and tubal ligation, or having one’s tubes tied, closing the fallopian tubes so that the egg cannot enter the womb.

The unifying factor in sterilisation is that they are intended to prevent conceiving a child permanently. Depending on the method, it varies from being extremely difficult to impossible to reverse.

Celibacy

Not for the faint-hearted.

 

Find out more about contraception choices at www.talkchoice.co.uk




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