This section provides basic information on a range of contraceptive methods, including factors to consider when choosing a method. Contraception or birth control is the practice of preventing or reducing the possibility of becoming pregnant.

To achieve this goal, various techniques and methods are utilized, these are:

• Barrier methods.
• Hormonal methods.
• IUD and Norplant System methods.
• Natural methods.
• Sterilization.

Barrier Methods

Barrier methods prevent pregnancy by blocking sperm from entering the uterus/womb. The barrier must be placed correctly, and before intercourse, for the method to work.

Types of Barrier Methods

• Male condom.
• Female condom.
• Diaphragm.
• Cervical cap.
• Contraceptive sponge.
• Contraceptive creams, foams, jellies and suppositories.

Male Condom

The male condom is a flexible, latex sheath placed over the erect penis before intercourse. There is a wide variety of condom brands available today for males.

Advantages

• Affordable and easy to use.
• No medical side effects.
• Reliable when used carefully.
• Protects against STIs.

Disadvantages

• Viewed as interruption to sex.
• Decreased sensation during for some men.
• Rupturing or slipping during sex.

Step-by-step Instructions

1. Verify the expiration date on the condom wrapper - Do not use if expired.
2. Open the foil wrapper along one side.
3. Press firmly together the tip of the condom to expel air that may be trapped inside the condom. Air pockets can cause the condom to burst.
4. Put the rolled-up condom on the tip of the erect penis.
5. Fully unroll the condom over the shaft of the penis.
6. Withdraw penis immediately after ejaculation, holding condom at the base.
7. Remove condom carefully so as not to spill semen.
8. Wrap and dispose in the garbage.

Female Condom

Female condoms are larger than male condoms, plastic with a stiffened ring-shaped opening, and are designed to be inserted into the vagina.

Advantages

• Protects against STIs.
• Does not reduce partner’s stimulation.
• No hormonal side effects.
• Can be inserted well in advance of intercourse.

Disadvantages

• Noticeable during intercourse.
• May be difficult to insert properly.
• Does not contain spermicide.
• May rupture during intercourse.
• More expensive than male condom.

Diaphragm

The diaphragm is a shallow, rubber cap that is positioned inside the vagina, over the cervix. To maximize effectiveness, this device should be coated with a small amount of sperm-killing jelly before intercourse. It guards against pregnancy for up to 6 hours after insertion, and must remain there for a minimum of 6 to 8 hours after intercourse. The diaphragm should not be worn longer than 24 hours.

Advantages

• Can be inserted well in advance of intercourse; no interruptions.
• May be used only when necessary.

Disadvantages

• Difficult to insert and remove.
• Must remain in place 6 - 8 hours after intercourse.
• Offers no protection against STIs and HIV.

Cervical Cap

This is a thimble-shaped latex cup that is squeezed between the fingers and thumb and positioned over the cervix. For maximum effectiveness, the cap should be laced with a small amount of sperm-killing jelly, and can be kept in place for up to 48 hours.

Advantages

• Can be inserted well in advance of intercourse; no interruptions.
• May be used only when necessary.
• Can be remain in place for 48 hours.

Disadvantages

• Difficult to insert and remove.
• Offers no protection against STIs and HIV.

The Sponge

The contraceptive sponge is a disposable, circular plastic that is pre-treated with a spermicide (sperm killing chemical). It has a curved side that must be attached to the cervix, and a loop to assist in removal. The sponge must be moistened with water before insertion, and should remain in position for a minimum of 6 to 8 hours after intercourse.

Advantages

• Can be inserted well in advance of intercourse; no interruptions.
• May be used only when necessary.

Disadvantages

• Must remain in place 6-8 hours after intercourse.
• Does not guard against STIs and HIV.

Creams, foams, jellies and suppositories

These all contain a sperm killing chemical or spermicide, and must be applied before intercourse to destroy sperm before they enter the uterus. Creams, foams and jellies are deposited in the vagina prior to intercourse with the aid of an applicator. Suppositories should sit for 10-15 minutes before intercourse to ensure that they have dissolved sufficiently.

Advantages

• Available without a prescription.
• May be used only when necessary.
• Very effective when used with other contraceptive devices, such as condoms.

Disadvantages

• Requires a waiting period before intercourse.
• Must be re-applied if intercourse is repeated.
• Messy application.
• Does not protect against STIs and HIV.

Who might prefer barrier methods?

• Women who cannot use chemical methods or IUD (intrauterine device).
• People who want a safeguard, in case they skipped taking a pill.
• Women who are not very sexually active.

Who might not use barrier methods?

• People who would not use them correctly every time intercourse is desired.
• People who may have allergic reactions to the chemicals in the latex or spermicides.

Hormonal Methods

Hormonal contraceptive methods mimic the role of the natural female hormones oestrogen and progesterone. These hormones prevent pregnancy by either, turning off the message to the ovary to release an egg and secondly or by thickening the cervical mucus, making it difficult for the sperm to enter.

Forms of chemical birth control methods:

• The pill.
• Contraceptive injections.

The Pill

Birth control pills are the most common type of chemical birth control. There are 2 main kinds of birth control pills, namely the “combination pill” and the “mini pill”.

The combination pill contains artificial versions of oestrogen and progesterone. In a 28 day pack, one pill must be taken for 21 days, followed by 7 “reminder” pills. In a 21 day pack, 1 pill is taken for 21 days, followed by 7 days without pills.

The mini pill contains only an artificial version of progesterone and fully relies on the thickening of the cervical mucus to be effective.

Advantages

• Menstruation is shorter, lighter and less painful.
• The combination pill is more than 99% safe when used correctly.

Disadvantages

• Occasional headaches.
• Nausea.
• Vomiting.
• Bleeding between periods.
• Possible weight gain.
• Breast tenderness.
• Difficulty wearing contact lenses.
• Higher risk of developing blood clots (long term usage).
• Risk of high blood pressure (long term usage).
• Does not protect against STIs and HIV.

Contraceptive Injections (Depo-Provera)

Depo-Provera is an injection of progestin (artificial version of progesterone), that is given by your doctor once every 3 months.

Advantages

• 99% effective.
• Injections only once every 3 months.
• Long lasting effectiveness.
• Less expensive than the pill.

Disadvantages

• Can cause bleeding between periods.
• Need to quit several months ahead before fertility returns.
• Higher risk of developing blood clots.
• Risk of high blood pressure.
• Linked to liver disease, stroke, and breast cancer.
• Does not protect against STIs and HIV.

Who might benefit from chemical birth control methods?

• Couples who are seeking a method that is effective.
• Couples who want a reversible form of birth control.
• Couples who desire sexual spontaneity.

Who should not use chemical birth control methods?

Women with:

• Known or suspected pregnancy.
• Heart attack or stroke.
• Blood clots in legs, or eyes.
• Known or suspected cancer of breast, uterus, cervix or vagina.
• Liver tumours.
• Chest pains (angina).
• Unexplained vaginal bleeding.
• Yellow of the whites of the eyes or skin (jaundice) during pregnancy.
• Allergic reactions to Depo-Provera

IUD and Norplant System methods

These involve procedures that require a qualified medical physician.

IUD (Intra Uterine Device)

IUD (An Intra-Uterine Device) is a small tube inserted in the womb by a doctor and works by inhibiting implantation of the egg. There are different types of IUDs, some containing copper and others, progesterone.

Advantages

• Effective for 1-10 years, depending on the type

Disadvantages

• Heavier periods.
• Irregular or loss of periods.
• Possible detachment or loss of IUD.
• Slight possibility of puncturing uterine walls.
• Expensive.
• Does not protect against STIs and HIV.

Norplant System

This system is made up of 6 thin, flexible, 1 inch capsules that contain progestin; and are implanted under the skin of the inside upper arm. The progestin prevents egg release and triggers the cervical mucus to thicken, thus blocking the entrance of sperm. This system is effective for up to 5 years.

Advantages

• Reversible and easy form of birth control.
• Effective for 5 years.

Disadvantages

• Headache.
• Nausea.
• Nervousness.
• Dizziness.
• Removal difficulties.
• Linked to liver disease.
• Unusual vaginal bleeding.
• Risk of high blood pressure.
• Does not protect against STIs and HIV.
• Only a doctor can apply it.

Who may benefit from IUD and Norplant System Methods?

• Couples who want a reversible and easy form of birth control.
• Women considering sterilization or longer spacing of children.
• Women recommended by the doctor not to have oestrogen birth control.
• Couples who have difficulty remembering to take medication.
• Women who have had at least one child.

Who might not use IUD and Norplant System Methods?

Women with:

• Known or suspected pregnancy.
• Abnormalities of the uterus.
• Women with more than one sexual partner.
• Past history of pelvic, cervix, fallopian tube, ovarian infection (IUD).
• Genital Actinomycosis (IUD).
• Postpartum endometritis or infected abortion within the last 3 months (IUD).
• Liver disease.
• Liver tumours.
• Unusual vaginal bleeding.
• Blood clots in leg, lungs or eyes.
• Known or suspected breast cancer.
• Idiopathic intracranial hypertension (Norplant System).
• Allergic reactions to chemicals contained (Norplant System).

Natural Methods

Natural methods are the oldest form of birth control and require no involvement of medications, chemicals or foreign objects.

• Withdrawal method.
• Rhythm method.
• Abstinence.

Withdrawal Method

This involves the male removing his penis from the vagina right before ejaculation, so that the sperm does not enter the vagina.

Advantages

• Inexpensive.
• No medical side effects.

Disadvantages

• Very Ineffective.
• Male has no control over timing of ejaculation.
• Sperm can enter vagina thru pre-ejaculation.
• Interruption during intercourse.
• No protection against STIs and HIV.

Rhythm Method

The rhythm or fertility method consists of avoiding sex during a woman’s fertile period. Three methods can be used together to determine your most fertile period, these are the calendar, basal body temperature, and cervical mucus.

1. The calendar method is determined by calculating the time of ovulation, which is roughly 2 weeks before your monthly period.
2. The basal body temperature method involves taking your temperature every morning. A slight increase in temperature occurs after an egg is released.
3. The cervical mucus method detects the quality of the vagina mucus to determine the fertile period. When the mucus appears clear and thin, as opposed to thick and sticky, sexual intercourse should be avoided.

Advantages

• Inexpensive.
• Women becomes familiar with her body.

Disadvantages

• Ineffective if body signs are interpreted incorrectly.
• Inconvenient and time consuming.
• Does not protect against STIs and HIV.

Abstinence

This is the avoidance of sex during a women’s fertile period or the total refusal of sex altogether.

Advantages

• Very effective.
• Protection against STIs and HIV resulting from intercourse.
• No side effects.

Disadvantages

• May not be suitable for every person.
• May create tension in a relationship.

Who might benefit from Natural Methods?

• Women whose beliefs prohibit usage of other birth control forms.
• Women unwilling or unable to use other methods.

Who might not use Natural Methods?

• Women who cannot interpret their fertility signs correctly.
• Women with persistent reproductive tract infections that affect the signs of fertility.
• Women with irregular cycles that make the rhythm method hard to use.

Sterilization

Sterilization is a surgical procedure that can be done in 2 ways.

1. It seals off the fallopian tubes in women, preventing the release of egg to uterus (tubal ligation).
2. It seals off the ducts that carry sperm from the testicles, in men (vasectomy).

Advantages

• 100% effective against pregnancy.

Disadvantages

• Is considered irreversible.
• Requires surgery.
• May experience transient discomfort and pain following surgery.
• Expensive.
• Possible surgical complications like, bleeding, infection, damage to blood vessels, damage to bowels in females, swelling and tenderness near testicles in men.
• Does not protect against STIs and HIV.

There are many different types of contraception. No one method is right for everybody. Consult your doctor to decide with birth control method will work for you.

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