A means, either mechanical or chemical, to prevent pregnancy.
Mechanical methods include:
° Preventing implantation of fertilised ovum in womb (e.g. inter uterine device)
° Preventing release of seminal fluid into vagina (e.g. condom)
° Preventing seminal fluid passing into womb (e.g. cap)
Chemical methods include:
° Spermicidal cream, which kills sperm
° Oral contraceptive pills, which stops the woman from ovulating
Methods of contraception include:
° Oral contraceptive pill
° Condom
° Diaphragm or cervical cap
° Inter uterine device (IUD)
° Sterilisation, either man or woman
Other methods, which don't fall into the above categories include:
° Rhythm method
° Withdrawal
No form of contraception is 100% effective. However, male and female sterilisation is the best at about 99%. The pill and IUD are about 90-95% effective, followed by the condom, diaphragm and cap, which are about 60%. The least effective is the rhythm and withdrawal method.
With the exception of sterilisation, the effectiveness of any form of contraception is largely controlled by the individual. For example, the pill will become less effective if the woman forgets to take it for a few days, the condom becomes less effective if the man only puts it on just before ejaculation.
Before starting any sexual relationship, there are certain consequences which should be considered. The risk of unwanted pregnancy is very high when unprotected intercourse occurs.
There's an added risk AIDS, which can be passed between couples during unprotected intercourse. It is a popular myth AIDS only exists in the homosexual population. The only contraceptive method which may protect against AIDS (and other diseases) is the condom.
THE ORAL PILL
Many different types of oral contraceptive pill are available and should only be prescribed by a doctor. The pill suppresses ovulation, but is not suitable for all women because of the side-effects.
The varieties available are:
° Progesterone
° Mixture of oestrogen and progesterone
° Low dose oestrogen, with progesterone
° Medium dose oestrogen, with progesterone
° High dose oestrogen, with progesterone
The pill may be taken continuously, or in 21 day courses, restarting after a 7 day rest, when the period occurs. They are usually supplied in a foil blister pack with each day marked as a reminder when to take them. While taking the pill it is necessary to visit your doctor regularly to keep a check on weight, blood pressure and breasts.
Disadvantages:
° Headaches
° Excessive weight gain
° Rise in blood pressure
° Bleeding outside normal period cycle
° Periods delayed for up to 2yrs after stopping
° No protection from sexually transmitted disease (STD's)
° Antibiotics and gastro-enteritis prevents absorption of the pill, reducing effectiveness of contraception
° Risk of heart attack if taking combined pill at 35+yrs
Advantages:
° Simple to take
° Highly effective form of contraception
° Aesthetically acceptable (no interference with intercourse)
° Possible protection from cancer of womb and cervix
Current medical opinion suggests there is an increased risk of breast cancer in women taking the pill. However, there is conflicting evidence. The risk is believed to be only slightly higher than normal. If you decide to take the pill, it makes sense to remember the following:
° Visit your doctor/clinic every 6mths to check weight and blood pressure
° Examine your breasts regularly (see 'Self-Examination' supplement)
° Have a pap smear every 3yrs
CONDOM
The condom is possibly the most common method of contraception. Consisting of a fine latex rubber tube with a ring at the base, it fits over the erect penis and collects semen when the man ejaculates.
The condom also offers excellent protection against AIDS and other sexually transmitted diseases. However, the practice of putting on a condom just before ejaculation, but after penetration, must be avoided. This not only reduces the effectiveness as a contraceptive, but also eliminates any protection against sexually transmitted diseases.
DIAPHRAGM
The diaphragm consists of a ring covered with latex rubber. Before intercourse, the ring is fitted behind the pelvic bone by the woman. It covers the neck of womb and fixes behind in the vaginal vault. It is often used with a spermicide (gel or cream) for greater protection.
Disadvantages:
° Not as effective as pill or condom
° Messy and inconvenient to use
° No protection from sexually transmitted disease
° Not always available when required
Like a diaphragm, the cervical cap is a rubber cap but fits tightly over the neck of the womb. It must be carefully fitted and should be used with a spermicide.
IUD
The inter uterine device (IUD), or coil, is not advised for young women who have not completed their families.
There are 2 main types available, a plastic coil, or a plastic coil with a small amount of copper.
The device acts as a mechanical irritant to the wall of the uterus and, in theory, prevents implantation of the ovum.
However, this does not provide 100% protection. The IUD is best suited to women who have completed their families and must be fitted by a skilled doctor.
Disadvantages:
° Heavy periods
° Risk of tubal pregnancy
° Risk of infection of fallopian tubes
° Risk of pelvic infection
° Risk of perforation of womb or cervix
° Risk of infertility caused by blocked fallopian tubes
STERILISATION
In a steady relationship, when the family has been completed, the best form of contraception is by male or female surgical sterilisation.
Male sterilisation is the easiest operation and providing there are no psychological sexual problems beforehand, there should be no difficulty. The operation should however, be performed by a skilled surgeon in hospital.
Advantages:
° Performed under local anaesthetic
° Only takes 15-20mins to complete
° Abdomen is not opened
° Normally return to work within 48hrs
° Complications are rare
2 negative sperm counts, 6 and 10 weeks after the operation, are required before the patient is declared 'sterilised.'
The male tends to store sperm, so it's necessary for the female partner to continue contraceptive precautions until the 2 negative counts have been confirmed.
Female sterilisation is another option.
Disadvantages:
° General anaesthetic is required
° Abdomen has to be opened
° May cause excessively heavy periods
° May not be fit for work up to 2-3 weeks after operation
Male sterilisation is the ideal choice. Many men, however, would not agree with this. The main objections are based on fear and ignorance of the outcome.
There is no decline in libido, no increase in incidence of heart disease, rate of ageing remains the same. Ejaculation and achievement of orgasm are unaltered. The only difference is that the male does not produce sperm.
RHYTHM METHOD
The rhythm method involves planning intercourse during the time a woman is not fertile. This depends on when the woman partner ovulates and may be accurately predicted by monitoring her temperature. Intercourse can safely happen up to 7 days before ovulation and when 7 days has elapsed after ovulation.
The time between 7 days before ovulation and 7 days after ovulation is not safe. The other 14 days is considered to be safe. However, there are exceptions; some women may ovulate at odd times in the cycle (this is rare).
WITHDRAWAL
Withdrawal is the act of withdrawing the penis from the vagina just before ejaculation. This can lead to a variety of psychological sexual problems (e.g. delayed ejaculation) both for the man and woman. Additionally, it is an unreliable method of contraception.