Contraception
Description of Contraception
Definition
Birth control, also known as contraception, is designed to prevent pregnancy. Birth control methods may work in a number of different ways and helps to avoid unwanted pregnancy.
Different ways to prevent sperm from getting to the eggs are:
1. Use of protection such as condoms, diaphragms, cervical caps, and contraceptive sponges.
2. Keeping the woman's ovaries from releasing eggs that could be fertilized. Types include birth control pills, patches, shots, vaginal rings, and emergency contraceptive pills.
3. IUDs, devices which are implanted into the uterus. They can be kept in place for several years.
4. Sterilization, which permanently prevents a woman from getting pregnant or a man from being able to get a woman pregnant
Your choice of birth control should depend on several factors such as:
1. Individual’s health
2. Frequency of sexual activity
3. Number of sexual partners
4. Desire to have children
NIH: National Institute of Child Health and Human Development
Content Details
Last updated on:
04 Sep 2017 | 12:28 PM (IST)
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Read Our Editorial PolicyFrequently Asked Questions about Contraception
Yes, oral contraceptive pills can delay or stop periods. Oral contraceptives take the charge of regulating your menstrual cycle with the help of hormones present in these pills. This leads to change in your periods. Some women can experience bleeding between periods, irregular to no periods while taking these pills. Consult your gynecologist in case you suffer from any change in periods while on OCPs.
Birth control pills have been shown to be less effective in overweight/obese women (body mass index ≥30 kg/m2), although very few studies -- revealing this link -- have been published till date. Other than pills, birth control injection, combined contraceptive vaginal ring, or intrauterine devices show significant positive outcomes in obese/overweight women. Barrier methods such as condoms, cervical caps, etc. are also some good alternatives in preventing conception, if used properly.
Although birth control pills can safely be used by most of the women, some risks and side effects are associated with these pills. Headaches, breast tenderness, weight gain, mood swings, irregular periods, are some common side effects observed.
Yes, condoms are effective in reducing the likelihood of pregnancy by creating a barrier that keeps the semen and other body fluids away from entering the vagina.
Women taking birth control pills frequently report of having mood changes/depression, although studies do not reveal a clear cause for the same. In such cases of mood changes, one can go for barrier methods such as condoms, IUDs, vaginal rings or sponges, or surgical methods to avoid conception without much effect on the mood.
No reasonable evidence exists to support the association between taking a particular contraceptive pill and gaining weight. For a few women, fluid retention (bloating) caused during the oral contraceptive course might be a cause of slight weight gain.
Contraceptive coil, also known as an intrauterine device, is a T-shaped copper and plastic device inserted into the uterus. It functions by ceasing the survival of sperm and egg in the uterus or fallopian tubes, or by stopping the sperm to move toward the egg via the uterus. If the egg gets fertilized, this coil prevents the implantation of that egg into the uterus. A trained doctor inserts the contraceptive coil through the vagina and then fits it into the uterus.
The birth control shot is injected into a muscle in your buttocks, or can sometimes be injected into a muscle in your upper arm. If one gets it injected within the first 5 days of the menstrual period, it starts to work immediately as birth control and is effective up to 12 to 14 weeks.
Some women think that taking birth control pills decreases their libido; it is possible, but quite rare. Factors such as physical activity, alcohol, and stress, play a major role in affecting libido. So, instead of artificial methods, lifestyle changes (including proper nutrition and meditation) are the key in enhancing libido.
A doctor’s consultation is necessary before taking any kind of oral contraceptive pills. These pills come in various forms and dosage. The most common type of contraceptive pills contains either 21 active pills and 7 inactive or placebo pills, or 24 active pills and 4 placebo pills. It is advisable to take these pills at about same time every day without missing on the dose. In case if you miss a dose, take it right away as soon as you remember it, but do not take a double dose to compensate for one missed dose.
Women with bleeding disorders, heart diseases, liver diseases, or those who smoke, have breast cancer, or experience migraine are not advised to take birth control pills as a method of contraception. Breastfeeding mothers are also advised other methods of contraception apart from oral contraceptives. In these high-risk populations, other barrier methods such as condoms, cervical caps or diaphragm, spermicides or sponges, contraceptive coils, and natural family planning methods can be used for conception.
Hormonal pills, birth control injections, barrier techniques (like condoms), etc. are some effective methods of contraception in women with epilepsy. However, some hormonal pills interact with anti-epileptic drugs. In such cases, either an alternative method of contraceptive should be chosen, or interaction between the two therapies should be well understood to avoid drug interactions. Consult with your doctor to know the right contraceptive method if you are on anti-epileptic medications or suffering from epilepsy.
Intrauterine devices (IUDs) and birth-control implants are some preferred reversible contraceptive methods for avoiding unintended pregnancy, rapid repeat pregnancy, and abortion in young women. Apart from these, condoms and hormonal pills are effective too, if used properly.
Combined oral contraceptive pills, prior to in vitro fertilization, helps to stimulate the ovaries (female reproductive organ) in producing egg cells. Before the first step in IVF cycle is initiated, a pre-treatment with a combined oral contraceptive pill comprising of estrogen and progesterone is given. This suppresses woman's own hormone production, which aids in her response to hormone therapy (gonadotropin-releasing hormone analogue injections and follicle-stimulating hormone injections) in IVF cycles.
Antibiotics like rifampin, used in the treatment of tuberculosis, interacts with oral contraceptives and reduces the efficacy of these pills. Similarly, some anti-fungal, anti-HIV, and anti-seizure drugs also interact with birth control pills, and, hence must be taken after consulting your doctor.
A contraceptive method such as male condoms is highly effective in preventing sexually transmitted diseases, including AIDS. Condoms create a barrier between the penis and vagina that prevents the exchange of infected body fluids, and minimizes skin-to-skin contact, thereby reducing the risk of disease transfer.
A mini-pill (progesterone only) can be a safer oral contraceptive option for breastfeeding mothers as compared to the combination pills. Combination pills contain both progesterone and estrogen, and studies have revealed that estrogen supplementation during breastfeeding can significantly reduce the mother’s milk supply, which in turn can hamper the child’s optimal growth and development. Apart from this, breast tenderness, irregular bleeding, headache, water retention, etc. are some side effects pertaining to the use of these combination pills. Other than pills, IUDs, barrier methods (condoms, cervical caps, and diaphragm), implants, oral contraceptive injection, etc. can be chosen to prevent conception in nursing women. Always consult your gynecologist to know the right contraceptive method for you.
Smoking, in women who are on oral contraceptives, increases the risk of heart diseases and bleeding disorders. This risk amplifies in women who are heavy smokers and are aged more than 35 years. Additionally, significant changes in the menstrual cycle (heavy bleeding, irregular, or no bleeding), headache, migraine, fatigue, abdominal pain are some side effects seen in women who smoke during their course of oral contraceptives.
Birth control pills (combination or minipills) are one of the most effective and safe methods of contraception in women with polycystic ovarian syndrome. Other methods such as the vaginal ring, progesterone-containing intrauterine devices, barrier methods including condoms, and cervical caps are also effective.
Male or female condoms are contraceptive methods that offer the least amount of side effects compared to other methods, along with having an efficacy rate of more than 80%.
Studies don’t clearly show a link between oral contraceptives and depression, still, many women claim depression after using them. If you feel depressed during your course of pills, a doctor’s consultation can help in deciding whether to continue taking the same pills, try other formulation, or use another contraception measure apart from hormones.
Studies have shown an increased risk, although insignificant, with oral contraceptives which may cause low birthweight of the baby, urinary tract disorder, or premature delivery if taken during pregnancy. It is suggested to stop taking the pill (if your home pregnancy test is positive) and consult your doctor immediately.
Selection of a contraceptive method, in a medically challenged patient, is done after considering each medical condition. Long-acting reversible contraception methods such as birth control shot (hormonal injection), intrauterine devices (IUDs), hormonal IUDS etc., may prove to be useful in this subset of the population. Always consult the doctor to know the right contraceptive method to be used.
Some studies show that birth control pills may increase the risk of breast cancer in women undergoing long-term hormonal therapy (10 years or more); however, the results remain controversial.
Though earlier studies have shown an interaction between oral contraceptive pills (estrogen, or hormone replacement therapy) and warfarin (blood thinner), recent studies say it is safe to take contraceptive pills with blood thinners without increasing the risk of blood clots or bleeding. However, it is advisable to intensify warfarin monitoring on initiation or alteration of hormonal contraceptive pills to keep a track of drug-drug interactions and to consult your doctor on same.
Emergency contraceptive pills help prevent conception after an unprotected intercourse or after a contraceptive failure. Of all emergency pills available globally, there are two particular types (one containing progesterone only, and the other one is a combination of estrogen and progesterone) that are commonly recommended. These pills act by delaying ovulation temporarily or preventing the sperm to bind to the egg. Also, inserting an IUD within 5 to 7 days after unprotected intercourse is highly effective in preventing pregnancy by stopping implantation of a fertilized egg.
Hormonal pills may be safe in women with medical conditions, such as well-controlled blood pressure, uncomplicated diabetes, heart disease, and depression. For women who cannot take estrogen, progestin-only contraceptives are recommended. Birth control shots are preferred in women with sickle cell disease and also in women with epilepsy. Always consult your gynecologist to know the right contraceptive method for you.
Hormonal pills that are low on estrogen or that contain progestin only are effective in patients suffering from a migraine. Always consult your gynecologist to know the right contraceptive method for you.
Oral contraceptive pills and condoms are the commonest contraceptive methods used by sexually active youngsters. For young women, intrauterine devices (IUDs) and birth control implants can also be used to avoid conception; birth control shots (an injectable form of progesterone) are also effective but require a visit to the doctor every 11 to 13 weeks for a repeat injection. Always consult your gynecologist to know the right contraceptive method for you.