Written by: Mutshidzi Kwinda
For women of childbearing age, contraceptives are one of the choices to opt for to avoid unplanned pregnancies. However, given that there are several different methods of contraceptives, it makes it harder for most women to choose which one to go for. For that reason, you should consult with your doctor or pharmacist to help you decide on what’s best and suitable for you. In this article, I will outline the effectiveness, benefits, and important notes of some of the commonly used methods of contraceptives.
Injection contraceptives (also known as progestogen-only injection contraceptives).
Effectiveness: More than 99% when used perfectly. That means going for your injection as instructed by the healthcare professional without skipping or delaying the appointment. And if not used perfectly, the effectiveness of the injection contraception can go down to about 94%.
Benefits: The injection can last for 8-13 weeks. Compared to the pill, you do not have to remember to administer it every day. It does not interrupt sex and it is safe to use during the lactation period (However, WHO recommends delaying initiation of the injection until after six weeks of giving birth).
NB: If you are planning to get pregnant (say within a year), this method may not be suitable because of delayed return of fertility which is between 6 – 9 months.
Implant (also known as Etonogestrel subdermal implant).
Effectiveness: More than 99% when inserted correctly and used properly. This method of contraception is effective for 3 years. However, if you want, you can remove it before the specified duration.
Benefits: It lasts longer (3 years). It also does not interrupt sex and it is safe during the lactation period (same as an injection). It may reduce heavy and painful periods (it is advisable to consult your doctor if bleeding occurs for more than 10 days). According to the NHS, fertility returns to normal as soon as the implant is taken out.
NB: Make sure that you are not “already” pregnant before inserting the implant.
Intrauterine device (IUD).
Effectiveness: More than 99% effective when inserted correctly. South African Medicines Formulary (SAMF) notes that copper IUDs have a 5-fold lower failure rate compared to others and therefore should be used preferably.
Benefits: Last longer (up to 10 years). Once inserted (by a certified and trained healthcare professional), you don’t have to think about it, and neither does your partner. It is also safe to use if you are breastfeeding.
NB: It is important to be transparent about your medical and sexual history before insertion to avoid any possible complications and contraindications.
Vaginal ring.
Effectiveness: More than 99% effective if used correctly. However, if not used correctly there is a 9% decrease in its effectiveness. This means that there is a chance that 9 in 100 women would get pregnant in a year while using this method of contraceptive.
Benefits: It is easy to insert and remove. It also does not interrupt the sexual intercourse act. Its effectiveness is not affected if you vomit or have diarrhea. In some women, it may help with PMS. And lastly, there is no long-term effect on your fertility associated with this method of contraceptive.
Patch.
Effectiveness: 99% effective if used correctly. Apply the first patch on day 1 of menstruation, effective immediately. And then apply a new patch weekly for 3 consecutive days (i.e. on days 1, 8, 15), followed by 1-week patch-free. Commence the next patch cycle after no more than 7 patch-free days.
Benefits: It is easy to use. Do not interrupt sex. And is not affected by food or gastrointestinal diseases.
NB: Not recommended for women who weigh over 90kg. Speak to your healthcare provider for other possible and effective methods to consider.
Condoms.
Effectiveness: Male condoms (82 – 98%); Female condoms (79 – 95%) effective depending on whether it is used correctly or not.
Benefits: The utmost benefit of condoms compared to other methods of contraceptives is that they are effective in reducing the risk of contracting sexually transmitted infections including HIV.
NB: The effectiveness of condoms is significantly increased when used in combination with other contraceptives methods.
The pill.
Effectiveness: Both combined oral and progestogen-only contraceptives have a 99% effectiveness when used correctly as indicated by a healthcare provider. That is, taking the pill every day at the same time. If the pill is not taken correctly, the effectiveness decreases. Read the package insert for information on what to do if you miss a pill or vomit within a specific time of taking the pill.
Benefits: Sometimes it can help with acne and it may reduce PMS symptoms. It also doesn’t interrupt sex. Usually, it makes your menstrual blood regular, lighter, and less painful.
NB: New onset of a migraine, the occurrence of aura or crescendo headache, is an indication to stop combined oral contraceptives and consider other alternative methods.
End Note
It is important that before using any of the contraceptive methods above, you speak to your healthcare provider for more and detailed information such as contraindications, drug interactions, precautions, and directions of use. For women who smoke, it is advisable to quit smoking if you are considering using contraceptives. Especially if you smoke and are over 35 years old.
