By Dr. Aruna Muralidhar
The right to choose whether to be pregnant is a very important prerogative of women Unfortunately, many women may be unaware of the different options available to them or may hesitate in seeking help regarding this aspect. Many myths about contraception still exist which need to be busted. Most may only think of birth control pills when the word contraception is uttered.
Contraception is the process of taking various precautions to avoid falling pregnant while having sex. Hence, natural methods such as withdrawal, safe period, and barriers such as condoms also qualify as contraception. There are many options available to choose from. Different methods may be right for different couples at different times of their life.
Contraceptives may be classified broadly into these five categories in the increasing order of effectiveness.
- Natural methods such as avoiding fertile period, withdrawal, etc
- Barrier methods such as male and female condoms.
3• Hormonal contraceptives such as vaginal rings, patches, and combined oral contraceptive pills (birth control pills).
- Long-acting reversible contraception like intrauterine devices (Copper-T or hormone-releasing systems), implants, and injections.
- Finally, permanent methods such as tubectomy or vasectomy (also called sterilisation). Each of these methods has it’s own advantages and disadvantages. One may choose the type of contraception based on some factors-How effective it is, possible risks and side effects, plans for future pregnancy, personal choice, whether there is a medical problem that might affect the efficacy, and finally whether any current medication may cause drug interactions with the contraceptive.
Asking these questions may help in choosing the right contraceptive for you:
• Do I need contraception occasionally and only during sex? These may include barrier methods such as condoms.
• Am I comfortable using contraceptives inserted in the vagina? These include vaginal rings, diaphragms.
. Will I be able to remember to take the contraceptive every day? These include oral contraceptive pills.
. What if I cannot use contraceptives containing estrogen? (These women include smokers above 35 years of age, obese women, those who take certain kinds of medication, or those who have certain types of conditions like poor circulation and migraines with aura). Theiroptions would include condoms, copper-T; hormonal intrauterine system, mplants, and injections that contain only progesterone hormone.
. I have completed my family and need long-term contraception. These include Intrauterine devices releasing copper or hormone and last for 3-5 years or permanent sterilisation like tubectomy.
If you have had sex without using any protection or have any doubt about the correct use of any of these contraceptives; the use of emergency contraceptives may become mperative. These include taking the emergency contraceptive pill as soon as possible and no later than 72 hours or getting a copper-T inserted no later than 5 days from
the time of sex.
Contraception at different times of life
. Young women who are sexually active benefit from the use of dual protection ie.,using both barriers such as condoms and another more effective contraceptive like birth control pills or intrauterine devices. Condoms also prevent sexually transmitted diseases. If remembering to take pills is an issue, long-term contraceptives can be strongly onsidered.
. Women who have just delivered must not rely completely on lactation amenorrhoea (the phase of no periods during breastfeeding). They must seek contraceptive advice 6 weeks after their delivery and ideally plan for an 18-24-month gap between pregnancies. For the first 6 months, progesterone-only pills can safely be used to avoid pregnancy. long-term reversible contraceptives also are ideal after completing the family.
. Women over 40 years of age also need effective contraception as there is a possibility of falling pregnant until menopause. The average age of menopause in Indian women is 46 years Options such as birth control pills, long-acting reversible contraceptives, or even permanent methods are suitable.
. It is important to seek a consultation with a general physician or gynecologist for an appropriate evaluation and prescription of the safest and most effective contraception for you. However, condoms and emergency contraceptive pills are available over-the-counter.
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