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Contraception aims to prevent sexual intercourse from causing pregnancy and also from protecting your body from sexually transmitted diseases and infections. This section contains information on the currently available male and female contraceptive methods.

Following are the main methods of contraception:

Barrier methods
Natural methods
Birth Control Pills
Sterilisation



















Barrier methods
These are physical barriers that stop the sperm coming into contact with the egg, thereby preventing fertilisation.

Male Condoms:
Male condoms are thin sheaths made of rubber, vinyl or natural products which are placed on the penis once it is erect. Male condoms may be treated with a spermicide for added protection. If used according to the instructions, condoms are 98% effective at preventing pregnancy. Male condoms prevent sperm from gaining access to the female reproductive tract and prevent microorganisms (STDs, including HBV and HIV/AIDS) from passing from one partner to another (latex and vinyl condoms only).

Female Condoms:
Female condoms are thin sheaths of polyurethane plastic with polyurethane rings at both ends. They are inserted into the vagina before intercourse. If used according to the instructions, the female condom is 95% effective. Like male condoms, they prevent sperm from gaining access to the female reproductive tract and prevent microorganisms (STDs, including HBV and HIV/AIDS) from passing from one partner to another.

Diaphragms:
A diaphragm is a dome-shaped latex (rubber) cup which is inserted into the vagina before intercourse and covers the cervix. Diaphragms prevent sperm from gaining access to the upper reproductive tract (uterus and fallopian tubes) and serve as a holder of spermicide.

Cervical cap:
A cervical cap is a small, latex, thimble-shaped cup used with spermicide to block sperm from reaching the uterus. It fits over the cervix and is 82-91% effective. It can be put in place several hours before intercourse so it doesn't interrupt foreplay, and may offer some protection against sexually transmitted diseases when used with a spermicide. To avoid toxic shock syndrome, the cap should not be left in place for more than 24 hours. It must be fitted by a doctor, but is reusable and available with a prescription. As with the diaphragm, oil-based lubricants should not be used with the cervical cap. Some women may be allergic to the spermicides used with the cervical cap.

Spermicides:
Spermicides are chemicals (usually nonoxynol-9) that inactivate or kill sperm. They are available as aerosols (foams), creams, vaginal tablets, suppositories, and dissolvable films. They can increase the effectiveness of barrier methods of contraception, but they do not provide reliable contraception when used alone. Spermicides can be bought without prescription at pharmacies. Some condoms have a coating of spermicidal lubricant.

Vaginal Ring:
A vaginal ring is a thin, transparent, flexible ring that you insert into the vagina, usually around the cervix. Unlike vaginal barrier methods, such as the diaphragm, exact placement is not essential. Obtained by prescription only, the ring is left in the vagina for three weeks, slowly releasing estrogen and progestin hormones into the body. These hormones work by stopping ovulation, thickening cervical mucus as a barrier to sperm, and preventing implantation of the embryo if fertilization occurs. It is worn continuously for three weeks followed by a week off which triggers menstruation. Each vaginal ring provides one month of birth control, even during the week when the ring is not worn. The ring does not provide protection against STDs.



Natural methods

Lactational Amenorrhea Method (LAM)
LAM is the use of breastfeeding as a contraceptive method. It is based on the physiologic effect of suckling to suppress ovulation. To use breastfeeding effectively as a contraceptive requires that the mother either feed the baby nothing but breastmilk or, at the very least, breastfeed for almost all feedings. In addition the baby must be less than 6 months old and the mother's menses cannot have returned.

Natural Family Planning
To use NFP, a couple voluntarily avoids sexual intercourse during the fertile phase of the woman's cycle (time when the woman can become pregnant) or has intercourse during the fertile phase to achieve pregnancy. There are four types of NFP: Calendar (Rhythm) Method, Basal Body Temperature, Cervical Mucus Method and Symptothermal Method.

Withdrawal (Coitus Interruptus)
Withdrawal is a traditional family planning method in which the man completely removes his penis from the woman's vagina before he ejaculates. As a result, sperm do not enter the vagina and fertilization is prevented. It is not a very reliable method and involves lot of risk and control because some sperm can leak out of the penis before ejaculation.



Birth Control Pills

Birth control pills help prevent pregnancy with synthetic versions of female hormones--estrogen and progesterone. They work either by stopping the release of eggs from the ovaries or by making the uterus reject a fertilized egg. The pills come in different types, brands, and strengths, and are taken for 21 or 28 days each menstrual cycle. Pills require a doctor's prescription, and must be taken on a strict schedule. They are 97-99% effective, but can cause weight gain, tender breasts, spotting, nausea, headache, bowel irregularities, high blood pressure, and abnormal blood clotting. Pills do not provide protection against STDs.

Combined Oral Contraceptives:
Combined Oral Contraceptives (COCs) are pills which contain the hormones estrogen and progestin. They are taken daily. COCs suppress ovulation, thicken the cervical mucus (preventing sperm penetration) change the endometrium (making implantation less likely), and reduce sperm transport in the upper genital tract (fallopian tubes).

Progestin-Only Pills
Progestin-Only Pills (POPs) contain the hormone progestin. They are taken daily by the woman. POPs suppress ovulation, thicken the cervical mucus, change the endometrium, and reduce sperm transport in the upper genital tract.



Sterilisation

This is an operation to permanently prevent fertilisation. It is therefore only recommended for people who are sure they do not want to have any more children. The failure rate of sterilisation is around one in 2,000 for men and about one in 200 for women. These operations are not easily reversible.

Men
Men are sterilised in a procedure called a vasectomy. Vasectomy can be done by the standard method or the no-scalpel technique which is the preferred method. Vasectomy blocks the vas deferens (ejaculatory duct) so that sperm are not present in the ejaculate. This is a minor operation usually performed under local anaesthetic. A vasectomy should have no effect on a man's sexual desire, erections, or sexual performance. Vasectomies are safe and in most cases, 100% effective.

Women
Tubal ligation is the most common type of female sterilization. This is an operation performed under general anaesthetic, usually as day case surgery. The Fallopian tubes are cut, tied or blocked, often through keyhole surgery. After tubal ligation, there is almost no chance of pregnancy. Risks of tubal ligation include bleeding, infection, and other complications. The alternative is a hysterectomy, removal of the womb, after which pregnancy is impossible.

 

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