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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 |
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. |
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| 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. |
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| 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. |
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| 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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