Most couples have a need for contraception at some time in their reproductive lives. A wide range of methods are available, each having individual merits and disadvantages. Couples may choose different methods at different times in their lives depending on their age, medical needs and desire for children. The effective provision of information, education and advice regarding all aspects of contraception and sexual health is an important role of family planning clinics, gynecologists and general practitioners.

 

Different methods of contraception include hormonal, intra-uterine devices, barrier methods, and natural methods and sterilization. The ideal contraceptive would be 100%reliable, fully reversible, free from all side-effects, easy to use and cost-effective. No single method fulfils all these criteria, but many come close. 

 

The combined oestrogen/progesterone oral contraceptive pill
 

There are 3 types: combined estrogen/progesterone pills, progestogen only pills, and injectable progestogens. It is the most popular contraceptive for women under the age of 30 years, and it is extremely effective if taken regularly. They inhibits ovulation. The progestogen component renders cervical mucus hostile to sperm and the endometrium unfavorable for implantation, which further add to the contraceptive effect. The progestogen –only pill accounts for 10% of oral contraceptive use. It is taken continuously without the 7 day break, and this must be to within 3 hours of the same time each day.
 

Progestogen Injections and implants
 

Long-acting slow release depot progestogen preparation are ideal for women who are forgetful with pill taking. The injection inhibit ovulation due to higher serum levels of progestogen. The disadvantages is they are irreversible until their effects have worn off, unpredictable bleeding and amenorrhea.  An implant is a small flexible tube inserted subcutaneously under local anesthetic which release continuously a small amount of hormone. The inner upper arm is the usual site. 
 

Intra-uterine devices
 

The intra-uterine device (IUD) produces a high level of contraceptive reliability, and is particularly suitable for the older woman who has contraindications to the combined pill. The main advantage is that following insertion no further motivation is required by the user, and the contraceptive action is unrelated to sexual intercourse. Removal is usually straightforward and is effected by pulling on the threads of the device, which project into the vagina. This brings about an immediate reversal of the contraceptive action. They produce a mild inflammatory reaction in the endometrium. The viability of gametes is reduced, and both fertilization and implantation are impeded.
 

The levonorgestrel-containing IUD releases a small continuous amount of progestogen from a reservoir, which causes endometrial atrophy. This frequently causes amenorrhea, which is a useful therapeutic effect in women with menorrhagia (heavy periods). It is effective for 5 years. Currently, Mirena®, a levonorgestrel-releasing IUD, is the only FDA approved hormonal IUD and is prescribed by a doctor.
 

Mirena is over 99% effective at preventing pregnancy. It’s made of soft, flexible plastic and placed into your uterus by your healthcare provider during a routine office visit and lasts as long as you want. It is important to note that Mirena is recommended for women who have had a child. It might be a good birth control choice for busy moms. Mirena does not protect against HIV or STDs.
 

Barrier methods of contraception
 

Most widely used contraceptive method worldwide, they prevent contact between sperm and ovum, thereby preventing fertilization. They comprise diaphragm, spermicides, male and female condom.
 

Contraception and Protection against STIs
 

Not all methods of contraception provide protection against STIs. The best way to reduce your risk of STIs is to use barriers methods. They stop sperm from entering the uterus and they can be very effective if used the right way, but can have high failure rates if not used consistently and correctly. Male condoms are relatively inexpensive and are available without a prescription from pharmacies and from supermarkets.
 

Emergency contraception
 

If you find yourself in a situation where the birth control methods you have been using have failed, or in the case of rape then obtaining emergency contraception such as the ‘morning-after pill’ isn’t too difficult (over the counter at most pharmacies). 
 

Sterilization and Natural methods
 

This procedure blocks the fallopian tubes, preventing an egg from passing down the tube and being fertilized in women (tubal ligation) or cuts the tubes that carry sperm from the testes to the penis in men (vasectomy). 
 

Natural methods
 

They are based on an understanding of the menstrual cycle to help determine when a woman is most likely to be fertile each month and avoidance of sexual intercourse at the fertile time of the cycle.
 

Where to get help: Guangzhou Elizabeth Women’s Hospital 

Dr. Djobo Clemence 

MD.PHD.OB-GYN

Tel:400 886 9268  Email:inquiries@eliza.hk

Guangzhou Elizabeth Women’s Hospital 

Address:No.484 Middle Kang Wang Road,Liwan  District, Guangzhou City,P.R.China