Preventing pregnancy in women

A woman can get pregnant if a man's sperm reaches one of her eggs (ova). Most believe that hormonal birth control serves one purpose: to prevent pregnancy. While it’s very effective compared to other forms of birth control, the effects aren’t just limited to pregnancy prevention. In fact, they can even be used to help treat other health concerns such as menstrual relief, skin changes, and more.

However, hormonal birth control isn’t without side effects. As with all drugs, there are beneficial effects and potential risks that affect everyone differently

Contraception tries to stop this happening by keeping the egg and sperm apart stopping egg production,stopping the combined sperm and egg (fertilised egg) attaching to the lining of the womb. Many elements need to be considered by women, men, or couples at any given point in their lifetimes when choosing the most appropriate contraceptive method. These elements include safety, effectiveness, availability (including accessibility and affordability), and acceptability. Voluntary informed choice of contraceptive methods is an essential guiding principle, and contraceptive counseling, when applicable, might be an important contributor to the successful use of contraceptive methods.

In choosing a method of contraception, dual protection from the simultaneous risk for HIV and other STDs also should be considered. Although hormonal contraceptives and IUDs are highly effective at preventing pregnancy, they do not protect against STDs, including HIV. Consistent and correct use of the male latex condom reduces the risk for HIV infection and other STDs, including chlamydial infection, gonococcal infection, and trichomoniasis.

Implant—The implant is a single, thin rod that is inserted under the skin of a women’s upper arm. The rod contains a progestin that is released into the body over 3 years. Typical use failure rate: 0.1%.1

Injection or “shot”—Women get shots of the hormone progestin in the buttocks or arm every three months from their doctor. Typical use failure rate: 4%.1

Combined oral contraceptives—Also called “the pill,” combined oral contraceptives contain the hormones estrogen and progestin. It is prescribed by a doctor. A pill is taken at the same time each day. If you are older than 35 years and smoke, have a history of blood clots or breast cancer, your doctor may advise you not to take the pill. Typical use failure rate: 7%.1

Hormonal vaginal contraceptive ring—The ring releases the hormones progestin and estrogen. You place the ring inside your vagina. You wear the ring for three weeks, take it out for the week you have your period, and then put in a new ring. Typical use failure rate: 7%.1

Spermicides—These products work by killing sperm and come in several forms—foam, gel, cream, film, suppository, or tablet. They are placed in the vagina no more than one hour before intercourse. You leave them in place at least six to eight hours after intercourse. You can use a spermicide in addition to a male condom, diaphragm, or cervical cap. They can be purchased at drug stores. Typical use failure rate: 21%.1

  COMMON QUESTIONS ASKED ABOUT CONTRACEPTIVE

What Are the Benefits of Combination Pills?

You have less than a 1% chance of getting pregnant if you use them exactly as directed. That means taking your pill every day. Their effects are easy to reverse, too. When you want to get pregnant, stop taking them. It’s possible to get pregnant right away.

Usually, if you miss two of these pills in a row, you’ll need to use backup birth control for a week.

Combo pills have benefits beyond birth control.

• They help regulate your period and lessen cramping.

• They can lower your risk of certain cancers.

• They might clear your acne.

• Two brands (Beyaz, Yaz) are approved to treat a severe form of premenstrual syndrome.

Do Combination Pills Contain the Same Level of Hormones?

Most of them use between 20 and 35 micrograms of estrogen along with some progesterone. Your doctor may start you on this level and then change it if side effects bother you.

Some pills have as little as 10 micrograms of estrogen. Low-dose pills may be a good option if you’re in perimenopause. They can help with symptoms like hot flashes or irregular periods.

Combination pills are either monophasic (one phase) or multiphasic (many phases).

• Monophasic pills deliver an even level of hormones throughout the month.

• Multiphasic ones have slightly different levels of hormones in active pills. They mimic normal hormonal changes that happen during your menstrual cycle.

Both are equally effective at preventing a pregnancy.

What Are Minipills?

These are pills that contain only one hormone, progestin. They don’t have estrogen and may be prescribed for people who are breastfeeding or have nausea or other side effects of estrogen.

Minipills work by thickening the cervical mucus so the sperm can’t reach the egg. The hormone in the pills also changes the lining of the uterus so that implantation of a fertilized egg is much less likely. In some cases, minipills prevent the release of an egg. You take a minipill every day.

If minipills are used consistently and correctly, they are about 95% effective -- somewhat less effective than standard birth control pills.

What if I Forget to Take a Birth Control Pill?

If you forget to take a birth control pill, take it as soon as you remember. If you don't remember until the next day, go ahead and take two pills that day. If you forget to take your pills for 2 days, take two pills the day you remember and two pills the next day. You will then be back on schedule. If you miss more than two pills, call your doctor. You may be told to take one pill daily until Sunday and then start a new pill pack, or to discard the rest of the pill pack and start over with a new pack that day.

Any time you forget to take a pill, you must use another form of birth control until you finish the pill pack. When you forget to take a pill, you increase the chance of releasing an egg from your ovary. If you miss your period and have forgotten to take one or more active pills, get a pregnancy test. If you miss two periods even though you have taken all your pills on schedule, you should get a pregnancy test.

With some pills, you may not have a period. Talk with your doctor before you start taking your pills about what to expect, and follow their instructions about what to do if you don't have a period.

It is very important to take the minipills at the exact same time each day. If you miss a pill or are more than 3 hours late for a pill, you should take the pill as soon as you remember and use a backup method (such as a condomor spermicide) for the next 48 hours.