Birth control: A gynaecologist challenges common misconceptions

“If you don’t want to start a family yet, you must choose a regular contraceptive method. Please understand that taking Unwanted 72 (a morning-after pill) again and again is bad for your health,” Dr Shahnaz Zafar explained over the phone from the South Delhi office of myUpchar. “Yes, a little bit of bleeding or spotting is normal. Unwanted contains hormones,” she added patiently. A gynaecologist, Dr Zafar gives such phone consultation dozens of times a day. The problem: wide-spread misinformation about contraceptives. [caption id=“attachment_7573211” align=“alignleft” width=“380”]  Representational image. Image source: Getty Images.[/caption] On 25 October, the World Health Organization (WHO) released a study on unintended pregnancies and the use (or rather disuse) of contraceptives across 32 countries. According to the WHO news release, 56% of participants said they hadn’t been using any contraceptive method for five years before they got pregnant and almost 10% said they were still practising “traditional” methods like “withdrawal” (where the male pulls out before ejaculation). WHO data also show that every year 74 million women living in low- to middle-income countries have an unintended pregnancy. “This leads to 25 million unsafe abortions and 47,000 maternal deaths every year,” according to the WHO release. “Planned pregnancies can be the cornerstone of a happy, healthy relationship. But with so many choices available, such as condoms, contraceptive pills and intrauterine devices, often people are not able to decide what is best for them,” said Dr Zafar. “In truth, each method has its pros.” Here’s Dr Zafar’s guide to the most popular contraceptive methods available today, so you can make an informed choice:

Intrauterine device

“If you don’t plan to get pregnant for the next five years, consider an intrauterine device (IUD). It’s a small T-shaped plastic device that is inserted into the uterine cavity,” said Dr Zafar. There are two types of IUD - copper IUD and hormonal IUD. The copper one works by killing the sperm or by changing the way it swims, thereby preventing it from fertilizing the egg. And the hormonal IUD either releases progestin which thickens the mucus in the cervix so the sperm can’t meet the egg or it pauses ovulation for a few years (depending on what kind of device you opt for). IUDs have a 99% efficiency rate. Placed inside the uterus, they have the added advantage of always being there when you need them. Another option is birth control implants that contain the hormone progestin - the implant is placed in the upper arm.

Contraceptive pills

Just like the hormonal IUD, birth control pills contain hormones - mainly progestin and estrogen. They too prevent fertilization and have an effectiveness of 99%. Depending on your needs, your gynaecologist may prescribe a combination pill (with both progestin and estrogen) or a mini-pill that contains only progestin. “We can also prescribe a low-dose pill in people who have a low tolerance for these hormones,” said Dr Zafar. “Patients sometimes have questions about the side-effects of going on the pill, and we are more than happy to answer them. Birth control pills have been around since the 1950s - so much research has gone into making them safer.” Birth control pills can have other advantages like reducing the risk of ovarian cancer. Gynaecologists also prescribe these pills for the management of symptoms in women living with polycystic ovarian syndrome (PCOD).

Condoms

Condoms act as a physical barrier - they prevent pregnancy as well as sexually transmitted diseases. (Condoms are also an effective way to prevent STDs during oral sex.) However, condoms have a success rate of 98% and can tear when not used properly. “Please remember that a condom should not be reused. Even if you resume sex after a break of a few minutes, use a new one,” advised Dr Zafar.

Pill versus IUD

Which should you pick? Dr Zafar shared the benefits and contraindications of both, so you can make a better choice:  

• Contraceptive pills can cause tenderness in breasts; IUDs won’t.
• IUDs cause irregular periods for two to three months - they just take a little time to get comfortable inside the uterus.
• With IUDs, you won’t need to set a daily reminder. Pills have to be taken every day, at roughly the same time.
• If you have a pelvic infection, a sexually-transmitted disease, uterine or cervical cancer or a history of abortion in the last three months, you are not a suitable candidate for an IUD.
• An IUD may be better suited for women living with hypertension - some birth control pills increase the risk of cardiovascular diseases. Talk to you gynaecologist before you decide on a method.
• For women who don’t want, or can’t tolerate, additional hormones from pills or an IUD, a copper IUD is an effective method for birth control. Your doctor may prescribe a pill in addition to implanting a copper IUD for extra protection.

Whichever method you choose, always use condoms to guard against STDs.

Also read:  11 myths about condoms you shouldn’t believe

Health articles in Firstpost are written by myUpchar.com, India’s first and biggest resource fo__r verified medical information. At myUpchar, researchers and journalists work with doctors to bring you information on all things health. For more information, please read our article on   Birth Control Pills_._