Contraception
There are many different and effective contraception options out there.The most effective contraceptive options are the LARCs (Long Acting Reversible Contraceptives). The other options include barrier methods, FAM (fertility awareness method) and irreversible contraception.
LARCs – There are 3 types of LARCs that will stop you getting pregnant for a number of months or years (IUD and Jadelle). All of them have a 99% efficacy rate – meaning that less than 1 in 100 women who use a LARC will get pregnant. The advantages are that they are effective and low cost, you don’t have to remember to use contraception every day, they don’t interfere with sex, and once you have it removed, your fertility will return to normal.
Copper IUD – is a small intrauterine device that acts as a barrier within the uterus to prevent conception. It lasts for 5 years and has the advantage of being non-hormonal. It can however, make your periods slightly heavier. The Copper IUD can be fitted in clinic at All Women.
Mirena and Jaydess IUDs– they are small (Jaydess being even smaller than Mirena) intrauterine devices that sit in the uterus like the copper IUCD. In addition to acting as a barrier, they also contain progesterone which thins the lining of the uterus and also thickens the cervical mucous. They do not routinely suppress ovulation. The Mirena (LNg IUD) lasts for five years and Jaydess lasts for 3 years. They have the advantage of making periods very light or non-existent for up to 90% of women. All IUCDs can cause some cramping, but this usually settles within the first few days. The disadvantage of the hormonal IUDs is that they usually cause some light unpredictable bleeding for the first few months after insertion and can have some mild hormonal side effects in sensitive women. Only 1/10th of the progesterone dose can be measured in the blood so blood hormone levels are very low. The risk of infection is very low for IUCDs, less than 1 in 1000. The Jaydess is better for teenage and younger women who have not yet had babies as it is smaller and there for possibly more comfortable to have inserted. We can insert both the Mirena and Jaydess in clinic at All Women.
Provera – is a three-monthly injection of MPA (a type of progesterone). It works by switching off the ovaries and preventing ovulation. 70% of women who have the Depo-provera have no periods after the first couple of injections. While you have the three-monthly injections it is > 99% effective. Side effects can include weight gain and mood issues, and it carries a 15% risk of bone loss or osteoporosis when taken for over 2 years. For some women it is better to have the injection every 10 weeks rather than 12.
The Progesterone Only Pill (POP or mini pill) works by thinning the lining of the uterus and thickening the cervical mucous so that sperm cannot pass through to fertilise the egg. It has an efficacy rate when used perfectly of 98% and an efficacy rate of 90% when taking into account human error. It is very important to take the mini-pill at the same time every day for it to be effective. The mini-pill is a good option for women whom oestrogen is contraindicated. It is also a good management option for controlling pain due to endometriosis.
The Combined Oral Contraceptive Pill has two hormones (oestrogen and progesterone), that prevent ovulation. You need to take a pill every day for it to be effective. It works by switching the ovaries off so that an egg is not released. The pill may also make periods lighter and less painful. It has an efficacy rate of more than 99% when taken correctly and a 91% efficacy rate when taking into account human error. It can cause some hormone side effects such as mood disturbance, decreased libido, nausea and breast tenderness. The pill has the advantage of often improving acne and clearing the skin as it reduces testosterone. This can be a good choice for women who have heavy painful periods, endometriosis or troubles with acne.
Tubal Ligation – is a permanent method of contraception which involves a keyhole surgery to place tiny clips on your fallopian tubes to prevent the egg and sperm from meeting. This method has a 1 in 300 failure rate and should only be used if you are 100% sure that you don’t want to conceive in the future. It can also have a risk reducing effect for developing ovarian cancer (however the background risk for the majority of women is very low in developing this type of cancer).