Choosing the best contraceptive technique can be
challenging. Experts list the pros and cons of various methods to prevent
unplanned pregnancies
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Written by Nandita Narayanan & Swathy R Iyer
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With
quotes from Dr. Shalini Chawla Khanna (senior gynecologist), Dr. Sarada M
(obstetrician and gynecologist), Dr. Nandita Palshetkar (gynecologist), Dr. Kevin
Gala (gynecologist and obstetrician), Dr. Priyanka Dilip Kumar (gynecologist and
obstetrician)
From male and female condoms to oral contraceptive pills
and vaginal rings, several birth control methods to prevent unplanned
pregnancies are available today. However, there is no one-size-fits-all when it
comes to choosing the right contraception, say experts.
Dr. Shalini Chawla Khanna, senior gynecologist, IVF and
laparoscopy consultant, Max Hospitals, Delhi & NCR, explains that
when a couple seeks birth control, they are counselled on the various
methods available and the success rate, side effects and advantages of each
method. “They can then choose the one that suits them the
best.”
Dr. Khanna says that there are natural, hormonal and barrier
methods available to prevent pregnancies.
Natural methods
The abstinence method: Avoiding sexual intercourse.
The withdrawal or pull-out method: Where the man pulls
his penis out of a woman’s vagina before ejaculation.
The withdrawal method has a higher failure rate and is
hence not recommended, says Dr Khanna.
Barrier methods
Male and female condoms: They act as a barrier and
prevent sperm from getting into a woman’s vagina.
Spermicide: Chemicals known to stop sperm
from reaching an egg.
Diaphragm: A cup inserted in the vagina to block the
sperm’s access to the cervix.
Dr. Khanna says, “Male condoms are 98 per cent effective.
They are also the only method of contraception that can also prevent sexually
transmitted diseases (STDs).”
Dr. Priyanka Dilip Kumar, consultant gynecologist,
obstetrician and reproductive medicine, Milann Fertility and Birthing Hospital,
Bengaluru, says that for people with latex allergies, latex condoms may not be a viable option.
She advises switching to another contraceptive method or using non-latex
condoms.
Hormonal methods
Dr. Sarada M, consultant obstetrician and gynecologist,
Yashoda Hospitals, Hyderabad, says that hormonal contraceptives mainly come in
the form of:
Implants: A rod that contains progestin, the hormone
that prevents pregnancy, is inserted under the skin of a woman’s upper arm.
Pills: Oral contraceptive pills contain a combination
of estrogen and progestin and must be taken every day. Progestin-only pills are
also available, which are usually recommended for lactating mothers as estrogen
can reduce milk supply, informs Dr. Nandita Palshetkar, Mumbai-based
gynecologists and former president of the Federation of Obstetric and Gynaecological
Societies of India (FOGSI).
“Combined oral contraceptive pills are highly effective and
the failure rate is just 0.1 per cent. It is highly recommended. They are easy
to use and you can stop whenever you want to,” Dr. Khanna adds. Moreover, Dr
Khanna says that combined oral contraceptive pills can help regularise period
cycles, decrease the menstrual flow, reduce dysmenorrhea (the pain you
experience during periods) and lower the risk of endometrial and breast cancer.
However, Dr. Khanna also cautions that if one
misses taking a pill for a day, it could cause breakthrough bleeding or
spotting. “One could also have nausea, vomiting, fatigue, and gain weight
temporarily,” she adds.
Krishnendu K J, a creative designer from Bengaluru, recalls
how she was advised to be on the pill in 2020 due to hormonal imbalance issues.
“Although it did help clear my acne, one of the predominant side effects that I
faced was extreme weight gain,” she says. “Within two years, I went from being
underweight to obese.”
Dr. Khanna says that a person who wants to opt for the
combined oral contraceptive pill should consult a gynecologists. “If one is
severely diabetic, has jaundice, is hypertensive, smokes, has migraines or a
history of thrombosis (when blood clots form within blood vessels), they should
avoid taking these pills,” she explains.
These pills also help prevent ovulation by thickening the
mucus of the cervix, Dr. Kumar explains. “They are cyclical — they have to be
taken duly. There have been instances where women have skipped the pill, and
the contraceptive effect reduces.”
Dr. Palshetkar says that one of the rarer side effects of
oral birth control pills is the formation of blood clots.
Injections: Progestin is administered in the form of
injections every three months.
However, there are chances of unwanted pregnancy
if the course is not followed diligently as well as irregular
periods, says Dr Kumar
Skin patches: The skin patch contains the hormones
estrogen and progestin, and can be worn on the arm or belly, among other body
parts.
Vaginal Rings: Small plastic contraceptive rings
inserted into the vagina. It needs to be worn for three weeks, after which
it is to be removed for a week before one inserts a new ring.
Intrauterine devices (IUD)
Also known as long-acting reversible contraceptives or
LARC, IUDs such as Copper-T and hormonal IUDs are placed in the uterus.
IUDs, especially Copper-T, can work for five to ten years,
Dr. Khanna informs. She adds, “If a couple is looking for a long gap before the
birth of their second child, for instance, these might be the methods they
prefer. They can get it removed whenever they want to conceive.”
Dr. Kevin Gala, consultant, gynaecology and obstetrics, SRCC
Children’s Hospital, Mumbai, says that LARC birth control methods such as
implants and IUDs are highly effective as birth control methods and have a low
failure rate. “They provide long-term contraception without requiring daily
maintenance. They also do not interfere with sexual spontaneity,” he says.
At the same time, IUDs could cause irregular, breakthrough
bleeding and irregular, scanty periods. “These are also operator-dependent. One
must get these devices placed only in a hospital setting and not take it on
their own,” says Dr Khanna.
Permanent birth control
Tubal ligation: A permanent birth control method for
women whereby a portion of the fallopian tube is cut or tied to prevent the
fertilizations of eggs by the sperm.
Vasectomy: A procedure to cut and seal the vas
deferens for men, which prevents sperm from entering the semen.
Emergency contraception
Dr. Palshetkar says that emergency contraceptive pills,
which contain a high dose of progestin, can be taken up to five days after one
has had unprotected sex. These pills are known to have side effects like
nausea, irregular bleeding, and tiredness.
Takeaways
There are many contraceptive methods, including barrier
methods like condoms and diaphragms and hormonal contraceptive methods like
pills and implants. These methods do come with risks and adverse
effects. However, besides preventing unplanned pregnancies, your choice of
birth control could also help regularise your periods or lower the risk of
endometrial and breast cancer. It is crucial to understand the different forms
of birth control available and pick the one best suited to you.
