How to choose my hormonal contraceptive?
A friendly guide
Worldwide almost 50% of pregnancies are unplanned and 50% of them result in abortions.
There is a great medical and psychological effort to reduce the rate of unwanted pregnancies worldwide.
So – let’s discuss how science can assist us in getting pregnant or avoiding pregnancy through different METHODS OF CONTRACEPTION.
NOTE – contraception success is measured here by success rate – the percentage of women that avoided pregnancy during the first year of usage.
HORMONE based contraception:
Estrogen+progesterone
The pill, patch & ring – all have a 91% success rate.
The Pill – is swallowed once daily usually for 21 days and 7 days off, should be taken at the same time, many hormone doses and types.
The patch – Set on the skin and changed every week. Has low hormone doses.
The Ring – Self inserted vaginally for 3 weeks. Has low hormone doses.
Pro’s:
• 91% effectiveness (it means 91 out of 100 women will not get pregnant while taking it during the first year).
• Helps with heavy and irregular bleeding, and may minimize acne and menstruation-related pain.
• Prolonged use decreases the risk for ovarian and uterine cancer.
• May be taken continuously to avoid menstruation altogether for a few months.
• The ring may be left in the vagina even during sex.
Con’s:
• Does not protect against sexually transmitted diseases.
• May not be used for women with blood clotting problems or smoking after the age of 35.
• User dependent – If forgotten or left out women are at risk for unwanted pregnancy for several days.
• May lower sexual desire or cause vaginal dryness and pain during sex (dyspareunia).
Progesterone only pill:
The Pill – is swallowed once daily and taken continuously.
Pro’s:
• 97% effectiveness.
• safe for women at risk for blood clotting and immediately after birth or abortion.
• Reduces heavy bleeding effectively.
• Progesterone is a good choice for lactating women as it enhances milk production.
Con’s:
• Side effects like Irregular bleeding and spotting (usually only the first few months)
• Some progesterone types may worsen acne.
• If forgotten puts women at risk for unwanted pregnancy.
• Does not protect against sexually transmitted diseases.
Intrauterine device – progesterone based inserted once at the OBGYN appointment, for 3 or 5 years.
Pro’s:
• 99.9% effectiveness
• comes in a few sizes, recommended for all ages. 100% reversible
• Reduces heavy bleeding and pain related to menstruation
• recently added as an emergency contraception option up to 5 days after sex.
Con’s:
• Insertion and extraction may be painful, lasts approx. 5-10 min.
• Some women experience irregular bleeding and spots – which usually disappear after a few months.
• Risk for pelvic infection is small and only lasts for one month following insertion (antibiotic is sometimes recommended in advance).
• Does not protect against sexually transmitted diseases.
Long acting – hormone injection once every month or 3 months or an implant under the skin:
Pro’s:
• 99.9% effective and not dependent on the user.
• No need for daily reminders.
• Usually no menstruation for long periods.
Con’s:
• No protection against sexually transmitted disease.
• Some women may experience side effects like heat waves, vaginal dryness, and painful intercourse.
• Menstruation may take a while to return after discontinuation.
Next time we will continue to discuss Contraceptives – How to choose a contraceptive without hormones?
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