The right contraceptive

By admin
01 September 2014

Your little one only just left the diapers behind, and you aren’t quite ready for another addition to the family. Here is all you need to know about your options for contraceptives.

The Implant

How it works:

The small rod-like Implanon or Jadelle implant is inserted under the skin of the upper arm. It releases progesterone into the bloodstream at a slow, steady rate and lasts between three and five years.

Effectiveness:

Only one in 2 000 women falls pregnant in the first year of use. Less than one in 1 000 falls pregnant in three years, making it the most effective contraceptive of all, Dr Judy Kluge says.

Possible side effects:

Changes in menstruation, headaches and nausea. Some women stop having periods altogether.

Use it if you:

  • Want a long-lasting, effective contraceptive.
  • Can’t use contraceptives containing oestrogen.
  • Forget to drink your pill every day.

Find an alternative if you:

  • Have breast cancer or any type of cancer that’s sensitive to progesterone.
  • Have liver cancer or liver disease.
  • Have blood clots. S Have undiagnosed abnormal vaginal bleeding.
  • Find the side effects unbearable.
  • Are on ARVs or TB medication.

Copper IUD

How it works:

A gynaecologist inserts the T-shaped intrauterine device (IUD) into the womb. The hormone-free device releases copper ions, which kill sperm.

Effectiveness:

One in 200 women falls pregnant in the first year. Possible side effects Changes in menstruation, cramps and abdominal pain, small risk of infection during insertion. It can be expelled during the first menstruation. Let your doctor teach you how to feel for the strings.

Use it if you:

  • Want a long-lasting contraceptive.
  • Can’t use contraceptives that contain hormones.
  • Need an effective emergency contraceptive. The copper T can be inserted up to five days after unprotected sex and still be effective at preventing pregnancy.
  • Are forgetful about administering shorterterm contraceptives.
  • Are on ARVs or TB medication as this doesn’t affect the contraceptive’s effectiveness.

Find an alternative if you:

  • Are allergic to copper.
  • Have cervical or uterine cancer.
  • Suffer from heavy, painful periods. The copper T won’t help with heavy bleeding; in some cases it could make it even worse.
  • Have a condition that affects the shape of your womb, for example, fibroid tumours.
  • Are prone to infections.
  • Have abnormal vaginal bleeding.
  • Have an STI.

Hormonal IUD:

How it works:

Similar to the copper T, the hormonal IUD or Mirena is inserted into the uterus but instead of copper it releases the hormone progesterone. It lasts up to five years.

Effectiveness :

One out of 500 women falls pregnant in the first year. Side effects Lighter but unpredictable and prolonged bleeding during the first six months, cramps and abdominal pain, a small risk of infection during insertion. Make sure it isn’t expelled during your first menstruation.

Use it if you:

  • Suffer from heavy, painful bleeding.
  • Suffer from endometriosis.
  • Want a long-lasting contraceptive.
  • Can’t use contraceptives that contain oestrogen.
  • Forget to take the pill every day.

Find an alternative if you:

  • Have breast, cervical or uterine cancer.
  • Have liver cancer or liver disease.
  • Have a womb that’s shaped differently because of a medical condition such as fibroid tumours.
  • Have a pelvic infection.
  • Have vaginal bleeding.
  • Have an STI.

Injection:

How it works:

It contains progesterone. If you’re on Nur-Isterate you have a shot every two months. Depo-Provera or Petogen injections are administered every three months.

Effectivenes:

Three out of 100 women fall pregnant in the first year. Side effects Changes in menstruation, breast tenderness, nausea, headaches, an average weight gain of 3 kg, acne.

Use it if you:

  • Can’t use contraceptives containing oestrogen.
  • Are on ARVs or TB medication as the Petogen injection’s effectiveness isn’t affected by other medications.
  • Have recently given birth.
  • Require longer-acting contraception.

Find an alternative if you:

  • Have severe, uncontrolled high blood pressure.
  • Have irregular vaginal bleeding.
  • Plan to become pregnant in the next year. It can take up to one year before the effects of the injection wear off.
  • Have blood clots or have had a stroke.

Combination Contraceptive:

How it works:

The best-known combination contraceptive – so called because it contains both oestrogen and progesterone – is the pill. You have to take it once a day for three weeks, after which you can have a week in which you take either no pill or a placebo. During this week you’ll have a withdrawal bleed. If you keep taking the active pill after the three weeks you won’t have a period. The vaginal ring, also a combination contraceptive, sits inside the vagina from where it releases oestrogen and progesterone for three weeks. You can go ring-free for a week or insert a new one. The patch, which administers hormones through the skin, is replaced once a week for three weeks. You can go patch-free for a week or decide to continue with it, thus preventing your period.

Effectiveness:

Eight out of 100 women fall pregnant in the first year. Side effects Breakthrough bleeding, moodiness, breast tenderness, headaches, nausea, fluid retention, weight gain.

Use it if you:

  • Want to control your periods.
  • Suffer from painful periods or PMS.
  • Suffer from acne (not all pills help with this).
  • You plan to become pregnant in the near future.
  • Have excessive hair you want to get rid of (with the recommendation of your doctor).
  • Suffer from endometriosis or ovarian cysts.

Find an alternative if you :

  • Have breast cancer (or any other type of cancer that’s sensitive to progesterone or oestrogen).
  • Have liver cancer or liver disease.
  • Are 35 or older and smoke.
  • Are overweight.
  • Have a family or personal history of blood clots.
  • Have diabetes.
  • Have high blood pressure.
  • Have a heart disease or abnormality.
  • Have high cholesterol.
  • Suffer from migraines with auras.
  • Are immobile, for example, from being bedridden.
  • Suffer from lupus.
  • Are on ARVs or TB medication.

- Petro-Anne Vlok

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