Which contraceptive suits me?

Are you considering planning your family and spacing your children at an interval of your choice, not having children at all or having achieved the desired number of children?

Well, then you could be doing some research on a suitable contraceptive that best suits you but how can you tell what’s suitable for you?

Dr Joan Okemo, a consultant obstetrician gynaecologist at Aga Khan University Hospital Nairobi gives you insights on what to consider when choosing a suitable contraceptive.

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What contraceptive options do I have to choose from?

There are two types of contraceptives; natural and artificial birth control. Natural methods work on the understanding of the female reproductive cycle and the fertile window.

This includes safe days during the menstrual cycle or pulling out by the male partner. They offer a choice for couples not willing, or able to use other contraceptive options.

These methods require a very predictable, regular cycle, partner cooperation, and a lot of consistency, their typical failure rate fluctuates significantly and can be quite high.

What artificial contraceptives are there?

Artificial contraceptives can be classified under two categories; non-hormonal and hormonal.

Non-hormonal contraceptives include male and female condoms, cervical cap, or diaphragm, copper IUD (coil) and sterilisation. Sterilisation is tubal ligation in women and vasectomy in men.

Hormonal methods of birth control are pills, injections, contraceptive patches, implants, and the hormonal IUD, or coil.

Implants are small flexible plastic rods about the size of a matchstick embedded with hormones that are implanted under the arm skin. They can last three, or five years.

The commonest contraceptive injection is the three-month ‘depo’ injection. It is related to the implants in hormone content but is slightly less effective. The contraceptive patch is a good substitute for those who may wish to take contraceptive pills but are unable to sustain daily doses.

The woman sticks the small adhesive patch on her skin and changes it every seven days. If fixed on dry skin it will withstand taking a bath and even swimming.

How effective are emergency pills?

Emergency contraceptive pills (e-pills) are among the most misunderstood and hence abused contraceptives in the Kenyan market.

There are several emergency contraceptive pill choices including counterfeit products. However, the most commonly used e-pill contains the hormone Levonorgestrel. It is 98 percent effective in preventing pregnancy if taken at the earliest within 72 hours of sexual activity.

Unknown to a majority of people, the copper coil is an alternative emergency contraceptive that is effective and works if fitted up to five days after unprotected intercourse.

Any permanent forms of family planning?

Male and female sterilisation is a permanent birth control option for couples who do not wish to have more children. They entail a small cut to block the fallopian tubes in women or semen passages in men. Both can be performed in an outpatient clinic.

What are the pros and cons of the options listed above?

A major concern amongst the majority of women considering hormonal birth control is weight gain, menstrual irregularities, decrease in libido, or, change in skin texture. Each contraceptive exposes women to different side effects. Personal preference affects the choice of contraceptives.

On average what’s the likelihood of a contraceptive failing?

Contraceptive methods are safe, provide good protection against unwanted pregnancy but nothing is perfect; failure rates are very low and depend on the method used. For example, there have been reports of women conceiving while on the coil.

It is very rare and could be a result of downward displacement, or even expulsion of the coil due to contractions of the uterus during menstruation. As a preventive measure, women usually receive instruction on how to check for the position of the coil.

Can I discontinue a contraceptive choice when I want to have children before the stipulated duration?

Ovulation and fertility resume soon after contraceptive use. We advise couples to be patient and tailor their expectations appropriately. Even without prior contraceptive use, a healthy couple may take a year, or more to conceive.

However, couples with, or without a history of contraceptive use are advised to have a check-up just to be sure all is well if they have not conceived after a year of regular unprotected intercourse.

How do I know which contraceptive suits me?

The type that works best for you will depend on your health status and the reason behind the need to use contraceptives. Before choosing, it’s important to discuss with your doctor to guide you on what is suitable for you.