Types of contraceptives and its effectiveness

What are contraceptives?

Contraceptives are also called as birth control. These contraceptives are usually pills or medicines that are used to prevent pregnancy. Contraceptives are not only used to prevent childbirth but also to prevent the transmission of certain deadly viruses like HIV and hepatitis. These diseases are sexually transmitted and are life-threatening.

Birth control techniques only work when they are used properly. There are many types of birth control techniques like pills, condoms, intrauterine devices and permanent birth control techniques like surgery. The blog will give the types and uses of contraceptives.

Types of contraceptives

There are many types of contraceptives used depending on their purpose.

Long-Acting Reversible Contraception (LARC)

Long-acting and reversible contraception does the job of contraceptives, and also birth control can be reversed. Some examples of long-acting reversible contraception are intrauterine methods and implants.

Intrauterine Methods

Intrauterine devices or intrauterine systems are small T-shaped devices that will be inserted into the woman’s uterus to prevent pregnancy. The T-shaped device will be fitted by a healthcare professional and will play its role for a destined period of time.

After the recommended time of usage, the device will be removed by a healthcare professional. It is not necessary that it will only be removed, depending on the purpose of the device will also be replaced.

Some of the commonly used intrauterine are hormonal IUDs and copper IUDs. Hormonal IUDs release progestin hormone into the uterus. The released hormone will lead to the thickening of cervical mucus and inhibits the sperms from fertilising the eggs.

According to research, the failure rate of hormonal IUDs is less than 1%, and these IUDs surpassed the effectiveness period for more than their recommended usage. It is also used for heavy menstrual bleeding.

Another type of IUD is the copper IUD. The mechanism is as same as the intrauterine hormonal device. However, the copper IUD is not recommended for women with pelvic infection or cervical cancer.

Implants

Implants are matchstick-sized, plastic and flexible implantable rods. According to research, the failure rate of implants is less than 1%.

The implants are usually inserted under the skin of a woman’s upper arm. The inserted rod will remain for a period of 5 years. These rods release progestin for the implanted period.

Hormonal Methods

Hormonal methods are the use of hormones to regulate or stop the ovulation process. By doing so, we can prevent pregnancy. Ovulation releases an egg from the ovary, making the egg available for fertilisation.

Hormones that control ovulation can be given in the form of pills, skin patches, injections, transdermal gels and vaginal rings.

The hormones will prevent ovulation by thickening the mucus and blocking the sperm from reaching the egg. These hormonal contraceptives will be monitored by a healthcare professional.

Some of the commonly used hormonal methods are

• Short-Acting Hormonal Methods
• Injectable birth control
• Progestin-only pills (POPs)

The short-acting hormonal methods are pills, patches, rings and injectables.  The injectable birth control is given in the arms or buttocks every three months. The injectables can lead to loss of bone density. However, the condition is temporary and commonly seen among adolescents.

After discontinuing the injectables, the loss of bone will stop, and the growth will be regained. People using injectables are advised to consume a diet rich in calcium and vitamin D to strengthen the bones.

Progestin-only pills are pills that should be taken only once a day. These pills interfere with the process of ovulation or with sperm function. These pills tend to thicken the cervical mucus, which makes the sperm difficult to swim to the uterus and then to the fallopian tubes to fertilise the eggs.

These pills can potentially change the cyclic schedule and lead to breakthrough bleeding. However, these pills are not associated with the risk of blood clots.

Combined Hormonal Methods

Combines hormonal methods containing synthetic oestrogen and progestins. These hormones thicken the cervical mucus and inhibit the process of ovulation. The combined hormonal methods are usually delivered in the form of patches, pills and vaginal rings.

The combined hormonal methods have medical risk factors like blood clots. Consult your healthcare professional before using them.

Some of the commonly used combined hormonal methods are

• Combined oral contraceptives
• Combined patch
• Vaginal ring

The combined oral contraceptives contain synthetic hormones like oestrogen and progestin. The primary function of the combined oral contraceptives will be to inhibit ovulation.

There are many types of oral contraceptives available, and only a healthcare professional should determine the type of oral pills that meets a woman’s needs.

A contraceptive patch is a thin plastic that can stick to your skin and helps release hormones through the skin into the bloodstream.

The placement of the patch is usually done on the lower abdomen, outer arm, buttocks or upper body. A replacement of a new patch will be required after three weeks, and on the fourth week patch will not be used to regulate menstruation.

Vaginal rings are flexible, thin and approximately 2 inches in diameter. The vaginal rings deliver a combination of ethinyl estradiol and progestin. The ring will be inserted into the vagina, where the hormones will be released continuously for three weeks.

The removal of the vaginal ring is advised on the fourth week, and reinserting it after seven days. However, vaginal rings are not recommended for women with health conditions like high blood pressure, cervical cancer and heart disease. The risk of vaginal rings is similar to that of contraceptive pills.

Barrier Methods

The barrier methods are primarily for women who cannot use hormonal methods of contraception. The barrier method aims to prevent sperm from entering the uterus. The failure rate depends on the type of method used. Some of the common barrier methods are explained below.

Male condoms

Male condoms are made of thin plastics that cover the penis. The thin plastic collects the sperm during ejaculation and prevents it from entering the woman’s uterus. The condoms are usually made of polyurethane or latex.

There are many natural alternatives like lambskin available. The lambskin is made of the intestinal membrane of lambs. However, condoms made of latex or polyurethane can prevent sexually transmitted diseases (STD), whereas a condom made of lambskin cannot prevent an STD.

Female condoms

The female condoms are made of thin, flexible plastic pouches. A small part of the female condom will be inserted into the woman’s vagina with a ring hanging out. Female condoms prevent sperm from entering the uterus.

With the help of the ring that is hanging out, you can remove the condom and dispose of it. Female condoms can also prevent the transmission of STDs.

Contraceptive sponges

Contraceptive sponges are soft, spermicide-filled foam sponges that can be disposed of. These sponges should be inserted into the woman’s vagina before intercourse. This will prevent the sperm from entering the uterus.

The sponges should be left for at least six hours after intercourse and should be removed within thirty hours after intercourse. There are many FDA-approved contraceptives available in the market.

Spermicides

Spermicides are used to kill sperms and are used in combination with a cervical cap or diaphragm. The commonly used spermicidal agent is a chemical called nonoxynol-9 (N-9).

The spermicides are available in various concentrations and forms like gels, foams, creams, film and suppositories.

The spermicide should be inserted into the vagina close to the uterus before 30 minutes of intercourse and should be left for about 6-8 hours after the intercourse to prevent pregnancy. However, spermicides will not prevent the transmission of STDs and can cause an allergic reaction or vaginitis.

Diaphragms

Diaphragms are made of shallow flexible cups that are soft. They are made of latex and rubber. These diaphragms should be inserted into the vagina before intercourse, which helps block the sperms from entering the sperms.

The diaphragms should be left for about 6-8 hours after intercourse and should be removed within 24 hours after intercourse.

Cervical caps

Cervical caps are similar to diaphragms but smaller in size and rigid. The cervical cap is made of latex and should be inserted into the vagina before intercourse to prevent the sperm from entering the uterus.

The cap should remain in place for about 6-8 hours after intercourse and should be removed within 48 hours after intercourse.

Emergency Contraception

Emergency contraception is used when unprotected intercourse occurs, like a condom getting torn. Some of the commonly used emergency contraceptions are

• Copper IUD
• Emergency contraceptive pills (ECPs)

A copper IUD is the most effective emergency contraception. The device can be inserted within 120 hours of unprotected intercourse. According to research, the method is reported to be 100% effective in preventing pregnancy. It also adds the benefit of contraception as long as the device is left in place.  

Sterilisation

Sterilisation is a permanent method of contraception that prevents a woman from getting pregnant. The sterilisation procedure will be performed by a healthcare professional. Usually, surgery is carried out, and the procedure cannot be reversed.

Some of the common types of sterilisation are

• Sterilisation implant
• Tubal ligation
• Vasectomy

A sterilisation implant is a non-surgical procedure that blocks the fallopian tubes permanently. A professional will thread a thin, flexible tube through the vagina and into both fallopian tubes.

The procedure will not require an incision, and after three months of insertion, scar tissue forms around the inserts and blocks the fallopian tubes in such a way the sperms cannot reach the egg.

Tubal ligation is a surgical procedure where the fallopian tubes are cut, tied or sealed. This will block the path between the ovaries and uterus and prevents the sperms from reaching the eggs. The surgery will be performed by a healthcare professional.

The vasectomy is a surgical procedure that blocks, cuts or closes the vas deferens. The surgery blocks the path between the testes and the urethra, which prevents the sperm from leaving the testes. The procedure can take about three months to become fully effective.

How to choose a contraceptive?

With the knowledge of the types and uses of contraceptives, you can choose the one that is best suitable.

• Choose the ones that are comfortable for you.
• Select the contraceptives that have a higher efficacy to prevent pregnancy.
• Look for methods that prevents a sexually transmitted disease (STDs).
• Consider your age and health.
• Risks and side effects of usage.
• Frequency of sexual intercourse and the number of partners.

Pros and cons of contraceptives

The advantages and disadvantages of the contraceptive depend on the method.

Method	Effectiveness	Pros	Cons
Birth Control Implant	99%	Lasts for about 3-5 years.	Expensive when compared to other methods.
IUD (Intrauterine Device)	99%	It lasts for about 5-10 years and is low maintenance.	Expensive and may cause irregular/heavy periods.
Vasectomy	99%	Does not affect ejaculation.	Cannot be reversed and expensive.
Tubal Ligation	99%	Very effective.	It cannot be reversed and is expensive.
Tubal Implants	99%	Most effective and doesn’t require surgery.	It cannot be reversed and is expensive.
Birth Control Shot	97%	Better than birth control pills.	Expensive and causes spotting and other side effects.
Birth Control Pill	92%-95%	Effective and can cause more regular, lighter periods or no periods.	It may cause breast tenderness, spotting, blood clots and raised blood pressure.
Vaginal Ring	92%-95%	They are effective like pills and can cause lighter and regular periods.	It may cause vaginal irritation or other side effects similar to the pill.
Male Condom	84-89%	Inexpensive. One of the few birth control methods to prevent sexually transmitted diseases.	It cannot be reused and is effective only if used correctly every time.
Diaphragm	84-89%	Inexpensive	The doctor must initially fit it to ensure proper function.
Cervical Cap	84-89%	Inexpensive can stay in place for 48 hours	The doctor must initially fit it to ensure proper function
Birth Control Sponge	84-89%	Effective immediately. Works about as well as the cervical cap	It can be hard to put in

Why is contraception is important?

Contraceptions are important to reduce the unplanned pregnancy. It also prevents contracting sexually transmitted diseases.

When to consult a doctor?

Consult a doctor if you have side effects like heavy bleeding. Also, discuss the permanent contraception methods and their effectiveness of the method.

Conclusion

Contraceptive methods are essential to prevent unplanned pregnancy and transmission of STDs. There are various methods available, and use will depend on the purpose and how many sexual partners a person has.

However, consult your doctor to know about the contraceptive methods, their use and side effects.

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