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Birth control refers to the process of preventing pregnancy before it occurs. It refers to any medicine, device or method used for this purpose. Couples opt for birth control due to different reasons, the most common being, family planning. There are different methods of achieving birth control. Some of these pose health risks and others are completely safe.

The choice of method depends on the health status of the individual, the desired duration of contraception (birth control) and personal choices of the individual. It is important to note that both men and women can practice birth control.

All these methods of birth control, including barrier devices (male and female condoms), birth control pills, implants, shots, intrauterine devices (IUDs), and male and female sterilisation techniques will be discussed ahead along with some natural methods of birth control.

  1. Contraception
  2. Birth control methods
  3. Natural methods of contraception

Conception (childbirth) occurs when the male and female gametes, the sperm and the ovum, respectively, meet inside the female body. This can be avoided by preventing the process of fertilisation, achieved by the process of contraception. Several methods, like, forming a barrier which prevents gametes from meeting or making the female womb hostile for the implantation of the foetus, and many more are the ways of achieving contraception.

There are several methods of birth control, each having different effectiveness. They can be used at home or given at a private clinic or centre. Some of them like sterilisation methods require surgical expertise. Since none of these methods can be regarded to be the best for every couple seeking birth control, all of these methods have been discussed in this section.

  1. Condoms
  2. Contraceptive pills
  3. Contraceptive pills in India
  4. Contraceptive injections
  5. Contraceptive implant
  6. Intrauterine devices
  7. Cervical cap
  8. Spermicide
  9. Vasectomy and tubectomy procedures

Condoms

Condoms are a barrier type of device and are the safest form of contraceptive? Why? Because they have no side effects and, in addition, work to protect you from sexually transmitted diseases and infections.

Functioning

Condoms function by forming a barrier between the male and female reproductive organs, which prevents the semen from entering the vagina. So, fertilisation and conception fail to occur.

Both male and female condoms are available and cover either the penis or the vagina, functioning in the same manner.

Benefits of using condoms

Condoms are a preferred method of birth control because they have no side effects as opposed to contraceptive pills or implants. They also do not affect your fertility and you can get pregnant immediately as soon as you stop using the device.

Side-effects

Allergy to latex may cause irritation.

Contraceptive pills

Another popular method of contraception is the contraceptive pill or the combined pill or just the pill, which is available in different combinations and functions by various mechanisms.

Functions

It functions by increasing the thickness of the cervical mucosa, which makes it difficult for the sperm to penetrate and reach inside the female reproductive system. Another method by which it functions is that it thins the lining of the uterus, which reduces the chances of implantation of the foetus.

Some of the contraceptive pills may reduce the production and availability of the egg or the ovum, thus, desisting fertilisation. Contraceptive pills contain female hormones, estrogen and progesterone, in an artificial form, which is responsible for such actions.

Dosage

They are meant to be taken for a duration of 21 days, following a rest of 7 days during which bleeding occurs. Monophasic and phasic pills function in this way, with the difference between the two being in the amount of hormones.

A packet of monophasic pills has 21 pills with the same amount of hormone to be taken at the same time each day, following which no pills are to be taken for 7 days. Phasic pills contain 2 or 3 sections of pills marked in a different colour, containing different amount of hormones. They need to be taken in the correct order.

Another type of contraceptive pills are the everyday pills, which contain a pill for every month of the day. The first 21 pills contain hormones and are termed as ‘active pills’ and the remaining pills are placebo or inactive. Bleeding occurs while taking placebo pills.

They are meant to be taken beginning at the recommended day by your doctor, following which you take them for 21 days and then stop for 7 days during which bleeding occurs. On the eighth day, you are supposed to take the pill regardless of the state of bleeding.

The characteristic of these pills is that they are meant to be taken at the same time each day as prescribed by your doctor. Failure to do so may reduce the effectiveness of these pills and diminish their contraceptive actions.

Side-effects

These pills have certain side effects like nausea, vomiting, diarrhoea, mood swings, headache and breast tenderness. They are also mildly associated with weight gain and clotting of the blood.

Whether or not the pill is suitable for you and which pill must be taken will be recommended to you by your doctor. You must sincerely follow this advice and ensure uniformity in time while taking the pill.

Contraceptive pills in India

To reduce the side-effects caused due to usual contraceptive pills and to increase the utilisation of these pills by the masses, new contraceptive pills were developed in India.

These pills did not contain the hormone estrogen rather contain centchroman, a compound which blocks estrogen. So, it is relatively safe and is widely used by women, especially those living in rural India. Under the brand name of Saheli or Chhaya, it is also distributed free to women living in such areas.

Dosage

It is meant to be taken twice a week for the first three months, following which, it is taken once weekly, as prescribed.

Benefits

The advantage of using this over a conventional pill is that it has fewer side-effects and is even found to possess anti-cancerous properties.

Contraceptive injections

Contraceptive injections release the hormone progesterone in the body, which prevents pregnancy. This reduces ovulation reducing the chances of fertilisation. Other mechanisms of contraception include thickening of the cervical mucosa and thinning of the lining of the uterus.

Dosage

Contraceptive injections can be taken at any time during the cycle and require a few days before being effective. They are injected by a physician or a health care provider.

Benefits

It is 99% effective against pregnancy and lasts for 8 to 13 weeks once injected. This makes it a more lasting method of contraception other methods, which need to be used daily or at each time while having sex.

Side effects

It works by reducing ovulation, that is, the production of egg, so it has several side-effects. These include headaches, weight gain, mood swings, irregular menstruation and in severe cases, even amenorrhoea.

They are not the most suitable methods of contraception if you are looking to get pregnant anytime soon. It may, however, take about a year for fertility to return to normal.

Contraceptive implant

Contraceptive implants work in the same way in the body by releasing progesterone preventing ovulation to occur each month. It is inserted below the skin and is functional for a duration of 3 years after its insertion, once activated.

Benefits

Implants are inserted within minutes, under the effects of local anaesthesia and leave no scar.  It can be easily removed immediately, restoring your fertility, as opposed to contraceptive injections.

Side effects

It has similar side effects as contraceptive injections including changes in menstrual cycle and amenorrhoea. Some other side effects include irritation or swelling of the skin in the area of the implant.

Intrauterine devices

Intrauterine devices (IUDs) are loops or T-shaped devices made of copper, which are slowly released after its placement in the uterus. It is inserted in the uterus through the cervix by holding open the vagina by a general practitioner or nurse. This process can be painful and may be performed under the effects of local anaesthesia.

Functions

It functions by inhibiting implantation of the fertilised egg in the uterus and by reducing ovulation.

Benefits

The advantage of this method is that it is 99% effective for a period of 5 to 10 years, which is quite longer than the other contraceptive methods. Another advantage is that it can be checked if the device is still in place by feeling for the copper loop by inserting your hand deep in the vagina. Moreover, fertility is restored immediately after removal.

Side effects

IUDs some serious side effects like pelvic infection, damage to the womb or ectopic pregnancy. Cramping is commonly experienced after the procedure.

Some cases of rejection of IUD by the body have also been reported, wherein the body expels out the device leading to a loss of contraceptive action.

Cervical cap

Cervical cap is another barrier type of device, which is tightly worn around the cervix, that is the opening of the uterus. It prevents the entry of the sperm preventing fertilisation.

Benefits

It can be left on for 24 hours, so, you can have sex for as many times you want during this duration without worrying to change the device. However, for this, it is important that the cap is correctly placed and tightly held by suction. This may require you to visit a surgeon to get the right fit of the device.

Side effects

Some of the disadvantages include vaginal irritation or allergy or the development of a urinary tract infection.

Spermicide

Spermicide is a method of birth control, which functions by preventing the union of the sperm and ova. This is enabled by thickening of the cervical mucosa which prevents the entry of the sperm. But, the primary function of spermicide is to reduce the motility of the sperm, so it cannot reach the ovum.

Forms

It is available in the form of foam, creams, gels and lotions, which are meant to be inserted deep within the vagina (at the base of the cervix) each time you have sex.

Uses

When used alone, spermicides are 77% effective, but this function can be improved by combining it with a condom device or some other form of contraceptive.

Side effects

Though generally safe, spermicides may have some serious side-effects, which include a higher risk of STDs with its use. This is because it may irritate the vagina making it easier for infections to spread within the body.

Vasectomy and tubectomy procedures

Vasectomy and tubectomy refer to sterilisation procedures in males and females, which are performed in individuals who are looking for a permanent contraception.

Tubectomy

This is the surgical procedures conducted on the fallopian tube in females

Procedure

In tubectomy, the fallopian tube is ligated and tied by laparoscopy or mini-laparotomy procedures by forming an incision in either the area of your belly button (laparoscopy) or above your pubic area (mini-laparotomy).

It works by avoiding the eggs from reaching down the fallopian tube, which makes it unavailable for fertilisation.

Benefits

This method is very effective and does not alter your hormone levels, menstrual cycle, libido or general health.

Side effects

  • It has minimal surgical complications like internal bleeding or infections, but, sometimes damage to internal organs may also occur.
  • One must be totally sure before undergoing a tubectomy procedure since it is highly difficult to reverse it.
  • At times, the fallopian tubes may reunite themselves after years, which is not desirable for contraception.
  • In some cases, an ectopic pregnancy may also occur.

Vasectomy

This is the surgical procedure carried out on vas deferens in men as a method of contraception. 

Procedure

In a vasectomy, vas deferens or the tube that carries sperms to the testicles is ligated. This is a surgical procedure performed on the scrotum under the effect of local anaesthesia. It is performed as a scalpel or a non-scalpel surgery, both of which prohibit the entry of sperms in the semen, preventing the fertilisation of the eggs.

Benefits

It does not affect sex drive and other sexual functions.

Side effects

  • Vasectomy is difficult to reverse just like tubectomy. So, both the partners must be sure before going for this procedure.
  • The side effects of this procedure include pain or bruising in the testicles.
  • There is also a risk of infection, hematoma or granuloma with this procedure.
  • In rare cases, vas deferens may reconnect reversing contraceptive actions.

Natural methods of contraception refer to methods of birth control, which do not involve the use of an external device or method.

Pulling out

Pulling out is one of the most common methods of contraception, in which the male pulls out his penis during sex before the process of ejaculation.

Side effects

Withdrawal or pull out is not a 100% effective technique, since sometimes even the pre-ejaculation may contain sperms. Using a spermicide along may, however, increase the effectiveness of this method.

Outercourse

Outercourse is another method of contraception, which involves different practices like mutual masturbation, touching each other’s genitals or ejaculating on another body part to avoid pregnancy.

Benefits

It usually involves non-sexual intimacy activities, which cannot lead to pregnancy and have no other risks.

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References

  1. National Health Service [Internet]. UK; What is contraception?.
  2. National Health Service [Internet]. UK; Combined pill.
  3. National Health Portal [Internet] India; New Contraceptives
  4. National Health Service [Internet]. UK; The contraceptive injection.
  5. National Collaborating Centre for Women’s and Children’s Health (UK). Long-acting Reversible Contraception: The Effective and Appropriate Use of Long-Acting Reversible Contraception. London: RCOG Press; 2005 Oct. (NICE Clinical Guidelines, No. 30.) 4, [li
  6. National Health Service [Internet]. UK; Intrauterine device (IUD).
  7. Office on Women's Health [Internet] U.S. Department of Health and Human Services; Types of birth control.
  8. Planned Parenthood Federation of America. Spermicide. [Internet]
  9. National Health Service [Internet]. UK; Female sterilisation.
  10. National Health Service [Internet]. UK; Vasectomy (male sterilisation).