Dr Sindi Van Zyl explains the advantages and disadvantages of the most commonly used forms of contraceptive to help you find the best birth control for you.
What is birth control?
Also known as contraception, this is a method or device used to prevent pregnancy. The methods come in different types. Not one size fits all, and different women will experience the same method differently because our bodies are varied. So, be sure to get full consultation with your doctor before you get a contraceptive method. Also, choose the right method for you – something that you will use correctly and consistently. Different types are available:
- Natural birth control. Also known as the rhythm or calendar method, it relies on observing your body and menstrual cycle. You need to know when you ovulate, and avoid unprotected sex on those days. This method requires discipline.
Pros: There are no hormones involved.
Cons: It has a very high failure rate.
- The barrier methods are the most familiar type. Condoms are the best example. If used consistently and correctly, they have a 98% success rate at preventing pregnancy and the transmission of sexually transmitted infections. Other methods include the diaphragm, cervical cap and contraceptive sponge. All of these devices are inserted into the vagina.
Pros: Barrier methods offer protection from STIs, and are easily accessible. The government issues male condoms, which are freely available in public hospitals and clinics as well as other public places such as nightclubs.
Cons: Some people are allergic to latex, and so have to use latex-free condoms. Brand name male condoms are costly. But, the female one is an option even though it is not as readily as available as male condoms.
- Intra-uterine devices (IUDs) have gained popularity in recent years. Both available are hormonal and non-hormonal IUDs. These devices are very tiny, and inserted into the uterus by a medical doctor or nurse. The procedure is quick with little discomfort.
Pros: IUDs are long-acting, and last from 5 to 10 years.
Cons: Some women may experience excessive bleeding, period pain or bloating. Some stop menstruating, which is called secondary amenorrhoea.
- Surgical birth control. This method is generally permanent. So, it is important for a doctor to counsel you thoroughly. Make sure that you understand exactly what is going to happen before signing any papers. The male surgical method involves a vasectomy. This is when the vas deferens tube is blocked or cut. It prevents sperm from being released in the semen, thus preventing pregnancy. A disadvantage is that reversal is not always an option. The female surgical method, also known as tying tubes, is tubal ligation. The Fallopian tubes are blocked or sealed.
Pros: This prevents the eggs from reaching the uterus and getting fertilised.
Cons: Reversal is not always an option. So, you need to be certain.
- Hormonal contraception – This works by preventing eggs from being released from the ovaries. It thickens cervical mucous to prevent sperm from entering the uterus, and by thinning the lining of the uterus to prevent implantation of the egg. Hormonal contraception is contra-indicated (not to be used or given because it could cause harm) on anyone with a history of significant hypertension/high blood pressure, ischaemic heart disease, venous thromboembolism and stroke. Let the doctor know if you fall into this category. The Pill is one of the most widely used forms of hormonal contraception. Other examples of hormonal contraception include the implant, patch and vaginal ring. Injectable contraception is also available, such as Depo–Provera.
Pros: If taken consistently and correctly, it has up to 99.9% efficiency rate.
Cons: The man-made hormones oestrogen and progestogen are not for everyone. Your doctor has to first assess you thoroughly.
Public sector facilities, private sector facilities including general practitioners or gynaecologists, Marie Stop Clinics and selected retails pharmacies that have a clinic and nurse clinician are where you can find out about, and receive birth control options. Not all methods are always available so it is best to enquire ahead of time.