Birth control, also known as contraception, is designed to prevent pregnancy. People have used birth control methods for thousands of years. Today, we have many safe and effective birth control methods available.
Birth control methods may work in a number of different ways.
- Preventing sperm from getting to the eggs – such as condoms, diaphragms and intrauterine devices (IUDs)
- Keeping the woman’s ovaries from releasing eggs that could be fertilised – such as birth control pills
- Making the womb lining not suitable for implantation of fertilised egg – such as intrauterine system (Mirena-IUS) and emergency birth control pills
- Sterilisation, which permanently prevents a woman from getting pregnant or a man from being able to get a woman pregnant.
Each woman has different needs when choosing the method of contraception. However, the choice of birth control should depend on several factors. These include the woman’s health, frequency of sexual activity, the number of sexual partners and her desire to have children in the future. It also includes the smoking habit, weight of the woman and family history.
How effective the birth control is depends on the type of birth control the woman uses and whether she uses it correctly.
Some methods of contraception are more effective than others. The woman needs to follow the instructions and use the chosen method correctly for it to be as effective as possible. For some methods, there is no need to remember to take or use them. These are known as methods with no user failure. It includes implant, injection, IUS (intrauterine system- mirena) and IUD (intrauterine device).
No birth control is 100% reliable and some can have side effects.
Here are several methods of birth control available and their effectiveness, for a woman to choose.
Male and female condoms
- Male condoms: 98% effective if used correctly.
- Female condoms: 95% effective if used correctly.
- However, there can be between 15-24 pregnancies per 100 women each year due to incorrect usage.
- It is very good for prevention of sexually transmitted disease in couples with multiple partners.
Diaphragms and caps
- Diaphragms: latex diaphragms with spermicide are 92-96% effective if used correctly.
- Caps: latex caps with spermicide are 92-96% effective if used correctly.
- However, the failure rate can be up to 24% due to incorrect used and it is less effective for women who have given birth.
Contraceptive pill
- Combined contraceptive pill: over 99% effective if taken correctly. Less than one woman in 100 will get pregnant in a year while taking the combined pill.
- Progestogen-only pill: 99% effective if taken correctly. One woman in 100 will get pregnant in a year while taking the progestogen-only pill.
- There can be between 2-9 pregnancies per 100 women in a year due to miss taking the pills.
Long-active reversible contraceptive (LARC) methods
- Contraceptive injections: over 99% effective. They last for eight or 12 weeks, depending on the type of injection. Less than one woman in 100 will get pregnant in a year when using contraceptive injections.
- Contraceptive implants: over 99% effective. They work for three years but can be taken out earlier.
- Intrauterine system (IUS): over 99% effective. An IUS normally works for five years but can be taken out earlier.
- Intrauterine device (IUD): over 99% effective. An IUD can stay in place for five to 10 years, depending on the type but can be taken out at any
- time. It is not suitable for women with multiple sexual partners because it increases risk of infection and STD.
Patch and ring
- Contraceptive patch: over 99% effective if used correctly. Less than one woman in 100 will get pregnant in a year when using the contraceptive patch.
- Vaginal ring: over 99% effective if used correctly.
- The woman uses it for 3 weeks with 1 week (4th week) without the contraceptive patch or the vaginal ring.
Sterilisation (permanent contraception)
- Female sterilisation: more than 99% effective. One in 200 women will become pregnant in their lifetime after being sterilised.
- Male sterilisation or vasectomy: about one in 2,000 men can become fertile again in their lifetime after a vasectomy. Have to use another method for the first 3 months.
Natural family planning
Natural family planning can be up to 99% effective but the methods need to be followed precisely. These include monitoring cervical secretions, monitoring the woman’s basal body temperature, withdrawal technique by the man during sexual intercourse and abstinence during fertile period. It’s more effective if more than one method is used.
Up to one woman in 100 will get pregnant in a year when using natural family planning correctly. However, for some women, natural family planning is not suitable or it may be less effective, especially when they have irregular menstrual cycle.
Special precautions
Woman who is overweight, woman who is smoking, woman who is 40 years and above, woman with medical problems and woman with family history of cancer, stroke or heart disease needs medical advice from medical personnel before using any hormonal birth control.
Dr Nurhazinat Mohamed Yunus
Consultant Obstetrician & Gynaecologist,
Fertility Specialist, Tropicana Medical Centre
