The choices
Effectiveness & advantages
Main drawbacks
Duration
Long-acting hormonal contraception
Contraceptive implant
– Small flexible rod which is placed just under the skin of the upper arm
– Contains progestogen only
•
•
•
•
Over 99% effective
Effective and rapidly reversible method of contraception
Useful for women who cannot remember their contraceptive
Works primarily by:
– Thickening cervical mucus (this blocks sperm from meeting an egg)
– Disrupting the menstrual cycle, including preventing the release of eggs from the ovaries (ovulation)
•
•
•
•
•
Many women have changes in menstrual patterns
Every
Insertion and removal must be performed by 3 years
trained healthcare professionals
Many women experience changes in menstrual patterns
Insertion and removal must be performed by trained healthcare professionals
Not for women who have liver disease, blood clot, on medication for seizures or history of breast cancer
Contraceptive
injections
Contains progestogen
only
•
•
•
•
As commonly used, 97% effective over the first year. When women have injections on time, this method is 99% effective
Given by injection into the muscle (intramuscular injection). The hormone is then released slowly into the bloodstream
Works primarily by preventing the release of eggs from the ovaries (ovulation)
Useful for women who cannot remember their contraceptive
•
•
•
•
Cannot be immediately reversed in event of
side effects
Most women experience changes in menstrual patterns
Requires a few months for fertility to return to normal
Not for women who have liver disease, blood clot, or history of breast cancer
Every 2-3
months
Levonorgestrel
Intrauterine Device
– Intrauterine device that is fitted into the womb
– Contains
progestogen only
•
•
•
•
Over 99% effective
Effective and rapidly reversible method of contraception
Works primarily by suppressing the growth of the lining of uterus (endometrium)
Useful for women who cannot remember their contraceptive
•
•
•
Many women experience changes in menstrual patterns
Insertion and removal must be performed by trained healthcare professionals
Not for women who have liver disease, blood clot, or history of breast cancer
Every
5 years
CONTRACEPTION
AND YOU
Long-acting non-hormonal contraception
Copper-bearing
Intrauterine Device
(IUD)
–Small, flexible plastic frame with copper sleeves or wire around it
–Intrauterine device
that is fitted into the womb
•
•
•
•
98–99% effective
Women who want longer term contraception or who do not want to take hormones
Useful for women who cannot remember their contraceptive
Works primarily by causing a chemical change that damages sperm and egg before they can meet
•
•
Periods may become heavier, longer or more
painful
Insertion and removal must be performed
by trained healthcare professionals
Sterilisation
(Female sterilization
and male vasectomy)
•
•
•
•
•
97% to over 99% effective
Permanent method of contraception that involves no hormones
No long term side effects. Vasectomy does not affect male sexual performance
Female sterilization works by cutting and tying the cut ends of the fallopian tubes, therefore closing them off, not allowing eggs to go through the fallopian tubes to the womb to be fertilized by sperm
Vasectomy works by closing off each vas deferens, keeping sperm out of semen. Semen is ejaculated, but it cannot cause pregnancy
•
•
•
•
•
•
Reversal is usually not possible
Permanent
Involves an operation
For female sterilization, a small risk of pregnancy remains beyond the first year of use and until the woman reaches menopause.
Over 10 years of use:
– About 2 pregnancies per 100 women
(18 to 19 per 1,000 women)
Male sterilisation is not effective immediately
There is a 3-month delay in taking effect. The man or couple must use condoms or another
contraceptive method for 3 months after the vasectomy
Every
3-10 years,
depending
on type of
IUD used
WHAT ARE YOUR CHOICES?1
The choices
Effectiveness & advantages
Main drawbacks
Duration
Short-acting hormonal contraception
Combined pills
Tablet containing estrogen and progestogen
•
•
•
99% effective or more when used correctly
Useful for young healthy women who can reliably take a pill
Works primarily by preventing egg release from the ovaries (ovulation)
•
•
Daily
Not suitable for women with conditions such as high blood pressure, diabetes for more than 20 years or damage to your arteries, vision, kidneys, or nervous system caused by diabetes, gallbladder disease, history of blood clot, stroke, breast cancer, severe migraine, or on medication for seizures
Not suitable for women over 35 who smoke
Progestogen-only
pills
Tablet containing
progestogen only
•
•
•
97% to 99% effective when used correctly
Suitable for women who do not want to or cannot take estrogen
Useful for women who have migraine headaches, who are breastfeeding, smoke cigarettes, adolescents or older women over 40 years old. Works primarily by:
– Thickening cervical mucus (this blocks sperm from meeting an egg)
– Disrupting the menstrual cycle, including preventing the release of eggs from the ovaries (ovulation)
•
•
Bleeding changes are common but not harmful - no monthly bleeding, frequent or irregular bleeding may occur
Not for women who have liver disease, blood clot, on medication for seizures or history of breast cancer
Daily
Contraceptive patch
Patch containing
estrogen and
progestogen
•
•
•
99% effective or more when used correctly
Applied once a week for 3 weeks then no patch
for the fourth week. During this fourth week, the woman will have monthly bleeding
Works primarily by preventing the release of eggs from the ovaries (ovulation)
•
•
•
•
May be seen on the skin
Not suitable for women with conditions such as high blood pressure
Unsuitable for women over 35 who smoke, or have migraine headaches
Bleeding changes are common but not harmful. Typically, irregular bleeding for the first few months and then lighter and more regular bleeding
Weekly
Condoms
Barrier method that
the man or woman
can use
•
•
•
•
When used correctly, around 98% effective for male condoms and 95% for female condoms
In common use, 85% efficacy for male condom and 79% for female condom
Avoids hormones
Works by forming a barrier that keeps sperm out of the vagina, preventing pregnancy. Also keeps infections in semen, on the penis, or in the vagina from infecting the other partner
•
•
•
Natural methods
Recognising the
fertile and infertile
times of your cycle
to plan when you
should avoid
intercourse
•
•
•
•
•
•
•
•
75% effective with common use
Calendar-based methods involve keeping track of days of the menstrual cycle to identify the start and end of the fertile time
Symptoms-based methods depend on observing signs of fertility
Cervical secretions:
– When a woman sees or feels cervical secretions, she may be fertile. She may feel just a little vaginal wetness
Basal body temperature (BBT):
– A woman’s resting body temperature goes up slightly after the release of an egg (ovulation), when she could become pregnant. Her temperature stays higher until the beginning of her next monthly bleeding
Works primarily by helping a woman know when she could become pregnant. The couple prevents pregnancy by avoiding unprotected vaginal sex during these fertile days — usually by abstaining or by using condoms or a diaphragm
Avoids devices or hormones
Can be used at all stages of reproductive lifes
• Can take up to 6 months to learn effectively
As and
• Stress or illness can make the method unreliable
when
• Need to avoid intercourse at certain times of the required
month and be highly motivated
• In the following situations calendar-based methods must be used with caution:
– Menstrual cycles have just started or have become less frequent or stopped due to older age (Identifying the fertile time may be difficult)
– Taking any mood-altering drugs, long-term use
of certain antibiotics, or long-term use of any nonsteroidal antiinflammatory drug (such as aspirin, ibuprofen, or paracetamol). These drugs may delay ovulation
• In the following situations calendar-based methods has to be delayed:
– Recently gave birth or is breastfeeding (Delay until she has had at least 3 menstrual cycles and her cycles are regular again. For several months after regular cycles have returned, use with caution)
– Recently had an abortion or miscarriage (Delay until the start of her next monthly bleeding)
– Irregular vaginal bleeding
Short-acting non-hormonal contraception
Putting a male condom on can involve interruption of intercourse (female condom can be inserted ahead of time and not interrupt sex)
The male condom can break or slip off
Inserting and removing the female condom from the vagina may require some practice
As and
when
required
An educational service brought to you by
This brochure does not replace to need to speak to your doctor.
Talk to your doctor to decide which contraceptive option is suitable for you.
1. World Health Organization Department of Reproductive Health and Research (WHO/ RHR) and Johns
Hopkins Bloomberg School of Public Health/Center for Communication Programs (CCP), INFO Project.
Family Planning: A Global Handbook for Providers. Baltimore and Geneva: CCP and WHO, 2007
22-JUL-2013 WOHE-2011-SG-4859-PE