Erectile dysfunction, also known as impotence, is the inability of a male to achieve or maintain an…
What is contraception?
Contraception involves various methods of preventing pregnancy. Your doctor can help you to decide which methods of contraception are right for you. Whatever your decision, it is important to remember no method of contraception is 100% effective.
The combined pill, more commonly known simply as 'the Pill', contains oestrogen and progestogen hormones. In addition to being an effective form of contraception, benefits of taking the Pill include more regular, lighter periods and a smaller risk of getting cancer of the ovaries or uterus.
The Pill might not be the best option for you if you are extremely overweight, have high blood pressure (hypertension) or liver problems, experience migraine headaches, or smoke and are over 35 years of age.
The contraceptive effect of the Pill can take from one to twelve days. Also, medications for epilepsy, St John's Wort (a herbal remedy sometimes used to treat depression), antibiotics and others may stop it from working.
The mini pill
The mini pill only contains one hormone: a progestogen. It works better in older rather than younger women and does not start working until you've taken the first three pills. It may not work if you take it more than three hours late, vomit, have diarrhoea, or take certain medications such as anti-seizure medications, antibiotics or St John's Wort.
The mini pill is often better if you experience side effects of the combined pill such as migraines, or if you have high blood pressure or are a smoker over 35 years of age. The downside is that the pill needs to be taken at the same time each day and you may experience more frequent or irregular periods, bleed between periods, or have no periods at all.
Vaginal rings are rings that can be used for three weeks at a time. They work by slowly releasing oestrogen and progestogen. However, if removed from the vagina for more than 24 hours in the three-week period, or if you take certain medications, it might not work.
Implants and Depo injections
Implant and injection forms of hormonal contraception (Depo injections) are more effective than contraceptive pills or rings, but they have greater side effects. However, they may be more convenient to use rather than having to remember to take tablets every day. They are most commonly used in women, however, male hormonal contraceptives are currently being trialled.
Rod-shaped implants can be inserted in the arm beneath the skin, or injections can be administered every 12-14 weeks. Importantly, if you have any liver problems you should speak to your doctor before starting Depo injections. Also, medications for epilepsy, antibiotics or St John's Wort may stop implants from working.
Intrauterine devices (IUDs) are small, T-shaped and made of plastic or copper, with a nylon string at the end. They are inserted by a doctor and positioned inside the uterus. They have the advantage of lasting for 5-10 years, but it is important to note they do not provide protection against sexually-transmitted infections (STIs). The string also needs to be checked after every period to ensure the IUD has not fallen out of place. Copper IUDs can make your periods heavier, but IUDs also come in a hormonal form, which makes your periods lighter.
Emergency contraception is commonly known as the morning-after pill. It consists of a high dose of hormones taken in the event of unprotected sex, or a condom breaking during sex. The sooner it is taken, the better. Ideally, emergency contraception should be taken within 24 hours. However, it can be used up to four days from the event, although its effects are reduced the longer it is delayed.
Emergency contraception is not an abortion pill and, in the event it does not work and you get pregnant, it will harm your baby. Side effects of emergency contraception are nausea and vomiting and bleeding between periods or late periods. If you vomit within two hours of taking emergency contraception you need to take another dose, otherwise it will not work.
Barrier contraception aims to block sperm from entering the uterus. It includes male and female condoms and the diaphragm. Used properly, barrier contraception can be very effective and can also reduce your risk of contracting STIs, although diaphragms should not be relied upon for this.
Condoms are usually made from latex. In men they are used to cover the penis and in women a flexible ring is inserted into the vagina. It is very important not to use a male and female condom at the same time, as this can cause them to tear. Non-latex condoms are available for people who are allergic to latex.
Condoms can only be used once and you should always check the expiry date before use. They should not be stored in warm places, or kept in your wallet for more than a month. Oil-based lubricants and saliva are not to be used with condoms, as they can create holes. Water-based lubricants should be used instead.
Diaphragms are silicone cup-shaped caps that fit inside the vagina and cover the opening to the uterus. It needs to be the right size as determined by a doctor, placed inside the vagina before any contact with a penis and left inside for six hours after sex. It is a good idea to use other types of contraception until you know you are using the diaphragm the right way. It is important to remember to clean it and check for holes before and after use. The downside is the diaphragm does not provide as much protection as condoms against STIs and it carries a small risk of bladder infection.
Unlike other forms of contraception, sterilisation is permanent and requires a surgical procedure to be performed. In men this involves a vasectomy, in which the tube that carries sperm out from the testes is divided. In women, the fallopian tubes are blocked, which prevents the egg from passing through them and entering the uterus. This can be done by tubal ligation, in which a clip is placed on the fallopian tubes, or tubal occlusion, in which a small coil is put inside them. Men who undergo a vasectomy still ejaculate and women who undergo tubal ligation or occlusion still have their periods and experience menopause.
Other types of contraception include pulling out (withdrawal) and spermicides, which are chemical substances that destroy sperm. However, neither are very effective and cannot be relied upon to prevent pregnancy, though both may be useful as an additional measure when used in conjunction with other forms of contraception, such as condoms. Condom use is still a good idea because it reduces your risk of contracting STIs and is much more effective as a means of contraception.