Contraception is defined as the collective methods for preventing pregnancy, and it has become a common and obvious term for many women over the years.
But for some women, it is still a myth. Although the practice now seems widespread, many women are still not aware of how these preventive measures work. So it is urgent to bring some clarity to those whose knowledge on this subject is still very low.
Definition and history of contraception
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According to the World Health Organization contraception describes itself as “the use of agents, devices, methods, or procedures to avoid, or reduce the likelihood of, conception”. In general, these methods mostly concern women, who can now control their pregnancy freely. But going back further in history, we see that this has not always been the case.
Contraception has long been considered illegal. It was only in 1972 that it was legalised because of the 1967 Neuwirth Act. A long time after this, the 2001 Act arrived to improve the former’s provisions, still with the aim of facilitating access to contraception. In 2013, NIDS (National Institute of Demographic Studies) published the figures from the latest survey on the contraceptive practices of women aged 20 to 44 years of age. 76.2% of women were using a contraceptive method, whilst 23.8% did not use any. It is also noted that in UK, the pill remains the favourite choice of contraception amongst women. Indeed, 25% of them are using this contraceptive method, while in the US, this percentage is shared between condoms, sterilization and the pill. In China, for example, the IUD is far ahead.
Why do 100% of people not use contraception? In addition to personal considerations, this is due to a severe lack of information, as well as strong social and family barriers in certain cases.
Hormonal contraception is one of the most popular methods in the field of female contraception. This method securely and discreetly protects women from getting pregnant.
The pill is the most effective method, as it is almost 100% reliable. There are more than 30 types of oral contraceptives available to women, with each pill being different and having various advantages and disadvantages. Women must learn to find the pill that will give them the highest amount of protection with the lowest amount of side effects, with their doctor’s help.
How should I choose my method of contraception?
The best contraception is the one that you choose and the one that suits you. This is particularly affected by your age, personality (forgetful or organised), and your lifestyle (nomadic or sedentary), because there will be methods that suit you better than others. It also takes into account your biology, i.e. your tolerance to drugs’ side effects, which will vary according to the method.
There will definitely be a method that suits you best. You simply need to be informed about your choices, as a lack of information can lead you to choose an inappropriate method, which could cause complications. Whether you are in your young teens, a young adult or mature woman, you should follow your doctor’s instructions, which will help you find the right contraception depending on your medical history and your medical or personal circumstances. You might also want to know about how to control your menstrual cycle: a must for any woman.
The different phases of menstruation
Before choosing a type of contraception, a woman must know how her body works, including her menstrual cycle. This is an important step that will help you find the best-suited choice of contraceptive method. The menstrual cycle starts on the 1st day of menstruation, lasts 28 days and ends the day before the first day of your next period. Menstruation is the first phase of the menstrual cycle. It lasts from the 1st until the 7th day of the cycle.
The follicular phase
The follicular phase is the one that follows the 8th to 11th day of the cycle. Also called the pre-ovulation phase, it is characterised by the ovary’s creation of an oocyte (follicle). Oestrogen is created to help change the endometrium, also known as the uterine lining. The endometrium starts to change and it thickens to prepare for an egg to potentially nest. The cervix glands will also use the oestrogen, as they secrete cervical mucus, which is essential to the movement of the sperm towards the egg. This mucus changes and becomes viscous.
The ovulation phase
Then comes the ovulation phase, which runs from the 12th to the 14th day, about 15 days after the first day of menstruation. During this phase, the ovary expels the oocyte through the fallopian tubes. Once freed, it becomes an egg and is ready to be fertilised in the next 24 hours, which is its life expectancy. At this time, it is important to note—before you have intercourse—that sperm lives for 5 days. If you have sex 2 or 3 days before ovulation, the day of ovulation or after 24 hours, there is a risk of pregnancy.
The post-ovulatory phase
The next phase is post-ovulatory and starts the same time as ovulation, so between the 12th and 15th day of your menstrual cycle. It lasts between 12 and 14 days. Here, the ovary continues to produce oestrogen and also starts to produce another hormone, progesterone, to allow the endometrium to remain thick and form a nest. The expelled egg is waiting to be fertilized. If there is no fertilization, the ovary stops its production of oestrogen hormones, whose rate drops sharply. However, progestin hormones increase, hence the term “luteal phase”. It marks the end of the menstrual cycle, and leads to the next.
The decrease in oestrogen levels will cause the uterine lining to be destroyed, because it is deprived of the hormone that is essential to maintaining its thickness. It is this destruction that triggers menstruation or bleeding, which is made up of all non-functional tissue that have not been fertilized.
Note that the figures and periods given here are indicative. Indeed, every woman has their own menstrual cycle. That is why many women prefer contraceptive methods that deal with various contingencies, as well as stopping them from getting pregnant by accident.
Natural methods of contraception
They are mostly practiced by those who know their menstrual cycles and their bodies. A small percentage of women practice these methods. They make up about 7.1% of women, and all of these methods are unreliable. Some methods are:
Periodic abstinence, which includes three methods, being:
The calendar method
This involves calculating the ovulatory phase of the menstrual cycle in order to abstain from sexual intercourse. This method is not the most reliable because the woman can get pregnant at any time of the cycle due to shifts in the ovulation date, for example. Furthermore, the cycle length may vary
The temperature method
This is when you check your rectal temperature every day and wait for a rise in temperature so you can stop having sex from the 1st day of ovulation, which is when the body temperature rises. You do this until your next period. This method is not reliable as body temperature can vary due to other factors, such as infections, stress, late nights, etc.
The cervical mucus method
With this method, you wait for the cervical mucus to change in consistency and colour by taking daily samples from the vagina. It becomes more consistent, opaque and abundant just before ovulation. This method is often a lot of bothers.
Coitus interruptus
This involves removing the penis from the vagina just before ejaculation. Not only is this limiting, but it also reduces the pleasure of sex. This method is also far from being the most effective, as a small amount of liquid containing sperm escapes from the penis before ejaculation.
Women using natural methods have an 80% chance of getting pregnant. Therefore, these methods are not efficient and we must also note that they are fairly disturbing, whether or not they are “natural”.
Unnatural methods of contraception
These include hormonal and physical methods of contraception. These methods are barriers that block the movement of sperm after ejaculation. They include:
Chemical methods
The role of spermicides is to kill sperm with benzalkonium chloride. This dissolves and diffuses into the vagina after you insert the product, which should be at least 5 minutes before intercourse. Different types include: eggs, creams and sponges.
These methods are 82% effective when used correctly. In addition, they are accessible to all. Another advantage is that spermicides are safe for your health and do not affect your sexual pleasure. On the other hand, these methods require you to think ahead and take time to apply. Spermicides also have an unpleasant smell and taste. These factors can mean that you feel less aroused by the time you have sex.
Mechanical methods
These include non-chemical devices that you use and then can be removed. These include the diaphragm, cervical caps, condoms and the copper IUD.
They are very effective when used correctly: 94% for the diaphragm and 98% for condoms (which also provide protection against STDs) and for the copper IUD. They are also very accessible and some, including the diaphragm, are reusable. For the most part, they do not affect sexual pleasure. You can use them along with spermicide to increase their effectiveness. However, drawbacks of these methods mainly involve inserting them (diaphragm, cervical caps, copper IUD) and the quality of the material, for example condoms. Improper installation will disrupt not only the sexual act, but will also expose you to risks.
In sum, we can conclude that unnatural methods are much more effective than “natural” ones.
What are the benefits of the contraceptive pill?
Today, the pill is the most effective birth control on the market. Taken once a day, it is extremely practical, and is usually taken during the first three weeks of a cycle. After this, you take a one-week break before starting the treatment again for another three weeks.
Apart from its primary function, contraception pills can also help women to treat various health problems such as acne, soothing menstrual pain, reducing periods if they are heavy, or even treat endometriosis.
How does this contraception work?
Most oral contraceptives operate in the same way. It incorporates two hormones, a progestogen and an oestrogen hormone. These two hormones help to stop ovulation from happening. Hormones affect the cervical mucus, which makes it more complicated for sperm to enter into the uterus.
Oral contraception also impacts the uterine lining by making it less conducive to embryo formation.
What are the different types of oral contraceptives?
The monophasic pills
This is the most common oral contraceptive on the market, as well as being the most efficient. The monophasic pill should be taken every day for the first three weeks, or 21 days. You then take a seven-day break before starting a new packet. Celeste and Microgynon both belong to this group of pills.
The phasic pills
A box of phasic pills includes between two and three rows of different colours. All the pills contain hormones. Each of them must be taken in the right order for the first 21 days. As with monophasic pills, you should take a one-week break between packs.
The 28-day pills
As its name suggests, the box contains 28 pills. 21 of them are “active” and the other 7 are placebos. The objective of this contraception is to avoid disrupting your normal ritual, so you keep your normal pill-taking routine.
The mini-pill
As its name suggests, the box contains 28 pills. 21 of them are “active” and the other 7 are placebos. The objective of this contraception is to avoid disrupting your normal ritual, so you keep your normal pill-taking routine.
The best contraception is the one that you choose
What are the side effects of birth control pills?
Some women find it difficult to choose their contraceptive pill. They generally choose their pill based on the possible side effects. Some mild side effects may occur at the beginning of treatment, but these effects fade after some time.
The most common side effects of the contraceptive pill
| Weight gain | Slight loss of blood between each period |
| Changes to your mood | Increased sensitivity in the chest |
| Headaches | Nausea |
Choosing the right contraceptive pill can help you reduce the number and intensity of side effects. Sometimes it is recommended to try several pills before you find the one that best suits you.
Sources
- What is contraception: NHS
- What are the different types of contraception: Nichd.nih.gov
- The different phases of menstruation: Webmd
- istory of the birth control pill: PBS
Medical review on January 7, 2021 by Dr. Davis Taylor
