Contraceptive Options (Part I)



What is contraception?

Contraception, or birth control, is a method for preventing pregnancy. Sexually active women who are not planning on becoming pregnant, for various reasons such as age, medical conditions, priorities, should consider contraception.


How to choose a contraception method?

There are many factors to consider when choosing a birth control method, which includes age, lifestyle, pre-existing medical conditions, and cost. You should talk to your doctor so that he or she can suggest a method that is suited to your needs.


Types of contraception

There are many options to choose from; these can be broadly categorised according to reversibility.


The reversible options can include long-acting methods such as hormone injections, subdermal implants, intrauterine devices as well as short-acting methods such as patches, rings, pills, and condoms.


The irreversible options include male and female sterilisation.


Long-acting methods

Long-acting methods can last up to 5 years, and unlike short-acting methods such as the pill, do not require you to take them every day to be effective. They are also reversible, so if you want to be pregnant you may remove them at any time. While they may be expensive at the start, they will usually work out to be cheaper than pills or even condoms in the long run.


Hormone injections

A hormone called progesterone is injected into your buttocks and can last up to 3 months. Progesterone works by preventing ovulation (a process that allows your eggs to be released every month), thickening up the mucous membranes of your cervix and thinning out the lining of your womb so that fertilised eggs cannot be implanted into your womb.


It is highly effective, can be used during breastfeeding, and may reduce heavy and painful periods. A disadvantage is that it often causes irregular bleeding[1], and most women often experience infrequent or no bleeding. Hormonal contraception may also cause some side effects such as acne, headaches, and decreased libido. Do also note that this method does not prevent sexually transmitted diseases (STDs).

Subdermal implants

A subdermal implant is a rod that is about 4cm in length and is inserted under the skin of your arm. The implant works by slowly releasing progesterone. As mentioned before, this hormone prevents ovulation by thickening up the mucous of your cervix and thins out the womb lining. It also prevents ovulation.


This implant can last up to 3 years and is highly effective. The procedure is relatively quick and is done under local anesthesia, and the implant can be removed anytime. Like all other contraception that releases progesterone, it can be used during breastfeeding and may reduce heavy and painful periods. It may also cause irregular bleeding or infrequent or no bleeding. It also does not prevent STDs.


Intrauterine contraceptive device

Intrauterine contraceptive devices (IUCDs) are tiny T-shaped devices that are inserted into your uterus and can be categorised to hormonal and copper IUCDs. Both IUCDs can last at least 5 years and are highly effective.


For the hormonal IUCD, it works by slowly releasing the hormone progesterone into the uterus. Therefore, it can help with heavy and painful periods and is safe to use while breastfeeding.


For the copper IUCD, it works by preventing sperm from reaching the egg as copper is highly toxic to sperm. The advantage is that it contains no hormones, and therefore you will not experience the hormonal side effects that some women might experience. The disadvantage, however, is that it may cause longer and heavier periods.


Both hormonal and copper IUCDs do not prevent STDs. Very rarely they may also perforate into the uterus, fall out, or cause ectopic pregnancy. You will also require a doctor to remove them.



[1] Irregular bleeding – bleeding that does not occur at regular intervals; most women experience menstruation every 28 days (but varies according to individuals) – your menses may be irregular if you experience bleeding outside of your normal cycles


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