HOW TO CHOOSE BIRTH CONTROL THAT’S RIGHT FOR YOU

Posted on: April 15, 2024

Birth Control: What Suits You Best

If you’re considering birth control, you’re spoilt for choice. Finding the right one for you is an important decision. Exploring all of the options available, allows you to decide what best suits your lifestyle and health status.

There are two main categories of birth control methods:

Hormonal
Non-hormonal

Let’s look at each type.

What are hormonal contraceptive methods?

1. The Pill (a.k.a combined pill)

The pill is the most prevalent method to prevent pregnancy in Malaysia.¹ A small tablet containing the female hormones oestrogen and progestin, it is more than 99% effective if used correctly.²

How does it work?²

It works by:

preventing the ovaries from releasing an egg
thickening the mucous at the entry of the uterus making it harder for the sperms to enter
thining the uterine lining which discourages a fertilised egg from attaching itself into the uterus

How do you take it?²

To be on the pill requires you to take it once a day, every day and at around the same time. So, if you’re an organised person or prefer following a routine, you could ask your doctor or phamacist about the pill.

However, this form of contraception may not be recommended by your doctor or pharmacist if you’re over 35 years old and smoke. It is also not suitable for women with certain medical conditions such as:

history of blood clots in legs or lungs
having an abnormal heart or heart disease
having high blood pressure
history of severe migraines

Sometimes women take the pill to reduce acne or premenstrual symptoms.² Side effects of the pill are rarely serious. They may include temporary headaches, nausea, breast tenderness, or mood swings.

The pill may lose its efficacy if you’re currently taking certain medications e.g. medicines for epilepsy and HIV or St John’s wort supplement. Be aware that your chances of getting pregnant returns within the first month after quitting the pill.

2. Contraceptive patch

A birth control patch is a small, stick-on patch that releases the same hormones found in combined oral contraceptive pills, into your body through your skin.³ If you prefer birth control that you don’t have to remember to take every day, talk to your doctor or pharmacist about the patch. It’s simple and effective if you replace it every week, for three weeks continuously before having a patch-free week.

How does it work?³

As the patch contains the same hormones as the pill, it works the same way to prevent pregnancy.

How do you use it?³

The patch needs to be placed directly on to your skin any time from the first to the fifth day of your period. If at any other time, use it together with an additional contraceptive for the first seven days.

Ensure that the area you choose is:

clean
dry
not very hairy
isn’t sore, irritated or broken

You may place the patch on your stomach, back, buttocks or arms, but avoid the breasts. You’ll still be able to shower, soak in the bath and go swimming with the patch on as it is very sticky and should not come off.

Just as with the pill, the contraceptive patch is not suitable for everyone. You’ll have to consult your doctor or pharmacist before deciding to start on the patch to make sure that it is suitable for you.

Your fertility will be unaffected when you go off the patch.

Some women may be concerned by the visibility of the patch, skin irritation, short-term headaches, nausea, breast tenderness, or mood swings.

Remember:

You must make sure that the patch is constantly attached to your skin for the whole week and to change it every seven days. Find out what to do if the patch falls off, you’ve forgotten to remove it or place a new patch, here. (Link to the NHS site: https://www.nhs.uk/conditions/contraception/contraceptive-patch/)

3. Contraceptive injection

The contraceptive injection contains a progesterone (hormone) shot that lasts for two to three months.⁴ You will need a doctor to prescribe and administer the injection, either in the muscle or under the skin. Set up a reminder to have repeat injections before the last one lapses.

Unlike the pill and the patch, these injections do not contain oestrogen. Birth control injections may be safe while breastfeeding. They are also suitable for women who are over 35 years old and who smoke⁵ or who can’t take contraceptives that contain oestrogen. These injections arenot affected by other medicines. Side effects may include headaches, mood swings, and irregular bleeding during your periods.

Keep in mind that it may take up to a year after going off contraceptive injections for your fertility to be restored.⁴

How does it work?⁴

Even though these injections do not contain the oestrogen hormone, the way they work is similar to taking the pill or the patch.

How do you take it?⁴

As these are injections, they are given by either a doctor or trained nurse. Like the patch, you should be protected if it is given to you any time during the first five days of your period. However, at any other time use added contraception for seven days after receiving the injection.

4. Contraceptive implant

A birth control implant prevents pregnancy by releasing progestogen into your bloodstream and lasts three years.⁶ Your doctor inserts a tiny flexible plastic rod under your skin in your upper arm, so it is not visible. Removing it at any time is a small, easy procedure and your fertility should return to normal quickly.

Women who are over 35 years old and who smoke can use contraceptive implants.⁵ Possible side effects include: headaches, nausea, breast tenderness and mood swings. ⁶

As this method of contraception is not suitable for certain women, consult your doctor before deciding if this is for you.⁶

5. Intrauterine system (IUS)

An IUS (intrauterine system) is a long-term oestrogen-free contraception that protects you against pregnancy for up to 5 years.⁷ It is a small T-shaped device inserted into your uterus and like other progesterone-only contraceptive methods, is considered an option for women who are over 35 years old and who smoke.

When you’re ready to have a baby, the IUS can be easily removed because it is not permanent.⁷ Possible side effects include: headaches, acne, breast tenderness, mood swings, and reduced libido.

As this method of contraception is not suitable for certain women, consult your doctor before deciding if this is for you.⁷

What are non-hormonal contraceptive methods?

1. Male condom⁸

The condom could arguably be the most popular barrier contraception purchased over the counter. Without advanced preparation your man needs only to wear it each time while having sex. It may be a reliable solution if it’s properly worn throughout intercourse, unless it splits or tears.

It’s the only birth control method that protects both partners from STDs (sexually transmitted diseases) such as chlamydia and HIV. Additionally, there may be little to no medical side effects. Your man may have to hold the condom firmly as he withdraws after ejaculation before his penis becomes flaccid.

2. Diaphragm or cervical cap

The diaphragm or cervical cap is a dome-shaped latex device placed between the vagina and the cervix to block sperm from entering the uterus.⁹ While it is a form of barrier contraception, it does not protect against sexually transmitted diseases.

If used alone it may not be the most effective type of birth control. It may be more effective if used in conjunction with spermicide each time before sex.⁹ If you experience recurring genital irritation and bladder infection (cystitis), try using other contraceptive methods.¹⁰

3. Spermicide¹¹

Spermicide is a type of cream, foam, or gel that restricts sperm movement. It may not be reliable, unless used with other methods such as the diaphragm, cervical cap or condom. However, some people may experience allergic reactions.

4. Intrauterine device (IUD)¹²

The IUD (intrauterine device) is a long-term non-hormonal contraception that goes into your uterus and lasts for five to ten years. You will need your doctor’s expertise to insert this tiny T-shaped device made from plastic and copper. As it doesn’t contain any hormones (the IUD works because the copper in it prevents pregnancy by changing the mucous in the cervix), it will not interfere with other medications and is suitable for women who can’t use hormone based contraceptive methods.

You may get pregnant as soon as the IUD is removed. Risks of an IUD are rarely serious. However, it may be uncomfortable when the IUD is first inserted and your periods may become heavier, longer or more painful. There is also a small risk of infection and hence may not be suitable for women who have history of pelvic infections.

5. Female sterilisation¹³

Women can undergo a permanent procedure that removes or blocks their fallopian tubes. As it is a permanent procedure, it is only recommended to women who are very certain that they do not want to conceive again or those who have “completed” their family. So, before deciding on this procedure, discuss it with your partner and doctor.

Sterilisation does not affect sex drive, sex, hormone levels, or periods. However, it does not protect you from STDs.

Make an informed choice

Your reproductive health is in your hands. Explore our website and discuss with your doctor or pharmacist for solutions that work for you.

References

Najimudeen M, Sachchithanantham K. An insight into low contraceptive prevalence in Malaysia. Int J Reprod Contracept Obstet Gynecol. 2014;3(3):493-496. Available at https://www.ejmanager.com/mnstemps/89/89-1404152512.pdf Accessed on 12 October 2018.
National Health Services, United Kingdom. (2018) .Your contraception guide: Combined pill. Available at https://www.nhs.uk/conditions/contraception/combined-contraceptive-pill/ Accessed on 12 October 2018.
National Health Services, United Kingdom. (2018). Your contraception guide: Contraceptive patch. Available at https://www.nhs.uk/conditions/contraception/contraceptive-patch/
National Health Services, United Kingdom. (2018). Your contraception guide: Contraceptive injection. https://www.nhs.uk/conditions/contraception/contraceptive-injection/ Accessed on 12 October 2018.
National Health Services, United Kingdom. (2018). Your contraception guide: Which method of contraception suits me? Available at https://www.nhs.uk/conditions/contraception/which-method-suits-me/ Accessed 12 October 2018.
National Health Services, United Kingdom. (2018). Your contraception guide: Contraceptive implant. Available at https://www.nhs.uk/conditions/contraception/contraceptive-implant/ Accessed on 12 October 2018.
National Health Services, United Kingdom. (2018). Your contraception guide: Intrauterine system (IUS). Available at https://www.nhs.uk/conditions/contraception/ius-intrauterine-system/ Accessed on 12 October 2018.
National Health Services, United Kingdom. (2018). Your contraception guide: Condoms. Available at https://www.nhs.uk/conditions/contraception/male-condoms/ Accessed 12 October 2018.
University of Michigan. University Health Service. (2018). Other barrier methods: diaphragms, cervical caps and sponges, plus spermicide. Available at https://www.uhs.umich.edu/contraception-other Accessed on 12 October 2018.
National Health Services, United Kingdom. (2018). Your contraception guide: Contraceptive diaphragm or cap. Available at: https://www.nhs.uk/conditions/contraception/contraceptive-diaphragm-or-cap/ Accessed on 12 October 2018.
Bedsider.org. Birth control methods: spermicide. Available at: https://www.bedsider.org/methods/spermicide#details Accessed 12 October 2018.
National Health Services, United Kingdom. (2018). Your contraception guide: Intrauterine device (IUD). Available at https://www.nhs.uk/conditions/contraception/iud-coil/ Accessed on 12 October 2018.

13. National Health Services, United Kingdom. (2018). Your contraception guide: Female sterilisation. Available at https://www.nhs.uk/conditions/contraception/female-sterilisation/ Accessed on 12 October 2018.

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