Contraceptive methods – how safe is "safe"?
There are various methods for contraception. Every woman, every couple has to figure out which method is best for her, for them. In general:
You should always be using a condom. It prevents genital diseases that can be transferred through having sex. Especially AIDS is prevented through a condom.
You can combine the condom with every other method of contraception. To lower the risk of a pregnancy – especially in younger years, when a pregnancy is not an option and the condom is sometimes misused – the following can be a good idea:
Birth control + condom = prevention of a pregnancy + protection against AIDS
Which method is best for me?
Before you decide on one of the options, you should think about how high you want the level of protection to be and weigh the various methods over against each other.
When you think about contraception, you should also think of your wish now or in the future of having a child:
- Do I want children (in general)?
- Do I want to become pregnant in the foreseeable future?
- Or do I want some more time without having a child?
- Is there a specific time frame in which I would like to become pregnant?
Those are the kind of questions we should talk about.
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Sterilization
final decision (for women refertilization successful only in 30-50%)
Contraception including hormones “Mirena”/”Kyleena”
duration of use up to 5 years
Contraception including hormones “Jaydess”
up to 3 years
Copper IUD
up to 5 years
Implant
up to 3 years
Injection for three-month
Duration of effect 3 months
Combination pill/estrogen-free pill
For women who do not want long-term contraception but still need a high level of safety, hormonal contraceptives are an option because pregnancy can occur quickly after stopping the pill.
Vaginal ring/contraceptive patch
For women who do not want to think about taking the pill every day, the vaginal ring or the contraceptive patch is an option. The ring is in place for three weeks and then removed for one week, the patch is changed once a week, and after three weeks there is a patch-free week. Transdermal or vaginal application also has health benefits – less liver stress and lower dose.
Condom
For women who do not have a steady partner, or who need contraception only on rare occasions, the condom is a good choice, possibly combined with a spermicidal vaginal suppository or gel to increase safety. With this method, you are also largely protected against sexually transmitted diseases.
Contraception with an IUD has advantages and disadvantages.
PRO ARGUMENTS
The two regular checkups a year are sufficient. You don’t have to think or take care of your contraception every day. If you choose one made of copper, no hormones are included; therefore, it has no effect on your body. Even if you decide for one that includes hormones the effects on your body will be minimal.
CONTRA ARGUMENTS
Complications can occur, such as a bleeding disorder and an infection of the uterus. Moreover, inserting the device can be uncomfortable.
Hormonal contraception has advantages and disadvantages.
PRO ARGUMENTS
You have control over your menstruation. It is predictable; you always know when and will be able to shift the date of the menstruation. Also it is usually pain-free and weaker through the taking hormones. Acne can be improved and the growth of hair optimized. Hair loss and disturbing hair (for example, in the face) is minimized.
CONTRA ARGUMENTS
Contra-indications do exist. Women above the age of 35 who are smokers should be cautious about taking hormones which increase the risk of developing a blood clot (thrombosis). Therefore, your blood pressure has to be checked regularly. For women who don’t need protection on regular basis might want to consider other options.
This is intended as an emergency solution. The “morning-after pill” must be taken in the first 72-120 hours after unprotected intercourse and prevents or postpones ovulation or delays the transport of an egg in the fallopian tubes due to a high hormone dose. However, it also works only for that one time and not for the whole cycle.
Side effects such as nausea or bleeding disorders may occur. It is not necessary to take the “morning-after pill” in every case, because there are infertile days. For women who are not allowed to take hormones for health reasons, there is still the possibility of using an IUD after unprotected intercourse.
Contraception and safety – the Pearl Index
If you have then decided to use contraception, the so-called Pearl Index helps you with the next step – choosing the right contraceptive method. The Pearl Index makes a statement about the effectiveness of a contraceptive method, the lower the value, the higher the reliability of the contraceptive method.
Pearl Index = number of pregnancies that occur despite contraception in 100 sexually active women in 1 year.
A Pearl Index of 1 says that one in a hundred women will become pregnant in a year despite the respective contraceptive method, a Pearl Index of 0.1 says that one in a thousand women will become pregnant in a year with the respective method. Here, of course, age also plays a major role.