Different contraceptives
Perhaps you have just come out of a pregnancy and want to look at a new or different form of contraception or perhaps you are not satisfied with your current contraception. There is so much on offer that it always takes some time to delve into the right choice that suits your situation and your body.
If you can't see the forest for the trees or you want to know what is possible, gynaecologist Florien ten Cate is here to help you. For today she has listed a number of different options.
There are a lot of contraceptives to choose from and the question is what exactly is so important in making the right choice. I have listed a number of questions that you should think about. The answers to these questions will help you make the right choice.
- Do you want contraception that you can stop at any time, or for a longer period of time?
- Do you want contraception with hormones or without hormones?
- Do you want to keep your own cycle? Or a cycle that you can control yourself if necessary?
- Is there a specific situation/factors you need to take into account?
- Do you suffer from acne?
- Do you also want protection against STDs?
Do you want contraception that you can stop at any time, or for a longer period of time?
In the first case: Choose a contraceptive method where you can control the use yourself: the pill, Nuvaring, condoms or the contraceptive patch. With these methods you can maintain your own cycle or regulate your cycle yourself by, for example, swallowing the pill continuously. It is important that you know that taking it on time is crucial for the reliability of these contraceptive methods. If you choose contraception for the long term, you are more likely to think of options such as: Implanon (2-3 years, depending on your weight), IUD (with or without hormones, most IUDs can be left in for 5 years, some even for 10 years), Depot-Provera (the injection pill, an injection every 3 months) or sterilization. The advantage is that you do not have to think about your contraception for a longer period of time, this reduces the chance of forgetting and makes these methods relatively reliable. The disadvantage is mainly that you have to visit a doctor for insertion and removal. And sterilization is of course a permanent form of contraception.
Do you want contraception with hormones or without hormones? And do you want to keep your own cycle? Or a cycle that you can regulate yourself if necessary?
The most well-known contraceptive methods are with hormones, only the composition of the hormones differs. The hormones used in contraception are estrogens and progestogens. Estrogens only occur in combination with progestogens, these are called combination preparations, for example the pill and the Nuvaring. With this you can imitate a natural cycle of 4 weeks, you can also postpone the cycle by swallowing the pill continuously, but you must occasionally insert a stop week (every 3-6 months or if you have a breakthrough bleeding).
Progestogens are also used alone, this is the case with the mini pill, Implanon, Mirena and injection pill. This means that these methods can sometimes even suppress your menstruation completely. However, sometimes people also suffer from very irregular blood loss. The predictability of a bleeding is therefore less. Sometimes there are reasons to prefer not to use hormones. For example, you suffer from side effects, you do not feel comfortable with it or you have a contraindication for certain hormones. More about this later.
There are also non-hormonal contraceptive methods: Copper IUD (Multiload, Flexi-T, T-safe and Gynefix), condoms and sterilization. Sterilization (male or female) is permanent and irreversible, there are reversal operations but they have a limited chance of success. This is only recommended for couples with a definitively completed family.
There are also “natural” methods of contraception where you take into account your fertile days with knowledge of your natural cycle and do not have intercourse on those days. These methods include the temperature method, natural family planning, Persona, periodic abstinence. Unfortunately, these methods have a high degree of unreliability.
Do any specific situations apply?
For example, you have just given birth. Important here is: Are you breastfeeding or bottle feeding?
You are breastfeeding: Your cycle often stops for a while. Unfortunately, you cannot assume that you cannot become pregnant. Couples often use condoms during this period. However, there are other options: Contraception with the pill is possible, with the preference going to the mini pill (Cerazette). This pill only contains progesterone. This hormone does enter the breast milk but is not harmful to the child. And it does not affect milk production, so your breastfeeding does not decrease. The regular pill is also an option, but this could reduce milk production. Other options are a coil with hormones (Mirena) or without hormones, both of which are possible during breastfeeding and are preferably inserted from 6 weeks after your delivery.
You are giving artificial nutrition: In fact, the situation is no different than outside pregnancy, you just have to take into account that you have to start the pill two weeks after giving birth (mini pill) or 3 weeks after giving birth (combination pill) to be able to rely on it. Starting later is also possible, but then you have to take into account that the pill is not yet reliable in the first month. Other options are: IUD and Implanon.
You have a contraindication for certain hormones:
Contraindications can be, for example: Increased risk of thrombosis (especially combination preparations), for example due to a clotting disorder in your family or if you have had thrombosis in the past. An increased risk of cardiovascular disease (combination preparations). This group also includes women aged 35 and over who smoke. If you have had hormone-sensitive breast cancer in the past. In that case, it is better to choose options that only use progestogens (Mirena, Implanon, Minipill, Injection) or no hormones at all (copper IUD, condoms or sterilization).
You are taking medication that affects the reliability of medication: This is especially true for medication that affects the functioning of your liver, such as anti-epileptics. In that case, contraception by means of a hormonal coil, copper coil or injection is recommended.
Liver disease: If you have suffered from cholestasis during pregnancy (a condition in which you have itching in combination with increased levels of bile salts in your blood) or if you have ever been diagnosed with a liver adenoma (a benign swelling in the liver that grows under the influence of hormones).
Are you taking the pill because you suffer from acne?
Then the contraceptive pill is the most suitable, it is effective against acne. Previously, the Diane pill was recommended for this. This is no longer done because of a higher risk of thrombosis with the Diane pill. The other pills (combination preparations) have also proven to be just as effective against acne.
Do you also want protection against STDs?
No contraception other than condoms protects you from contracting an STD. So there are really only two pieces of advice: Use condoms if you have changing contacts. Get yourself and your new partner tested for STDs before having unprotected sex.
This overview was a brief insight into what is involved in your choice of contraception. I hope that this overview helps you in making your choice. If you want more help in making your choice, it is possible to discuss this with your doctor so that you can make the most suitable choice for you.
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