19 Approved Family Planning (Contraception) methods

May 15, 2020ODOCTORFamily planningbestchoicecontraceptionFamily planning3

Family planning or contraception is a way of preventing pregnancy, mostly for the purpose of spacing childbirth or stopping entirely. There are many methods of family planning. But before I delve into that proper, here this statistics from World Health Organisation :

214 million women of reproductive age in developing countries who want to avoid pregnancy are not using a modern contraceptive method.

WHO

Broadly speaking, there are two methods of family planning contraception – Modern methods of contraception and Traditional method.

Modern methods of family planning

1. Combined Oral contraceptive Pills (COCP) aka ‘The Pills’

The combined oral contraceptive pills is a combination of oestrogen and progesterone. As you can see, there two different colours. One is oestrogen, the other is progesterone..It works by preventing ovulation.

Ovulation is the release of egg from the ovary. The pills is very effective, almost 99% effective if used accurately and consistently. Other benefits of COCP, aside family planning are

• Protects against ovarian and endometrial cancer
• Reduces heavy menstrual bleeding
• Benefits against irregular periods
• Reduces menstrual pain
• Hirsutism
• Acne

Side effects of oral contraceptive pills–

– Increased risk of Breast cancer,

-increased risk of cervical cancer

2. RING AND PATCH

Combined contraceptive pills can also come as vaginal ring, or skin patch. They also contain oestrogen and progesterone. They work on the same principle of the oral one described above.

3. PROGESTOGEN-ONLY ORAL family planning method

This family planning method contains only progesterone.  No combination with oestrogen as we have above.

It works by making the cervical mucus thick,  preventing the transport of sperm, and eventually prevents fertilization. This method of family planning is very effective in 99% of the cases. 

This is progesterone-only pill. This family planning method is taken through the mouth. A big disadvantage is that you take drugs everyday. Side effects are,

• Irregular bleeding
• Acne

Benefits : No risk of cervical cancer, protects against endometrial cancer.

4. Progestogen Implants

The implant family planning method in inserted below the skin of your arm. Some last up to three years. Others may last up to five years. It works by the same principle of of other PROGESTOGEN-ONLY contraceptives – thickening of cervical mucus, thereby preventing sperm penetration. Once inserted, there is no need for followup until 3 years.

5. Progestogen Injectable

This is PROGESTOGEN-ONLY injectable method of family planning. Depo-provera 150mg/1ml. It contains only progesterone. It is injected into your muscles. Some may be injected below the skin. It is usually injected every 12 – 14 weeks. This is the only hormonal method of family planning that dates conception when you stop. In some cases it can take up to one year before fertility returns.

6. Intrauterine Device

The intrauterine device (iud ) can last 3-10 years or more depending on the types. It has a failure rate of 1 in 10.. It works by preventing fertilization, impairment of implantation and also increases cervical mucus

7. Male Condom:

This prevents the sperm from entering the woman’s body. Some have spermicide inside them. Spermicides are chemicals that kill sperms. Condoms have an additional advantage of protecting against sexually transmitted infections. It is very effective as a method of family planning. The only problem people have is that they do not know how to use condom properly.

8. Female condom.

The female condom covers the cervix area, and captures the sperm. As you can see from the picture, it is like a baloon blown into the vagina. It also protects from sexually transmitted infections, just like male condoms. It is an effective means of family planning contraception

9. Cervical Diaphragm and Cup :

Cervical diaphragm and cap are not popular in Nigeria as a method of family planning or contraception. They are barrier method like condoms. They are fixed at the cervix just like the way you wear a cap on the head.

It covers the cervix and prevent sperm entry. Both the cap and diaphragm work on the same principle. The cap is worn over the cervix, while the diaphragm is inserted into the cervix and made to hook over the tip of the cervix. They very effective methods of family planning. But cannot protect against sexually transmitted infections.

10. Female Sterilization

This is a permanent method of family planning done through surgery. The Fallopian tube is blocked. The sperm coming from the vagina cannot meet the egg coming from the ovary.

This contraception method must be well thought before venturing into, because it is irreversible. So make sure all your babies are made before thinking of this method. In fact I strongly advise you avoid this method. Use other reversible method pleased, for obvious reasons. Winks**

11. Vasectomy (Male sterilization)

This is the surgical cutting of the vas deferens. The vas deferens is a tubelike structure that carries sperm from the site of production (testes) to the site o ejaculation (penis).

When this channel is cut, the sperm produced cannot be ejaculated. So no feet. It is also irreversible family planning method. Care must be taken in getting this contraception method. For me I cannot even try it. 

Natural methods of contraception also known as fertility awareness

This involves understanding how the female body works and take advantage of it. As we already know, an average woman has a 28 day cycle during which she can only be pregnant during ovulation.

Natural methods of contraception or fertility awareness based method of family planning simply avoids this ovulation time or fertile days. This can be achieved in 5 ways:

• Calender or rhythm method
• Temperature method
• Cervical mucus method
• Cervical palpation
• Personal fertility monitor

12. Calendar or rhythm:

Fertile days are calculated by a formula, using the longest and shortest cycle you had in the past 6 months . First fertile day = shortest cycle minus 20. Last fertile day = Longest cycle minus 10.

For example,  Ada in the past 6 months had a longest cycle of 35 days,  and a shortest cycle of 28 days. What is Ada’s fertile period? 

First day of fertile period = 28-20 =8

Last day of fertile period= 35-10 =25

So Ada’s fertile period is from day 8 to day 25 of her menstrual cycle. So she should avoid intercourse on these days to avoid pregnancy. Note: The counting starts on the first day you bleed. That’s your day 1 of that cycle.

Assignment : Chinenye’s longest Cycle in the past 6 months 28 and shortest cycle is 21. What are Chinenye’s fertile days?  Drop your answer in comment,  show all working. 

Note: This method is not so reliable. The human body is not mathematics. So eventualities do happen. This method of family planning is usually combined with male or female condom. 

13. Temperature method of family planning 

During ovulation / fertile days,  the temperature rises to about 0.2-0.4 degree centigrade. So you measure your temperature everyday, and keep record, to know when this 0.2-0.4 increase happens.

Failure rate is very high,  because fever,  infection, exercise , and drugs can make your temperature high. Moreover, do you even have such time? Lol 

This is very unreliable too. It is based on the fact that mucus from the vulva during a fertile period is clear,  watery,  and Slippery, like raw egg white. So when you notice such,  you know you are in your fertile(ovulation) period. After ovulation,  it becomes thick and opaque.

Semen in the vagina can be mistaken as this mucus,  and this mucus may also be mistaken to be semen. So be circumspect. 

15. Cervical palpation method of family planning 

At ovulation,  (fertile period) , the cervix rises about 1-2cm and feels softer and moist. 

16. Personal fertility monitor 

This is a handheld tool. You use it to test your urine every morning. A red light indicates fertile phase (risk of getting pregnant)  and a green light shows infertile (low or no risk of pregnancy). works like a pregnancy Lab test.

17. Lactational Amenorrhea

If a mother is doing exclusive breastfeeding for the first 6months of child birth, that’s a method of contraception. The risk of getting pregnant is about 2%. This family planning method is usually combined with condom.

Read about : Menopause

18. Emergency Contraception

There are so many methods of contraception that can be employed in emergency, like when condom bursts or unprotected sex happens. The commonest and easily available in our environment is Postinor 2. It must be taken within 3 days of the emergency if it must work. Postinor 2 works by preventing ovulation and implantation. It has alot of side effects, commonest one being that it makes your menstrual cycle irregular. And could cause abdominal/menstrual pain, and ectopic pregnancy.

19. Withdrawal method

This is very crude. But some persons still practise it. And it works for them. It involves withdrawing the penis immediately he feels ejaculating. It is an unreliable means of contraception.

References

https://www.who.int/news-room/fact-sheets/detail/family-planning-contraception

Wikipedia.org

Mayoclinic.org

Gynaecology by Ten Teachers,  20th edition. Chapter 6- written Sharon Cameron. Edited by Helen Bickerstaff MD, MRCOG and Louise C. Kenny MBChB(Hons), MRCOG, PhD