Contraception (otherwise called birth control) includes a series of methods, which eliminate any chances of the ovum being fertilized by the sperm. A gynaecologist’s role is essential, as he is called to inform the couple in detail about all contraceptive methods and their parameters, to recommend a method according to each case, or rule out specific methods that could harm the couple’s health.
There are three types of contraception:
- natural methods of contraception
- mechanical (barrier) methods of contraception
- hormonal contraception
The natural methods include coitus interruptus and the rhythm (calendar) method. Both methods have the lowest success rates. Coitus interruptus is based on early withdrawal by the male before ejaculation, which however, is not always easy to predict.
Rhythm (calendar) method involves refraining from sexual intercourse during a woman’s fertile days. Neither this method is effective since a woman’s cycle many times is not regular; therefore, it is not easy for a couple to determine exactly which days to refrain from sexual activity. Natural contraception also includes some other less effective methods: basal body temperature monitoring, cervical mucus monitoring, and vaginal douching immediately after intercourse.
The mechanical methods include the use of a condom and intrauterine devices (spirals). The male condom is made of synthetic latex. It fits on the male organ and has the benefit of both protecting the couple from an unwanted pregnancy and reducing the risk of sexually transmitted diseases, as long as it is used consistently and correctly.
A female condom is made of polyurethane and is a sheath with a ring at each end. The inner ring (at the closed end) fits over the cervix, while the outer ring (at the open end of the sheath) has a larger diameter and covers part of the external genitalia.
Intrauterine devices are small plastic or metal objects, which are inserted inside the vagina by gynaecologists and have a high efficacy rate, over 97%. They create a sterile inflammation in the intrauterine cavity. Leucocytes, which accumulate due to this inflammation, release toxic substances which act “defensively” against both sperm and the fertilized egg. This is what their great efficacy is based on. Intrauterine devices can be used for up to 5 years.
Another mechanical method is the vaginal ring, a flexible ring releasing estrogen and progesterone. This way it prevents ovulation and therefore, fertilization.
Hormonal contraception involves taking oral contraceptive pills, acting solely on a doctor’s advice. Birth control pills are a combination of estrogen and progestogen. They suspend ovulation and they make the endometrium and cervical mucus hostile to sperm. Oral contraceptives have a number of benefits to the woman; they reduce pain and loss of blood during menstrual period, they regulate the menstrual cycle and as a long-term effect they may reduce the risk of endometrial and ovarian cancer.
The process of taking oral contraceptives is quite complicated: A woman takes a pill on a daily basis for 21 days. On the 22nd day she stops and three or four days later she gets her period. Eight days after her first day of menstruation the woman starts the same process all over again. Oral contraceptives may sometimes have side effects. Some of them are dizziness, nausea, vomiting, headaches and weight gain.
Hormonal contraception also includes the emergency contraceptive pill –sometimes simply referred to as the “morning-after pill”, which is taken after sexual intercourse. If there is risk of conception, the woman takes this pill within 48-72 hours after intercourse. It is intended to disrupt fertilization and is reported to have a 99% effectiveness.