Contraception

The benefits of contraception1

Preventing pregnancy related health risks in women I Reducing infant mortality I Helping to prevent HIV/AIDS I Empowering women and enhancing education I Reducing adolescent pregnancies I Slowing population growth

Pills containing estrogen and progestin
These are hormone-containing tablets (also called combined pills or COCs). There are pills available which contain hormones that are structurally similar or identical to a woman’s own, naturally occurring hormonesb. They work primarily by preventing the release of eggs from the ovaries (ovulation), thickening cervical mucus and inducing changes in the endometrium.2,4,5

Contraception

Pills containing only progestin
These are hormone-containing tablets(also called POPs). They work primarily by thickening cervical mucous which prevents sperm from meeting an egg and disrupting the menstrual cycle, including preventing the release of eggs from the ovaries.2,4

ADVANTAGES: Can be easily stopped if fertility is desired. Does not interfere with sex.2,3
DISADVANTAGES: Must be taken every day at a fixed timec. There may be changes in the bleeding pattern.2,3

Common side effects are change in bleeding pattern, headaches, dizziness, nausea, breast tenderness, weight change, mood changes and acne.2,3,d

Contraception

This is a flexible ring placed in the vagina that continuously releases estrogen and a progestin; the ring is kept in place for three weeks followed by a week long ring-free period. The hormones prevent the release of the egg from the ovary, thicken the cervical mucus and induce changes in the endometrial lining.4,6

ADVANTAGES: Do not have to think about taking every day.6
DISADVANTAGES: Bleeding may become irregular.6

Common side effects are changes in monthly bleeding; headaches; irritation/redness/ inflammation of the vagina; white vaginal discharge.6

Contraception

A small, thin, square of flexible plastic worn on the body which continuously releases estrogen and a progestin into the bloodstream, through the skin; a patch is worn every week for 3 weeks, then no patch for the fourth week. The hormones prevent the release of the egg from the ovary, thicken the cervical mucus and induce changes in the endometrial lining.4,7

ADVANTAGES: Do not have to think about taking every day.7
DISADVANTAGES: Bleeding may become irregular.7

The most common side effects are changes in monthly bleeding; headaches; skin irritation or rash where the patch is applied; nausea; vomiting; breast tenderness and pain; abdominal pain, flu symptoms; vaginitis.7

Contraception

Progestin-only injectables
These are contraceptive injections containing only progestin-like hormones, injected once every 2-3 months. They prevent the release of eggs from the ovaries, thicken the cervical mucus and suppress the endometrial lining.4,8

ADVANTAGES: No daily action is required.8
DISADVANTAGES: Bleeding may become irregular.8

The most common side effects are changes in monthly bleeding; headaches; skin irritation or rash where the patch is applied; nausea; vomiting; breast tenderness and pain; abdominal pain, flu symptoms; vaginitis.7

Contraception

These are small, flexible capsules or rods that are placed under the skin in the upper armbya physician and release progestogen. They prevent sperm from entering the womb and meeting the egg (by thickening the cervical mucosa). They also prevent the release of the egg from the ovary and induce changes in the endometrium.1,4,9

ADVANTAGES: Does not require self-administration. Long-lasting protection. No interference with sex.9
DISADVANTAGES: Bleeding may become irregular. Some other side-effects may be seen.9

The most common side effects are changes in bleeding pattern, headaches, abdominal pain, acne, weight change, breast tenderness, dizziness, mood changes and nausea.9

Contraception

Male condoms
A thin sheath or latex covering that forms a barrier between the male and female sexual organs. The barrier prevents sperm from entering the vagina.12

Female condoms
A loosely fitting sheath, made of thin, transparent, soft plastic film, that is
placed inside the vagina. The barrier prevents sperm from entering the vagina.13

ADVANTAGES: No hormonal related side effects. Can be used as a temporary or back-up method. Protection from STIs.12,13
DISADVANTAGES: Needs to be correctly used with every act of sex.12,13

There are no side effects. All men and women can safely use condoms except those with severe allergic reaction to latex rubber.12,13

Contraception

Male sterilization
The tubes (vas deferens) that carry sperm are blocked or cut, therefore the
ejaculated semen does not contain sperm.15

Female sterilization
The tubes (fallopian tubes) that help transfer eggs to the uterus are blocked
or cut, therefore the eggs do not enter the tube to meet the sperm.16

ADVANTAGES: Few/no side effects. No need to do or remember anything/any appointment.15,16
DISADVANTAGES: There’s a three month delay in contraceptive protection after male sterilization. Requires minor surgery.15,16

There are minimal side effects. No risk of serious complications.15,16

Contraception

Copper IUDs
A small plastic device with copper wire/sleeves that is inserted into the uterus. The copper IUDs cause a chemical change that damages sperm and egg before they meet.10

Hormonal IUDs
This is a plastic T-shaped device inserted in the uterus that releases small amounts of the progestin hormone (levonorgestrel). The hormone suppresses the thickening of the lining of the uterus.11

ADVANTAGES: Does not require self administration. Long-lasting protection.10,11
DISADVANTAGES: Bleeding may become irregular.10,11

Common side effects are changes in bleeding patterns are often seen. With hormonal IUDs, there may be acne, headache, breast tenderness, nausea, weight gain, dizziness, and mood changes.10,11

Contraception

Emergency contraceptive pills
Pills containing progestin only, taken within 5 days after unprotected sex. It works primarily by preventing or delaying the release of eggs from the ovaries; they do not work if the woman is already pregnant.14

Copper intrauterine devices
These can also be used as an emergency contraceptive.10

ADVANTAGES: Offer a second chance at preventing pregnancy. Can be kept on hand in case an emergency arises.14
DISADVANTAGES: Cannot help if pregnancy has already occurred.14

Common side effects are changes in bleeding pattern, nausea, abdominal pain, fatigue, headaches, breast tenderness, dizziness and vomiting.14

Emergency contraceptive pills contain hormones and must be used within 3-5 days after unprotected intercourse, depending on the regimen, the sooner the better.14

Contraception

REFERENCES – Further Reading:

World Health Organization. Family Planning. Fact sheet (No. 351. Updated May 2013. Available at: http://www.who.int/mediacentre/factsheets/fs351/en. Accessed on 13 October 2014. 2. Combined Oral Contraceptives. In: World Health Organization Department of Reproductive Health and Research (WHO/RHR) and Johns Hopkins Bloomberg School of Public Health/Center for Communication Programs(CCP), Knowledge for Health Project. Family Planning: A Global Hand book for Providers (2011update). Baltimore and Geneva: CCP and WHO, 2011. p1–24. 3. Progestin-Only Pills. In: World Health Organization Department of Reproductive Health and Research (WHO/PHR) and Johns Hopkins Bloomberg School of Public Health/Center for Communication Programs (CCP), Knowledge for Health Project. Family Planning: A Global Handbook for Providers (2011 update). Baltimore and Geneva: CCP and WHO, 2011. p25–44. 4. Apgar BS et al. Am Fam Physician. 2000;62(8):1839– 1846. 5. Mansour D, Verhoeven C, Sommer W. et al. Efficacy and tolerability of a monophasic combined oral contraceptive containing nomegestrolacetateand17b-oestradiolina24/4regimen, in comparis onto an oral contraceptive containing ethinylestradiolanddrospirenone in a 21/7 regimen. Eur J Contracept Reprod Health Care. 2011;16(6):430–443. 6. Combined Vaginal Ring. In: World Health Organization Department of Reproductive Health and Research (WHO/RHR)  and Johns Hopkins Bloomberg School of Public Health/Center for Communication Programs(CCP), Knowledge for Health Project. Family Planning: A Global Handbook for Providers (2011 update). Baltimore andGeneva: CCP and WHO, 2011. p105–108. 7. Combined Patch: In: World Health Organization Department of Reproductive Health and Research (WHO/RHR) and Johns Hopkins Bloomberg School of Public Health/Center for Communication Programs(CCP), Knowledge for Health Project. Family Planning: A Global Handbook for Providers(2011update). Baltimore and Geneva: CCP and WHO, 2011. p101–104. 8. Progestin-Only Injectables. In: World Health Organization Department of Reproductive Health and Research(WHO/RHR) and Johns Hopkins Bloomberg School of Public Health/Center for Communication Programs (CCP), Knowledge for Health Project. Family Planning: A Global Handbook for Providers (2011 update). Baltimore and Geneva: CCP and WHO, 2011. p59–80. 9. Implants: In: World Health Organization Department of Reproductive Health and Research(WHO/RHR) and Johns Hopkins Bloomberg School of Public Health/Center for Communication Programs (CCP), Knowledge for Health Project. FamilyPlanning: A Global Handbook for Providers (2011update). Baltimore and Geneva: CCP and WHO, 2011. p109–130. 10. Copper-Bearing Intrauterine Device.
In: World Health Organization Department of Reproductive Health and Research (WHO/RHR) and Johns Hopkins Bloomberg School of Public Health/Center for Communication programs (CCP), Knowledge for Health Project. Family Planning: A Global Handbook for Providers (2011update). Baltimore and Geneva: CCP and WHO, 2011. p131–156. 11. Levonorgestrel Intrauterine Device. In: World Health Organization Department of Reproductive Health and Research(WHO/RHR) and Johns Hopkins Bloomberg School of PublicHealth/Center for Communication Programs(CCP), Knowledge for Health Project. Family Planning: A Global Handbook for Providers(2011update). Baltimore and Geneva: CCP and WHO, 2011 p157–164. 12. Male Condoms. In: World Health Organization Department of Reproductive Health and Research(WHO/RHR) and Johns Hopkins Bloomberg School of PublicHealth/Center for Communication Programs(CCP), Knowledge for Health Project. Family Planning: A Global Handbook for Providers(2011update). Baltimore and Geneva: CCP and WHO, 2011. p199–210. 13. Female Condoms. In: World Health Organization Department of Reproductive Health and Research(WHO/RHR) and Johns Hopkins Bloomberg School of Public Health/Center for Communication Programs(CCP), Knowledge for Health Project. Family Planning: A Global Handbook for Providers (2011update). Baltimore and Geneva: CCP and WHO, 2011. p211–220. 14. Emergency ContraceptivePills: In: World Health Organization Department of Reproductive Health and Research (WHO/RHR) and Johns Hopkins Bloomberg School of Public health/Center for Communication Programs(CCP), Knowledge for Health Project. Family Planning: A Global Handbook for Providers(2011update). Baltimore and Geneva: CCP and WHO, 2011p45–58. 15. Vasectomy. In: World Health Organization Department of Reproductive Health and Research (WHO/RHR) and Johns Hopkins Bloomberg School of Public Health/Center for Communication Programs (CCP), Knowledge for Health Project. Family Planning: A Global Handbook for Providers (2011update). Baltimore and Geneva: CCP and WHO, 2011. p183–198. 16. Female Sterilization. In: World Health Organization Department of Reproductive Health and Research (WHO/RHR) and Johns Hopkins Bloomberg School of Public Health/Center for Communication Programs (CCP), Knowledge for Health Project. Family Planning: A Global Handbook for Providers (2011 update). Baltimore and Geneva: CCP and WHO, 2011. p165–182.

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