Methods of Contraception

1. Methods of Contraception

2. Abstinence • Works 100% of the time (if people “use” it all of the time) • There are no side effects

3. Hormonal Methods Hormonal methods of contraception are very effective as they prevent ovulation (Pill, Patch, Ring, Depo Provera, Implant). They do not prevent STIs

4. Oral Contraceptive Pill The OCP is 97-99% effective if taken properly. In South Africa they can be prescribed by a nurse or a doctor 21 pills are taken, during a 7 day break the women has her period. If the women forgets to take her pill, vomits, has diarrhoea or is taken antibiotics she must abstain from sex or use another method (eg condom) whilst she is ill/medication and for 7days afterwards. OCPs are relatively safe medications for young, non-smoking women to use

5. Depo-Provera • Depo Provera is an injectable contraceptive given every 12 weeks • It works by preventing ovulation and making the mucus in the cervix thicker • It is 99.7% effective • It can cause irregular menstrual bleeding

6. Patch & Ring • The patch and ring are also reliable hormonal methods of contraception; not available in South Africa • The rings sits in the vagina and releases Oestrogen and Progesterone. It is 99% effective • The patch is 4cm square which releases hormones, it also 99% effective

7. Intrauterine Device (IUD) The IUD contains copper (ParaGuard) or hormones (Mirena) that • keep sperm from joining egg • It is a very effective form of contraception (99%) • not effective against sexually transmitted diseases, male or female condoms can reduce risk of infection • Can be used as emergency contraceptive up to 5 days after sexual intercourse • It does not protect against STIs ParaGuard may be left in place for up to 10 years and Mirena for up to five years Mirena may reduce menstrual cramps

9. Sterilisation • Male Sterilisation is Vasectomy, the vas deferens is cut, not allowing sperm to enter into the vagina • Female sterilisation: tubal ligation, the fallopian tubes are cut or clipped so that the eggs cannot meet the sperm

10. Combining 2 methods of Contracption By combining 2 methods of contraception (e.g. hormonal method with condom). This is a very effective method of contraception which also protects against STIs

11. Less Effective Methods of Birth Control

12. Condoms • MALE CONDOMS Male condoms are 85% effective in typical use. They are very effective in the prevention of many Sexually Transmitted Infections. • FEMALE CONDOMS Female condoms are 79% effective in typical use. They are more expensive than male condoms and are not easily available in South Africa.

13. Spermicides • Sponge These methods are not particularly effective when used by themselves.

14. Fertility Awareness A woman is taught to recognise when she is most fertile. She must abstain from sexual intercourse for the 9+ days of her cycle Can take 6-12 months of training and record keeping to use this method. 75% effective

15. Withdrawal • Not a reliable method of birth control • 76-96% effective • Not effective against STIs

16. Emergency Contraception • Emergency Contraception Pill • can reduce the risk of pregnancy if started within five days of unprotected sex. • It works best when taken within 72 hours — can reduce the risk of pregnancy from 75 to 89 percent. • The sooner a woman starts EC, the more effective it may be. Nausea, vomiting, and cramping are common side effects. • IUD-can be used within 5 days of unprotected intercourse

17. Diaphragm Prescribed by a doctor • It is used by the woman • Can be awkward to insert and remove • Does not protect against STIs It is 85% effective.