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Female contraceptive methods
How to choose your contraception
Male contraceptives

This file will be follow, in the weeks to come, with some articles, which will deal with each method.

Female contraception is quite diversified and contraceptives are numerous, contrary to male contraception, which is not very developed yet.

If the contraceptives for woman are numerous, it is because none of them is perfect to suit to every woman. Each contraceptive have some advantages and some disadvantages but among all the effective contraceptives, you will certainly find one, which will be perfect for you.

Your doctor will give you all the advices you need and will help you to change your contraception if the one you use does not suit you.

Contraceptives can be classified in five rubrics: 

• Hormonal, which has a general action.

• Chemical, which has a local action.

• Physical.

• Surgical or sterilization.

• Others.

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◊ Hormonal

It is a hormonal-based contraception. These hormones enter the general circulation and so can have an impact on the all organism, hence the numerous medical contraindications against the use of this type of contraceptives.

The work of the hormones in the contraceptives is to block ovulation.

Among hormonal contraceptives method, you can find: 

• The different pills (their hormones dosages are more and more low).

• Adhesive skin patches. 

• Implants that the doctor inserts himself under the skin, after a weak local anesthesia and a little skin incision.

• The new vaginal rings containing hormonal.

◊ Chemical

This type of contraception is toxic-based, and has an effect only on spermatozoon by destroying or immobilizing them. These contraceptives does not contain hormones, there is only few medical contraindications for their use.

The main types of chemical contraception are as follows: 

• Spermicidal (sperm-killing) gels and foams, that woman put into her vagina before intercourse.

◊ Physical

These types of contraceptives do not contain hormones or toxic products, except for mixed contraceptives, which has a double action, physical and chemical.

They are: 

• Intrauterine device (IUD) with metallic device (copper or other metal) or intrauterine system (IUS) which contains hormones (dual action hormonal and physical)

• Female condom, which is quite new and very well tolerate.

• Vaginal diaphragm and cervix cap which are almost not used anymore since female condom exists which is more accepted by women and more effective. 

◊ Surgical contraception or sterilization

Surgical contraception is also called sterilization.

It consists in blocking the fallopian tubes, in order to stop the egg and the sperm meeting. This technique needs a coelioscopy, which is a surgical act. 

A new technique consists in the introduction of a foreign body into the fallopian tubes, in a natural way, in order to create an inflammatory reaction, which will leads to the combination of the walls of the fallopian tubes stopping in this manner the egg and the sperm meeting.

All these techniques should be considered as sterilization because they are often irreversible without a surgical act of fallopian tube reconstruction, delicate act and not always effective.

◊ Other contraceptives

The other contraceptive methods are not really reliable. Their aims are to recognize the fertile times of a woman in order to avoid a sexual relation during this period. The risks of failure of these methods are quite high (up to 10%).

They are:

• Temperatures methods called Ogino method or one of its variants.

• Chemical reagents, which study the characteristics of the cervical phlegm in order to indicate, approximately, the fertile time. The cervical phlegm has particular physical and chemical characteristics during the ovulation period.

The different methods that women can choose will depend of some elements:

• Different age of life of woman.

• Desire or not of future pregnancy.

• Impossibility to manage contraception that needs to be taken at regular intervals. 

• Post partum period (which is after the delivery) with or without feeding. 

• Sexual relation frequency.

• Existence, or not, of contraindication to an effective method.

We can classify the choice that women can take, according to the different above data:

• For young girl or young women who have occasional sexual intercourses, because they are not living in couple, the criterions of choice will be based on the necessity of a maximum efficiency and on a necessary protection against sexually transmitted diseases. A dual-contraception, hormonal and physical will be advised.

As hormonal contraception, it will be possible to choose pill, vaginal ring, patch or implant inserted under the skin, which are four efficient methods (the failure rate of pills, implants or patches is less than 1%).

As physical contraception, for protection against STD, male or female condoms will be advised.

Male condom, used alone, would be perfect if it did not experience too many failure due to the risk of forgetting to use it while unexpected intercourses, the risk of condom tearing or a bad use of it.

• For young women, living in couple or not, but who can give up the condom because they trust their partner, pill, patch, implant under the skin or vaginal ring will be advised.

Intrauterine devices or systems are not indicated for young women who want kids because of a possible risk of infection, which could decrease the fertility after the withdrawal of the intrauterine device or system.

• For women who cannot manage contraception that needs to be taken at regular intervals because of psychiatric problem for example, implants under the skin or quarterly intramuscular injections are deeply advised.

It is important to remind that every year there is more than 6000 abortions and more than 100 000 non-desired pregnancies!

• For women who do not want a child anymore, whatever their age, but especially for women in pre-menopause period, which is a decreased fertility period, intrauterine devices or systems will be the best solution. Intrauterine devices or systems are also perfect for women who cannot take hormonal contraception because of contraindication.

However, be careful, intrauterine devices with metallic device increase the abundance of the period, and in pre-menopause, women has often profuse period. In this case, it is necessary to ask to a doctor an intrauterine system, which is progesterone-based, and not an intrauterine device with metallic device, in order to decrease the period profusion.

Regarding surgical sterilization (which consists in blocking of fallopian tubes), the risk of irreversibility of this technique is quite high. This sterilization will be practiced only on women who have a contraindication to a new pregnancy or who are determined to not have kids anymore.

• After the delivery, even if the woman is breast-feeding, the take of micro pills is not contraindicated (see with your doctor). It is necessary to remind that during breast-feeding; a woman can get pregnant, contrary to what most of people can think. This risk is quite low but it does exist and is increased with the length of breast-feeding.

• At all age, for woman who likes to take some risks, gels and foams spermicidal could be suitable (failure rate close to 5%).

• Finally, for women who are not afraid of getting pregnant, a bit indecisive between contraception and pregnancy, the temperature method, or chemical tests of cervical phlegm, could be suitable, knowing that failure is quite high but not really important for these women who, unconsciously want to get pregnant. 

For a man living with a partner, who wants to take in charge the couple contraception, or when his partner has a contraindication to an efficient method, pill for man could be suggested. Recently, this hormonal contraception made lots of progress. Its aim is to block the spermatogenesis. 

If this couple does not want kids anymore, a vasectomy could be a good solution. It is important to know that vasectomy is often irreversible. Therefore, it is necessary for the man to be very well determined, whatever the circumstances of his life.

For a man who has several sexual intercourses, who does not want kids anymore and who is afraid that one of his partners made him "a kid behind his back", condom will be indispensable in order to avoid a sexually transmitted disease, uses with or without male contraception such as vasectomy or pill for man.

It is important to note that new condoms are perfumed, with different tastes, different sizes etc.

To conclude, a word about the withdrawal method, that is the withdrawal of the penis before ejaculation. This method is not really reliable because the control of the ejaculation is always difficult, and it can happen that some mini ejaculations occur without that the man can notice it. Besides, this method is not satisfying for the man and for the woman, who have the anguish of the withdrawal at the right time, which disturb a lot the sexual pleasure.