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Friday, January 23, 2009

Choosing a contraceptive method

There are so many different types of contraception available that you should be able to find the right method. You may have to try several different things before you choose the one you like most.We have reached the stage where unplanned pregnancies really should be rare, because there are so many good methods of birth control.What are the most popular types of contraception? According to the Office of National Statistics (ONS), the Pill remains the most popular method in the UK. Among women aged 16 to 49, 27 per cent were using the Pill in 2007 and 20 per cent were relying on the condom.Below is a league table of popularity among the various non-permanent methods of family planning, based on the ONS figures.It’s based on the recent survey carried out by the Office of National Statistics (ONS) on contraception among women aged 16 to 49. (The figures may differ very slightly from those in other surveys. Even when using large samples, minor variations in results will occur.)
The Pill including the mini-Pill – 27 per cent.
Male condom – 22 per cent.
Vasectomy – 11 per cent
Female sterilisation – 9 per cent
The coil (intra-uterine device) – 4 per cent
Withdrawal method – 3 per cent.
Persona and other variations of the rhythm method – 3 per cent.
Contraceptive injection – 2 per cent.
Mirena (intra-uterine system) – 2 per cent.
Skin patch – 1 per cent.
The cap or diaphragm – 1 per cent.
Female condom – less than 1 per cent.The league table changes from time to time, depending on factors such as Pill scares and the introduction of new methods.For instance, the number of women using Depo-provera (the contraceptive injection) seems to have increased a little since 2000.What works and what doesn't?With the exception of withdrawal (coitus interruptus), the above methods have the blessing of family planning experts because when used properly, they prevent pregnancy.However, while the rhythm method is okay for well-motivated couples who have been trained in its use by a qualified natural family planning teacher, for the rest of us, it’s a bit risky.Also very risky are certain non-approved methods, for instance, using spermicides (chemical pessaries, creams or foams), or douching your vagina after sex.Practices like ‘doing it standing up’ or ‘coughing a lot afterwards’ or ‘trying not to come’ don’t work, and will simply lead to unwanted pregnancy. How effective are the various methods?Some contraceptive methods are more effective in preventing pregnancy than others, while only condoms offer protection against sexually transmitted infections.The following figures will give you some idea of which kinds of contraception are the most efficient at protecting you against pregnancy.
Contraceptive method
Almost 100 per cent
Female sterilisation
Almost 100 per cent
The Pill
Almost 100 per cent
Contraceptive injection
Almost 100 per cent
IUS (Mirena)
98 to 99 per cent
IUD (the coil)
97 to 98 per cent
The mini-Pill
Around 98 per cent
Male condom
90 to 98 per cent
Female condom
90 to 98 per cent
Diaphragm with spermicide
90 to 96 per centNone of the methods is 100 per cent effective, which means the only guaranteed way of preventing conception is to not have sex!You should also remember that some methods are quite complicated to use, and no method is as safe as the figures quoted if you don’t follow the instructions carefully.For example, if you are taking the Pill, you shouldn’t miss taking a tablet. If you are using condoms, you should make sure you put them on before sex starts – not half way through. If you’re relying on the contraceptive injection, you need to turn up for your jab on time.Every method can fail if you don’t take care.What about new methods of contraception?Other methods of contraception will be available in the future. Below are two recent developments.
The vaginal hormone ringThe vaginal hormone ring (NuvaRing) has been tried out extensively since 2001. It is approved in 32 countries, but not yet in the UK.You keep it in your vagina for three weeks out of every four. During the week you take it out, you will have your period.Like the Pill, it contains two hormones. We don’t know what its long-term effects will be.The most common side effects are known to be:
vaginal inflammation – 14 per cent
headache – 10 per cent
Discharge – 6 per cent
Nausea – 5 per cent.The ring hasn't been generally released in Britain, though you can get it through a few private gynaecologists.As is common with hi-tech methods of contraception, the ring has attracted legal action. In 2008, a lawsuit was launched by a husband who claims that his wife died as a result of using it.
The male PillThe male Pill is still at least five years away from general release, despite the fact that it keeps making headlines.At present, it’s an injection, not a pill.It’s unlikely to reach the British market before 2013.Where do I get advice about choosing a contraceptive?The UK has good, free contraceptive services.Traditionally, advice has been provided by the specially-trained experts at Britain’s large chain of family planning clinics, which were originally set up by the Family Planning Association (fpa).You can find your local family planning clinic in the phone book or use the clinic finder on the fpa website.These days, nearly all GPs also offer advice on contraception. If you don’t want to talk to your own doctor about family planning, you can ask to see another. You can go to a different practice if you want to. It's fair to say that many GPs aren’t experts in all methods of family planning. But usually there is one partner in the practice who does have good qualifications in contraception.If you’re under 25, you could go to a Brook advisory clinic or a local youth advice clinic.

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