Rotimi Adesanya

Every year, the 26th of September is observed as World Contraception Day. Like every year, even in 2018, the focus is to create awareness about the topic of contraception, which remains more or less stigmatised in Nigeria. Population explosion can put a great strain on the resources of the nation, reducing the quality of life. Proper knowledge about contraception methods is the only way to reduce the burden of STDs and unwanted pregnancies. The contraceptives chosen must take into consideration personal preferences, habits and health concerns. Complete abstinence is the only method that prevents pregnancy 100 per cent of the time, but most contraceptive methods have a very high success rate when practiced correctly.

When choosing contraception, considerations should include accurate information about: effectiveness in pregnancy prevention, health issues which may limit some choices, ease of use, side effects( change in monthly cycle), cost and availability, reversibility, protection against sexually transmissible infections. The most effective reversible methods are the “fit and forget” long-acting reversible contraceptives – intrauterine devices and contraceptive implants.

Some methods are temporary, while some are permanent. The temporary method is used when spacing pregnancies. It can be discontinued anytime one wish to get pregnant, while the permanent methods are irreversible and indicated for women who don’t want to get pregnant again or men who don’t want to impregnate any woman again in their lifetime.

Natural contraceptives: These include abstinence – including periodic abstinence, calendar calculations, cervical secretions, basal body temperature, feel of cervix, lactational amenorrhea method for mothers feeding their babies on exclusive breast milk.

Male and Female condom: The condom is put on the erect penis. The condom prevents pregnancy. It also prevents sexually transmitted diseases such as HIV. Side effects are rare and this may be allergy or rash. It is 86-97 per cent effective. The woman inserts a female condom in her vagina before sexual intercourse. The female condom also prevents STDS and HIV. It must be used during each acts of sexual intercourse. It is 79 to 95 per cent effective.

The Patch: It is similar that to oral contraception. Instead of taking a pill every day, you just stick on a new patch once a week. It also contains estrogen and progesterone which are slowly released through the skin. It is usually placed on the belly, upper arm, back or butt.

The Vaginal Ring: It is a small, flexible ring that inserted in the vagina and kept there for 21 days before being taken out. It releases the two hormones to stop ovulation and are absorbed through the vaginal lining. You have to push it up into the vagina as far as possible or it can come out easily. You can remove it during sex but remember to put it back soon.

Diaphragm: The diaphragm is a shallow rubber cup that acts as a collection and blocks the sperm and prevents it from making contact with the vagina.

Spermicides: This includes cream, jelly, pessaries inserted by the female into the vagina prior to sexual intercourse. Spermicides kill sperm by preventing it from making contact with the eggs. The effectiveness is 74 per cent. When used with barrier method, the effectiveness increases.

Injectable contraceptives: They are given through a shot in the arm or buttocks. Examples are Depot Provera, which is given three-monthly, while Noristerat is given every two months. The injectable is made from hormone. The hormone stops the body from releasing an egg every month. Side effects include headache, breast tenderness, upset stomach, weight again in few people. Once the injection is stopped, it may take 6-12 months before the person becomes pregnant.. Its effectiveness is 99 per cent.

Oral contraceptives: They are often called the pills. It is important to take the tablet every day even if there is no sexual intercourse. One may have side effects like headache, breast tenderness and weight again. Effectiveness is 92-99 per cent.

Implant: The implant is a set of one or two small capsules. The capsules contain hormone and are safe if you are breastfeeding. The capsules are put under the arm and are used for long term. It works for up to five years with the effectiveness being about 99 per cent.

Intrauterine contraceptive device: The IUCDs are made of flexible plastic or metal inserted in the woman’s vagina. The IUCD stops the sperm from meeting the egg or it also stops an egg from attaching to the uterus. It is not suitable for women with infection. It works for up to five years. Effectiveness is 98 per cent.

Fit and forget method: The most effective reversible methods are the “fit and forget” long-acting reversible contraceptives (LARCs) – intrauterine devices and contraceptive implants mentioned above.

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