All You Need to Know About Contraceptives

Thousands of years ago, circa 1550 BC, women placed honey, acacia leaves, and lint in their vaginas to avoid getting pregnant. Women, through the centuries, have tried everything to prevent pregnancy, often with life-threatening consequences.

But the struggle took a turn with the introduction of "the pill," which was co-created by long-term women’s rights proponents Margaret Sanger and Gregory Pincus, often called The Father of the Pill.

Approved by the FDA in 1960, the oral contraceptive pill changed the way birth control had been perceived all these years. The pill started a revolution where women had the freedom to lead a healthy sex life without worrying about getting pregnant after intercourse.

While popular thought was that it was for young women with zero moral scruples, access to easy contraception changed the lives of married couples as well. It also had an impact on the post-World War baby boom, putting a check on the sudden population explosion. 

Finding the best approach that will suit your needs depends on several variables. While some techniques call for daily maintenance, some are permanent. Your personal circumstances and choices will ultimately determine the best contraception method for you. 

Senior consultant at Apollo Clinic, Dr Shivani Jain, recommends a "cafeteria approach." She explains, "Factors like age, medical history, and family planning objectives are crucial. Most importantly, the chosen technique should suit both partners and align with pregnancy protection timelines.”

Dr Anagha Karkhanis, the director and lead consultant at Cocoon Fertility, also highlights the importance of considering effectiveness and pregnancy risk when choosing a contraceptive method.

Intrauterine contraceptives offer higher effectiveness than barrier protections, such as condoms. However, they are not suitable for everyone. Each individual’s unique needs and experiences make birth control a very personal decision.

Hormonal: These include birth control pills, patches, shots, vaginal rings, and implants. They work by preventing ovulation or thickening cervical mucus to prevent sperm from reaching the egg.

IUDs: These small, T-shaped devices are inserted into the uterus to prevent pregnancy. There are two types of IUDs: copper and hormonal. Copper IUDs work by preventing fertilisation, while hormonal IUDs prevent ovulation and thicken cervical mucus.

Barrier Method: These include condoms, diaphragms, and cervical caps. They work by physically blocking sperm from reaching the egg.

Permanent Sterilisation or Tubal Ligation: This surgical procedure permanently blocks the fallopian tubes, preventing eggs from reaching the uterus and sperm from reaching the egg.

Dr Shivani Jain emphasises opting for an approach that is both useful and safe. She adds, "Patient autonomy is essential to enable educated, independent decision-making." 

Dr Anagha Karkhanis insists on asking the right questions. She breaks it down into three steps:

• Assess the effectiveness of the chosen contraceptive method. 
• Inquire about potential contraceptive side effects and health risks. Different methods come with other risks.
• Determine if the method is reversible and understand the timeline for regaining fertility after discontinuation. Keep future reproductive plans in mind. 

When not used under medical guidance, contraceptives can result in health issues. 

According to Dr Shivani Jain, the long-term repercussions of oral hormonal contraception can include thrombosis, cancer, heart problems, and stroke. These hazards rise with a higher generation of progesterone.

Injectable contraception may result in irregular menstrual periods, weight gain, and bone density loss.

Dr Kiran Coelho, one of India's leading obstetricians and gynaecologists, says, “While certain remedies can ease painful or heavy periods, few actually provide STD prevention. Sterilisation for men or women can be done permanently. Your doctor can, therefore, help you choose the best type of contraception after carefully weighing these aspects.”

She adds, “When it comes to birth control, different methods bring various advantages and potential drawbacks."

Here's a simplified breakdown:

Positive aspects:
Some contraceptive methods can help with mental health issues and physical wellbeing. This includes better moods, more regular periods, less acne, and relief from specific medical ailments.

Drawbacks to be aware of:
On the other hand, some approaches could result in unfavourable side effects, such as a lack of STI prevention. Additionally, contraceptives can cause mood swings, weight gain, and a decreased sex drive.

Being informed about these factors is essential for making choices that align with your health and lifestyle.

Dr Shivani Jain warns, “Hormonal contraception should not be used by women who have health conditions such as high blood pressure, heart troubles, or a history of stroke."

She further adds, “It is not advised for regular smokers, some migraine sufferers, or breast cancer survivors. When non-hormonal methods are ineffective for treating obesity, transdermal treatments could be preferred.”

These recommendations underline the significance of taking individual health into account while selecting contraceptives.

Medically reviewed by:

Dr Suma Shet, Obstetrician and Gynaecologist