Contraceptive Methods: a long way since crocodile dung, honey and soda ash…

In 1850 BC, Egyptian women used a mixture of crocodile dung, sodium carbonate and honey, inserted into the vagina, to block and kill sperm. Flash forward about 2100 years, and the US Federal Drug Administration approved the first birth-control pill – Enovid – in 1960.

In the years in between and since, modern contraceptive methods have become more effective, cheaper to produce and more accessible than ever before.

This post will cover modern methods of contraception and how help make family planning for all a reality. For each method, we have also included the effectiveness with correct and consistent use, compared with the effectiveness as commonly used (in brackets).

Combined oral contraceptives or “The Pill”

The combined oral contraceptives, commonly known just as “The Pill”, is an oral contraceptive that is taken daily. It contains two hormones – a progestogen an oestrogen – which act to prevent the ovaries from releasing eggs.

The effectiveness of The Pill relies on consistent and regular daily usage.

Effectiveness = >99% (92%)

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Progestogen-only pills or “The Mini-Pill”

The progestogen-only pill, also known as “The Mini-Pill” is another contraceptive that is taken daily. Small dosages of progestogen prevents ovulation, as well as thickening the cervical mucous. This blocks the sperm from meeting the egg. Progestogen doses in The Mini-Pill are similar to levels naturally produced by the female body.

As with The Pill, the Mini-Pill’s effectiveness also relies on regular and consistent daily use

Effectiveness  = >99% (90-97%)

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Condoms

Condoms are the only contraceptive method that prevent pregnancy and protect users from STIs. They come in a variety of forms:

  • Male Condom

As one of the two contraceptive methods for men (the other being sterilization), condom usage is one of the most common forms of contraceptives. Male condoms are latex or polurethane coverings that fit are rolled over the erect penis before sex, preventing sperm and egg from meeting.

Effectiveness = 98% (85%)

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  • Female Condom

The female condom is a polyurethane sheath that fits loosely inside a vagina, inserted before sex. Two flexible rings keep the condom in place in the vagina.

Effectiveness: 90% (79%)

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  • Diaphragm

The diaphragm is a dome-shaped cap made of silicone, that fits into the vagina before sex. It stops sperm getting into the uterus by forming a physical cover for the cervix.

Users should be fitted for the right size diaphragm and instructions be provided by their health-care provider.

Effectiveness = 94% (88%)

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Implants

Contraceptive implants are small capsules or flexible rods that are inserted under the skin of the upper arm and release progestogen. The hormone released thickens mucous in the cervix to prevent fertilization, and prevents ovulation. Depending on the brand, one implant will last 3-5 years but must be inserted and removed by a health-care provider.

Effectiveness = >99%

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Intrauterine device (IUD)

Intrauterine devices (IUDs) are small devices that are fitted into the uterus of users. IUDs are made of plastic and are either covered in copper wire or contain a progestogen hormone.

  • Copper-containing

Copper-containing IUDs (Cu IUDs) stop sperm from reaching the egg, and prevent any fertilised eggs from sticking to the uterus wall. As they do not contain any hormones, Cu IUDs do not affect normal menstrual cycles – however periods may be slightly heavier. Cu IUDs need to be replaced every 5-10 years, but may be removed easily at anytime.

Cu IUDs may also be used as a form of emergency contraceptive (see below for other).

Effectiveness = >99%

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  • Hormone-containing

Hormone-containing IUDs slowly release small progestogen doses into the uterus over a 5 year time frame. Periods may become lighter or stop when using the device.

Effectiveness = >99%

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Hormone injectables

Hormone injectables are a variety of contraceptive injections given into a muscle over varying periods of time, depending on the specific product. For example, progestogen-only injectables are given every 2 or 3 months, while combined injectable contraceptives are injected monthly.

Effectiveness – 99% (97%)

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Emergency contraception pills

Emergency contraception pills, colloquially known as “the morning-after pill”, can be taken to prevent pregnancy up to 5 days after unprotected sex. This method is most effective if taken in the first 24 hours after sex.

Effectiveness: Varies – 85% when taken in the first 3 days after sex

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Sterilisation

Sterilisation a is non-reversible procedure that provides permanent contraception for an individual. The procedure is different for males and females:

  • Male sterilisation (vasectomy)

A vasectomy involves an operation on the vas deferences that prevents sperm from joining the ejaculated semen. The procedure involves a 3-month delay in taking effect.

Effectiveness : >99% (97-98% with no semen evaluation)

  • Female sterilisation (tubal ligation)

Tubal ligation is an operation that blocks or cuts the Fallopian tubes to stop the ovum (unfertilised egg’s) passage. This operation generally requires a general anaesthetic.

Effectiveness: >99%

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References and for more information:

World Health Organisation Contraception Fact Sheet

Family Planning NSW – Contraception Choices

 

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