Choices, Choices: other methods of contraception
Choices, choices…
Sterilization
Intrauterine system Mirena
The copper coil
One-monthly/Three-monthly injectable
The diaphragm
Chemical contraceptives
The Condom (sheath)
Computer-aided methods
Temperature method
Withdrawal
Rhythm method (Knaus-Ogino)
Alternatives to the pill
Sterilization
Using anesthesia, a woman's Fallopian tubes are closed with electric current or a clamp, or a man's sperm ducts are cut. This is a virtually final act. Doctors usually refuse to use this method in mothers under 30 or childless women under 35.
The body's natural hormone production and the function of ovaries are retained. Women planning sterilization often re-consider and choose a long-term contraceptive method instead.
Intrauterine system
The intrauterine system is a progestin-delivering reservoir that is introduced into the womb during menstruation. It is effective for five years, and continuously releases small amounts of progestin, leading to a thickening of the mucus in the neck of the womb. This prevents sperm from ascending into the womb. In addition, the growth of the womb lining (endometrium) is strongly reduced and the local milieu of the womb and the Fallopian tubes inhibits sperm motility and function thus preventing fertilisation. The natural hormone production in the ovaries is not affected. The intrauterine system is a very effective and convenient form of contraception. In the first few months of use the woman may experience irregular bleeding. The system is not suitable for women whose womb is abnormally formed.
The Coil
The coil consists of a plastic body that is wound with a copper coil, and is introduced into the womb by a doctor. There it releases minute amounts of copper. This inhibits sperm motility, egg transport and the capacity of sperm to fertilise eggs. Among the possible side effects are increased menstrual bleeding and pain.
The coil is not suitable for young girls or childless women. Women who suffer from heavy bleeding, blood coagulation disturbances, malformations of the uterus or a copper allergy should not use the coil. It must be changed every three to five years.
One-monthly/Three-monthly injectable
The One-monthly injectable contains a natural estrogen in combination with a progestin. It works like the pill, is well tolerated and leads to very good cycle stability.
The Three-monthly injectable only contains progestin and works like the minipill.
Both products are injected into the gluteal muscle.
The diaphragm
The diaphragm is a round rubber device that is placed before the entrance to the womb previous to sexual intercourse and must remain there for eight hours.
Doctors recommend the additional use of spermicidal creams. The diaphragm is not suitable for women suffering from descent of the womb, inflammations or constrictions of the vagina.
Chemical contraceptives
These include tablets, ovula, cones or creams. Either a viscous substance occludes the neck of the womb, or a chemical kills the sperm. Doctors warn against a combination with condoms, because the condoms may become porous from the substances contained in the chemical contraceptives. Side effects include irritation of the mucous membranes and a feeling of heat.
The Condom (sheath)
Is not only a contraceptive but also a fairly safe method for protection against sexually transmitted diseases and HIV (AIDS). Note: It is important to use a new condom for every sexual act, and the man must withdraw his penis from the vagina directly after ejaculation.
Many men complain of reduced feelings when using a condom. Another possible problem is a latex allergy.
Computer-aided methods
These small gadgets identify fertile and infertile days by analyzing hormones in the woman's urine. The method's effectiveness is relatively poor and is also influenced by the conscientiousness of use.
Temperature method
One or two days after ovulation, a woman's body temperature rises by 0.3 to 0.5 degrees Celsius. Five days before until three days after the increase are considered fertile days, and sexual intercourse should be avoided on these days. Women who have unstable cycles should refrain from using this method. With correct and conscientious use, this method can achieve a Pearl index of 1-3.
Withdrawal (Coitus interruptus)
The man withdraws his penis from the vagina shortly before ejaculation. A very ineffective method, with a Pearl index of 15-35. The reason is that sperm can be release even before orgasm.
Rhythm method (Knaus-Ogino)
Complicated method of calculating the fertile days, developed in 1925 by Austrian Hermann Hubert Knaus and his Japanese colleague Kyusaku Ogino. In order to be able to use the method, a woman must have registered her menstrual rhythm for a minimum of six, better twelve months. And even then, the method only works if the menstrual cycles are regular, and if the long times of required sexual abstinence are respected. The Pearl index of 15-35 shows the practical difficulties of this method.
