Family Planning

Contraception at different phases of a women’s life

  • Having an unwanted and unplanned pregnancy at any age and stage of life can ruin the mental and physical health of a woman. It is always a better idea to plan a family when one is prepared for it and circumstances are suitable.
  • There are different contraceptive methods which women or her partner can use at different phases of their lives. For a young woman who does not have any children, one of the best methods is oral contraceptive pills. Nowadays, ultra low dose pills are available which have fairly low quantity of hormones. These have to be started on the first day of the period and continued daily for three weeks each month. These give excellent protection from pregnancy and have other beneficial effects such as regular menses, reduction in bleeding during periods and improvement in acne.
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  • The use of condom by the male partner sometimes has a high failure rate due to improper use. It is best to combine use of condom with spermicidal jelly or vaginal tablets and with the safe period of the woman.
  • If the condom tears or leaks or the woman forgets her pills, emergency contraception should be used within 72 hours of unprotected sex. These are available in the form of hormone tablets.
  • Injectable contraception which consists of once in three month hormone injections are available and work well, but they can cause irregular periods, stoppage of menses for a long time and delay in return of fertility. Permanent sterilization involves applying a band on both the tubes in the woman using a laparoscope. This is a short procedure and involves only one stitch on the navel. Sterilization is a permanent method; however it can be reversed by a surgery if necessary.
  • Men can undergo a vasectomy which is a safe, simple and short surgery to tie the vas deferens. This again is a permanent procedure. It can also be reversed with microsurgery.
It should be a couple’s choice when they want to plan their family and these methods go a long way in helping them gain control over this decision.

Low dose hormonal pills

  • For a young woman who does not have any children, one of the best methods is oral contraceptive pills. Nowadays, ultra low dose pills are available which have fairly low quantity of hormones. These have to be started on the first day of the period and continued daily for three weeks each month. These give excellent protection from pregnancy and have other beneficial effects such as regular menses, reduction in bleeding during periods and improvement in acne.
  • Women who have recently recovered from jaundice, those with diabetes, migraines or history of thrombosis should not take pills. Also breast feeding mothers cannot take the usual contraceptive pills. However they can take ‘minipill’ or progesterone only pill, which has no effect on breast milk.

Intrauterine contraceptive device

Copper-T or intrauterine device can be inserted by women who have had one child. There are different varieties available, those which last for 3 , 5, 7, or even 10 years. These take a few minutes to insert into the womb and can be removed in one minute, whenever desired. In some patients however copper T can fail or it can result in heavy bleeding.

Hormone intra uterine device

  • There is now a new hormone containing copper-T called LNG-IUD which is more effective than the previous ones and has the added benefit of reducing or even temporarily stopping menstrual bleeding. This device can even be used as a treatment for heavy bleeding.

Tubal sterilization with laparoscopic method

  •  Permanent sterilization involves applying a band on both the tubes in the woman using a laparoscope. This is a short procedure and involves only one stitch on the navel. Sterilization is a permanent method; however it can be reversed by a surgery if necessary.

Male sterilization

  • Men can undergo a vasectomy which is a safe, simple and short surgery to tie the vas deferens. This again is a permanent procedure. It can also be reversed with microsurgery.
  • It should be a couple’s choice when they want to plan their family and these methods go a long way in helping them gain control over this decision.

FAQ

Q.1.   I am 22 years old and have been on contraceptive pills since one year. Now I am getting married and am worried whether that will affect my chances of becoming pregnant later?

Ans: Oral contraceptive tablets are being used for many years worldwide without any proven side effects on fertility. Pill use does not cause infertility and patient may be able to conceive immediately after stoppage of pills. However after long-term usage sometimes there is stoppage of periods for few weeks following discontinuation of the drug. This goes back to normal in time. There have been no reported side effects on subsequent pregnancies in previous pill users.

Q.2.   I have a 2 years old child and have had a Copper- T (loop) inserted one year ago. However I have started very heavy or frequent menses since then. I want to remove it but what are my alternatives?

Ans: Some patients do get heavy and irregular menses with a Copper-T or intrauterine device. The alternatives are to remove the Copper-T and insert a new type of hormone loop also called the LNG –IUD. This looks like a Copper-T but has a hormone inside that will cause the bleeding to reduce gradually and the periods may even stop temporarily. This works for 5 years and has a low failure rate. This can even be used as a treatment for women with heavy bleeding who are older and do not need contraception. The other alternative is to take contraceptive pills for 3 weeks every month. These will also regularize the periods and reduce the flow.