Alternatives to the pill
The Pill has become the mainstay for Female Contraceptives since the 1960’s. The pill along with Condoms are the most used contraceptives, but they don’t suit everyone. So what are the alternatives? Each form has its advantages and disadvantages. Here we take a look at what is available.
It is important to note that male condoms remain the most effective method of preventing the transmission of Sexually Transmitted Infections.
Female Condom (Femidom)
Similar to the condom worn by Men, the female condom is a barrier device but it is worn internally in the vagina. The female condom is a thin, soft, loose-fitting sheath with a flexible ring at each end. They come in various sizes. It is advised to read the instructions before use. The Female Condom has a failure rate of 21% due to it being a thinner sheath then the male condom and it does take some practice as one ring does remain outside vagina and covers parts of the external genitalia. There are no side effects associated with the use of the female condom. The female condom can also be used by the receptive partner in anal sex.
This is another barrier method and involves the placing of the diaphragm over the cervix with spermicide to prevent pregnancy. The diaphragm can be made from latex, silicone or natural rubber and come in different types involving different rim and spring designs. The diaphragm should be removed six hours after sexual intercourse. The diaphragm is an affordable form of birth control and can be reused. Fitting it may be difficult and it is often first put in by a healthcare professional. The diaphragm has a failure rate of 12%. Side effects of use include a higher risk of bacterial vaginosis and urinary tract infections. Also if left in the vagina for twenty-four hours it can lead to toxic shock syndrome which can be fatal.
Vaginal Rings are a contraceptive drug delivery device that is inserted into the vaginal for three weeks where it slowly release hormones into the body. These are similar to the hormones in the Oral Contraceptive Pill. The ring is removed after the three weeks and a new one inserted after a ring free week to allow for menstruation to occur. The rings have a failure rate of 9%. As the ring includes estrogen there is an increased risk of heart attack, stroke, and other serious side effects. Additionally certain medications including Anti-Seizure medication may compromise the effectiveness of the ring.
An alternative to taking the pill is the wearing of a transdermal patch which releases hormones into the skin. Similar to the ring, the patch is worn for three weeks and a patch free week is left to allow menstruation before a new patch is attached. The patch has a failure rate of 9%. Unlike the oral contraceptive pill, the patch is less likely to be affected by anti-biotics, however the rate of Deep vein thrombosis reported is similar to that of the pill.
The Intrauterine device is a medical device inserted into the uterus. There it release the hormone levonorgestrel. The IUD is left in place for between three to five years. It has a failure rate of 0.2%. Once removed fertility returns within two to six months. Once inserted the thread position should be checked on a monthly basis. The side effects of the IUD include irregular, but often lighter, periods, pelvic pain, benign ovarian cysts and depression. There is transient risk of developing Pelvic inflammatory Disease and there is rare risk of pelvic perforation.
A hormonal injection is also available. This injection may be suitable for those who have a poor pill compliance and it lasts for three months. It has a failure rate of 6%. While it does not have the same risks as the pill, there are a number of side effects associated with the injection. These include no periods (but spotting may occur during first month), abdominal pain, headaches and anxiety. The injection can reportedly decrease the risk of endometrial cancer.
The implant is a long acting reversible contraceptive that is inserted into the arm. It lasts for three years. It is a very effective contraceptive with a failure rate of 0.05%. About 33% of women using the implant report no periods, while others report irregular bleeding. Like other hormonal contraceptives the implant may lead to weight gain. Migration of the implant, especially if the second implant is inserted in the same location, may lead to it being harder to remove.
As always you should discuss with your doctor about all the benefits and side-effects of each from of contraceptive to find the one that suits you and your situation.