Tanushri is looking forward to her wedding with excitement. In the midst of the frenetic preparations, Tanushri also has an appointment with her gynaecologist. She and her fiancé have decided to wait for a year before planning a family. Sumangali has just had a baby. At her postnatal check-up, her obstetrician discusses birth control with her. She wants to avoid a pregnancy for a few years. Dhanalakshmi has two children and wants a permanent measure to avoid further pregnancies.

The need for contraception varies with each individual. It is important to choose the right method of avoiding a pregnancy.

What is contraception?

Contraception (birth control) is the term used for the prevention of pregnancy. There are many ways to prevent pregnancy. Some are much more effective than others. They include the use of hormone medications, contraceptive devices (barriers), periods of avoiding sex (the so called ‘safe period’), and surgery.

The revolution in contraception has empowered women and given them several safe options. Knowing what methods are available, will help you decide which method is right for you and your lifestyle.

What are the different methods of contraception?

Hormonal methods

Birth control pills (oral contraceptives), and injectable hormones, contain manufactured forms of the hormones estrogen and/or progesterone. The hormones stop a woman's ovaries from releasing an egg each month. They also cause the mucous in the cervix (mouth of the uterus) to thicken, which then acts as a barrier to sperm. Birth control pills are ideal for somebody who is recently married and wants to postpone a pregnancy for a while.

• A woman takes birth control pills according to a daily schedule prescribed by her gynaecologist
• An injectable hormone preparation is available which prevents pregnancy for 3 months.

Myths surrounding hormonal preparations:

Women are concerned that they will put on weight with birth control pills. This is not true. A very minimum gain of 1 or 2 kilos may occur because of water retention. The fear of cancer also worries women. It is interesting to note that birth control pills actually protect women against ovarian cancer.

Condoms:

The male condom is a tube of thin material (latex rubber is best) that is rolled over the erect penis just before any contact of the penis with a woman's genitals. The male condom also provides the best protection against sexually transmitted diseases, including HIV and hepatitis B. Condoms have a high failure rate (15%) and should be used only if an unintended pregnancy will not pose a problem.

The intrauterine device (IUD):

The intrauterine device (IUD) is a small plastic device containing copper or hormones, which is placed inside the uterus. Instead of stopping sperm from entering the uterus, the IUD changes the physical environment of the reproductive tract, which prevents the egg from being fertilized or implanting and growing in the uterus. An IUD is inserted into the uterus by a gynaecologist. Depending on the type, it may be worn from 3 to 5 years before it must be replaced. It has a low failure rate (3-5%) and is ideal for a woman who has already had a child.