Contraception

THE PILL

The Pill is a tablet you take once a day – there are a few different types of the pill. The combined pill contains oestrogen and progestin, which stop the ovaries from releasing eggs. It also thickens the cervical mucus, which keeps the sperm from getting to the egg.

 

The so-called mini pill contains only one hormone, a progestin, which offers an alternative to those affected by the hormone oestrogen. You should swallow the pill at the same time every day.

Different pills have different cycles, with some pill types you have to take hormone-free pills during the breaks to maintain continuous intake.

PROS AND CONS

• Highly effective when used as directed.
• It’s easy to use.
• It permits sexual spontaneity and doesn’t interrupt sex.
• Some pills may reduce heavy and painful periods.
• Some pills may have a positive effect on acne.
• Can be taken over a long period of time.
• It may cause some women to experience headaches and mood swings.
• It requires keeping track of the number of days taken.
• It may cause breast tenderness, nausea, headaches and weight gain.
• It may cause changes in your menstruation cycle.
• It is not common, but some women who take the pill develop high blood pressure.
• It is rare, but some women will have blood clots, heart attacks and strokes.
• Does not protect against HIV infection (AIDS) and other sexually transmitted infections (STIs).

DEPO-PROVERA INJECTION

Depo-Provera is a well-known brand name for medroxyprogesterone acetate, a contraceptive injection for women that contains the hormone progestin. Depo-Provera is given as an injection every three months. Depo-Provera typically suppresses ovulation, keeping your ovaries from releasing an egg. Depo-Provera also thickens cervical mucus to keep sperm from reaching the egg.

Depo-Provera is used to prevent pregnancy. Your gynaecologist might recommend Depo-Provera if:

• You don’t want to take a birth control pill every day.
• You want or need to avoid using oestrogen.
• You have health problems such as anemia, seizures, sickle cell disease, endometriosis or uterine fibroids.

Among various benefits, Depo-Provera:

• Doesn’t require daily action.
• Eliminates the need to interrupt sex for contraception.
• Decreases menstrual cramps and pain.
• Lessens menstrual blood flow, and in some cases stops menstruation.
• Decreases the risk of endometrial cancer.

Depo-Provera isn’t appropriate for everyone, however. Your gynaecologist might discourage use of Depo-Provera if you have:

• Unexplained vaginal bleeding.
• Breast cancer.
• Liver disease.
• Sensitivity to any component of Depo-Provera.
• Risk factors for osteoporosis.
• A history of depression.
• A history of heart attacks or stroke.

In addition, tell your gynaecologist if you have diabetes or a history of heart disease or strokes.

Among the things to consider about Depo-Provera are:

• You might have a delay in your return to fertility.After stopping Depo-Provera, it might take 10 months or more before you begin ovulating again. If you want to become pregnant in the next year or so, Depo-Provera might not be the right birth control method for you.
• Depo-Provera doesn’t protect against sexually transmitted infections.In fact, some studies suggest that hormonal contraceptives such as Depo-Provera might increase a woman’s risk of chlamydia and HIV. It isn’t known whether this association is due to the hormone or behavioural issues related to the use of reliable contraception.

Using condoms will decrease your risk of a sexually transmitted infection. If you’re concerned about HIV, talk with your health care provider.

• It might affect bone mineral density.Research has suggested that Depo-Provera might cause a loss of bone mineral density. This loss might be especially concerning in teens who haven’t reached their peak bone mass. And it’s not clear whether this loss is reversible.

If you have other risk factors for osteoporosis, such as a family history of bone loss and certain eating disorders, it’s a good idea to discuss the potential risks and benefits of this form of contraception with your gynaecologist, as well as learn about other contraceptive options.

Other side effects of Depo-Provera usually decrease or stop within the first few months. They might include:

• Abdominal pain
• Bloating
• Decreased interest in sex
• Depression
• Dizziness
• Headaches
• Irregular periods and breakthrough bleeding
• Nervousness
• Weakness and fatigue
• Weight gain

Consult your health care provider as soon as possible if you have:

• Depression
• Heavy bleeding or concerns about your bleeding patterns
• Trouble breathing
• Pus, prolonged pain, redness, itching or bleeding at the injection site
• Severe lower abdominal pain
• A serious allergic reaction
• Other symptoms that concern you

NUR-ISTERATE

The Nur-Isterate injection is a reversible, progestin-only method of prescription birth control. Nur-Isterate is a contraceptive injection that contains the progestin hormone, norethisterone enantate. The effectiveness, advantages, and disadvantages of Nur-Isterate are similar to Depo Provera but its duration of action is shorter (Nur-Isterate lasts for 8 weeks as compared to Depo Provera, which lasts for 12 weeks). Nur-Isterate does not offer any protection against sexually transmitted infections.

Uses

Nur-Isterate is a contraceptive that is injected into the muscle of the buttock. The injection is usually given during the first one to five days of your monthly period. Nur-Isterate will continuously release progestin into your bloodstream over a period of eight weeks (2 months).

After eight weeks, you can only have one more Nur-Isterate injection.

Who Should Use Nur-Isterate

Nur-Isterate is meant to be a short-term method of contraception. It is mainly used by women:

• Whose partners are having a vasectomy (the Nur-Isterate injection will offer pregnancy protection until the vasectomy becomes effective).
• Who are being immunized against rubella.

Nur-Isterate does not have any oestrogen, so this injection may be a good short-term birth control method if you cannot use oestrogen-based contraceptives. It is also a contraceptive option if you are breastfeeding.

How It Works

The norethisterone protects against pregnancy mainly by preventing ovulation. Towards the end of the eight weeks, the Nur-Isterate works mainly by thickening your cervical mucus. The hormone may also thin the lining of the uterus.

After the Injection

For the eight weeks that you are using Nur-Isterate, it is important for you to check your breasts and nipples once a month for any changes (such as dimpling of the skin or lumps). If you need to have blood work done, make sure that your doctor knows that you are using Nur-Isterate). This is because Nur-Isterate may affect some of your results. Your doctor also needs to be aware that you have had the Nur-Isterate injection if you are going to undergo any surgery during the eight-week time frame. Keep in mind that once you stop taking Nur-Isterate, it can take up to a month longer (than other hormonal methods) for you to start ovulating again and regain your fertility.

Side Effects

Not every woman will have side effects from this injection. The most commonly reported Nur-Isterate side effects are:

• Spotting or breakthrough bleeding
• Delayed period
• Irregular or heavier bleeding
• Weight gain
• Headaches
• Dizziness and/or nausea
• Skin reactions (such as pain, rash and/or itch at the injection site)

Effectiveness

Nur-Isterate is 97% to 99.7% effective. This means that with typical use, 3 out of every 100 women who use Nur-Isterate become pregnant in one year. With perfect use, less than 1 out of every 100 women who use Nur-Isterate will become pregnant in one year.

If you receive the Nur-Isterate injection during the first five days of your period, then it is effective immediately and no back-up birth control is needed.

There are certain medications that can lower the effectiveness of Nur-Isterate.