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Contraceptive choices for women

Published:Wednesday | February 17, 2010 | 12:00 AM

Women choose contraception based on her existing health and risk factors, regularity of sexual activity, nature of relationship (for example, being stable or monogamous), convenience, side effects, and affordability of the contraceptive method. The medical doctor and pharmacist can help women to determine a suitable method.

Tubal ligation ('tie-off') - the Fallopian tubes which carry eggs to the womb are surgically disrupted, so egg and sperms cannot meet.

Essure procedure - micro-inserts are placed through the vagina, into the Fallopian tubes to create blockage between sperms and eggs.

Contraceptive injection - a hormone is injected every three months or monthly, depending on which formulation is used.

Contraceptive implant - a small flexible rod containing a hormone etonogestrel is placed under the skin on the inner upper arm. It may be removed at any time, after which normal level of fertility should return.

Vaginal ring - tiny plastic device which releases hormones. It remains in place for three weeks of every month, the fourth week is for menstruation.

Contraceptive skin patch - applied to skin once per week for three weeks. No patch is applied in the fourth week to allow for menstruation. In Jamaica it is marketed under the brand name Evra (norelgestromine and ethinyl estradiol).

Intra-uterine device (IUD) - small, flexible plastic and copper device containing a hormone is inserted into the womb for five to 10 years.

No user failure

All the aforementioned methods are regarded as 'no user failure' since their effectiveness is not dependent on us remembering to use them. Fit it and forget it.

However the effectiveness of the following methods depends on us using them properly during sexual activity.

Barrier methods - these include the female condom, cervical cap/diaphragm made of latex or silicone and fits over the cervix to block sperms.

Natural family planning (rhythm) methods like temperature and mucous methods rely on indicators during the woman's menstrual cycle to determine when to have and abstain from sex as a contraceptive method.

Fifty years after its introduction, the Pill remains the most popular contraceptive choice for women. In a nutshell, it prevents the ovaries from releasing eggs, prevents sperms from entering the womb and/or produces a womb lining (endometrium) which prevents a fertilised egg from being implanted in it.

It's fairly easy to use, doesn't interrupt sexual activity and does not jeopardise future fertility. It offers a host of benefits like reduction in menstrual bleeding, period pain and post-menstrual symptoms, but also carries bothersome possible side effects like irregular bleeding, weight gain, weight loss, headaches, breast tenderness, nausea, blood pressure increase and stroke. Most of these side effects, if experienced, will disappear after a few months.

Sex on Valentine's Day

Emergency contraceptive pill or the 'morning-after pill' (Pregnon, Postinor) is a relatively new addition to the contraceptive menu. It is best taken during the first three days after sexual activity. For example, women who had unprotected sex on Valentine's Day (Sunday), may still take Pregnon or Postinor today to prevent pregnancy.

Dahlia McDaniel is a pharmacist and final year doctoral candidate in public health at the University of London; email:

Health trend

Mumps outbreak in New York

A mumps outbreak among Orthodox Jews in New York and New Jersey has now surpassed 1,500 cases and shows no sign of ending soon, health officials said last Thursday. The seven-month-old outbreak began last summer at a boys' camp in the Catskills. The campers were from Orthodox Jewish families, and cases multiplied when they returned to their close-knit communities in and around New York City.

Most had a mumps vaccination, but the shots don't prevent all cases, according to the Centers for Disease Control and Prevention. The mumps vaccine is 79 to 95 per cent effective if two doses are given, so illnesses will still occur in vaccinated people when the virus spreads, health officials said.

With 1,521 cases, the mumps outbreak is the largest in the US since 2006, when nearly 6,600 cases were reported, mostly in six Midwestern states. Usually fewer than 300 cases are reported annually.

Mumps is spread by coughing and sneezing. Common symptoms are fever, headache and swollen glands. Most cases are in children and teens. It is a mild disease but sometimes can lead to complications such as hearing loss, meningitis and swollen testicles that - in rare cases - can lead to sterility.

Source: The Associated Press