Non hormonal methods of contraception

Family planning is an important aspect of everyone's life. Therefore, it is necessary to choose the most effective and convenient contraceptive. Hormonal contraceptives protect 98 per cent of unwanted pregnancies, and they are convenient to use. But they influence a woman's hormone levels. They may also give rise to side effects such as headaches, nausea, sore breasts and vaginal yeast infections, mood swings, and reduced women's sexual desire.

Furthermore, it can cause breakthrough bleeding between periods. They also don't offer any protection against sexually transmitted diseases. There could be a risk of thrombosis, which means the risk of blood clots formation. The risk of developing the same is higher in women who smoke, are overweight, who have a risk of vascular diseases or women above the age of 40. Furthermore, they are not recommended for women who have clotting tendencies, heart diseases, and cancers.

Condoms are the most widely used non-hormonal contraception method. Both males and females can use condoms as they come for both genders.

Male or female condoms are a basic barrier method of contraception. The concept of using condoms is to prevent sperm from entering the uterus and further prevent the fertilization of eggs leading to an unplanned pregnancy. Condoms are meant for a single-use and are easily available in the market and online. While the male condom is used more as a contraceptive method for couples, the male condom is used to cover a man's erect penis while the female condom is inserted vagina. While latex is the most commonly used material for condoms, if one is allergic to it they can opt to use one made of lambskin.

There are many misconceptions and myths attached to the use of condoms. The majority of people are hesitant to use and discuss the utility of condoms. Moreover, awareness around female condoms is less. Condoms are very useful and easy to use. However, we need to talk more about it to raise awareness. The female condom, also known as an internal condom is used inside the vagina so that it prevents the semen from getting into the womb. It is as effective as a male condom when used correctly.

The advantages of using the condom are:

* It protects against unplanned pregnancy

* It protects both males and females from sexually transmitted diseases

* There are limited or no serious side effects

* Female condoms can be used for anal sex as well

* The external ring is designed in a way to enhance the pleasure

* Even if the partner loses their erection the condom stays in place

* Female condom can be easily inserted few hours before intercourse

* It gives females the choice and they don't have to rely on their partners

* The material used to make a female condom is a soft plastic that doesn't irritate sensitive skin

Some disadvantages of using a condom are as follows. While they are not harmful, knowing about them will help in better use:

* Like any other method, in a condom, there is no guarantee of durability

* It may slip into the vagina during intercourse

* Female condom is less commonly available and therefore is more expensive

* There may be loud noise during the intercourse due to the internal condom

Don't's

* Don't use a male condom with a female condom, as this can cause tearing

* Don't reuse a female condom

Here is how to use it -- after buying, open the pack and take the condom out. Once out, there will be two rings, one smaller ring and another slightly bigger. One has to take the smaller ring and insert it into the vagina. The larger ring at the open end will cover the area which is the opening of the vagina. During intercourse, one should ensure that the penis goes inside the condom and not on the side. Post intercourse, remove the condom by twisting the larger ring and pulling it out. Close the end with a knot and throw it into a dustbin.

For people around the world, there are different types of contraception methods that are ready to use. However, condoms are the quickest method as they are easily available. In each case, both male and female condoms are equally effective in preventing pregnancy. There have been studies that prove that no contraception method is 100 per cent effective but condoms do tend to do a good job overall. One must keep in mind that both male and female condoms can't be used together.

Other non-hormonal methods of contraception include:

IUCD: An intrauterine contraceptive device (IUCD) is a device that is made from plastic and copper. It is placed inside the womb to prevent unwanted pregnancies The material copper in the device ensures that it is difficult for the sperm to fertilize an egg. It makes the mucus in the womb lining hostile to sperm and eggs. While modern IUCDs are very effective, approximately 2 of every 100 women who are using IUCD as contraception will become pregnant over five years of use. Most IUCDs work well for at least five years, and many also work until ten years.

Advantages of Copper IUCD 380A:

* Offers long term, highly effective reversible protection against pregnancy

* Is effective immediately after insertion

* Does not require daily attention from the user or special attention before sexual intercourse

* One time procedure and is cost-effective

* The IUCD does not interfere with sex or sex drive. It is not a hormonal method thus will not affect your mood, weight or libido

* Can be used by lactating women

* Does not interact with any medicines

* Prompt return of fertility after removal

Side Effects:

* There may be an increase in the duration/amount of menstrual bleeding or spotting or light bleeding during the first few days or months after insertion

* Discomfort or cramps during IUCD insertion and for the next few days which subsides in due course.

Potential Health Risks:

* A hole in the womb during insertion could be a rare complication that occurs in 0.5 to 1.5 per 1000 insertions

* It may come out on its own in about 2-8 per cent and is most likely to occur during the first three months after insertion, and during menstrual periods

* Infection following IUCD insertion is less than 1 per cent

* If pregnancy occurs with Copper T in the womb, there is a risk of spontaneous abortion, infection and ectopic pregnancy.

Non-hormonal pill consumed once a week

In our country, ormeloxifene is available as birth control since the early 1990s, and it is currently marketed here under the trade name Saheli, it is now available as Chhaya. Ormeloxifene is a selective estrogen receptor modulator (SERM) wherein In some tissues of the body, it has weak oestrogenic action (e.g, bones) while in others it has strong antiestrogenic action (e.g, uterus, breasts etc).

Advantages

* It is taken once a week

* No side effects are seen with this

* It is safe for new mothers and breastfeeding women

* Women of all ages can take this pill

* It is safer in women as compared to hormonal pills who had a stroke, blood clot in legs or lungs, heart attack and women with a history of breast cancer.

Side Effects

* It causes delayed periods in few women. But this occurs in around 8 per cent of users and usually in the first three months

* Periods can get scanty over time in some women.

(Neema Sharma, Director, Obstetrics and Gynecology, Fortis Hospital, Vasant Kunj)