Contraception methods

Contraceptive methods are devices or procedures used to prevent sperm from fertilizing an egg to avoid pregnancy. There are various reasons for choosing one method over another. This includes physiological and personality traits, each person’s life conditions, the way the person lives their sexuality, and the possibilities of accessing these methods, etc. 

For the World Health Organization, the main contraceptive methods include:

Condoms

These are made from latex and act as a barrier to prevent sperm from entering the vagina, anus, or mouth. Male condoms are placed on an erect penis for sex. The female condom is inserted in the vagina; it is the same membrane between two latex rings. There are many variants of the female condom, though they are not available in every country. There are also condoms for oral sex and for fingers. All of these are removed and disposed of after sex, except some of the female condoms.

Double protection: contraception and sexually transmitted infections

The World Health Organization states that the correct and constant use of condoms has been proven to be one of the most effective methods against sexually transmitted infections (STIs). ’In this regard, the issue of exposure to STIs, including HIV, merit special consideration since it is equally important to prevent pregnancy and prevent transmitted diseases among sexually active people of reproductive age’.

Subdermal implant

This is a small rod, approximately 4cm long, which a medical professional introduces in the person’s arm below the skin. It contains low doses of progestin, which hinders ovulation, changes the endometrial consistency, and thickens cervical mucus. This process prevents the sperm from fertilizing the egg. This is a highly effective method that lasts approximately five years. Once removed, fertility returns. 

Although the subdermal implant is a very effective contraceptive method, it does not protect against sexually transmitted infections.

Intrauterine contraception

Copper intrauterine device (IUD). This is a T-shaped rod wrapped in copper. The copper damages the sperm and prevents its passage. The IUD must be inserted in the uterus by a medical professional, preferably during menstruation or after a Caesarean section, birth, or abortion. It can also be effective as an emergency contraception if placed within five days of sexual intercourse.

Intrauterine system (IUS). This is a small T-shaped device placed in the uterus. This device is similar to the copper IUD, but the IUS constantly releases small amounts of levonorgestrel. It suppresses ovulation.

Intrauterine contraception is very effective for 5 to 7 years depending on the type of device and medical recommendation. However, it does not protect against sexually transmitted infections.

Sterilization and voluntary surgical contraception (VSC)

Female sterilization is a surgical procedure that involves cutting, tying, or blocking the fallopian tubes. It is also known as tubal ligation .

Male sterilization is a surgical procedure that cuts or seals the tubes that allow sperm to pass into semen. It is also called a vasectomy. 

Sterilization is a very effective contraception method, but it does not protect against sexually transmitted infections.

Contraceptive injections

Progestogen-only injections. These are administered every two or three months and prevent ovulation. They can produce menstrual irregularities and even amenorrhea (the absence of menstruation). 

Combined injectable contraceptives with estrogen and progestin. These are administered on a monthly basis and also hinder ovulation.

Injectable contraceptives are a very effective contraception method, but they do not protect against sexually transmitted infections.

Oral contraceptive pills

Combined oral contraceptives. These pills contain estrogen and progestin. These prevent ovulation, that is, the release of eggs from the ovaries. These also change the cervical mucus and the endometrium, which is the lining of the uterus.

Progestogen-only pill These thicken the cervical mucus, which prevents sperm from joining the egg, impeding ovulation. They are also known as the minipill .

Emergency contraceptive pills. These pills contain hormones which prevent ovulation, alter the endometrial consistency, and thicken the cervical mucus, preventing the sperm from fertilizing the egg. They can be taken after unprotected sex, after rape, or when a condom tears. They are highly effective when taken within 72 hours, but they work up to five days after sex. These pills come in a single dose or in two, and they can be freely purchased in pharmacies. They are commonly known as the morning-after-pills.

Contraceptive pills are taken orally, in other words, they are administered by mouth. Finally, this is a very effective contraception method when used correctly, but it does not protect against sexually transmitted infections.

Contraceptive patch

This is a small patch placed on the skin. It continuously releases progestogen and estrogen. These hormones go into the bloodstream through the skin. A box contains three units. The first patch is placed within the first 24 hours after the beginning of the menstruation. The second must be placed on the exact day of the week when the first was applied, and then in the third week in the same way. Finally, nothing is applied in the fourth week to allow for menstruation. 

The contraceptive patches are a very effective contraception method, but they do not protect against sexually transmitted infections.

Vaginal ring

This is a 5 cm plastic, transparent, and soft ring. It releases progestogen and estrogen, which changes the characteristics of the cervical mucus and prevents ovulation. The ring must be introduced into the vagina on the first day of menstruation and be left in for three weeks or 21 continuous days. It is then removed on the fourth week and left out for a week. A new ring is inserted again on the same day the following week. If the ring has been outside of the vagina for more than three hours, the person must use a condom to avoid pregnancy. The vaginal ring tends to be expensive and it is not easy to find in health centres.

Vaginal rings are a very effective contraception method, but they do not protect against sexually transmitted infections.

Lactational Amenorrhea Method (LAM)

This is a natural contraception method that takes advantage of the lactation period. During breastfeeding, the production of prolactin inhibits ovulation. This is a short-term method that lasts approximately six months after birth. Its effectiveness relies on amenorrhea, which is the absence of menstruation. Some factors—including weak suction—can affect the effectiveness of this method.

LAM is a relatively effective contraception method during the first six months after birth, but it does not protect against sexually transmitted infections.

Coitus interruptus

This refers to withdrawing the penis from the vagina before ejaculation. The goal is to prevent the sperm from coming into contact with it to avoid fertilization. This is not as effective as other contraceptive methods. It is also known as withdrawal method or pulling out.

Coitus interruptus is not a very effective contraception method and it does not protect against sexually transmitted infections.

Other methods based on knowledge of fertility

Cervical mucus method

This method consists of tracking changes in the cervical mucus to identify fertile and infertile days in the menstrual cycle. Pregnancy is prevented if vaginal penetration occurs only on infertile days. On these days, there is less mucus or the mucus is sticky and cloudy. On fertile days, the mucus is slippery and clear. For this method to work, the cycle must be very regular, consisting of no less than 26 days and no more than 32 days. Even so, many factors affect a person’s menstrual cycle, which is why this is not a highly effective contraceptive method to prevent pregnancy.

It is also known as the Billings ovulation method. This is not a very effective contraception method and it does not protect against sexually transmitted infections.

Calendar method

This consists of observing and tracking the menstrual cycle for at least six menstrual periods to monitor signs of fertility. This allows a person to predict the first and last fertile day and not have vaginal sex or use another contraceptive method during this period. This contraceptive method has a different degree of accuracy depending on each person and it is not ideal if cycles lasts less than 27 days.

It is also known as the rhythm method or Knaus-Ogino method. This is not a very effective contraception method and it does not protect against sexually transmitted infections.

Basal body temperature (BBT) method

Body temperature is lower during the first part of a menstrual cycle (35.5 to 36.6°C, on average) and it increases during ovulation (36.1 to 37.2°C, on average). This involves keeping a record and including the temperature (preferably, rectal) every day.  This method prevents pregnancy if a person has vaginal sex only on infertile days, which begin after the increase in temperature remains during at least three days, and end when the temperature decreases before the next menstrual cycle begins. However, temperature can vary due to various reasons, including stress, hours of sleep, or tobacco use.

This is not a very effective contraception method and it does not protect against sexually transmitted infections.

To compare the different characteristics of the various contraceptive methods—including application, use, prevention against STDs, or the presence of hormones—the tool provided by the Find My Method organization is very practical.