Female contraceptives at a glance

About the IUD, Pill, Spermicides and Diaphragm

Choose a contraceptive method that best suits your body after some careful planning and medical advice. Also, you must discuss the contraceptive you finally choose, with your partner.

Today's woman no longer wants to rely on the contraceptive methods relied upon in earlier times. Monitoring of the menstrual cycle, withdrawal, or the use of herbal remedies are not recommended by any doctor since they can be cumbersome and place a lot of restrictions on the frequency and timing of intercourse.

A lot of contraceptives available these days are such that they are suitable to modern lifestyles. Yet, before you finally decide upon a contraceptive, you must visit a gynecologist who will weigh all the pros and cons and help you decide upon the method best for you. Here are some options:

IUD (Intra-uterine device)
What Is It?
This device which is placed inside the womb contains barium sulphate for improved radiographic visibility and may contain copper. Depending on the type, the device is effective from 5 to 10 years. Also available these days is a new generation of IUDs, which relies on releasing hormones within the uterus and is effective for a year.

The IUD prevents fertilization of the egg or changes the uterus lining so that the egg cannot implant.

The Reported Benefits
It is very cost-effective and once a doctor places it inside your body, you can forget about it.

The Downside
There are a couple of riders to it. The IUD has been known to cause bleeding in some women and perhaps a higher risk of pelvic infection. This device has also been linked to a higher risk of contacting sexually transmitted diseases. Since it is reported that many women who have the IUD inserted get heavy periods, it is not advisable for those who generally have the problem of heavy menstrual bleeding.

If You Opt For IUD…
You must talk to your gynecologist about any allergies or medical problems you suffer from. Make a list of any complaints like diabetes, blood pressure (high or low) or any frequency of urinary infections. Make sure to even mention things like backache or nausea. Both these complaints are also linked to the use of the IUD, so your medical record must be clear before.

Some women have reported that there are changes in body weight after the insertion of IUD, but your doctor would be the right person to advise you about it. This device is to be fitted in at a doctor's clinic. The price will include the physician's consultation, tests and the cost of the IUD.

While it is normal to feel discomfort and backache (and some bleeding) after insertion, rush back to your doctor if any of the symptoms persist or increase.

THE PILL
What Is It?
The oral contraceptive pill is of course the most popular form of contraception for women worldwide. The Pill has evolved and changed a lot with changing needs of people and with scientific advances. It is generally a combination of two synthetic hormones, oestrogen and progesterone. It prevents the ovaries from releasing eggs, thickens the cervical mucus to block sperm and alters the endometrial lining to prevent implantation. One Pill has to be taken everyday for about 3 weeks after which the period begins after a gap of 3-5 days.

The Reported Benefits
Women who use pills experience lighter, less painful and regular periods. The Pill has been shown to reduce the risk of pelvic inflammatory disease. Though there was a huge controversy in some sections of the press about the cancer risks in Pill users, yet later on, controlled studies revealed that actually the Pill reduces the chances of ectopic, ovarian and endometrial cancers. Recent studies have also hinted that these benefits last for upto 10 years after the use of the Pill has been withdrawn. The Pill is, in fact, prescribed to those who suffer from PMS symptoms and to those who suffer from irregular periods.

The Downside
Some women report nausea and certain lethargy after the initial use. The Pill is not recommended to women who have blood clots, suffer from cardiac problems, blood pressure or liver tumours. It has also been reported that most women gain a lot of weight after using the Pill regularly.

If you opt for the use of a pill…
You must go for a Pap smear before the use and then every six months after that. Also, checkups by a gynecologist are highly recommended every six months.

But by and large, with the advice of a gynecologist, you will be most comfortable using a pill than most other things. The cost of a month's supply of say, Ovral-L (one of the safest pills available in the Indian market) is about Rs 20 or so. The Marie Stopes Clinics around the country also supply Ecroz, another brand name.

SPERMICIDES
What Is It?
Spermicides are chemical formations that kill the sperms deposited in a woman's body. They are available in chemist shops as creams, foams, gels or suppositories (that can be inserted inside the vagina because of their favourable shape). Most of these formations contain a chemical agent-- Nonoxynol- 9 or Octoxynol.

The Reported Benefits
Insertion or application of a spermicidal gel, cream or suppository is pretty simple and can be done inside the bathroom with minimum fuss. Most of these creams have also been known to give protection against sexually transmitted diseases.

The Downside
Spermicides may not provide complete foolproof protection and have to be often used with another method of contraception--the condom or something. Also since it contains chemicals, there have been reports of some women being allergic to it. Some spermicidal creams come with a long embarrassing applicator, which may make their use quite messy. Besides the applicator should ideally be sterilised after each use. So you will find it difficult being discreet with it, in a family full of wedding guests.

If you opt for the use of a spermicide…
Make sure you have tried and tested it for any allergy that you may develop. Also spermicide suppositories (like the one called Today that was earlier widely marketed) are effective only for a little while. Read the instructions. You may need to reapply or reuse after every 30 minutes or 1 hour according to the directions mentioned in the pamphlet.

THE DIAPHRAGM
What Is It?
The Diaphragm is a latex disc that covers the cervix. It has to be inserted inside a woman's body. This disc is filled with spermicide. The disc prevents the sperm from entering the uterus and the spermicide inside it renders sperms inactive.

The Reported Benefits
The Diaphragm has been reportedly known to have an average effectiveness in about 85 per cent cases. It is known to offer protection against pelvic inflammatory disease and sexually transmitted diseases. It is also known to reduce the risk of cervical cancer especially in high-risk women.

The Downside
It is no longer used widely and few women opt for it, given the choices. Insertion can be difficult the first time. Some users also complain of urinary tract infections. In fact the instructions, that come along with it, also report Toxic Shock Syndrome as one of the side effects. This can be very serious.

If you opt for the use of a diaphragm…
Make sure your doctor takes your specification before inserting it. If you gain weight after marriage, you will need to insert another diaphragm. Also be particular about the fact that you may be allergic to the spermicide it contains.