Exploring Contraception: Pills, Patches, and Rings

When it comes to contraception, there are various options available, each with its own effectiveness and considerations. In this article, we aim to provide a comprehensive overview of three popular combined intrauterine contraceptive methods to help individuals and couples make informed choices.

1. Combined Hormonal Contraceptive Method

The combined hormonal contraceptive methods encompass birth control pills, patches, and intrauterine devices (IUDs). These contraceptives work by combining two hormones, estrogen and progestin, to regulate the body's hormonal processes.

Primarily, these hormonal contraceptives prevent ovulation, the release of an egg from the ovaries. Additionally, they induce several changes in the body to deter pregnancy, such as thickening the cervical mucus to impede sperm entry and thinning the uterine lining.

While these methods are popular, it's important to note that they are not foolproof. Statistics show that approximately 9 out of 100 women (9%) may become pregnant within the first year of using these contraceptives.

2. Benefits of Combined Hormonal Contraception

Apart from preventing pregnancy, combined hormonal contraceptive methods offer several advantages, including:

• Regulation of menstrual cycles with lighter and shorter periods.
• Reduction in menstrual pain.
• Lowered risk of uterine, ovarian, and colon cancers.
• Improvement in acne and reduction of unwanted hair growth.
• Treatment of conditions causing heavy menstrual bleeding and menstrual cramps, such as fibroids and endometriosis.
• Potential relief from menstrual-related migraines (though caution is advised for individuals with typical migraines with auras). It can also be used to manage heavy bleeding and pain by suppressing menstruation.

3. Potential Risks of Combined Hormonal Contraceptives

While generally safe, combined hormonal contraceptives come with some minimal risks, including deep vein thrombosis, myocardial infarction, and stroke. These risks are heightened in women with specific factors like age over 35, smoking habits, and pre-existing cardiovascular conditions. Additionally, the risk increases in the weeks following childbirth, making them unsuitable for use during this period.

Notably, contraceptive pills containing drospirenone and the birth control patch slightly elevate the risk of deep vein thrombosis. Nevertheless, the risk during pregnancy and the postpartum period is higher.

4. Use of Combined Hormonal Contraceptives While Breastfeeding

For breastfeeding individuals, estrogen can affect milk supply. It is advisable to wait until the fifth week after childbirth when breastfeeding is well-established before considering combined hormonal contraceptives.

5. Birth Control Pills

5.1 Types of Contraceptive Pills and Their Usage

There are various types of contraceptive pills with distinct usage patterns:

• 21-day pill cycle: Take one pill daily for 21 days, followed by a 7-day break when menstruation occurs.
• 28-day pill cycle: Consume one pill daily for 28 days, with the first 21 or 24 pills containing estrogen and progestin. The remaining pills contain either estrogen, nutritional supplements, or placebos, triggering a period during the non-hormone pill days.
• 90-day pill cycle: Take one pill daily for 84 days, with the last 7 pills devoid of hormones or containing only estrogen, leading to a period every three months.
• 365-day pill cycle: In this continuous regimen, take one pill daily throughout the year, gradually reducing and potentially stopping menstrual periods.

5.2 Side Effects of Combined Contraceptives

Possible side effects include headaches, nausea, chest pain, and vaginal bleeding between periods. Vaginal bleeding between cycles is typically temporary and diminishes as the body adapts to hormonal changes.

6. Intrauterine Device (IUD)

6.1 Understanding IUDs

An intrauterine device (IUD) is a small, long-term contraceptive device placed in the uterus. IUDs come in two types: copper-plated IUDs and hormonal IUDs. Copper IUDs do not contain hormones and can prevent pregnancy for up to 12 years, while hormonal IUDs use progestin to provide contraceptive protection for varying durations (e.g., Mirena for up to 7 years, Kyleena for 5 years).

6.2 How IUDs Work

Both types of IUDs prevent pregnancy by obstructing sperm's path to the egg. Copper IUDs make the uterus inhospitable to sperm due to their aversion to copper. Hormonal IUDs, on the other hand, thicken cervical mucus, trap sperm, and inhibit ovulation, preventing egg-sperm encounters.

A notable advantage of IUDs is their long-lasting effectiveness, and they can be easily removed by a healthcare provider when pregnancy is desired.

6.3 IUDs as Emergency Contraception

Copper IUDs can also serve as highly effective emergency contraception if inserted within 120 hours (5 days) of unprotected intercourse. This method is over 99.9% effective in preventing pregnancy and can provide long-term birth control for up to 12 years.

7. Contraceptive Patches

7.1 What is a Contraceptive Patch?

Contraceptive patches are small adhesive squares placed on the skin to prevent pregnancy. They release estrogen and progestin, which are absorbed through the skin into the body.

7.2 Usage Instructions for Contraceptive Patches

A prescription from a healthcare provider is required for the contraceptive patch, but it can be applied and replaced independently. It may be less effective for individuals weighing over 90 kg.

To use the patch, apply it to the buttocks, breasts (except nipples), upper back, arms, or abdomen. Replace it weekly for three weeks, followed by a week without the patch, during which menstruation occurs. Begin a new cycle with a new patch after the fourth week. Consistency is key for long-term birth control.

7.3 Side Effects of the Contraceptive Patch

Most side effects are mild and transient, including skin irritation, chest tightness, headache, and vaginal bleeding between cycles.
In conclusion, choosing the right contraceptive method requires a thorough understanding of each option, a reproductive health check-up, and consultation with a healthcare specialist. Making an informed decision empowers individuals to select the contraception that aligns best with their unique needs and circumstances.