September is the month to talk about contraception
Worldwide, the growing use of contraceptive methods has led to a reduction in maternal and infant mortality, improvements in socio-economic conditions and increased schooling for girls and women.
- There are about 210 million pregnancies and 4 out of 10 of them are unintended.
- It has been estimated that more than 21 million women have unsafe abortions each year and that 9 out of 10 of these take place in developing countries.
- In countries where less than 10% of women use contraception, the infant mortality rate is 100 out of 1,000 live births.
This rate is halved if contraceptive use is increased by 30%
- It has been estimated that the use of contraceptives has almost halved maternal mortality and that, without contraceptive use, the number of maternal deaths would be almost 266 times higher than the current rate.
The ability for women to choose how many children they want, and when they want to have them - if at all - is a human right. It is also central to women’s empowerment, reducing poverty and achieving sustainable development.
Using contraception helps women and couples decide freely and responsibly if to have children, when and how many. When used properly, hormonal contraceptives are an excellent method of birth control.
The choice of contraception should be tailored: what is good for one woman might not be the best for another. Healthcare providers can help a woman choose the best contraceptive method, bearing in mind a woman’s psychological and physical characteristics, her lifestyle and the presence of any risk factors or pathologies that may benefit from the choice of a specific contraceptive and respecting your personal needs and preferences.
Let’s look at the main options, with some indications on how to use each method:
Combined hormonal contraceptives
Traditional Pill, depending on the dosage and formulation, is to be taken:
- every day for 21 days, then no pill for 7 days
- every day for 28 days (the last pills do not contain hormones – only placebo), then a new pack is started on day 29
- every day without interruption or placebo pills (continuous regimen)
Vaginal Ring is to be left inside the vagina for 21 days after insertion, then removed for a 7-day break. A new ring can then be inserted for another 21 days.
Patch is to be applied once a week for three weeks and then, after a 7-day break, you start a new weekly application.
Withdrawal bleeding may start during your hormonal-free week, or when you are taking the placebo, or may not occur if you are on a continuous regimen.
Progestogen-only pill (also called Mini Pill), which is as effective as the traditional pill, is to be taken every day.
Long Acting Reversible Contraceptives (LARCs)
Lone acting reversible contraceptives (LARCs) are the most effective reversible methods of contraception.
The Intra-Uterine Systems, the Subdermal Implant and the Progestogen-Only Injectable differ as, once inserted by a healthcare professional or injected, they last for a period that varies from 3 months to 5 years, depending on the contraceptive. This is why they are called “Long Acting Reversible Contraceptives” (LARCs).
LARCs can be an excellent choice if:
- A woman admits to being forgetful with the pill, patch, or ring
- A woman wishes to postpone motherhood for a few years
All the Progestogen-Only Contraceptives can be used even in the presence of contraindications for the use of Combined Hormonal Contraceptives, as well as during breastfeeding.
Hormonal Contraceptives are not only a very effective form of contraception, but they may also be used to treat some pathologies related to the menstrual cycle, eg Premenstrual syndrome (PMS), Severe pain and cramping during menstruation, Heavy menstrual bleeding, Irregular menstrual cycles, Acne, Polycystic ovary syndrome (PCOS), endometriosis.