“Rights in terms of reproduction correspond to certain human rights already enshrined in national and international legislation. They have as fundamental the acknowledgment to couples and the individual of the capacity of decision, free and responsible, of the desired number of children and to schedule their interval. They must be informed about methods of preventing pregnancy, as well as having the right to the best possible health conditions.” (WHO)
There are several options available on the market, which are classified according to their mechanism of action. Hormonal contraceptive methods, such as the pill, the contraceptive patch, the IUS, the vaginal ring and the subcutaneous implant, are based on female hormones: estrogen and progesterone.
Some of these methods combine the two, while others have only progesterone. These prevent pregnancy by inhibiting ovulation and thickening cervical mucus (which makes it harder for sperm to reach the uterus).
Barrier birth control methods physically block sperm access to the uterus. These include condoms, diaphragms, cervical caps, contraceptive sponges and spermicides.
There are also surgical contraceptive methods: tubal ligation in the case of women, a permanent and difficult reversible method, and vasectomy, in the case of men, which can be reversed although not always possible.
Finally, natural/behavioral methods such as periodic abstinence/self-control of fertility, which are based on monitoring the woman's temperature and fertile period.
In Portugal, 94% of women use some form of contraception. Despite the pill being the most used method, its use had dropped from 62% in 2005 to 58% in 2015. There was an increase in the use of the intrauterine device, the subcutaneous implant, the patch and the vaginal ring.
Which method is most suitable for you?
You should seek advice from your doctor and choose the type of contraceptive that is most suitable/adapted to you. There are a number of questions that must be asked when choosing a contraceptive method:
- It is efficient?
Contraceptive methods can have variable effectiveness, obviously depending on their correct use. When properly applied, their effectiveness can be:
|
Method |
Efficiency |
|
Implant |
0.1 |
|
IUD with levonorgestrel (IUS) |
0.1 |
|
Vasectomy |
0.1 |
|
injectable AMP |
0.3 |
|
tubal ligation |
0.5 |
|
copper IUD |
0.6 |
|
progestative pill |
0.5 |
|
Combined oral contraceptives |
0.1 |
|
male condom |
3 |
|
coitus interruptus |
4 |
|
natural methods |
1-9 |
|
Spermicide |
6 |
Score: 0-1 very effective, 2-9 effective, 10-30 some effectiveness
Source WHO, 2001
- Is it suitable for your lifestyle?
This point alone can be evaluated. Depending on whether you have a busy lifestyle or not, taking the pill daily may not be the best option, as its effectiveness depends on taking it correctly, preferably always at the same time. Also depending on the number of partners you have, know that only condoms protect against sexually transmitted diseases.
- Is it reversible?
Most contraceptive methods are reversible. Only surgical methods can be irreversible.
- Is it accessible?
- Are there any health risks?
In general, contraceptive methods pose no risk to health. However, hormonal contraceptive methods can have side effects, the intensity of which varies from woman to woman.
If you smoke, taking the pill with estrogens is not recommended, especially for those over 35 who smoke more than 15 cigarettes a day, as it significantly increases the risk of cardiovascular accidents.
Also the IUD should not be used by women with pelvic infection, distorted uterus, uterine cancer or copper allergy. Many doctors also advise against its use by women who have not yet had children.
Can emergency contraception be used as a recurrent contraceptive method?
No, as the name implies, this medicine is just a backup method, which can be used after failure of the chosen method or when no other method was used. Its use and effectiveness are dependent on the time after intercourse at which it is used.
There are no contraindications if it is used only in occasional and emergency situations, but it does not replace the use of regular contraception nor does it prevent against sexually transmitted diseases.
Sources:
- Association of family planning in http://www.apf.pt/metodos-contracetivos , and http://www.apf.pt/sites/default/files/media/2015/consenso_sobre_contracecao_2011.pdf
- Directorate General of Health in https://www.saudereprodutiva.dgs.pt/publicacoes/contracepcao/album-seriado-de-metodos-contraceptivos-a4-pdf.aspx