Dr Richa Sharma and Dr Amit Basnotra
Fertility control is important to the majority of the population for a large proportion of their lives. Effective contraception brings both health and economic benefits to women, their families and wider society. The avoidance and management of unplanned pregnancies is a key issue for our society today.
Types of Measures:
LARC-Methods of contraception include those that are administered less than once per menstrual cycle, known as long-acting reversible contraception (LARC) and methods that are administered more frequently
Emergency contraception (EC)- is available to help women prevent unplanned pregnancies or if they suspect that their regular method of contraception has failed.
* intrauterine methods
* subdermal implants
* injectable contraception
* progestogen-only oral contraception
* combined hormonal methods
* barrier methods
* natural family planning.
Male and female sterilisation:
Sterilisation is the principle method of contraception used worldwide, with an estimated 190 million women and 42 million men having been sterilised and among latest ,hysteroscopic sterilisation is gaining in popularity.
Placement of a microinsert via hysteroscopic route
Sterilisation provides excellent long-term and permanent contraception; however, great care has to be taken to ensure that individuals and couples are counselled appropriately and that they have fully understood the implications of the procedure.
Failure Rate of each method:
Method Failure rate (% pregnant at first year)
Perfect use Typical use
No method
85 85
Barrier (male) 2 15
Diaphragm 6 16
Combined oral contraceptive
Progestogen-only contraception 0.3 8
Injection 0.3 3
Implant 0.05 0.05
Intrauterine device 0.6 0.8
Intrauterine system 0.1 0.1
Female sterilisation 0.5 0.5
Conclusion:
Most methods of contraception are safe for most women.For women with significant medical problems, they guidance by treating physician on the relative safety of each method .Long-acting reversible contraception methods are associated with lower failure rates as they are not as user dependent as other methods.Women requesting contraception should receive comprehensive and clear verbal and written information on all methods that are safe for them, in order to make an informed choice(Caffeteria Choice).
(The authors are Senior IVF consultant Delhi and Senior Gastroentrologist Delhi)
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