Because many of the things we think we know turn out to be mere myths, or because a lot of the time we don’t know who to ask, we thought it would be best to get the input and advice of an expert when it comes to contraceptives.
Confused about all the available types of contraceptives available, their effectiveness and possible side effects, we sought the help of Dr. Rasha Kamel, professor of Obstetrics and Gynecology at Cairo University’s Faculty of Medicine. Below are some of the most frequently asked questions and common concerns about the topic, and what Dr. Rasha had to say about them.
What are the different types of birth control? Are there any that are more readily available (or aren’t) in Egypt?
Contraceptives can either be hormonal or non-hormonal. Hormonal contraceptives include oral contraceptive pills (OCPs), injectables, intradermal capsules, hormone impregnated vaginal rings or Progesterone-releasing Intrauterine Contraceptive Device (IUCD), aka. the hormonal ‘loop’. Non-hormonal contraceptives can be an IUCD (loop), vaginal spermicides before intercourse, or barrier methods including the male condom, cervical cap or vaginal diaphragm. There is also the option of physiological birth control by the Rhythm method, where we determine the safe period to have intercourse (away from ovulation) or coitus interruptus (i.e. male ejaculation outside).
In Egypt, all these types are available except for the cervical cap and the vaginal diaphragm.
What about the level of effectiveness of each type and how they would rank in relation to one another?
Unless there is a reason why they can’t be used, regular and properly used hormonal contraceptives and a properly placed IUCD are the most reliable type of contraceptives, and what I would generally recommend.
As for the least effective method, it’s the Rhythm Method because it depends on the timing of ovulation and can fail with irregular cycles. Condoms are similarly unreliable because they are liable to break, and spermicides have high failure rates.
What about side effects? Do any of them have any that we should be aware of?
Unfortunately, they all come with a price to pay. Side effects are common to all of them except for the physiological methods and the barrier contraceptives where the only issue would be inconvenience.
IUCDs, for example, are known to cause slightly more painful, longer and heavier periods. While hormonal IUCDs were designed to decrease the bleeding, they are still painful and can sometimes cause very light periods, or even stop them, until they are removed.
Hormonal contraceptives, on their part, can cause breast pains, nausea, peripheral swelling and mood swings, whereas injectables, intradermal implants and mini-pills may cause irregular bleeding.
Generally, I would recommend OCPs for women who are attentive and/or regular with their medicine and IUCDs for those who are not.
Are there particular types that should be avoided in certain circumstances, for example if someone has a certain illness?
These are what we would call contraindications. Contraindications for IUCDs would be a malformed uterus. They are also less advisable for women who have never given birth before.
Hormonal contraceptives are a contraindication for heavy smokers and women with medical disorders including, but not limited to, hypertension, breast cancer, and increased blood clotting.
In the case of pills, injectables and vaginal rings, a relative contraindication (meaning caution is advised) is noncompliant and/or less attentive women who are likely to miss their doses.
It’s a lot to think about, we know, but knowing what are the best options for you and your reproductive health isn’t something that should be left until it’s too late (like an unexpected pregnancy!). If you are even considering having sex, book an appointment with a trusted gynecologist near you to find out more details about the best contraceptive method for you and how to get it.
Dr. Rasha Kamel is also a consultant of fetal medicine, IVF and ART. She is available by appointment at the Safa Medical Tower next to Safa Hospital in Al HIgaz Square, Mohandeseen. To get in touch with her: 01205950667/ 01286541910/ 0233386408 or via email at email@example.com