Q1. What are the contraceptive methods?
Besides the common methods such as condoms and contraceptive pills, one can get contraceptive injection once a month or every three months. Another option is the intra-uterine contraceptive device (IUCD), which is placed inside the uterus and remains effective for five to ten years generally. Male and female surgical sterilisations may also be recommended, and should be considered carefully as they are irreversible procedures.
Q2. What is the most effective contraceptive method?
Male surgical sterilisation is considered the most effective, with a failure rate of about 1 in 2,000. Yet it is less preferred due to concerns over possible impact on fertility and sexual function. Female surgical sterilisation is the second most effective method, with a failure rate of about 1 in 200. As an invasive procedure that requires general anaesthesia, it is not a common option either. Most common in recent years is the intra-uterine contraceptive device, which can remain effective for a long time, like five to ten years once inserted into the uterus. With a failure rate of less than 1%, it is a highly reliable option.
Q3. How to choose an intra-uterine contraceptive device? What should I beware of after placement?
There are two types of intra-uterine contraceptive device (IUCD), namely copper IUCDs, and hormonal IUCDs. The former type using copper wire is more commonly used. As a plastic device, the IUCD is wrapped with a copper wire to kill sperms. The device itself can also prevent embryo implantation.
The hormonal IUCD, also a plastic device, will release hormones inside the uterus over a long period of time. Generally, users who opt for hormonal IUCD mostly have experienced heavier menstrual bleeding or severe menstrual cramps. The use of hormonal IUCD can help reduce menstrual flow and alleviate menstrual pain.
Copper IUCDs are more popular as they do not interfere with the menstrual cycle, while the hormonal type may cause irregular bleeding. Upon insertion of a copper IUCD, increase in menstrual flow and menstrual cramps may occur. Many IUCD users may experience increased vaginal discharge as it has an attached string coming through the cervix. The string is used for later removal of the device. Sometimes it may stimulate the cervix and cause increased vaginal discharge, which does not necessarily indicate infection. Besides these side effects, IUCD expulsion tends to be rare. The risk of IUCD migration due to uterine perforation is also very low. Despite a low failure rate of contraception of less than 1 %, there is an increased risk of ectopic pregnancy if the IUCD fails and pregnancy occurs.
Q4. When should I get pregnant after stopping contraception?
Generally, if you have been taking oral contraceptives or receiving monthly contraceptive injections, you can try to get pregnant in the following month after discontinuation. If you are using a copper IUCD, you can also try pregnancy in the following month after device removal. However, if you are receiving \a contraceptive injection every 3 months or are using a hormonal IUCD, better try pregnancy after your menstrual cycle returns to normal.
Q5. If pregnancy occurs despite contraception, will my baby be affected?
There should be no significant impact on your foetus if you become pregnant while using oral contraceptive pills or contraceptive injections. However, pregnancy is not recommended while using contraceptive methods. In case of an unintended pregnancy, oral contraceptive pills or contraceptive injections should not increase the risk of birth defects, miscarriage, or premature birth. If one gets pregnant while using an intra-uterine contraceptive device, it is important to check if it is ectopic pregnancy. As a serious condition, ectopic pregnancy must be treated immediately by surgery or other methods. The risk of infection, miscarriage and premature birth increases if both the baby and the device are inside the uterus.
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