Contraception


What is the best contraception for me? What has the least side effects, is easy to take, is right for me at this stage of my life? These are the sorts of questions that we are asked and that we discuss in detail with women attending the Dublin Women’s Clinic. Please see below some options that you may wish to look at before making your decision. Namely; The Combine Pill, The Mini Pill, The Patch, Vaginal Ring,The Diaphram, Injectable Contraceptive, Implanon, The Mirena Coil (IUS)

Combined Pill

This is the best known form of contraception. It is taken in the form of one pill orally every day for three weeks, then one week ‘pill-free’ interval. It is a very effective form of contraception if it is taken correctly. It should ideally be taken at the same time every day. You have 12 hours to remember to take it if you have forgotten. It works by stopping ovulation from occurring. It has few side effects and most young women can safely use it. It is not recommended for women over the age of 35 who are smokers or overweight.

Mini Pill

This is an oral form of contraception which contains only Progesterone. This is a slightly less effective form of contraception but is ideally suited for women who cannot take the combined pill, for instance feeding mums, women who smoke over the age of 35, or overweight women. The minipill thickens cervical mucus and thins the lining of the uterus, preventing sperm from reaching the egg.

Patch

This is similar to the combined pill in its hormone content, but it is used once weekly as it’s a seven day patch. This product has the advantage of not having to remember daily pills. Its effectiveness as a contraceptive is that of the combined pill. Its few side effects include a skin reaction to the patch adhesive in a very small number of patients. The product available in Ireland is called EVRA.

Vaginal Ring

The vaginal ring releases hormones similar to the pill and patch forms, is easy to insert by the patient and is removed after three weeks. Following a bleed the new ring s inserted. Its effectiveness as a contraceptive it that of the combined pill. The product available in Irelands is the Nuvaring.

Diaphragm

This is small, plastic dome – shaped device which is easily inserted into the vagina prior to intercourse. It must remain in the vagina for 6 hours after intercourse. It should always be used in conjunction with a spermicidal. Its effectiveness is less than that of the hormonal forms of contraception. The advantages of a diaphragm is that it is a barrier form which does not involve hormones, and it may be suitable for women who are having less frequent sexual intercourse and only want to use contraception occasionally.

Injectable contraception

High dose progesterone can be given as a three monthly injection (Depo-Provera). This is a very effective form of contraception. It is suitable for most women and is ideal if remembering to take pills is proving difficult. Benefits include lightening or disappearance of periods. Disadvantages include a slight weight gain, and some irregular bleeding initially.

Implanon

The Implanon is progesterone only long active contraceptive. This product consists of a plastic rod shaped device containing the hormone etonogestrel which is release slowly over three years. Frequently asked questions concerning this form of contraception include:

How does it prevent pregnancy?

Its main action is prevention of ovulation (the release of an egg). The Implanon also acts by changing cervical mucus making it hostile to sperm

When should it be inserted?

Preferable between Day 1 to Day 5 of period

How is the implant inserted?

Answer: It is inserted subdermally into the inner aspect of the upper arm. The area is numbed with local anesthetic and the procedure is similar to an injection.

How effective is the Implanon?

Greater than 99% effective

How much does it cost?

Implanon Consultation €65, Implanon Insertion €120,  the patient is required to purchase the Implanon itself from a pharmacy by way of prescription, the purchase price at a pharmacy is approximately €130, please check with your pharmacy for accurate pricing and don’t forget to use your Drug Payment Scheme card.

How long is it effective for?

The product lasts for three years. It can be replaced after three years and a new one inserted at the same time.

Are there any side effects?

As with any of the progesterone only contraceptives, irregular bleeding may occur. This usually settles within 3 – 6 months. Other hormonal side effects include breast tenderness, acne or mood changes. It does not affect weight of interfere with bone density.

The Mirena Coil

A very popular, highly effective form of contraception. The Mirena Coil is a plastic T shaped device which is inserted into the womb. It contains a very low dose of the female hormone progesterone. It is effective for 5 years.

Frequently asked questions concerning this form of contraception include:

How much does it cost?

Pre Mirena Consult(inclusive of swabs) – €65, Insertion appointment – €140, Follow up appointment at 6 weeks – €0. Please note – the patient is required to purchase the Mirena Coil from a pharmacy by way of prescription, the purchase price at a pharmacy is approximately €130, please check with your pharmacy for accurate pricing and don’t forget to use your Drug Payment Scheme card.

What is involved in the initial consultation?

The doctor will explain the procedure and the possible side effects of the Mirena Coil. The hormonal side effects include mood changes, breast tenderness and acne. These are generally short lived and subside by 3 months. There is a possibility of irregular bleeding which again general subsides by the third month.

How effective is the Mirena?

Once inserted it can be relied on after 7 days. It is a long acting form of contraception which requires no action by the woman. It is therefore a very effective form of  contracetption with a failure rate less than the pill.

When should the Mirena be inserted?

It can be inserted any time during a cycle but preferable towards the end of a bleed. After having a baby you should wait 6 -8 weeks post normal vaginal delivery or 3 months following a caesarean section.

How does the Mirena work?

The Mirena works by thinning the lining of the womb, which means it is very effective for women with heavy periods. It changes the cervical mucus making it hostile to sperm. It prevents ovulation in some women.

Can it be removed easily?

Removal of the Mirena is a very simple procedure. Fertility returns immediately upon removal.