What you should know before choosing that birth control plan

Out of the compelling need to maintain an active sex life (a marital obligation) without necessarily having more children, couples have had to embrace all kinds of birth control methods. This phenomenon is

called family planning or contraception.

These methods include the use of condom; be it male or female, billings method, which involves calculating the time of the woman’s ovulation and avoiding sexual intercourse at such times, and coitus interruptus, otherwise known as withdrawal or pull-out method.

Other methods include taking pills, which are largely hormones, injections, vasectomy (for men), bilateral tubal ligation, which is a surgical procedure that involves blocking the fallopian tubes to prevent the ovum (egg) from being fertilised and patch, which is placed under the skin, and the insertion of Intrauterine Contraceptive Device, popularly known as IUCD, which is a small, T-shaped device that is placed in the uterus by a trained healthcare provider to prevent conception.

Findings however showed that many couples prefer other contraceptives to using condom because, according to them, condom reduces the enjoyment and the sensitivity of the organs. Thus, the patch, pills and IUCD are regarded as highly effective birth control methods, which many seem to be embracing for their higher reliability.

Perhaps Mrs. Dolapo (surname withheld) would not have had “an unwanted pregnancy” if she had embraced family planning after having her last child 11 years ago. At 44, the mother of three has yet to come out of the shock of being pregnant again.

She recalled, “I was shocked when the doctor confirmed that I was pregnant, because it was an accident. My husband and I had agreed to put a stop to having children. We wanted three children and we had them, but we can’t stop having sex. That is not possible. We have been using billings method but it failed us eventually. I’m not happy about it but it has happened.”

To avoid Dolapo’s kind of experience, many women have had to embrace the use of contraceptives to prevent pregnancy without denying themselves the pleasure of sex.

According to experts, even though none of these methods is 100 per cent effective, they are reliable to a large extent, in varying degrees.

According to a consultant gynaecologist, Dr. Olanrewaju Ekujumi, there are two main categories of contraceptives, the barrier-based and those that are non-barrier-based. The barrier type include condom and those that are hormone-based, like tablet, which could combine progesterone and oestrogen, known as combined oral contraceptive pill, or progesterone only, referred to as minipill.

He continued, “We also have injectables, which are progesterone only and could be for two or three months. We also have hormone-based implant that is put underneath the skin, which could be for two or five years and we have IUCD.”

These methods can be very effective in preventing pregnancy, coupled with the fact that the idea enables couples to have more sex, as it erases the fear of pregnancy. But beyond these advantages, it has been found that birth control methods have side effects on the body, thus, there is need for caution before using them.

According to a medical practitioner, Lori Smith, who wrote on Medical Daily, the common side effects of the several birth control methods include severe headache, vaginal discharge or bleeding, weight gain, fluctuating libido, stomach pain, sore or swollen breast, nausea, inter-menstrual bleeding, loss of vision, breast enlargement, thigh problem and increased blood pressure.

She said, “Inter-menstrual spotting may occur due to the uterus adjusting to having a thinner endometrial lining, or maybe due to the body adjusting to having different levels of hormones. Approximately, 50 per cent of people using pill experience vaginal bleeding within the first three months of starting. Generally, this resolves in over 90 per cent of cases by the third pill pack. If it persists or leads to heavy bleeding, such persons should contact a doctor.

“Some people experience mild nausea when first taking the pill, but symptoms usually subside after a short period of time. Birth control pills may also cause breast enlargement or tenderness but anyone who finds a lump in the breast or has persistent pain, tenderness or severe breast pain should seek medical help.”

She explained that some of the pills could lead to fluid retention in the breast and hip areas, leading to weight fluctuations and bigger breasts and that hormonal or thyroid abnormalities could make such women miss their menstrual periods.

She added, “Hormonal changes caused by the birth control pill can lead to fluid retention which, in turn, can cause the corneas to swell or change shape. When this swelling occurs, contact lenses may no longer fit comfortably.”

She cautioned that many of these are likely to come up if people do not take medical advice before choosing a method or if they refuse to follow up with their medical personnel.

This implies that the key to having a trouble-free family planning is to go for counselling and follow the recommendations of the doctor and even after that, report any unfriendly symptom to the doctor.

This is also the view of a consultant endocrinologist, Dr. Michael Olamoyegun, who noted that even though there are many side effects to the different contraceptives, people should visit medical practitioners before taking any birth control pill or adopting any of the methods to prevent avoidable complications.

He added, “This is because there are things we observe in individuals before we recommend the best method for them. There is no one-size-fits-all in this case. For example, if someone has the tendency of being fat or having diabetes or hypertension, some pills may not be good for the person because it can increase the blood pressure.

“So also barrier method like IUCD can predispose people, especially anyone with multiple sexual partners, to having vaginal infections and if somebody has repeated vaginal infections, it can ascend into the fallopian tube and cause infertility when they are ready to have pregnancy. For the non-barrier method, headache is a side effect of the hormones and they can have intermenstrual or excessive bleeding.”

Olamoyegun, however, noted that these birth control methods do not lead to miscarriage but that when women stop using the contraceptives, their period might not resume immediately.

Asked if it is safe to use these methods in spite of their effects, he said, “It is very safe. People only need to see a medical practitioner before taking a decision. Using pills that are not recommended could lead to infections and block the fallopian tube. There are surgeries to correct this but the success rate of opening up a blocked tube is very low.”

He added that apart from vasectomy and bilateral tubal ligation, none of the aforementioned methods prevents pregnancy 100 per cent as each of them has failure rate. “It is possible to have IUCD and still be pregnant, but the effectiveness of some of them is close to 90 per cent or even more than that, but none of them is 100 per cent effective apart from those two.”

Speaking further, Ekujumi stated that even though all the methods have side effects, they can be handled and none of them endangers life, “and that is why you should meet an expert before choosing a birth control plan.”

He continued, “For example, the implant can cause the woman’s period to scatter but usually after about six months to one year, it stabilises, just as the IUCD can cause severe bleeding but it will stabilise and if it doesn’t, you see the doctor.

“People should embrace it and stop believing what illiterates and those who are not knowledgeable about it tell them. People have fears about family planning but the effect of not doing it is even worse. All its side effects can be managed properly once you choose the right method.”