Contraception refers to the avoidance of pregnancy after sexual intercourse.
In Singapore, 2 of the commonest methods of contraception include:
- Barrier Methods, such as the use of condoms for the male or diaphragms for the female, with or without spermicide.
- Hormonal Methods, such as the taking contraceptive pills.
1.) Barrier Contraception
The commonest barrier contraception used is the condom, which is relatively inexpensive, safe and has the additional benefit of reducing the risk of HIV and other sexually transmitted diseases.
However, there are patients who develop itch, rashes or other localized reactions after using condoms. These may be due to latex allergy or allergies to the lubricant or spermicide used together with the condom. Latex-free condoms are available for such patients. If symptoms persist or worsen, do seek the advice of your doctor.
2.) Hormonal Contraception
Hormonal contraceptives aim to either prevent ovulation or stop implantation of the fertilized ovum in the womb. There are various ways to deliver these hormones – orally ( pills ), via injections or with daily skin patches.
Oral contraceptives remain the most widely used hormonal contraception. Benefits of oral contraceptives include:
- high reliability if taken as prescribed
- quick return of fertility once pills are stopped
- improvement in acne ( particularly for preparations which contain desogestrel or cyproterone )
- possible reduction in risk for ovarian cancer
Common side effects include breakthrough bleeding ( spotting in between menstrual periods ), weight gain, nausea, breast discomfort and headache. There may be small rises in blood pressure but this is usually of no concern in otherwise healthy patients. Our doctors will monitor your blood pressure periodically if you are on hormonal contraceptives.
Our clinics carry a variety of different preparations for oral contraception. Newer oral contraceptives are generally well tolerated and their hormonal content is much lower compared to the first generation pills. However, they may not be suitable for specific groups of patients, such as those who are:
- obese smokers
- previously diagnosed with breast or gynecological cancer
- previously diagnosed with clotting disorders
- hypertensives, with poorly controlled blood pressure
- have pre-existing liver or heart conditions
Such patients should discuss other available options with their family doctor or gynecologist.
Those who tend to forget to take their pills or prefer greater convenience may opt for injectable or implantable contraception. The former is injected into the gluteal ( buttock ) region within the first 5 days of the start of the menstrual cycle, and provides reliable contraception from the 2nd month onwards, for as long as the 3-monthly injections are continued. However, these injections may upset the menstrual cycle and patients should be prepared for this.
Implantable contraceptives ( Implanon ) are available at our clinics and can last up to 3 years. Apart from the ( small ) risk of injection site infection, the main side effects from these preparations are changes to the menstrual cycle, headaches and mood changes.
Patch contraceptives ( Evra ) deliver similar hormones as oral contraceptives and therefore carries similar side effects. Each skin patch, usually placed on the buttocks, abdomen or thigh, lasts for 1 week and has to be changed twice within 1 menstrual cycle ( therefore covering 21 days ). If you are interested in using the Evra patch, please speak with our doctors.
‘Emergency’ or post-coital contraception ( Postinor ) is also available in our clinic. This consists of 2 oral pills, to be started within 72 hours of sexual intercourse, to reduce the chance of pregnancy. Possible side effects include menstrual irregularities, nausea and vomiting. Please consult our doctors if you wish to consider post-coital contraception.
3.) Other Methods
Some patients may prefer to opt for other methods of contraception, such as insertion of an IUCD ( intra-uterine contraceptive device ) or Natural Family Planning methods.
Need more advice?
Dr. Tan and Partners @Bencoolen (Women’s Health Clinic)
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About Dr. Tan
Dr. Tan graduated from the National University of Singapore in 2001. His residency was in the two largest public hospitals in Singapore; Tan Tock Seng Hospital and Singapore General Hospital.