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How well do you know your breasts?

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Cervical Cancer: What You Need To Know

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Family planning? Know your available contraception methods

Family planning? Know your available contraception methods

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Almost all women who are sexually active would have Googled contraception methods. Figuring out which method of contraception is the best for you and your partner can be frustrating. It isn’t spoken about freely and it can be difficult to find out what methods are available to you.  Below we’ve collected all the important information you need to know. We have also explored the pros and cons of each contraceptive method to help you compare your options easily. 

So, here we go.

Firstly, what is contraception?

Contraception, also known as birth control, is the use of artificial methods and techniques to prevent pregnancy.

Birth control – the different types 

There are 5 general types of birth control methods and each works in a different way. Some are temporary and some are more permanent. Some prevent the sperm from meeting the egg whilst some prevent the egg from releasing. Either way, the goal of all the contraception methods is to prevent unwanted and unplanned pregnancies.

It is also important to note that birth control and contraception is not the same as prevention of sexually transmitted infections (STI). Condoms are the only method that prevents the spread and transmission of STI’s so it is advised that you combine the use of condoms with other types of contraception. 

1. Short-acting hormonal contraception

Short-acting hormonal contraception methods adjust the hormone level in the woman’s body making pregnancy much less likely to happen. Some of the commonly used short-acting hormonal contraception methods are the daily use birth control pill and the hormonal injection. Both of these methods require a prescription from your doctor. 

The birth control pill 

There are 2 types of birth control pills available: the progestin-only pill and the combination pill (which contain both progestin and estrogen). 

The hormones released by the pill prevent the release of the egg, the thickening of the uterus and the cervical muscle making it harder for the sperm to enter the uterus. By taking the pill at the same time every day, you maintain a steady level of the hormones in your body, making it a very effective form of pregnancy prevention. 

With perfect use, it’s over 99% effective.

Pros

  • Easy to use
  • Highly effective if taken regularly 
  • Doesn’t interfere with sexual activity 
  • Helps with heavy and painful periods

Cons

  • Mood swings, headaches and other similar physical side effects 
  • Effectiveness is time-sensitive, you have to take it regularly at the same time every day for maximum effectiveness
  • Does not protect against STIs

The Hormonal Shot

The hormonal injection is administered by the doctor every 1 or 3 months to the woman. Like the birth control pill, this too prevents the release of the egg and thickens the cervical muscle making it difficult for the sperm to enter the uterus. 

Pros

  • Easy to use
  • Highly effective if taken regularly 
  • Doesn’t interfere with sexual activity 
  • Helps with heavy and painful periods

Cons

  • Mood swings, headaches and other similar physical side effects 
  • Once off the shot, it may take up to a year for your menstruation to return to normalcy
  • Does not protect against STIs 

2. Long-term contraception 

This is a good option if you want lasting contraception with little maintenance. Available options include an implant inserted into your arm or an intrauterine device (IUD) inserted into your uterus. These methods are 99% effective at preventing pregnancy. They’ll work for 3–10 years, depending on the particular method you choose. 

Implant

The doctor will place 1 or 2 silicone rods under the skin in the arm of the woman. The rods will release the hormone, progestogen into your bloodstream that prevents the release of egg into your uterus. The hormone also thickens the cervical muscle thus stopping the sperm from entering the uterus. Further, It thins the muscle of your womb making implantation of the egg less likely. 

Pros

  • The most effective type of contraception 
  • Long-term, can be kept for 3-5 years
  • Does not affect sexual activity 
  • Not time sensitive 
  • A good option for women who can’t take oestrogen pills

Cons

  • Requires medical attention to insert and remove
  • Does not protect against STIs
  • May have side effects such as headaches and breast tenderness
  • Your periods may be irregular or stop

Intrauterine Device (IUD) 

The IUD is a T-shaped copper device which is inserted into your womb by your doctor. There are 2 kinds of IUD you can get implanted, the hormonal IUD or the non-hormonal version. 

The hormonal version releases the hormone progestin, which prevents sperm from fertilizing an egg. It also thins the uterine lining making implantation of the fertilised egg less likely and thickens the layer of mucus over the cervix to help block sperm from entering in the first place. 

The non-hormonal device releases copper ions which has similar effects to progestin. The ion immobilises the sperm making it difficult for them to swim to the egg. 

Pros

  • One of the most effective methods to prevent pregnancy 
  • Requires no effort from you 
  • Long term, can be kept in for 5-10 years
  • Does not affect sexual activity

Cons

  • Requires medical attention to insert and remove
  • Does not protect against STIs

3. Single use barrier contraception 

Male and female condoms, spermicides and cervical caps are all types of single use barrier contraceptives. As the name suggests, they act as a barrier between the sperm and the egg, preventing the sperm from fertilising the egg.

Condoms

Condoms are a sheath-shaped barrier device made of latex or polyurethane. The male condom is placed over the erect penis and when ejaculation occurs the semen is collected in the condom acting as a barrier preventing the sperm from entering the uterus. The female condom is inserted into the vagina preventing the sperm from reaching the egg. Condoms when used properly are the only form of contraception that effectively prevents pregnancy and STI transmissions. 

Pros

  • They are hormone-free
  • Protects against STIs
  • Has no effect with other medications 

Cons 

  • Interfere with sexual activity and pleasure 
  • Chances of tearing during sex 

Permanent contraception 

If you plan on never having kids you can opt for the permanent contraception methods of Tubal ligation (for women) or vasectomy (for men). They are both simple procedures and they’re almost 100% effective at preventing pregnancy. Recovery time from these procedures usually takes only a few days and have close to no impact on your sex drive and sexual functions. 

During a tubal ligation, both the fallopian tubes are blocked or cut off and during a vasectomy, surgery cuts are made in the vas deferens ( a tube that transports sperms) preventing the sperm from reaching the semen in the testes. Women will still continue to have their periods every month after tubal ligation and men after vasectomy,  will continue to release semen during ejaculation but it will not contain any sperm. 

Pros

  • Permanent contraception 
  • Does not affect sexual activity

Cons

  • Both surgeries are reversible but does not guaranty fertility 
  • Does not prevent STIs

Emergency contraception 

Emergency contraception can help you prevent pregnancy if you have unprotected sex or your birth control fails. There are 2 kinds of emergency contraception pills you can take in Sri Lanka. Please note that emergency pills should not be used as a substitute for contraception.  

Postinor-1 

Postinor One (morning after pill) is a single dose oral emergency contraceptive pill that should be taken within 72 hours of unprotected sexual intercourse. The sooner you take the pill, the higher the effectiveness. Postinor-1 has releases levonorgestrel which delays ovulation and in turn, reduces the chances of fertilisation occurring. Several studies claim that Postinor-1 has the potential to stop 85% of anticipated pregnancies. The tablet is safe to take and does not alter fertility. 

This pill does not have any abortive effect, so if you are already pregnant it will not impact it. 

Postinor-2 

Postinor-2 is a double dose pill. Both the tablets can be taken at once or separately with a 12-hour gap between each. It works the same as Postinor-1. 

It should be noted that the emergency pill will not cause abortion and should not be used as a contraceptive method.

Wondering what the best contraceptive method for you is?

Well, that depends on you and your goal. Speak to your partner and your doctor to decide on the most convenient and most suited method for you. Also, remember there is no 1 method that suits all. Feel free to experiment with each method till you find one that suits your liking. 

If you want more information or would like to speak to a Gynaecologist on the best form of contraception you do so via the oDoc app. 

Sources

  1. FPA Sri Lanka. (2017, January 6). Contraception | Family Planning Association of Sri Lanka. http://www.fpasrilanka.org/content/contraception
  2. Tesch, D. (2021, July 23). 5 types of birth control options: which is best for you? HealthPartners Blog. https://www.healthpartners.com/blog/how-to-figure-out-which-type-of-birth-control-is-right-for-you/
  3. WebMD. (2016, November 18). FDA Explains Pros, Cons of Permanent Birth Control. https://www.webmd.com/sex/birth-control/news/20161118/fda-explains-pros-cons-of-permanent-birth-control
  4. Vasectomy: Treatment & Information – Urology Care Foundation. (202–12-01). Urology Health. https://www.urologyhealth.org/urology-a-z/v/vasectomy
  5. Johns Hopkins Medicine. (n.d.). Tubal Ligation. Retrieved August 3, 2021, from https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/tubal-ligation
  6. WHO. (2020, June 22). Family planning/contraception methods. https://www.who.int/news-room/fact-sheets/detail/family-planning-contraception
  7. NHS website. (2021, March 12). Contraceptive implant. Nhs.Uk. https://www.nhs.uk/conditions/contraception/contraceptive-implant/
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Understanding the dynamics – breastfeeding, pregnancy and COVID vaccines

Understanding the dynamics - breastfeeding, pregnancy and COVID vaccines

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As Sri Lanka rolls out its vaccination program, the questions have shifted from “Which vaccine should I get?” to “Should pregnant and breastfeeding women get vaccinated?” 

The answer in short: Yes, everyone should get vaccinated when offered the chance.

For a more detailed answer on how the vaccine affects pregnant and lactating women, read more below.

Breastfeeding and vaccinations 🤱🏾

Women who have recently given birth or are still breastfeeding should get the vaccine. 

Initially, the clinical trials for the COVID-19 vaccines currently in use did not include women who were breastfeeding. So, there was no clinical data on the safety of vaccines in lactating women, effects of the vaccine in breastmilk production and the consequences on the baby. However, now according to the WHO and new research, lactating women can receive a COVID-19 vaccine.

Recent reports have shown that breastfeeding women who have received COVID-19 vaccines have antibodies that pass on to the baby via breast milk, helping in protecting the baby. 

 A study conducted in Israel with thePfizer-BioNTech vaccine, with 84 breastfeeding women, showed that IgA antibody (the first line of defence when exposed to an infection) secretion was present as early as 2 weeks after vaccination in the breast milk. This was followed by a spike in IgG antibody (important for remembering the virus to prevent future infections) 1 week after the second dose in the breast milk. This suggests a potential protective effect against infection in the infant as these antibodies are passed on to them via the milk. No mother or infant experienced any serious adverse event during the study period.

More data is needed to understand what protection these antibodies provide to the baby. Even though the studies on breastfeeding and vaccinations are not advanced, the present data shows no indication of harm to the mother or child.

Pregnancy and vaccinations 🤰🏾

As with many other vaccines, the effects of the COVID-19 vaccines on pregnant women have not been studied extensively yet. However, health professionals assess the risks of COVID19 vs. the COVID vaccine when deciding whether pregnant women should receive the vaccine. 

Pregnant women with any of the following conditions are at a higher risk of contracting severe COVID than women who are not pregnant: 

  • have underlying health conditions (for example diabetes, high blood pressure or asthma)
  • are overweight
  • are aged 35 years or over

Preliminary findings in a study conducted in the US on the effects of mRNA vaccine in pregnant women did not show obvious safety signals among pregnant women who received mRNA Covid-19 vaccines compared to the control group.

It must be noted that injection-site pain was reported more frequently among pregnant women than among non-pregnant women, whereas other side effects such as headache, chills, and fever were reported less frequently. However, a more detailed and longitudinal study is needed to understand the full impact of vaccination on pregnant women. 

We already know pregnant women are at a higher risk of getting severe COVID and also at a higher risk of delivering a baby prematurely. So in a country like Sri Lanka, where the transmission rate is high, the benefits of getting the vaccine far outweigh the risks. 

Fertility and vaccinations 🌸

Women who are planning to get pregnant in the near future can absolutely take the vaccine. There is no evidence of COVID vaccines affecting fertility or the chances of getting pregnant. So get your vaccine when it becomes available to you. 

If you want more detailed information on getting vaccinated you can speak to one of our on-demand GPs at any time via the oDoc app. If you or your loved ones are showing any COVID symptoms please consult a doctor via oDoc immediately or use the oDoc COVID symptom checker to understand what you should do next.

Sources

  1. Perl, S. H., Uzan-Yulzari, A., Klainer, H., Asiskovich, L., Youngster, M., Rinott, E., & Youngster, I. (2021). SARS-CoV-2–Specific Antibodies in Breast Milk After COVID-19 Vaccination of Breastfeeding Women.
  2. Vaccination Considerations for People Pregnant or Breastfeeding. (2021, June 16). Centers for Disease Control and Prevention. 
  3. Public Health Scotland. (2021, June 18). Pregnancy, breastfeeding and the coronavirus vaccine. The Coronavirus (COVID-19) Vaccine. 
  4. WHO. (2021, June 4). Episode #41 – Vaccines, pregnancy, menstruation, lactation and fertility. World Health Organisation.
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