Hospital Quirónsalud Barcelona: 932 136 876
/ Centre Mèdic Gineclinic: 934 515 100
Birth Control
Contraceptive methods are used to prevent or decrease the chances of pregnancy. There is no perfect method: all have advantages and disadvantages.
Sometimes the risk of acquiring a sexually transmitted infection (STI) should be considered.
Types of birth control
COMBINED HORMONAL CONTRACEPTIVES
- These extremely effective methods use two hormones similar to those produced by the ovary.
- They do not protect against sexually transmitted infections.
- Fertility returns immediately after stopping use.
- They also produce non-contraceptive benefits.
- They work by stopping ovulation, thickening cervical mucus and making it difficult for sperm to get into the uterus.
- They lower the amount and duration of menstrual bleeding.
- Non-contraceptive benefits: lighter menstrual bleeding (less anaemia) and menstrual pain, reduced risk of ovarian, endometrial and colon cancer.
- They can help treat benign breast disease.
- They can improve the appearance of the skin.
- Protection against ovarian cysts.
- Side effects: increased vascular and circulatory risk (women who smoke, are obese, hypertensive or have coagulation disorders). They can cause headaches and a feeling of heavy legs. Dark spots on the skin. Lower sexual drive.
- Contraindications: migraine with aura, women over 35 and smokers, coagulation disorders, breast cancer, liver disorders, high blood pressure and breastfeeding.
PROGESTIN-ONLY HORMONAL CONTRACEPTIVES
- They contain only one hormone: progestin (no oestrogen).
- They can be used during breastfeeding and in women who cannot take oestrogen.
- They do not protect against sexually transmitted infections.
- They do not interfere with the use of condoms.
- They work by stopping ovulation, thickening cervical mucus and making it difficult for sperm to get into the uterus. They alter menstruation and may cause long periods without menstruating or with very light periods.
- Side effects: breast tenderness, headache, bloating and heavy legs; some women experience a lower sexual drive.
INTRAUTERINE DEVICE – DIU
- 4-5 cm long plastic device wrapped with a copper wire.
- It is inserted into the uterus. Women of any age can use it but women who have been pregnant are less likely to have issues.
- Fertility returns quickly after removal.
- It is a very effective method.
- It works by producing an inflammatory reaction in the uterus that prevents nidation. It creates a hostile environment for sperm.
- It has a greater than 98% efficiency.
- The hormonal IUD has superior contraceptive effectiveness.
- It is not the most recommended method for women with multiple sexual partners because it increases the risk of tubal infection.
- The hormonal IUD has a beneficial effect on heavy menstrual bleeding, so it is especially recommended for women with this symptom.
NATURAL METHODS
- Pregnancy planning or prevention methods based on tracking natural signs and symptoms of the phases of the menstrual cycle.
- Abstinence from sexual intercourse on potentially fertile days.
- Several natural methods are known to prevent pregnancy, including Calendar-based (Ogino), standard days, temperature, Billings method, two-day, mucothermal, symptothermal, lactational amenorrhea, etc.
- Strictly speaking withdrawal is not a natural method, but rather a barrier to keep sperm from penetrating the vagina, with ejaculation occurring outside the genital area.
BARRIER METHODS
These are methods that block the sperm from finding the egg.
- Male condom: latex sheath worn over the penis that prevents sperm from coming into contact with the vagina. Protects against sexually transmitted infections.
- Female condom: thin rubber pouch that is inserted into the vagina with the aid of a flexible ring and has a ring on the open end that stays outside the vagina. Protects against sexually transmitted infections.
- Diaphragm: dome-shaped latex or silicone cup that is inserted into the vagina to cover the cervix. It is used with spermicides. It does not protect against sexually transmitted infections.
- Spermicides: chemicals that stop sperm from moving. Creams, pessaries and gels. Currently not marketed in Spain.
PERMANENT METHODS
Tubal ligation by laparoscopy: (female)
- Requires general anaesthesia.
- It is effective immediately and women can resume sexual activity once recovered from the procedure.
Transcervical sterilisation (Essure) (female):
- A small coil is inserted in each fallopian tube to form a barrier.
- It is an outpatient procedure.
- Anaesthesia is not required.
- It takes about three months to become effective, during which time another form of contraception should be used.
Vasectomy: (male)
- A small incision is made in the vas deferens, which are then tied to prevent sperm from entering into the seminal stream.
- It is performed under local anaesthesia.
- It takes about 3 months to become effective, and requires a semen test to verify the absence of sperm.