How contraceptives work

DAILY PILLS

Daily pillsAbout them: Pills that contain low doses of 2 hormones, a progestin and an estrogen – like the natural hormones progesterone and estrogen in a woman’s body. They work primarily by preventing the release of eggs from the ovaries (ovulation).

How to use: Take one pill everyday. For the greatest effectiveness a woman must take pills daily and start each new pack of pills on time. Take any missed pills as soon as possible. Missing pills risks pregnancy and will make some side effects worse.

Side Effects: Some users report the following:

Changes in bleeding patterns (lighter bleeding, irregular bleeding, infrequent bleeding, no monthly bleeding)

Headaches, Dizziness, Nausea, Breast tenderness, Weight change, Mood changes Acne (it can improve or worsen, but usually improves)

How to use it after a medical abortion: Your fertility returns within 7 days after the abortion. This means that you should start using the daily pills immediately after the abortion or even at the time of your medical abortion. The pills will protect you, if you are not yet ready for a pregnancy.

Correcting Misunderstandings

  • Daily pills can be used immediately after or even at the time of your medical abortion
  • Daily pills (or any other contraceptive method) do not strain your body after medical abortion
  • Women lose some blood during abortion, but not too much to stop you from using the daily pills, given that bleeding is a possible side effect.
  • Daily pills do not build up hormones in a woman’s body. Women do not need a “rest” from taking daily pills
  • Must be taken everyday whether or not you are having sex.
  • Do not make women infertile after they stop taking it.
  • Do not cause birth defects or multiple births.
  • Do not change women’s sexual behaviour.

 

3 MONTH INJECTION:

image (3)About It: This is an injection that contains a progestin like the natural hormone progesterone in a woman’s body.

How to use it: It is given by injection into the muscle. The hormone is then released slowly into the bloodstream.

Side effects: Most users report

  • Changes in monthly bleeding.
  • First 3 months (irregular bleeding or prolonged bleeding)
  • At one year (no monthly bleeding or infrequent bleeding)

Some users also report:

  • Weight gain, Dizziness, Headaches, Abdominal bloating, Mood changes, Less sex drive

How to use it after an abortion: Your fertility returns within 7 days after a medical abortion. This means that you can get the injection immediately after having the medical abortion or even at the time of your abortion.  The injection will immediately begin protecting you, if you are still not ready for pregnancy.

Correcting misunderstandings:

  • Women lose some blood during abortion but not too much to prevent them from starting a contraceptive method
  • The injection (or any other contraceptive method) does not strain your body after abortion
  • Can stop monthly bleeding (but this is not harmful, and could prevent anaemia).
  • Blood is not building up inside the woman.
  • Do not disrupt an existing pregnancy
  • Do not make women infertile

 

ARM IMPLANTS

image (2)About them: These are small flexible rods that are placed just under the skin of the upper arm. They release a progestin like the natural hormone progesterone in a woman’s body. Very effective for 3-5 years depending on the type of implant.

Types of implants:

Jadelle: 2 rods containing levonorgestrel, highly effective for 5 years.

Implanon NXT: 1 rod containing etonogestrel, labeled for upto 3 years of use.

Levoplant: 2 rods containing levonorgestrel, highly effective for 4 years.

How to use it: A specifically trained provider performs a minor surgical procedure to place one or 2 rods under the skin. You do not need to take any further action after the placement of the rods.

Side Effects: Some users report the following:

Changes in bleeding patterns (lighter bleeding, prolonged bleeding, irregular bleeding, infrequent bleeding, no monthly bleeding)

Headaches, Abdominal pain, Acne (which can improve or worsen), Weight change, Breast tenderness, Dizziness, Mood changes, Nausea

NB: Bleeding changes are normal and not harmful. If a woman finds them bothersome, counselling from a Trusted Pharmacist found here (insert link) can help.

How to use it after an abortion: Your fertility returns within seven days after the medical abortion. This means that can start using  an arm implant immediately after or at the time of your medical abortion. It will immediately protect you, if you are not yet ready for a pregnancy.

Correcting misunderstandings

  • Women lose some blood during an abortion but not too much to prevent them from starting a contraceptive method
  • Implants do not work once they are removed.
  • Their hormones do not remain in a woman’s body.
  • They do not cause any harm if they stop monthly bleeding.
  • Blood does not build up inside the woman.
  • They do not make women infertile.

COPPER-BEARING IUD

image (1)About it: This is a small, flexible, plastic frame with copper sleeves or wire around it. Almost all types of IUD have one or two strings or threads tied to them. The strings hang through the cervix into the vagina. It works by causing a chemical change that damages sperm and egg before they can meet.

It offers long-term pregnancy protection. It can be effective for up to 12 years and is immediately reversible.

How to use it: A specifically trained health care provider inserts the IUD into the uterus through the vagina and cervix. You do not require to do anything after the insertion.

Side Effects: Some users report the following:

  • Changes in bleeding patterns, especially in the first 3-6 months (prolonged and heavy monthly bleeding, irregular bleeding, more cramps and pain during monthly bleeding)

NB: Bleeding changes are normal and not harmful. If a woman finds them bothersome, counselling from a Trusted pharmacist here (Insert link) can help.

How to use it after an abortion: Go to a trained provider immediately after the bleeding stops (or within seven days after a medical abortion). The provider will examine you and rule out any possibility of infection on the genital tact, before inserting the IUD. Once inserted, it will immediately protect you, if you are not yet ready for pregnancy.

Correcting Misunderstandings:

  • Some women lose blood during abortion, but not too much to prevent them from starting to use the IUD immediately after the abortion.
  • Can be used by women of any age including adolescents.
  • Can be used by women who have children and those who have not.
  • Does not increase the risk of miscarriage after the IUD is removed.
  • Does not make women infertile
  • Does not cause birth defects
  • Does not cause cancer
  • Does not move to the heart or brain
  • Does not cause discomfort for the man or woman during sex

  

CONDOMS

image (1)About it: This is a sheath or covering, that fits over a man’s erect penis. It is also called “rubber”, or “CD”. It works by forming a barrier that keeps sperms out of the vagina, therefore preventing pregnancy. It also keeps infections in semen on the penis or in the vagina from infecting the other partner.

How to use it:

  • Use a new condom each time you have sex. (use a new one for every new round)
  • Before any physical contact, place the condom on the tip of the erect penis with the rolled side out.
  • Unroll the condom all the way to the base of the erect penis.
  • Immediately after ejaculation, hold the rim of the condom in place and withdraw the penis while it is still erect.
  • Dispose safely

Side Effects:

  • It has no side effects
  • It may dull the sensation of sex

How to use it after medical abortion: Your fertility returns within seven days after the abortion. You can start using condoms immediately after an abortion. The condom does not have any harmful effect after the abortion.

Correcting Misunderstandings

  • Condoms are safe for use immediately after abortion
  • Male condoms do not make men sterile, impotent or weak.
  • Do not increase men’s sex drive.
  • They cannot get lost in the woman’s body.
  • They do not have holes that HIV can pass through.
  • They do not cause illness in a woman.
  • They are not only for use outside marriage. They are also used by married couples.
  • They do not cause cancer, or contain cancer-causing chemicals.

 

EMERGENCY PILLS

imageAbout them: They are sometimes called ‘morning after’ pills. They work by preventing or delaying the release of eggs from the ovaries (ovulation). They do not work if a woman is already pregnant.

How to use them: They should be used as soon as possible after unprotected sex. The sooner the pills are taken after unprotected sex, the better they prevent pregnancy. They can help to prevent pregnancy when taken up to 5 days after unprotected sex.

Side effects: Some users report the following:

  • Changes in bleeding patterns, including: slight irregular bleeding for 1 – 2 days after taking ECPs, monthly bleeding that starts earlier or later than expected
  • In the first several days after taking ECPs: Nausea, abdominal pain, fatigue, headaches, breast tenderness, dizziness, vomiting

How to use it after an abortion: You can start to use emergency contraceptive pills immediately after a medical abortion. The pill will protect you from an unintended pregnancy.

Correcting Misunderstandings

  • Can be used by women of any age, including adolescents
  • Do not cause abortion
  • Do not prevent or affect implantation
  • Do not cause birth defects if pregnancy occurs
  • Are not dangerous to a woman’s health
  • Do not increase risky sexual behaviour
  • Do not make women infertile
  • Can be used more than once in a woman’s cycle

 

Source: Family Planning Handbook – 2018 Edition

 

 

 

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