When I hear the word "contraception", the first thing that comes to mind is the pill.

I was first officially introduced to contraception when I was in my first year of varsity, and I've been learning more about the various methods and effects of the different kinds of contraception now that I wish I knew more about before.

In an interview with Bhekisisa, Dr Tlaleng Mofokeng says that the biggest knowledge gaps regarding contraception are that we don't know more about the different types of contraceptives that are available and how they work. 

I spoke to Dineo Moerane, marketing and communications coordinator at Marie Stopes, about the most common contraceptives and how they function. 

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The oral contraceptive pill

It is a contraceptive that needs to be ingested daily and each pill contains hormones that prevent ovulation. Because there is no ovulation, the bleeding that you see at every cycle is called a breakthrough bleed which, as Dr Tlaleng explains, is caused by "the dip in hormones from the contraceptive". 

What are the most common side effects of the pill?

The pill may cause spotting or irregualr periods, headaches, nausea, skin problems and an increased appetite. 

Can it be used for skin problems such as acne?

Some contraceptive pills that contain progesterone and estrogen can improve the condition of your skin, decreasing acne flare-ups, severe acne, skin inflammation and pimples. 

What medication can affect the efficacy of the pill?

Studies show that certain anti-biotics such as Rifampicin and other medication can impact the effectiveness of the pill.

If you need to start taking other medication while you're on the pill, it is best to inform your doctor about your contraception type so that they can advise on the best medication you can take which will not make the pill less effective.

Does the pill have an affect on your sex life?

It's not likely that the pill can affect your sex life. It's common for women to experience a low sex drive or shift over time and it is not easy to confirm the pill as the cause.

Price at Marie Stopes*: R140 (Triphasil)

The implant

The implant is similar to the IUD in that it is implanted into your body (your arm, specifically) and it can remain there for as long as three years. It's a small, thin rod that releases hormones into your system and prevents ovulation. The implant, like the IUD, is convenient for women who prefer to have a contraceptive that they don't need to remember to take every day. 

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What are the most common side effects of the implant?

The implant may cause spotting or irregular periods, headaches, nausea, skin problems and an increased appetite.

What medication can affect the efficacy of the implant?

There is no medication that can greatly disturb the functioning of the implant.

Does the implant have an affect on your sex life?

There is no proof that the implant affects your sex life. Some women can report that it has increased their sex drive while some can say that it has decreased their sex drive. There are a lot of other factors that can affect a woman's sex drive.

Price at Marie Stopes*: R400 (plus R90 for consultation)

The IUD

The IUD, or intrauterine device, is a T-shaped device that is inserted into your uterus to prevent pregnancy. It's one of the long-term contraceptives because, once implanted, it could last for at least 3 years or more before you need to change it. This depends on which brand you use and whether it's a hormonal or non-hormonal IUD.

What are the most common side effect of the IUD?

The copper T may cause heavier periods and/or cramping. It can increase the frequency of infections as well. The Mirena may cause spotting or irregular periods, headaches nausea, breast and skin problems.

What medication can affect the efficacy of the IUD?

There is no medication that can greatly disturb the functioning of the IUD. There are tow types of the IUD that are offered in South Africa: the Copper T (non-hormonal) and the Mirena or Skyla (hormonal). At Marie Stopes we only offer the Copper T and it's efficacy cannot be affected by any medication. 

Do you need a prescription to get an IUD?

At other facilities you may be required to provide a prescription to insert the IUD, but you don't need one at Marie Stopes.

Price at Marie Stopes*: R400 (plus R90 for consultation)

Condoms

This is the most commonly used contraceptive there is. It is available for both males and females for free at public clinics, and the male condoms are available at practically any store at varied prices depending on the brand. Condoms are made of latex and are generally effective in preventing pregnancy and also preventing the contraction of STDs and STIs. The efficacy of condoms is decreased when they are exposed to heat and they are likely to tear or damage when used or handled incorrectly. 

Price at Pick 'n Pay: R164.44 (Durex Featherlite 12 pack)

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The contraceptive you use depends on several factors and these are the few that Dr Tlaleng suggests you consider consider when choosing the right one. 

Your current health condition

According to Dr Tlaleng, one of the things you need to consider when weighing the options about contraception is what your current health condition is. Some contraceptives clash with certain medications and might reduce their effectiveness. You need to do thorough research when it comes to how contraceptives work and what could make them fail.

In addition to your health, you also need to consider your preference, what is convenient for you and suits your lifestyle. Do you want to take a pill every day or get an injection every two to three months?

For instance, some women prefer that there be no breakthrough bleeding during their time on the pill, and some women don't mind the spotting; just as some women can handle the routine of taking a pill daily, and others prefer getting a less frequent injection, or a once-off patch. For instance, the IUD lessens the frequency of the breakthrough bleed while the injection may induce the opposite effect.

Your desired function of the contraceptive

It took me a couple of years after I first heard of the contraceptive pill to realise that preventing a pregnancy is not the only reason that women opt for contraceptives; specifically the pill. There are women who take the pill to improve the condition of their skin. Deciding on which contraceptive to use should be based on your individual needs; therefore consulting with a general practitioner, dermatologist (if the matter is skin-related) or gynaecologist is important.

Your future options

Some women choose a contraceptive without considering the long-term effects of it. Do you want to have children at some point? Sooner, or later? Depending on which contraception you use, you might need to wait a while after you drop it before you can conceive because some contraceptives stay longer in your system after you've stopped using them. Once again, you need to consult with a doctor regarding how long the contraception remains effective after you stop using it.

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In addition to all else, condoms should be your most consistent choice of contraception because they also protect you from STDs and STIs. 


*Marie Stopes prices vary according to clinic. These prices are from the clinic in Sandton.

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