Ecuador is the third country in South America with the lowest rate of use of female contraceptive methods, according to a report by the United Nations Population Fund (UNFPA). The same report indicates that the provision of contraceptives has several barriers such as: misinformation, limited variety and placement of methods without consent. Therefore, the first step to address this problem is to talk about the issue.
What are contraceptives?
According to National Geographic, they are a tool to prevent unwanted pregnancies. In addition, they also work to control irregular periods and reduce menstrual pain, as indicated by the Clue encyclopedia. On the other hand, the WHO states that they are essential for health and a human right that should be accessible to all. Below we will present several types.
- Barrier methods
According to the National Institute of Child Health and Human Development (NIH), these types of methods are removable and prevent sperm from entering the uterus by placing them on the genitals. Here are some of these methods:
a. Condoms: The Clue encyclopedia indicates that they are made of latex or other materials that cover the genitals to act as a barrier against bodily fluids. There are male and female ones. In the case of women, they are flexible, and are placed inside the vagina. For men, they are placed externally, on the erect penis, prior to sexual intercourse. According to the WHO, this method is 95% effective against unwanted pregnancies, and reports that this is the only method that can prevent pregnancy and the spread of sexually transmitted diseases, if used correctly. That is, it should not exceed the expiration date, should not have cracks, use a new condom for each sexual relationship, and avoid putting them in your wallet.
b. Contraceptive sponge: Planned Parenthood, a non-profit organization that provides sexual health care, describes it as a small, round, soft plastic sponge that is placed deep inside the vagina before sexual intercourse. When placed, it prevents sperm from entering the uterus and contains spermicide, which prevents sperm from moving. This method does not prevent sexually transmitted diseases and its effectiveness is 78% in people who have already had a child.
- Non-hormonal methods
The National Institute of Child Health and Human Development (NIH) reports that these are, as their name suggests, hormone-free and their function is to prevent pregnancy by blocking the meeting of a sperm with an egg. Below, we present the most common ones.
to. Copper intrauterine device (IUD): The BBC says that it is a small device made of flexible plastic material, covered in copper. The IUD is inserted into the uterus by a health professional and can last up to 10 years. This method prevents pregnancy, because the copper damages the sperm, preventing it from joining the egg. This device is 99% effective and does not prevent sexually transmitted diseases.
b. Tubal ligation: Mayo Clinic points out that it is a permanent contraceptive, after which the patient will not be able to have children, and it must be performed by a specialist. This procedure can be performed during vaginal delivery, a cesarean section, or in an outpatient procedure. It implies that the fallopian tubes are going to be cut, tied or blocked to prevent pregnancy. By sealing this channel, the egg cannot travel from the ovaries to the fallopian tubes. It also prevents the sperm from traveling to the fallopian tubes. This procedure does not affect the menstrual cycle and its effectiveness is 99 %. If you are a BMI client, go to our website to learn about the coverage for this procedure: https://www.bmicos.com/ecuador/
c. Vasectomy: According to the Mayo Clinic, this is a type of male birth control. It is performed by cutting and closing the tubes that carry sperm. The procedure is carried out by a health professional on an outpatient basis and with local anesthesia. There are two types: one with a scalpel (with a cut) and another without a scalpel (without a cut). This method of contraception is permanent, and if a reversal surgery is required, it is more complicated than a vasectomy, expensive, and may not be effective.
d. Spermicides: MedilinePlus states that it is considered one of the least effective forms of contraception. However, it is better than not using any protection at all. Spermicides are chemicals that prevent sperm from moving, and come in different forms such as gels, foams, creams or suppositories. They are placed inside the vagina before sexual intercourse. According to the Alabama Department of Public Health, it is 72% effective and if used with a condom, 97% effective.
Hormonal methods
The National Cancer Institute says that these types of birth control methods contain progesterone or a combination of progesterone and estrogen, which are responsible for preventing the ovaries from releasing eggs. They also thin the lining of the uterus and thicken the mucus in the cervix, blocking the passage of sperm to the egg. These types of birth control methods can be administered orally, by injection, or placed under or on the skin, in the vagina, or in the uterus.
a. Birth control pill: According to Medical News Today, can only be prescribed by a specialist; This is a medicine in pill form that prevents the body from producing an egg. This way, the sperm have nothing to fertilize and pregnancy cannot occur. Additionally, these pills can help with irregular, painful periods, endometriosis, acne, and premenstrual syndrome (PMS). This method can have side effects, which the treating physician will promptly inform the patient about. The most common ones are: nausea, breast tenderness, and headaches. It is 91% effective and does not prevent the spread of sexually transmitted diseases.
b. Patch: Mayo Clinic reports that it is a method that contains estrogen and progestin, is used for three weeks and must be removed in the fourth week. During this time, menstrual bleeding will occur. It prevents pregnancy because it releases hormones into the bloodstream that prevent ovulation. In addition, it thickens cervical mucus, hindering the arrival of sperm to the egg. It is important to mention that the patch is not a protection against sexually transmitted diseases. If used correctly, it is 99% effective according to Planned Parenthood.
c. Contraceptive ring: The Clue encyclopedia details that it can contain estrogen and progestin, releasing very low doses, which are absorbed by the vaginal mucosa, thus preventing ovulation. It is a circular piece of plastic, flexible and soft, which is placed inside the vagina for 3 weeks and removed for 1 week, so that menstruation occurs. This method must be prescribed by a specialist. If used following the specialist's instructions, it has an effectiveness of 99 % according to Kern Pharma. However, if any error is made, its effectiveness can drop to 93 % according to Planned Parenthood.
d. Hormonal IUD: Mayo Clinic says that it is a T-shaped plastic structure that is inserted into the uterus. This procedure must be performed by a doctor. The IUD releases the hormone progestin, which increases the thickness of the cervical mucus, making it impossible for sperm to reach the egg. It also reduces the thickness of the wall of the uterus and inhibits ovulation. This contraceptive method can last for 7 years and its effectiveness, if used correctly, is 99% effective.
and. Contraceptive injection: According to the Clue encyclopedia, this method contains progestin, and its dosage must be administered by a doctor and can last up to three months. The hormone it contains prevents ovulation, so pregnancy cannot occur. It also thickens the cervical mucus to prevent sperm from passing through. If used correctly, it can be up to 99% effective.
F. Contraceptive implant: According to the Mayo Clinic, they are a long-term method of contraception. It is a flexible plastic rod the size of a matchstick, which is placed under the skin on one of the arms. This device releases a low dose of the hormone progestin, which inhibits ovulation and increases the thickness of the cervical mucus. It is 99% effective if used properly.
g. Morning-after pill: According to the Mayo Clinic, it is an emergency contraceptive, meaning it is used in case a method has failed, such as a condom, if unprotected sex has occurred, or if the person is a victim of sexual assault. Under no circumstances should it be used as a primary contraceptive method, as it is not as effective as other methods. Even when used correctly, it can fail and does not provide protection against sexually transmitted diseases.
In conclusion, by talking openly about female contraceptive methods, we are breaking down stigmas and opening the door to informed and empowered decision-making. There are several alternatives for better family planning and a specialist will be the best person to recommend the best method for each patient. Finally, it is essential to mention that this process must always have the consent of the person who will use it.
