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Sex may permeate our popular culture, but conversations about it are still associated with stigma and shame in Indian households. As a result, most individuals dealing with sexual health issues or trying to find information about sex often resort to unverified online sources or follow the unscientific advice of their friends.
To address the widespread misinformation about sex, News18.com is running this weekly sex column, titled ‘Let’s Talk Sex’. We hope to initiate conversations about sex through this column and address sexual health issues with scientific insight and nuance.
The column is being written by Sexologist Prof (Dr) Saransh Jain. In today’s column, Dr. Saransh Jain explains how different contraceptive methods can be used as per your needs and lifestyle.
Whether you are travelling by a train or waiting for a plane at an airport, road or bus stop, temple or mall, hospital or any event, one thing which we see everywhere is the increasing crowd. This is a clear sign of our growing population. In recent years, India has continued to focus on sterilisation as well as the use of contraceptives to control population.
As per the latest national family health survey (NFHS-5), India’s total fertility rate or the average number of children per woman has dropped below replacement level. Replacement level TFR (Total Fertility Rate) of 2.1 is the WHO’s estimate of the level at which a population just replaces itself instead of growing. India’s TFR is recorded 2 according to NFHS-5 conducted over 2019-21.
What is Contraception?
Contraception is an artificial method or other methods mainly used to prevent or avoid pregnancy as a consequence of sexual intercourse. When a sperm reaches the ova in women, she may become pregnant. Contraception is a method that prevents this phenomenon by:
• Restricting the egg production
• Keeping the egg distinct or far from the sperm
• By stopping the fertilised egg attaching to the lining of the womb
What are the different methods of contraception?
There are many different types of contraception, but not all types are appropriate for all situations. The most appropriate contraceptive method depends on an individual’s overall health, age, frequency of sexual activity, number of sexual partners, desire to have children in the future, and family history of certain diseases.
The contraceptive methods can be broadly classified into the following categories:
1. Barrier Methods
Designed to prevent sperm from entering the uterus, barrier methods are removable and may be an option for women who cannot use hormonal methods of contraception.
o Male condoms: This condom is a thin sheath that covers the penis to collect sperm and prevent it from entering the woman’s body.
o Female condoms: These are thin, flexible plastic pouches. A portion of the condom is inserted into a woman’s vagina before intercourse to prevent sperm from entering the uterus.
o Contraceptive sponges: These are soft, disposable, spermicide-filled foam sponges. One is inserted into the vagina before intercourse. The sponge helps block sperm from entering the uterus, and the spermicide also kills the sperm cells.
o Spermicides: A spermicide can kill sperm cells. A spermicide can be used alone or in combination with a diaphragm or cervical cap. The most common spermicidal agent is a chemical called nonoxynol-9 (N-9).
o Diaphragms: Diaphragm is a shallow, flexible cup made of latex or soft rubber that is inserted into the vagina before intercourse, blocking sperm from entering the uterus.
o Cervical caps: These are similar to diaphragms but are smaller and more rigid. The cervical cap is a thin silicone cup that is inserted into the vagina before intercourse to block sperm from entering the uterus.
2. Sterilisation
Sterilisation is a permanent form of birth control that either prevents a woman from getting pregnant or prevents a man from releasing sperm.
o Sterilisation implant is a nonsurgical method for permanently blocking the fallopian. A healthcare provider threads a thin tube through the vagina and into the uterus to place a soft, flexible insert into each fallopian tube. No incisions are necessary. During the next three months, scar tissue forms around the inserts and blocks the fallopian tubes so that sperm cannot reach an egg.
o Vasectomy is a surgical procedure that cuts, closes, or blocks the path between the testes and the urethra. The sperm cannot leave the testes and cannot reach the egg. It can take as long as three months for the procedure to be fully effective.
o Tubal ligation is a surgical procedure in which a doctor cuts, ties, or seals the fallopian tubes. This procedure blocks the path between the ovaries and the uterus. The sperm cannot reach the egg to fertilise it, and the egg cannot reach the uterus.
3. Long-Acting Reversible Contraception (LARC)
o Copper IUD is a small, T-shaped device that is inserted into the uterus to prevent pregnancy. It prevents sperm from reaching and fertilizing the egg, and it may prevent the egg from attaching in the womb. Copper IUDs may remain in the body for 10 years.
o Implantable Rods is matchstick-sized, flexible, and plastic rod which is surgically inserted under the skin of the woman’s upper arm by a Physician. The rod releases a progestin and can remain implanted for up to five years.
4. Hormonal Methods
Hormonal methods of birth control use hormones to regulate or stop ovulation and prevent pregnancy. Depending on the types of hormones that are used, these methods can prevent ovulation; thicken cervical mucus, which helps block sperm from reaching the egg; or thin the lining of the uterus.
o Injectable birth control: This method involves injection of a progestin, given in the arm or buttocks once every three months.
o Progestin-only pills (POPs): A woman takes one pill daily, preferably at the same time each day.
o Combined oral contraceptives Pill: COCs contain a synthetic estrogen and a progestin, which functions to inhibit ovulation. A woman takes one pill daily, preferably at the same time each day. Researchers are also working on Male Birth Control Pills.
o Contraceptive patch: This is a thin, plastic patch that sticks to the skin and releases hormones through the skin into the bloodstream.
o Vaginal ring: The ring is thin, flexible, and approximately two inches in diameter. It delivers a combination of ethinyl estradiol and a progestin. The ring is inserted into the vagina, where it continually releases hormones for three weeks.
5. Emergency contraceptive pills (ECPs) are hormonal pills, taken either as a single dose or two doses 12 hours apart, that are intended for use in the event of unprotected intercourse. If taken prior to ovulation, the pills can delay or inhibit ovulation for at least five days to allow the sperm to become inactive.
There are many choices available, each with benefits and disadvantages. Speak with your healthcare provider about your options and which method or methods work best for you and your needs. It’s important to remember that the only contraceptive method that protects against sexually transmitted diseases (STIs) are condoms. Combining condoms with another form of contraceptive protects against STIs and gives extra protection from pregnancy.
