Sex may permeate our popular culture, but discussions about it are still associated with stigma and shame in Indian households. Consequently, most individuals who are dealing with sexual health issues or trying to find information about sex often turn to unverified online sources or follow the unscientific advice of their friends.
To address the widespread misinformation about sex, News18.com is holding this weekly sex column titled ‘Let’s Talk Sex’. We hope to start conversations about sex through this section and address sexual health issues with scientific insight and nuance.
The column is written by sexologist Prof (Dr) Saransh Jain. In today’s column, dr. Saransh Jain how different contraceptive methods can be used according to your needs and lifestyle.
Whether you are traveling by train or waiting for a plane at an airport, road or bus stop, temple or shopping mall, hospital or any event, one thing we see everywhere is the growing crowd. This is a clear sign of our growing population. In recent years, India has continued to focus on sterilization as well as the use of contraceptives to control population.
According to the latest National Family Health Survey (NFHS-5), India’s total fertility rate or the average number of children per woman has fallen below replacement level. Substitution Level TFR (Total Fertility Rate) of 2.1 is the WHO’s estimate of the level at which a population simply replaces itself instead of growing. India’s TFR was 2 recorded according to NFHS-5 conducted over 2019-21.
What is contraception?
Contraception is an artificial method or other methods used primarily to prevent or avoid pregnancy as a result of sexual intercourse. When a sperm reaches the ova in women, she can become pregnant. Contraception is a method that prevents this phenomenon by:
• Limit egg production
• Keep the egg clear or far from the sperm
• By preventing the fertilized egg from attaching to the lining of the uterus
What are the different methods of contraception?
There are many different types of contraceptives, but not all types are suitable for all situations. The most suitable method of contraception depends on an individual’s general health, age, frequency of sexual activity, number of sexual partners, desire to have children in the future and family history of certain diseases.
The methods of contraception can be broadly classified into the following categories:
1. Barrier methods
Barrier methods, designed to prevent sperm from entering the uterus, are removable and may be an option for women who cannot use hormonal contraceptive methods.
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 bags. 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 placed in the vagina before intercourse. The sponge helps prevent sperm cells 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 spermicide is a chemical called nonoxynol-9 (N-9).
o Diaphragm: Diaphragm is a shallow, flexible cup made of latex or soft rubber that is placed in the vagina before intercourse, which prevents 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 prevent sperm from entering the uterus.
2. Sterilization
Sterilization is a permanent form of birth control that either prevents a woman from getting pregnant or prevents a man from releasing sperm.
o Sterilization implantation is a non-surgical method to permanently block the fallopian tube. A healthcare provider threads a thin tube through the vagina and into the uterus to place a soft, flexible insert in each fallopian tube. No incisions are required. 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 ovum. It can take as long as three months before the procedure is fully effective.
o Tubal ligation is a surgical procedure in which a doctor cuts, binds or seals the fallopian tubes. This procedure blocks the pathway between the ovaries and the uterus. The sperm cannot reach the ovum to fertilize it, and the ovum cannot reach the uterus.
Long-acting reversible contraception (LARC)
o Copper IUD is a small, T-shaped device that is placed in the uterus to prevent pregnancy. This prevents sperm from reaching and fertilizing the egg, and it can prevent the egg from attaching to the uterus. Copper IUDs can remain in the body for 10 years.
o Implantable rods are matchstick-sized, flexible and plastic rods that are 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 type of hormones used, these methods can prevent ovulation; cervical mucus thickens, which helps prevent sperm from reaching the egg; or thin the lining of the uterus.
o Injectable birth control: This method involves the injection of a progestin, administered once every three months into the arm or buttocks.
o Progestin-only pills (POPs): A woman takes one pill daily, preferably at the same time every day.
o Combined oral contraceptives Pill: COCs contain a synthetic estrogen and a progestin, which function to inhibit ovulation. A woman takes one pill daily, preferably every day at the same time. 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 about two inches in diameter. It produces a combination of ethinyl estradiol and a progestin. The ring is placed in the vagina, where it continuously releases hormones for three weeks.
5. Emergency contraceptive pills (ECPs) are hormonal pills, either as a single dose or two doses 12 hours apart, which are intended for use in case of unprotected intercourse. If taken before ovulation, the pills can delay or inhibit ovulation for at least five days to leave the sperm inactive.
There are many choices available, each with advantages and disadvantages. Talk to your healthcare provider about your options and which method or methods work best for you and your needs. It is important to remember that the only method of contraception that protects against sexually transmitted diseases (STIs) is condoms. The combination of condoms with another form of contraception protects against STIs and provides extra protection against pregnancy.
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