The most effective contraceptive method  to prevent pregnancy is Long-Acting Reversible Contraception, or LARC. LARCs can be of both categories – hormonal and non-hormonal. They are reversible and can be removed at any point. LARCs are also considered to be a good alternative to sterilization considering that sterilization has high rates of failure among young people. It is very important to remember that despite being highly effective as contraceptives, LARCs do not protect against sexually transmitted infections and diseases.

LARCs are inserted in the uterus. It is common to feel some cramps when you get it inserted, but they will go away with rest or pain medication. Some women might feel dizzy, too. Once the intrauterine device is in, you will notice a little string that hangs down into your vagina. That is there so that the device can be removed later. (The strings do not hang out of the vagina.) These are usually inserted for long periods of 3-10 years.

The non-hormonal LARCs available in India are the Copper IUDs 380A and 375. These were introduced in 2002 and 2012 respectively free of charge but their prevalence rate is only 1.5%. Other IUDs such as Mirena and Implanon (both hormonal IUDs) are available in tier 1 cities at a very high cost.

non-barrier

Another form of contraceptive that is commonly used are hormonal pills, popularly known as oral contraceptive pills. These pills are commonly used to delay or prevent pregnancy. However, this method does not protect against sexually transmitted infections and diseases. They are effective if taken regularly and consistently. The pill is only for female bodies. There are two types of pills – Combined oral contraceptive pills and Progesterone-only contraceptive pills.

Combined oral contraceptive pills contain the hormones Progesterone and Oestrogen which work to prevent ovulation. These are most effective if taken consistently at the same time every day of the week and their efficiency reduces with inconsistent use. Progesterone-only contraceptive pills contain only one hormone and typically work by thickening the cervical mucus and preventing ovulation. They have a good success rate in preventing pregnancy if taken regularly.

non-barrier

These prevent the sperm from entering the vagina. Condoms help in protection against pregnancy and very importantly, sexually transmitted infections. They are very easy to use and widely accessible in public health systems as well as medical stores in India.

When used properly, 95 to 98 of every 100 individuals will manage to prevent pregnancy. But most people do not use condoms perfectly – if that is the case, only 82 of every 100 individuals using this method will manage to avoid pregnancy. One condom can only be used once. So, duration-wise, condoms are not the best option. However, there are provisions of cheap and easy-to-use condoms widely available.

There are two kinds of condoms – internal condoms (for female bodies) and external condoms (for male bodies). Most external condoms are made of latex which could be a problem for people who might have latex allergy. In that case, an internal condom is a good option to go for.

barrier

Sterilization is a permanent method of contraception. Unlike LARCs, sterilization is irreversible. Sterilization is considered a very effective means of contraception as it provides 99% results. It can be done on both male and female bodies. For male bodies, sterilization is called a vasectomy. It blocks the tubes that carry the sperm. For female bodies, sterilization is a procedure that closes or blocks the fallopian tubes so that one cannot get pregnant.

Unfortunately though, sterilization too does not protect from sexually transmitted infections. Sterilisation is to date the most popular method of contraception amongst married women in our country with 36 percent of women choosing this method . Whereas male sterilization/ Vasectomies stand at only 0.3per cent (NFHS4).

non-barrier

Implants are used for only female bodies. They are small plastic rods or capsules that are inserted under the skin of the upper arm. They are so small in fact that most people cannot see it once it is inserted. The implant releases progestin, a hormone that keeps the ovaries from releasing eggs and thickens the cervical mucus which helps block sperm from getting to the egg in the first place. It prevents pregnancy for up to 5 years, depending on the type of implant. Relatively new in India, implants are a little expensive but do provide a good result in preventing pregnancies. However, they do not protect from sexually transmitted infections and diseases.

non-barrier

If you do not want to take a pill every day, the Injectable might be a good option. You only need to remember to do something once every one (monthly injectable), two (NET-EN) or three months (DMPA). You will need to see a health provider or trained community health workers to get your injection. If taken on time and regularly, 99 out of 100 people will be able to prevent unwanted pregnancies.

The injectable prevents the ovaries from releasing eggs. It also thickens the cervical mucus to help block sperm from getting to the egg in the first place. Needless to say, this too is for only female bodies. An injectable could contain either only progestin or both progestin and oestrogen. Injectables do not protect from STIs.

non-barrier

A birth control patch is a small plastic square patch that is stuck on the female body once every week. In India, it is sold under the name of Ortho Evra which contains both oestrogen and progesterone. The patch prevents the egg from releasing from the ovary, thickens the inner lining of the uterus and changes the cervical mucus. The patch is pretty effective the way most people use it. With perfect use, 99 in every 100 people will prevent pregnancy. With typical use, or the way most people use it, the patch prevents pregnancy in 91 out of 100 people who use it. The patch does not prevent sexually transmitted infections and diseases.

non-barrier

The ECP is a single pill or sometimes, a set of two pills that can be taken after unprotected sex or if the used contraceptive failed. Both two pills and one pill regimens are equally effective. ECP options are very effective. 99 of every 100 individuals using these options will manage to prevent pregnancy. The ECP only prevents pregnancy from starting which is why it needs to be taken within 72 hours of unprotected sex. If the pregnancy has already begun (whether one is aware of it or not), the ECP will not work. Thus, it is advised to not use ECP as the primary method of contraception. This is only an SOS method. This too is for female bodies only and does not protect from sexually transmitted infections or diseases.

non-barrier

One way to avoid or delay pregnancies is increasing awareness of one’s fertility window, menstrual cycles and using this knowledge to plan intercourse. This is also known as the Rhythm method.  While this may be useful in preventing pregnancies, it does not protect one against sexually transmitted infections. This is a non-hormonal, not very effective method as there is always a chance of making mistakes.

non-barrier

Most often the ‘withdrawal’ method is also used during sexual intercourse to prevent pregnancy. This means that the penis is withdrawn from the vagina before ejaculation in order to prevent sperm from entering the female body. However, this method is not very effective and does not absolutely prevent pregnancy. Additionally, it does not protect against sexually transmitted infections and diseases.

non-hormonal, non-barrier