Contraception or birth control is a technique used to prevent pregnancy with the use of a contraceptive. Contraceptives have several types and work in several different ways.
There are 5 classifications of contraception that are accepted in the Philippines.
Long-Acting Reversible Contraception or LARC
LARC are methods that last for a long period of time often in years.
These methods include the Intrauterine Device (Copper IUD and Progestin IUD), and Implant.
Hormonal Methods
These are laboratory-made hormones to make changes to your body that prevent pregnancy.
These methods include the Combined Oral Contraceptive Pills (COC), Progestin-Only Pills (POP), Implants, and Progestin-only Injectables (DMPA).
Barrier Methods
These methods stop the sperm from reaching an egg.
These methods include the Male and Female Condoms, Diaphragm, Cervical Cap and Spermicide.
Fertility Awareness-based Methods
These make use of natural methods to identify the fertile days when you are likely to get pregnant after a sexual intercourse.
These methods include the Standard Days Method (SDM), Two Day Method, Billings Ovulation Method, Basal Body Temperature Method and the Symptothermal Method.
Permanent Methods
These methods involves surgical procedures to permanently block the release of the sperm from the man or egg from the woman.
These methods include the No-Scalpel Vasectomy (NSV) and the Bilateral Tubal Ligation.
The best method for you may differ depending on your age, your health, relationship status, and priorities. It’s best to get checked by a doctor. They will be asking you questions and based on your answer they will recommend the best and safest contraception for you.
Effectiveness of the Contraceptive Methods with Typical Use
- Implant – 99.90%
- Intrauterine Device Hormonal – 99.90%
- No Scalpel Vasectomy – 99.80%
- Injectable (DMPA) – 99.70%
- Bilateral Tubal Ligation – 99.50%
- Intrauterine Device (IUD) Copper T – 99.2%
- Progestin-only Pills (POP) – 99.00% Combined with breastfeeding
- Lactational Amenorrhea Method (LAM) – 98.00% First 6 months from giving birth
- Standard Days Method (SDM) – 95.00%
- Combined Oral Contraceptives (COC) – 92-97%
- Condom – Male – 85.00%
- Condom – Female – 79.00%
Only one method of contraception can prevent sexually transmitted infections, and that is the condom.
Non-hormonal barrier contraceptives like condoms have no side effects
You can get contraception from a nurse or doctor no matter how old you are. They can also help if you are not sure which method is best for you.
Other than abstinence, there is no method that can guarantee 100% that you will not get pregnant. If in case you are using birth control methods and you get pregnant, it is best you get checked by your doctor to make sure that you and the baby are healthy.
Many hormonal contraceptive choices have risks, but infertility is not one of them. According to numerous studies, you are as likely to conceive if you used birth control in the past as a woman who has never used hormonal contraceptives.
For some women using hormonal methods, it is possible that the re-balancing of hormones that occurs when starting or switching to a new contraceptive may cause changes in sexual desire. If reduced sex drive continues, talk to your doctor about different options.
If preventing pregnancy is the goal, women should not stop using birth control until they have gone twelve months without a period.
These methods are provided for FREE in all City and Municipal heath centers and hospitals.
- Combined Oral Contraceptives (COC)
- Condom – Male
- Implant
- Injectable (DMPA)
- Intrauterine Device (IUD) – Copper T
- Progestin-only Pills (POP)
Bilateral Tubal Ligation and No-Scalpel Vasectomy (NSV) are also provided for free under the PhilHealth Package in government facilities. The private practitioners charge professional fees for these surgeries.
Lactation Amenorrhea Method (LAM) has no cost.
The cycle beads for Standard Days Method (SDM) maybe provided for free by some City and Municipal heath centers and hospitals. If not, the cost of the cycle beads is around Php100.00.
No. Studies have not shown increased risk of any cancer with use of implants.
Women who stop using implants can become pregnant quickly because there is immediate return to fertility after the implant is removed. The woman’s menstrual pattern before she used implants generally returns after the implant is removed.
No. Subdermal contraceptive implants are safe and appropriate for most women and adolescents and is 99 percent effective. In the very rare situation that a woman becomes pregnant while using an implant or accidentally an implant was inserted when she is already pregnant, studies shows that implants will not cause birth defects and will not harm the baby.
Yes, a woman can do her usual work immediately after leaving the clinic. She should protect the insertion site from accidental bumps and water.
No. Subdermal implant do not move around in a woman’s body. The implants remain where they are inserted until they are removed. It can be felt anytime by touching the skin where it was inserted. On rare occasions,an implant may start to come out, most often in the first four months after insertion. This usually happens because they were not inserted well or because of an infection where they were inserted. If a woman notices an implant coming out, she should start using a backup contraceptive method and return to the clinic immediately.
There had been instances of implant getting damaged under the skin. When the integrity of the subdermal implant is not assured, replace it with a new one.
No. Studies on Etonogestrel implant have not shown that a woman’s weight causes a decrease in the effectiveness of subdermal implants.
Breastfeeding women can use subdermal implants right after giving birth or within 48 hours after giving birth.
Leaving the subdermal implant in a woman’s arm beyond their effectivity is generally not recommended if the woman continues to be at risk of pregnancy. The implants themselves are not dangerous, but as the hormone levels of the implants drop, they become less and less effective. The subdermal implants are made of chemically inert materials. Even if left for longer periods, they are not health risks to the woman.
No. Body weight is affected by the combination of diet, physical activity and age. In rare cases of unplanned weight gain or weight loss and body weakness, during implant use, return to the clinic for removal of the implant and get a new method of contraception.
Mood and libido can be affected by changes in the relationship and not by the use of subdermal contraceptive implants.
The duration of contraceptive protection varies from 3-5 years depending on the brand. A woman can have the implant removed any time. Implants are an excellent contraceptive method for women who wish to plan the first birth or young mothers who want to plan their next birth for two or more years. It is also good for couples not wanting to get pregnant at any time in the future but are not interested in permanent contraceptive methods such as BTL or NSV or are not medically eligible for sterilization, or for other long-acting contraceptive methods such as the IUD.
A woman can have implant service in the following facilities:
- All city and municipal health centers provide implant contraceptives for FREE.
- Government hospitals with family planning facilities.
- Private birthing homes or lying-in clinics.
- Private doctors and clinics.
Click HERE to search for Providers of “Implant” located near you.
No-Scalpel Vasectomy is different from a conventional vasectomy in the way the doctor approaches the vas deferens. In addition, an improved method of anesthesia helps make the surgical procedure less painful. In a No-Scalpel Vasectomy, the doctor feels for the vas deferens under the skin and holds them in place with a small clamp. Instead of making two incisions, the doctor makes one tiny puncture with a special sharp surgical instrument. The same instrument is used to gently stretch the opening so the tubes can be reached. The vas deferens is then blocked using the same methods as conventional vasectomy. There is very little bleeding, safe and low failure rate with the no-scalpel technique. No stitches are needed to close the tiny opening, which heals quickly, with no scar.
In a conventional vasectomy, after the scrotum has been numbed with a local anesthetic, the doctor makes one or two small cuts in the skin and lifts out each tube in turn, cutting and blocking them so the sperm cannot reach the semen. Then the doctor stitches the cuts closed.
No. Vasectomy has no effect on sexual ability. After the vasectomy procedure, men will look and feel the same as before. They can have sex the same as before and will ejaculate normally. They can work as hard as before, and they will not gain weight because of the vasectomy.
Since NSV is a minor surgical procedure, a man may feel a bit weak while recovering from the procedure, but this only lasts several hours or days after surgery. The man should rest for two days, if possible. Once recovered, a patient’s physical strength returns to normal.
After the procedure, there may be some pain or discomfort in the scrotum or testicular area for which pain relievers are given. If possible, cold compress on the scrotum is advised for the first four hours to decrease pain and bleeding. The man should also be advised to wear snug underwear or pants for two to three days to help support the scrotum. It is uncommon to have pain lasting for months. This can be treated by elevating the scrotum and taking pain relievers. If the pain does not subside, advise the client to visit the health care provider for assessment and treatment.
Yes. For the first three (3) months after the procedure, there are still sperms in the semen after ejaculation. In that case, clients need to use another FP method until after three months when semen analysis results demonstrate absence of sperm. Not using FP method for the first 3 months has been the main cause of pregnancies among couples relying on vasectomy. Thereafter, vasectomy is highly effective.
No. Castration is the removal of the testicles, which is not what happens during a vasectomy. A vasectomy is a procedure that blocks the passage of sperm from the testicles to the tubes called the vas deferens. A man’s testicles are not involved in the procedure.
Yes. A man will still be able to produce semen and ejaculate, but there will be no sperm in the semen.
No. Vasectomy does not protect against sexually transmitted infections including HIV. Clients must use condoms for protection against these infections.
Every man having a vasectomy should know that vasectomies sometimes fail and his partner could become pregnant as a result. The failure rate is 0.1%. He should therefore not make the assumption that his partner was unfaithful if she becomes pregnant. If a man’s partner becomes pregnant during the first three months after his vasectomy, remind the man that for the first three months they needed to use another contraceptive method. If possible, offer a semen
analysis and, if sperm are found, a repeat vasectomy
Generally, no. Vasectomy is intended to be permanent. In very rare cases, however, the tubes that carry sperm grow back together and sperms start appearing in the semen. In such rare cases, the man will require a repeat vasectomy or use another method of contraception.
No. Vasectomy is intended to be permanent. People who may want more children should choose a different family planning method. Surgery to reverse vasectomy is difficult and expensive and success is not guaranteed.
No. There is no justification for denying men a vasectomy just because of age, the number of living children, or marital status. Men are allowed to decide for themselves whether or not they will want more children and whether or not to
have vasectomy.
A man can avail of vasectomy services in the following facilities:
- Government hospitals with family planning facilities.
- Private clinics and hospitals.
Click HERE to search for Providers of “No-scalpel Vasectomy” located near you.
Yes. Injectables are safe and suitable for nearly all women including women who are breastfeeding, have or have not had children, women over 40 years old and even those who may just have had a miscarriage. Women who are
HIV positive can also safely use injectables. A woman can begin using injectables anytime of the month even when she is not having her monthly menses at the time, if it is reasonably certain she is not pregnant.
Yes. In the first few months, the client may experience lighter menstrual bleeding and fewer days of bleeding. After that, she may experience irregular, infrequent, prolonged or no monthly menstrual bleeding. Other possible side
effects may include headaches, dizziness, breast tenderness, and weight gain.
These side effects are not signs of illness. Most side effects usually become less or stop within the first few months of using the injectable. Most women do not have them. If any of these side effects bother you, consult a midwife, nurse or doctor.
Yes. POIs are a good choice for a breastfeeding mothers who want a hormonal method. POIs are safe for both the mother and the baby starting as early as 6 weeks after childbirth. They do not affect milk production.
No. Research on POIs finds that they do not disrupt an existing pregnancy. They should not be used to try to cause an abortion. They will not do so. Should injectables fail to prevent pregnancy, there will be no adverse effects on the pregnancy.
No. Good evidence from studies on other hormonal methods shows that progestin-only injectables will not cause
birth defects. The fetus will not be harmed if a woman become pregnant while using the injectable or accidentally starts the injectable when already pregnant.
No. The client should receive the injection every 3 months or 13 weeks for DMPA or can be given even up to 4 weeks late with no need for tests, evaluation or back-up method. The timing of injections should not be based on whether she is menstruating or not. It is recommended, however, that the client should return and can have the next injection up to 7 days late, as long as it is certain that she is not pregnant.
No. Injectables do not protect the woman against sexually transmitted diseases including HIV. She must use condoms for protection against these diseases.
No, not really. The great majority of injectable users do not report any such changes. Some women report that both their mood and sex drive improve because they are protected against an unwanted pregnancy. There is no evidence that progestin-only-injectables affect women’s sexual behavior.
No. There may be a delay in regaining fertility after stopping the injectable, but in time, the client will be able to become pregnant as before. Generally, fertility decreases as women get older. The menstrual pattern the client had before using the injectable generally returns a few months after the last injection although some women may have to wait longer. Even if the women’s regular menstrual period has not returned after stopping POI, it does not mean she
cannot get pregnant.
When the the woman stop using the injectable she may wait about a couple of months to become pregnant. Studies suggest that after the last injection a woman can become pregnant again within nine months on the average. She should not be worried if she do not become pregnant even as much as 12 months after stopping use. After stopping the injectable, the woman will ovulate before her monthly menses returns and can become pregnant.
These are common myths that says amenorrhea due to progestin-only injectables such as the Depo-Provera causes myoma uteri and other tumors, and that blood collects in the uterine cavity. These simply are not true and that there are no evidence that suggests otherwise.
Yes. The injectable is safe for women with varicose veins. Varicose veins are enlarged blood vessels close to the surface of the skin. They are not dangerous. They are not blood clots, nor are these veins the deep veins in the
legs where a blood clot can be dangerous (deep vein thrombosis) and would contraindicate the use of POI.
- Prevention of unintended pregnancy and its risks
- Reduced risk of cancer of the uterus if used long term
- Reduced pelvic pain caused by endometriosis
- Possible absence of periods
- Possible relief of certain symptoms of sickle cell disease and seizure disorders
- Possible decrease in bleeding associated with uterine fibroids
- Does not interfere with sex or daily activities.
- Does not affect the quantity and quality of the breastmilk among lactating women
A woman can have injectables in the following facilities:
- All city and municipal health centers provide injectable contraceptives for FREE.
- Government hospitals with family planning facilities.
- Private birthing homes or lying-in clinics.
- Private doctors and clinics.
Click HERE to search for Providers of “Injectables” located near you.
No. Most researches find no major change in bleeding patterns after tubal ligation or BTL.
Ligation does not cause hormonal imbalances that result to post sterilization syndrome (manifested by irregular bleeding, heavy bleeding, even amenorrhea.) Some incorrectly believe there is a causal relationship between irregularities and sterilization.
No. After ligation, a woman will look and feel the same as before. She may find sex more enjoyable because the fear of getting pregnant is no longer there.
No. There is no correlation between ligation and weight gain. Women may believe that sterilization causes weight gain because most women who avail of ligation are in their 30s or later, a time when the metabolism rate slows down and weight gain is common. The weight gain tends to be associated with aging rather than the procedure.
No. On the contrary, ligation greatly reduces the risk of ectopic pregnancy. The rate of Ectopic Pregnancy after ligation is extremely rare at 6/10,000 women per year compared to the rate of Ectopic Pregnancy among women using no contraceptive method at 65/10,000 women per year. However, when a woman gets pregnant after ligation, ectopic pregnancy should be ruled out because 33 of every 100 pregnancies after a failed ligation are ectopic that could be life-threatening.
Either. Each couple must decide for themselves which method is best for them. Ligation and vasectomy procedures are very effective, safe, permanent methods, and ideally, a couple should consider both. If both methods are acceptable to the couple, vasectomy procedures for a man would be preferable because it is simpler, safer, easier and less expensive.
Most often, it is because the woman was already pregnant at the time of the ligation. Pregnancy may also occur if ligaments of the womb rather than the tubes are ligated.
Yes. The two surgical approaches most often used are:
- Minilaparotomy involves making a small incision in the abdomen. The fallopian tubes are brought to the incision to be cut or blocked.
- Laparoscopy involves inserting a long thin tube with a lens in it into the abdomen through a small incision. This laparoscope enables the doctor to see and block or cut the fallopian tubes in the abdomen.
No. Ligation has no such side effects. Pain is usually transient and felt just after surgery. PID is caused by bacteria entering the fallopian tubes. Occluding tubes may help prevent bacteria from reaching the upper reproductive tract.
No. There is no justification for denying ligation to a woman just because of her age, the number of her living children, or her marital status. Health care providers must not impose rigid rules about age, number of children, age of last child, or marital status. Each woman must be allowed to decide for herself whether or not she will want more children and whether or not to have ligation. For married or underage women however, provisions of RA 10354 on marital or parental consent apply. If possible, counsel the couple together to obtain an informed consent prior to the surgery. RA 10354 is the Responsible Parenthood and Reproductive Health Act of 2012.
No. Emerging evidence show that ligation may help protect against ovarian cancer. Women who may have to undergo hysterectomy later in life are for reasons not related to the ligation.
No. Ligation works by blocking or cutting the tubes. Eggs released from the ovaries cannot gain access through the tubes to meet the sperm. Therefore, fertilization does not occur.
No. The decision to undergo ligation is based on informed consent by a patient who desires to undergo ligation. Women who are single but have achieved the desired number of children may have BTL. With regard to informed consent, provisions of RA 10354 or the Responsible Parenthood and Reproductive Health Act of 2012 still apply to cohabitating partners.
No. Women can have ligation without cervical cancer screening. Concern for fertility regulation should not be hampered by lack of capability of the facility to do Pap’s smear or other tests to screen for cervical cancer. This also applies to other contraceptive methods.
No. No woman should be denied ligation because follow up would be difficult or not possible. However, the woman should be fully instructed on postoperative care or how to take care of herself.
The woman can undergo ligation within seven days after vaginal delivery. If this period is missed, she can come back six (6) weeks after for interval ligation if it is reasonably certain that the woman is not pregnant. If the woman is undergoing delivery through Ceasarian section, ligation can be done concurrently with the surgery.
No. Ligation is meant to be a permanent method. Counseling is key before a decision is made because regret is a complication often seen.
A woman can avail of ligation services in the following facilities:
- Government hospitals with family planning facilities.
- Private clinics and hospitals.
Click HERE to search for Providers of “Ligation or BTL” located near you.
Sexually transmitted infections such as gonorrhea and chlamydia are the primary direct causes of PID. By itself, the IUD does not cause PID. Poor infection prevention practices at the time of insertion may lead to PID.
Yes. There is no minimum or maximum age limit for using an IUD. An IUD should be removed after menopause has occurred—within 12 months after the woman’s last monthly menstruation. Most women who are within their reproductive years can use the IUD regardless of whether they have previously given birth. The primary factor in deciding not to use an IUD is current STI or pelvic infection. History of adequately treated STI is not a contraindication for UD use.
It is the woman’s prerogative when she wants the IUD removed. The IUD can be removed immediately anytime during the menstrual cycle. You do not have to wait for the menstrual bleeding to have the IUD removed. When the IUD’s effectivity has passed (12 years for Copper-T IUD), the woman should have it removed.
No. The woman can continue to use the IUD while she is being treated for the STI. Removing the IUD has no benefit and may leave her at risk of unwanted pregnancy. If the infection does not respond to treatment, the IUD should be removed and use another family planning method.
No. There is no delay in the return to fertility. A woman can become pregnant once the IUD is removed just as quickly as a woman who has never used an IUD, although fertility decreases as women get older. However, if she develops a PID and is left untreated, there is some chance that she will develop or be at risk for infertility.
Yes. A woman who has not had children generally can use an IUD, but she should understand there is a small risk of expulsion with smaller uterus.
No. The IUD never travels to the heart, brain, or any other part of the body outside the abdomen. Even during sexual intercourse, the IUD does not move.
If a woman or her partner complains of discomfort during sexual intercourse, the woman needs to be examined. If the cause of discomfort is the long string, the string will be cut to 3 cm. If the cause of discomfort is partial expulsion, tje IUD will be removed and a new one maybe inserted. Within the first year of use, spontaneous IUD expulsion occurs in 2 to 10 percent of women. If a woman suspects that IUD expulsion has occurred, she should see a health care provider immediately.
Rarely, the IUD may come through the wall of the uterus into the abdominal cavity. This is most often due to a mistake during insertion. If this is confirmed within 6 weeks after insertion or causing symptoms at any time, the IUD will need to be removed by laparoscopic or laparotomic surgery. However, an out-of-place IUD usually causes no problems and should be left as it is. She will need another contraceptive in the meantime.
No. IUDs are very effective in preventing pregnancies therefore are likewise effective in reducing the risk of ectopic pregnancy. Ectopic pregnancies are rare among IUD users. The rate of ectopic pregnancy among women with IUDs is 12 per 10,000 women per year. On rare occasions that the IUD fails and pregnancy occurs, 6 to 8 of every 100 of these pregnancies are ectopic.
No. An IUD can be inserted at any time during her menstrual cycle if it is reasonably certain that the woman is not pregnant. Monthly bleeding may be a good time because the woman is not likely to be pregnant but may be difficult to see signs of infection.
No, usually not. Most recent research done where STIs are not common suggests that PID risk is low with or without antibiotics. When appropriate questions to screen for STI risk are used and IUD insertion is done with proper
infection-prevention procedures (including the “no-touch” insertion technique), there is little risk of infection. Antibiotics may be considered, however, in areas where STIs are common and STI screening is limited.
In a woman who made an informed decision to use an IUD, it can be inserted as soon as the placenta comes out within 10 minutes or the first 48 hours after delivery (postpartum). In abdominal deliveries, the IUD can also be manually positioned in the fundus before closing the incision of the uterus.
After a miscarriage, the IUD may be inserted within 12 days after the first- and second-trimester miscarriage, and if no infection is present (WHO FP Guidebook, 2018), and the uterus is clinically empty or right after the evacuation. If more than 12 days after miscarriage/abortion, IUD can be inserted if no infection is present and if it is reasonably certain that the client is not pregnant.
Some women report benefits that include:
- Prevents pregnancy very effectively
- Is long-lasting (12 years)
- One time application
- Can be easily inserted or removed by a trained provider
- Immediate return to fertility upon removal
- Has no further costs after the IUD is inserted
- Does not require the user to do anything once the IUD is inserted
- Prevents cervical cancer as Copper IUD causes inflammation to the cervix that prevents the attachment of the HPV virus to the cervical epithelial cells.
- Substantially reduce the risk of ectopic pregnancy.
A woman can have IUD insertion in the following facilities:
- All city and municipal health centers provide IUD insertion for FREE.
- Government hospitals with family planning facilities.
- Private birthing homes or lying-in clinics.
- Private doctors and clinics.
Click HERE to search for Providers of “IUD Insertion” located near you.
- POPs prevent ovulation in 50% of cycles in lynestrenol preparation and 97% of cycles in desogestrel preparation. Suppression of ovulation is more common in older women and those who are breastfeeding. This process takes effect after at least seven days of regular pill intake.
- POPs mainly thicken the cervical mucus and impair the entry of sperm into the uterus. These changes are effective 48 hours after beginning the pill
- For breastfeeding women, POPs are 99.5% effective with perfect use and 99% effective with typical use. These effectiveness rates are lower for women who are not breastfeeding.
- POPs must be taken at the same time every day. When taken even a few hours late, these pills will be less effective.
Yes. POPs are a good choice for a breastfeeding mothers who want a hormonal method. POPs are safe for both the mother and the baby and can be immediately started after childbirth or before discharge from the facility. They do not affect the quality and amount of milk produced by the mother.
No. The pill works by preventing ovulation or the release of an egg from the ovaries and thickens cervical mucus to make it harder for a sperm to enter the uterus.
Evidence finds that the pill do not disrupt an existing pregnancy or cause a miscarriage. POPs should not be used to try to cause an abortion. They will not do so. In the rare instances when POPs fail to prevent pregnancy, there will be no harmful effects on the pregnancy.
No. Good evidence shows that POP will not cause birth defects and will not otherwise harm the fetus if a woman becomes pregnant while taking them or accidentally starts to take the pill when she is already pregnant.
Yes. There is no minimum or maximum age for pill use. Oral contraceptives can be an appropriate method for most women from onset of monthly bleeding (menarche) to menopause unless there are medical conditions the prevents its use.
Yes. Oral contraceptives are safe for women with varicose veins. Varicose veins are not dangerous. They are not blood clots, nor are these veins the deep veins in the legs where a blood clot can be dangerous (deep vein thrombosis). But a woman who has or has had deep vein thrombosis should not use COCs but can use POPs.
- Ovarian and Uterine Cancers – oral contraceptives has protective effect for 15 or more years after using.
- Breast Cancer – global studies are difficult to interpret. Slight increase of risk after > 10 years of use but breast cancers hit both women who are using and not using. The key prevention is early detection with screening.
Breast cancers in pill users are caught early because pill users are checked on regularly and non-users do not. - Cervical Cancer – usually caused by sexually transmitted infection, the Human Papilloma Virus. Pill use of more than five years indicates a temporary slight increase in risk.
No. Taking a “rest” from oral contraceptive use can lead to unintended pregnancy. The pill can be safely used for many years without having to stop taking them periodically. The fluctuations in hormone from starting and stopping pill use can cause side effects to reappear and increase the risk of an unintended pregnancy, which poses a bigger health risk than using the pill.
A woman’s fertility return as soon as she stops taking oral contraceptives. She can become pregnant as quickly. The menstrual pattern she had prior to using the pill generally returns after she stops taking them. Some women may have to wait a few months before their usual menstrual pattern returns.
No. Most women do not gain or lose weight due to POP use. Weight changes naturally as life circumstances change and as people age. Because these are so common, many women think that the pill cause these weight changes. Studies have shown that, on average, oral contraceptives do not affect weight. A few women experience sudden changes in weight when using the pill. These changes reverse after they stop taking the pill. It is not known why these women respond to the pill in this way. Women experiencing some weight gain might need to review lifestyle changes first (exercise, diet) before advising them to switch to other modern family planning methods.
Generally, no. There is no evidence that POPs affect women’s sexual behavior. The great majority of pill users do not report any such changes, however, and some report that both mood and sex drive improve. It is difficult to tell whether such changes are due to the pill or to other reasons.
- Can be used by breastfeeding mothers six weeks after childbirth without affecting the quality and quantity of breast milk
- No estrogen side effects
- Promotes compliance in pill taking, as women take one pill every day with no break, and instructions are easily understandable
- Can be very effective during breastfeeding
- May help prevent benign breast disease, endometrial and ovarian cancer, and pelvic inflammatory disease
A woman can avail of POPs in the following facilities:
- All city and municipal health centers provide progestin-only pills for FREE.
- Government hospitals with family planning facilities.
- Private birthing homes or lying-in clinics.
- Private doctors and clinics.
Click HERE to search for Providers of “POPs” located near you.
This method is considered effective under the following three conditions:
- the monthly menstruation of the mother has not returned,
- the baby is fully or nearly fully breastfed and often day and night, and
- the baby is less than six months old.
When typically used, about 2 per 100 women in the first six months after childbirth become pregnant. When used correctly, about 1 per 100 women who use the method in the first six months after childbirth become pregnant. The risk of pregnancy is greatest when a woman cannot fully or nearly fully breastfeed her infant.
- The LAM can be started immediately after birth up to six months after childbirth. The client should breastfeed immediately (within one hour) or as soon as possible after the baby is born.
- The method can be used any time if the client has been fully or nearly fully breastfeeding her baby since birth and her monthly bleeding has not returned.
Important:
- Feed on demand (whenever the baby wants to be fed) and at least 10 to 12 times a day in the first few weeks after childbirth and 8 to 10 times a day thereafter, including at least once at night in the first months.
- Daytime feedings should not be more than four hours apart, and nighttime feedings should not be more than six hours apart. Some babies may need gentle encouragement to breastfeed more often even at night.
- Start other foods at six months in addition to breast milk. At this age, breast milk can no longer fully nourish a growing baby.
- The mother should plan for another method while the LAM criteria still apply to continue protection from pregnancy
For determining whether the first LAM criterion is met (i.e., the mother’s menstrual bleeding has not returned), consider any bleeding after two months postpartum to be menses/menstrual bleeding. Bleeding that occurs before two months postpartum may be considered normal postpartum discharge. In other words, bleeding in the first two months postpartum is not considered menstrual bleeding.
If a woman is HIV positive, she can pass HIV to her baby through her breast milk, but receiving HIV treatment significantly reduces these chances. WHO suggests that HIV-positive women use replacement feeding instead of breastfeeding if safe drinking water is consistently available, and if the replacement is:
- Acceptable to the mother and baby.
- Affordable for the mother.
- Feasible to purchase or make.
- Available for the full first six months of the infant’s life.
If all the criteria above cannot be met, WHO recommends exclusive breastfeeding for HIV-positive women rather than mixed feeding (breastfeeding and also providing replacement foods). The benefits of exclusive breastfeeding must be weighed against the danger of passing HIV to the infant. If the conditions above cannot be met for replacement feeding, especially in areas of the world where infectious disease and malnutrition are common causes of infant deaths, breastfeeding may still be the best choice for HIV-positive women and their children. Women who are HIV positive should be counseled about the risks and benefits of breastfeeding and about LAM no longer being effective once the mother begins giving her infant replacement.
The effectiveness of LAM depends on breastfeeding only/exclusively. This means as often as the baby is hungry “on demand,” day and night with no long intervals between feeds. Even if a woman expresses breast milk, if she is separated from her baby by more than a few hours, she cannot expect a high level of contraceptive protection. In one study on LAM for working mothers, the pregnancy rate increased by five percent. Women who are able to keep their baby with them at the worksite or can have their baby brought to them at least once every four hours can rely on LAM.
Advantages of using LAM include the following:
- Prevents pregnancy effectively for the first six months postpartum
- Is provided and controlled by the woman
- Can be used immediately after childbirth
- Is universally available to postpartum women
- Requires no supplies or procedures
- Is economical
- Is often acceptable to women who have never used contraception previously
- Has no hormonal or other major side effects (for mother or infant)
- Raises no religious objections
- Facilitates the reduction of weight gained during pregnancy
- Provides health benefits for mother
- Provides health benefits for baby. Mother’s milk alone can fully nourish a baby for the first six months of her/his life
SDM is a fertility awareness method that can be used by women if their menstrual cycles are 26 to 32 days long. Colored cycle beads are used to mark the fertile and infertile days of the woman’s menstrual cycle and to monitor her cycle length. Couples using SDM should abstain from sexual intercourse on fertile days (days 8 to 19) to avoid pregnancy.
About 5 per 100 women who consistently and correctly use the method and abstain on fertile days become pregnant over the first year of use.
The SDM works well for women who usually have menstrual cycles that are 26 to 32 days long. Women with cycles that are NOT 26 to 32 days long cannot use the method.
There are no side effects in using the SDM.
- The client keeps track of the days of her menstrual cycle and counts the first day of her monthly bleeding as day 1.
- Using the CycleBeads, the client moves the ring to the red bead to begin a new cycle and marks that day on her calendar. She moves the rubber ring one bead every day.
- Days 8 to 19 of every cycle (when the ring is on the white beads) are considered fertile days for all SDM users.
- The couple avoids vaginal sex (or uses condoms, spermicides, or withdrawal) during days 8 to 19.
- The couple can have unprotected sex on all the other days of the cycle (when the ring is on the brown beads) -days 1 to 7 at the beginning of the cycle and from day 20 until her next monthly bleeding begins.
- SDMs are provided for FREE in some City and Municipal Health Centers.
- SDMs are for sale in some private clinics
Click here to search for Providers of “SDMs” located near you.
The combined oral contraceptives (COCs) contain low doses of two hormones, a progestin and an estrogen, which are like the natural hormones progesterone and estrogen found in a woman’s body. COCs prevent pregnancy by stopping ovulation (the release of eggs from the ovaries) or thickening cervical mucus thus blocking sperm from meeting an egg.
No. The pill works by preventing ovulation or the release of an egg from the ovaries and thickens cervical mucus to make it harder for a sperm to enter the uterus.
Evidence finds that the pill do not disrupt an existing pregnancy or cause a miscarriage. COCs should not be used to try to cause an abortion. They will not do so. In the rare instances when COCs fail to prevent pregnancy, there will be no harmful effects on the pregnancy.
No. Good evidence shows that COC will not cause birth defects and will not otherwise harm the fetus if a woman becomes pregnant while taking them or accidentally starts to take the pill when she is already pregnant.
Yes. There is no minimum or maximum age for pill use. Oral contraceptives can be an appropriate method for most women from onset of monthly bleeding (menarche) to menopause unless there are medical conditions the prevents its use.
Yes. Oral contraceptives are safe for women with varicose veins. Varicose veins are not dangerous. They are not blood clots, nor are these veins the deep veins in the legs where a blood clot can be dangerous (deep vein thrombosis). But a woman who has or has had deep vein thrombosis should not use COCs but can use POPs.
- Ovarian and Uterine Cancers – oral contraceptives has protective effect for 15 or more years after using.
- Breast Cancer – global studies are difficult to interpret. Slight increase of risk after > 10 years of use but breast cancers hit both women who are using and not using. The key prevention is early detection with screening.
Breast cancers in pill users are caught early because pill users are checked on regularly and non-users do not. - Cervical Cancer – usually caused by sexually transmitted infection, the Human Papilloma Virus. Pill use of more than five years indicates a temporary slight increase in risk.
No. Taking a “rest” from oral contraceptive use can lead to unintended pregnancy. The pill can be safely used for many years without having to stop taking them periodically. The fluctuations in hormone from starting and stopping pill use can cause side effects to reappear and increase the risk of an unintended pregnancy, which poses a bigger health risk than using the pill.
A woman’s fertility return as soon as she stops taking oral contraceptives. She can become pregnant as quickly. The menstrual pattern she had prior to using the pill generally returns after she stops taking them. Some women may have to wait a few months before their usual menstrual pattern returns.
No. Most women do not gain or lose weight due to COC use. Weight changes naturally as life circumstances change and as people age. Because these are so common, many women think that the pill cause these weight changes. Studies have shown that, on average, oral contraceptives do not affect weight. A few women experience sudden changes in weight when using the pill. These changes reverse after they stop taking the pill. It is not known why these women respond to the pill in this way. Women experiencing some weight gain might need to review lifestyle changes first (exercise, diet) before advising them to switch to other modern family planning methods.
Generally, no. There is no evidence that COCs affect women’s sexual behavior. The great majority of pill users do not report any such changes, however, and some report that both mood and sex drive improve. It is difficult to tell whether such changes are due to the pill or to other reasons.
COCs help protect against risks of pregnancy, cancer of the lining of the uterus (endometrial cancer), cancer of the ovary and symptomatic pelvic inflammatory disease. They may also help protect against ovarian cysts and iron-deficiency anemia; reduce menstrual cramps, menstrual bleeding problems, ovulation pain, excess hair on face or body, symptoms of polycystic ovarian syndrome (irregular bleeding, acne, excess hair on face or body) and symptoms of endometriosis (pelvic pain, irregular bleeding).
A woman can avail of COCs in the following facilities:
- All city and municipal health centers provide combined oral contraceptives for FREE.
- Government hospitals with family planning facilities.
- Private birthing homes or lying-in clinics.
- Private doctors and clinics.
Click HERE to search for Providers of “COCs” located near you.
Effectiveness depends on the user: Risk of pregnancy or sexually transmitted infection (STI) is greatest when condoms are not used with every act of sex.
Very few pregnancies or infections occur due to incorrect use, slips, or breaks. For protection against pregnancy, as commonly used, about 15 pregnancies per 100 women whose partners use male condoms over the first year. This means that 85 of every 100 women whose partners use male condoms will not become pregnant.
When used correctly with every act of sex, about two pregnancies per 100 women whose partners use male condoms over the first year. There is no delay in the return of fertility after use of condoms is stopped.
Male condoms significantly reduce the risk of becoming infected with HIV when used correctly with every act of sex.
When used consistently and correctly, condom use prevents 80 percent to 95 percent of HIV transmission that would have occurred without condoms.
Condoms reduce the risk of becoming infected with many STIs when used consistently and correctly and protect best against STIs spread by discharge, such as HIV, gonorrhea, and chlamydia. Condoms also protect against STI spread by skin-to-skin contact, such as herpes and human papillomavirus.
No. Allergy to latex is not common in the general population and reports of mild to severe allergic reactions are very rare65. But there are non-latex condoms available in the market. Plastic condoms and condoms made out of animal skins have not been studied thoroughly and may not be commercially available.
Yes. For mutual protection against sexually transmitted diseases.
While condom breakage is not very common with high-quality condoms, a male condom can break during intercourse for many reasons, including how it was used, used past its expiration date, damaged when removed from the package, used more than once, or improperly manufactured or stored.
There is a small chance that a condom can become lodged inside a woman’s vagina, for example, if the condom fits too loosely or if a man withdraws his penis without holding the base of the condom. If the condom is lodged in the vagina, it cannot travel to other parts of the body. If the condom cannot be removed manually, the woman should go to her gynecologist or to a hospital’s emergency room for help and to prevent bacteria build-up that can lead to an infection.
To reduce the chances of breaking, the condom should be stored in a cool and dry environment. Users should also avoid tearing or damaging the condom while removing it from the package, squeeze the tip to press air out of the reservoir, unroll the condom over the erect penis, and apply a lubricant or spermicide that is not oil-based as the oil will damage latex condoms.
Similar to male condoms, female condoms cannot permanently lodge inside a women’s body.
Some men may, at times, experience a loss of erection while applying or using condoms. Men may be more likely to experience condom-associated erection loss if they lack confidence to use condoms correctly or experience problems with the way a condom fits or feels.67 If a man finds he is having difficulty keeping an erection while wearing a condom, more lubrication may help increase sensation for the man, or he may wish to try a different brand of condom. Men who suffer from premature ejaculation may find that using condoms helps them with this problem.
Condoms have no known side effects.
Some of the health benefits of condoms are it helps protect against the risks of pregnancy and risks of STs, including HIV.
Condoms may help protect against conditions caused by STIs such as:
- Recurring pelvic inflammatory disease and chronic pelvic pain
- Cervical cancer
- Infertility (male and female)
Source: “Frequently Asked Questions (FAQs) on Modern Family Planning Methods: Stop Rumors, Myths And Misconceptions with Correct Answers to Everyday Questions About Modern FP Method” by the Philippine DOH, USAID and JHPIEGO
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