Misconceptions about long-acting contraception
There was a time, somewhere in my mid-teens, when contraception talk was fairly frequent. Trading stories with friends, blushing through Sex Ed classes at school, assuring my mother that I was being sensible.
Now in my 30s, the topic hardly ever crops up, and it's ages since I've talked about it with my GP. It came as no surprise when a recent survey revealed that 30% of women hadn't had a conversation with their healthcare professional about contraception in the past year.The results also suggest women aren't being fully informed of their options.
More than two-thirds (70%) feel they're not receiving enough information on long-acting reversible contraception (LARC) – in fact, 65% admitted they'd never heard the term before. The survey of 3,000 women was commissioned by Merck Sharp & Dohme Ltd (MSD) which, in partnership with the Family Planning Association (FPA), has launched a campaign called Love, Life & LARCs, aimed at reducing misconceptions and encouraging communication between health professionals and women about contraceptive options.
"The results made disappointing reading," says GP and media medic Dr Dawn Harper. "I think sometimes when a woman asks for 'the pill', she may really mean that she wants a form of contraception other than condoms. That may well be the pill, but it could be that a different form would be more suitable.
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"There are 15 different types of contraception, and it's important healthcare professionals make sure women know their options, and that women feel they can talk openly about the issue."
A quick survey of my friends and colleagues, confirms these conversations haven't been happening.
"My doctor won't give out contraception due to religious reasons – his!" says Beth, 41. "He even looks shocked if it's mentioned. It means people have to go to a separate, overcrowded clinic."
Examples like this may (thankfully) be rare, but cases of people feeling poorly informed are common. Stephanie, 35, suffered severe, heavy bleeding after having the coil fitted. "I bled so heavily I thought I'd pass out," she recalls.
Her doctor told her to give it time to settle. "It didn't, and after a year I had it removed," she says.
For Rebecca, 26, like so many other women, the first pill she was given didn't agree with her – neither did the second or third variety she tried. "From 21 to 25 I tried different variations, but none seemed the right fit," she explains. "They made me too emotional, too angry, too hungry, and I wasn't happy."
Wanting something "hassle and hormone-free", a friend suggested she try an IUD – what the non-hormonal/copper coil is now known as – and found a method that suits her.
"The only downside is I do now get cramps with my periods, whereas I once didn't, but it's a small price to pay to be a more emotionally balanced person," she says.
That two people have had such different experiences comes as no surprise to Dr Harper.
"I think of contraception like the little black dress – what suits one woman just isn't right on another, and what looks a million dollars at 20 isn't necessarily the right choice at 40," she says. "Contraception needs to fit you and your lifestyle."
Sometimes it can mean trying a few different options before finding the right method for you
Preventing unwanted pregnancy may be the key purpose, but it's not a one-size-fits-all issue. Barrier methods, like condoms, also offer protection against many sexually transmitted infections (STIs) which LARCS don't. However, LARCS offer a simple long-lasting solution, and doesn't become less effective if you suffer a bout of sickness.
While most women go to their GP or practice nurse for contraception, you can also visit family planning or sexual health clinics.
For more information, visit www.talkchoice.co.uk
THE 15 OPTIONS
Pills containing oestrogen and progestogen are taken for 21 days followed by a seven-day break. More than 99% effective if used correctly, but certain antibiotics, sickness and diarrhoea can reduce effectiveness. May cause mood swings Not suitable for over-35s who smoke.
This contains no oestrogen and you don't have a seven-day break. Often a better option for women with high blood pressure.
A small 40mm flexible rod inserted under the skin of the upper arm. Steadily releases progestogen to stop eggs being released, thicken cervix mucus and thin womb lining. More than 99% effective, implants last three years.
Works in a similar way to the implant by administering progestogen. Eight or 12 weeks options available. It isn't affected by medication.
IUD (intrauterine device)
The IUD coil is a small plastic and copper device inserted into the womb by a medic. Releases copper, which prevents sperm from surviving in the womb.More than 99% effective and lasts five to 10 years.
IUS (intrauterine system)
Similar to the IUD but contains no copper and instead releases progestogen. Effective for five years.
A sticky 5x5cm patch delivers combined hormones – oestrogen and progestogen – through the skin into your body. Patches last for a week, are waterproof and more than 99% effective, and don't stop working if you experience sickness or diarrhoea.
A small, soft plastic ring which you place into your vagina for 21 days, before having a seven-day break then inserting a new one. It is more than 99% effective.
Traditional condoms are 98% effective if used correctly and they protect against a number of STIs.
Less well known, female condoms are made of thin polyurethane and you insert them yourself inside the vagina. Also protect against some STIs and are 95% effective.
A round silicone cap which is placed into the vagina, covering the cervix to prevent sperm entering, along with spermicide which kills sperm. Has to be kept in for six hours after sex before removing and washing to be reused. Slightly less effective (92-96%).
Natural family planning
Couples can study their cycle and use urine test sticks and other factors, such as body temperature, to monitor fertility levels. Reliable if done correctly but can be limiting.
Surgery to block or seal the fallopian tubes, preventing sperm reaching eggs. It's permanent and around 99% effective.
Male sterilisation (vasectomy)
Involves a minor op to block or seal the tubes that carry sperm from the testicles. More than 99% effective.