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contraceptives

CONTRACEPTION

Know your options

contraceptives

CONTRACEPTION

Know your options

The following information is to be used as a guide to and at the discretion of the end-user and should not replace a doctor’s opinion.

OVERVIEW

Contraception is vital for the health, wellbeing, and empowerment of women globally. By allowing women to plan and space their pregnancies, they can manage the impact pregnancy has on their education and income. Planned pregnancies also prevent maternal deaths and improve maternal and child health.

Certain contraceptive methods also provide essential protection against some Sexually Transmitted Infections (STIs).

Since 2007, World Contraception Day is celebrated on 26 September every year. The aim is to raise awareness about the importance of effective contraception in preventing unplanned pregnancies, reducing the risk of unsafe abortions and promoting overall sexual and reproductive rights for women.

THE DIFFERENT TYPES OF CONTRACEPTION

The most appropriate contraception method for you depends on your overall health, age, the frequency of sexual activity, number of sexual partners, and your family history of certain diseases like breast cancer. Health conditions that may prevent you from using certain hormones or methods include obesity, smoking, or a history of deep vein thrombosis (blood clots in the legs). You also need to consider your lifestyle; e.g. do you have a schedule that allows you to take a pill every day at the same time? Will you remember to take that pill? ‍It is best to choose contraception in consultation with a trained healthcare professional.

There are 5 categories to choose from:

  1. Short-acting contraception: oral (the pill), the patch, the vaginal ring
  2. Medium-acting contraception: the injection
  3. Long-acting, reversible contraception: IUD, subdermal implant
  4. Barrier contraception: condoms
  5. Permanent/irreversible: sterilisation

SHORT-ACTING CONTRACEPTION

Oral contraceptives

How do they work?

  • Contraceptive pills (often simply called “the pill”) thicken the fluid around the cervix to block sperm from getting through. Most contraceptive pills stop ovulation by preventing the ovaries from releasing an egg each month.

How effective are they?

  • If used correctly, contraceptive pills are very effective (up to 99%) at preventing pregnancy. If taken incorrectly, for example if you forget to take a dose, their effectiveness reduces to 93%. Vomiting, severe diarrhoea and some medications can also affect how well these pills work.
  • The pill can offer relief from menstrual cramps and lighten menstrual periods
  • It can reduce acne
  • It can help reduce the risk of ovarian and uterine cancer

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MEDIUM-ACTING CONTRACEPTION

Contraceptive injections

How do they work?

  • These injections work by preventing ovulation and thickening cervical mucus, making it harder for sperm to reach the egg

How effective are they?

  • When given on time, each injection is more than 99% effective at preventing pregnancy
  • Injections tend to make periods less painful. You may find you have no vaginal bleeding or very light bleeding
  • The injection lasts 8 – 12 weeks, depending on the type you choose, which makes it a good option for women who struggle to remember to take a daily pill
  • Contraceptive injections can be used if you are breastfeeding and after a baby’s birth
  • They reduce the risk of ovarian cancer

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LONG-ACTING CONTRACEPTION

Contraceptive implants

How do they work?

  • The implant works by releasing hormones that prevent ovulation and thicken cervical mucus to make it harder for sperm to reach the egg

How effective are they?

  • The implant has been found to be 99% effective at preventing pregnancy
  • It provides 3 years of protection
  • It can easily be removed and won’t stop you from getting pregnant in the future
  • It is safe to use if you are breastfeeding and can be inserted straight after the birth of your baby

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BARRIER CONTRACEPTION

How do they work?

  • Barrier contraception works by physically stopping the sperm from fertilising the egg.
  • Some barrier methods, like condoms, also provide protection against some STIs, including chlamydia and HIV.
  • Barrier contraceptives include:
    • The male condom: a strong latex (rubber) pouch that is put over the erect penis to stop sperm from getting into the vagina. Non-latex ones are available for people who have a latex allergy.
    • The female condom (Femidom): a loose non-latex pouch with a flexible ring at each end that sits in the vagina, to stop sperm from getting into the womb.
    • Diaphragms: basically, a soft, shallow, silicone dome that fits in the vagina and holds spermicidal jelly, gel or cream.

How effective are they?

  • The male condom:
    • If used correctly, male condoms are 98% effective in preventing unintended pregnancies
    • Sometimes split or come off during sex – usually through incorrect use. This brings the effectiveness rate down to 83%.
  • The female condom (Femidom):
    • If used correctly female condoms are 95% effective in preventing unintended pregnancies
    • Sometimes come out during sex – usually through incorrect use – or a man may inadvertently put his penis between the condom and the vaginal wall. This brings the typical effectiveness rate down to 79%.
  •  Diaphragms:
    • They have a higher failure rate than the more effective long-acting methods and are at best only 83% effective in typical use

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PERMANENT CONTRACEPTION (STERILISATION)

How does it work?

  • Sterilisation is a permanent method of contraception that involves having a surgical procedure
  • As with any form of surgery, there is a small risk of injury
  • Female sterilisation is called tubal ligation (known as having your “tubes tied”)
  • Male sterilisation is called a vasectomy (known as “the snip”)

How effective is it?

  • Sterilisation is a very effective (more than 99%) method of contraception

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CONTRACEPTION IN SOUTH AFRICA

According to the South Africa Demographic and Health Survey of 2016, 60% of sexually active women in South Africa use a method of contraception. Nearly all of these (99%) use a modern method, and 80% get their contraceptives from Government clinics, which provide free contraceptives and counselling to all women, men and teenagers in South Africa. The most widely used methods are injections (25%) and male condoms (16%).

South has one of the highest recorded rates of violence against women in the world. Our extremely high levels of gender-based violence, rape and teenage pregnancies continue to increase, putting South African women at high risk for unprotected and/or non-consensual sex. In events like these – as well as instances when the contraceptive method you’re using fails – emergency contraception is available 24/7.

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BONITAS CONTRACEPTIVE BENEFIT

Bonitas offers a comprehensive contraceptive benefit to all our members. Available on all our plans, this benefit ensures that members have the support and resources they need to make informed decisions.