WOMEN'S HEALTH
At Astute, we hold a wide range of services catered to Women’s Health. We offer a sensitive, discreet and comfortable service for all our female patients. We seek not just to treat but also to educate our patients about their own bodies.
CONTRACEPTION
There are many choices of contraception for women in the market these days that it can get confusing for most people. All of them have their pros and cons. Regardless, contraception use is extremely important if you do not have plans to get pregnant.
We will touch briefly on common and reversible methods of contraception.
Condoms
The most common and accessible form of contraception are condoms. They can be bought at most supermarkets and convenience stores. Proper usage is extremely important. When used as instructed, they are very effective at preventing pregnancy. This is also the only form of contraception that also minimise the risk of contracting STDs. If they break or slip off during intercourse, the intercourse is considered to be unsafe and we recommend that you obtain emergency contraception.
Oral Contraceptive Pills
There are many brands of oral contraceptive pills (OCPs) in the market. They contain hormones that prevent ovulation. Most of them contain a pack of 21 or 28 tablets to last a month. Patients are advised to start on the first day of menstruation, and they should ideally be taken at the same time daily to make it easier to remember.
They are a reliable option when used correctly, but if taken erratically, the failure rates can be quite high. They have the added benefit of helping to regulate the menstrual cycle for women with irregular or heavy periods, and even improve acne control. OCP usage has been associated with a decreased risk of endometrial and ovarian cancer.
The most feared side effects of OCPs are blood clots, stroke and heart disease. The risk of blood clots does increase by 3-4 times with OCPs, but because the baseline risk of getting a blood clot is low, the risk of getting a blood clot while taking OCPs is still very low. There is a slightly higher chance of stroke and heart disease, more so in those who smoke and with pre-existing illnesses, hence we discourage this group of women from taking OCPs.
Studies show that there is an increase in the risk of breast and cervical cancer among those who take OCPs.
Other side effects include breast soreness, nausea, headaches and mood swings. These side effects tend to improve after a few months into the treatment.
Hormonal Patch
Aside from pills, the hormones are also available in patch form. They work the same way as OCPs, but with the convenience of not needing to remember to take them daily. The patches are placed either on the shoulder or on the buttock. The patches can occasionally cause skin irritation.
Intrauterine Devices
Intrauterine Devices (IUDs) are a highly effective option (more than 99%). They are usually inserted into the uterus through a minor procedure by a doctor, usually on the second day of menstruation.
While in the uterus, they work by preventing the sperm from reaching the fallopian tubes. IUDs come in the older copper form, and the newer types that contain hormones. The newer variants release the hormone Progestin that has the added advantage of reducing menstrual bleeding, sometimes to the extent of stopping the menstrual cycle. This is an advantage for women who are bothered by heavy bleeding, but less so for those who prefer their regular menstrual rhythm. IUDs are also not suitable for those who might be at a higher risk of obtaining sexually transmitted diseases.
Other Options
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Hormones that help with birth control can also be delivered via a 3-monthly injection. Also known as Depo-Provera, it contains Progestin which prevents ovulation and causes the mucus on the cervix thicken, preventing sperm from getting through. It is convenient as you would only need to get the injections 4 times a year. Some people get irregular bleeding after starting on the injections, especially during the first year. For those who plan to get pregnant, it may take up to 10 months after stopping the injections to be able to conceive.
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There is also the option of an implant that releases Progestin. It come in the form of a very thin plastic stick that can be placed in the inside of the upper arm via a minor surgical procedure. It is convenient as it provides reliable contraception while it remains inside the arm for 3 years. The most common side effect would be irregular bleeding, especially in the first 6 to 12 months.
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The withdrawal method, where the male partner ejaculates outside of the vagina, is extremely unreliable and should not be used alone. However, it is an excellent way to increase effectiveness of preventing pregnancy when used together with other methods.
EMERGENCY CONTRACEPTION
If you have had unprotected sex (including accidents like the condom breaking or slipping off) and wish to minimise your chances of getting pregnant, there is the option of emergency Contraception.
We stock Ella, which is a single dose tablet that is effective for up to 5 days after intercourse. It is safe and side effects are minimal. While effective, it should not be used as first line contraception, but only in emergencies.
Summary of effectiveness of various forms of contraception
It is important to note that apart from condoms, the other forms of contraception do not protect against STDs.
Speak with our doctors to get an opinion of what is most suitable for you.