Choose the best birth control method for your body

Take a minute to imagine what a world without birth control would be like. An estimated 308 million more unintended pregnancies annually in developing regions alone, according to figures released by the World Health Organisation in 2017. Even if math gave you indigestion in school, those numbers speak for themselves.

The invention of birth control methods has given women the ability to chart out their own futures, not to mention offer relief to an already overpopulated planet.

The decision on what kind of birth control to use is a personal one. Your body, your rules.

“Keep in mind the frequency of intercourse, age, comorbidities (such as migraine, diabetes, obesity), menstrual pattern, and side effects of each birth control option,” says gynaecologist Veena Aurangabadwalla of Zen Multispeciality Hospital.

There is no single option that is safest or suits all. Mumbai-based marketing executive Priyanka Shah went on the pill in college to regulate her period and stayed on it till the age of 28.

“I suffered intense headaches, spotting and terrible PMS. Not once did I think it was because of the pill. My gynaecologist suggested getting an IUD and I feel better now. I wish there were more resources and education available regarding birth control,” she says.

“Ask your doctor about efficacy (based on compliance) as well as when and how frequently birth control should be taken,” says Dr Anu Vinod Vij, Motherhood Hospital.

Age is a factor too. “Women older than 35 may experience perimenopausal signs that could be managed with certain contraceptives,” says Dr Rajalaxmi Walavalkar, Medical Director at Cocoon Fertility.

“Others could have medical conditions that make some contraceptive approaches unsuitable for them. Women over 40 prefer an enduring form of contraception.” Access to safe birth control is every woman’s right, so our health experts break down the options available in India.

Best birth control methods in India

1. Hormonal birth control methods
“It’s amazing how much a little pill can impact your life. I tried four before finding one that worked for me. My period is lighter and my mood changes, headaches and irritability are a thing of the past,” says Vidya Sharma, a Mumbai-based advertising professional.

Hormonal birth control methods stop ovulation by making the user temporarily infertile.

Birth control pills: These doctor- prescribed pills contain progestin and estrogen and are about 91% – 95% effective. One strip costs approximately Rs 100 and lasts for a month.
Pros: Periods are lighter and regular. PMS symptoms reduce.
Cons: Must take the pill daily at the same time. Side effects could range from headache and breast tenderness to nausea and high blood pressure.

Hormonal patches: You put patch on your stomach, butt, arm or back to absorb estrogen and progestin. Prescribed by a doctor, the effect lasts about a week with costs starting at Rs 300.
Pros: Easy to use. 91% effective.
Cons: Must be changed on time. May cause tender breasts and mood swings.

Birth control implants: A doctor sticks a small rod with progestin under the skin of your arm using a needle. Though costs start at Rs 15,000, this lasts up to 3 years and is about 99% fool-proof.
Pros: Longer acting. No need to worry about daily dosage.
Cons: Could cause dermatitis and scanty periods.

Vaginal ring: A flexible plastic ring that releases progestin and estrogen is placed in your vagina. The ring needs to be replaced every month and prices start at Rs 790.
Pros: 99% effective, rapid recovery once the ring is removed. Reduces risk of ovarian cancer.
Cons: Has a high failure rate if not placed correctly. Spotting between periods, nausea and headache are known to happen.

Depot-Provera injection: The doctor will give you a shot of progestin, which lasts about three months and is 94% effective. Costs start at Rs 1,400.
Pros: Protection starts immediately after the first shot. It’s longer acting and relatively inexpensive.
Cons: Irregular or absent menses.

2. Barrier birth control methods
These methods help prevent the sperm from reaching and fertilising an egg.

Diaphragms: A bendable silicone disk — often containing spermicide — is placed inside your vagina to cover the cervix. About 88% effective, the effectiveness lasts about two hours. Prices start at Rs 1,000 for a pack of 2.
Pros: No hormonal changes. Can be left inside the vagina for up to 24 hours.
Cons: Infections and irritation. Could cause toxic shock syndrome if left inside for more than 24 hours.

Female condom: You have to insert a thin pouch into your vagina before intercourse. This single-use method is about 79% effective and costs start at Rs 100 for a pack.
Pros: Easy to use. Can prevent STDs.
Cons: Fear of breakage. You have to remember to place it just before having sex.

Cervical caps: This soft cap is used to cover the cervix, and can last up to 42 hours. Prescribed by a doctor, it costs about Rs 17,000 and is 88% effective with spermicide.
Pros: Smaller than a diaphragm. Reusable.
Cons: Allergic reactions and irritation. Does not work well with women who’ve given birth.

Spermicide: You put a cream, jelly or film containing chemicals that kill sperms in your vagina. Costs start at Rs 3,000.
Pros: Easy to apply, 80% effective. To be used only prior to intercourse.
Cons: Risk of allergies and developing UTI.

3. Natural methods
“I decided to stop using the cervical cup after suffering an infection. I wanted to be more aware of myself and my body, so I now track my monthly cycle as a form of birth control,” says Anuja Kamath, a Mumbai-based housewife.

Cervical mucus examination: You track your fertility based on the mucus patterns during the course of your menstrual cycle.
Pros: No side effects. No hormonal imbalance.
Cons: No protection against STIs and high failure rate if not done right.

Rhythm method: It is done by tracking the menstrual cycle, monitoring basal body temperature and watching for changes to cervical mucus.
Pros: No side effects. No hormonal imbalance.
Cons: Requires close tracking. Not as effective as other methods.

4. Other medical options

“I got on the IUD after my doctor told me of its high efficacy and how it could prevent pregnancy for up to five years. I’d had a string of forgotten pill days and the thought of an accidental pregnancy forced me to listen,” says Varuni Kamdar, a Mumbai-based lawyer.

Intrauterine devices: Your doctor places a small T-shaped device in the uterus that lasts up to 5 years. It’s about 99% effective and costs Rs 300 onwards.
Pros: Long-acting reversible contraceptive, efficient and has low failure rate.
Cons: Risk of pelvic infections. Could cause heavy bleeding and menstrual cramps.

Tubal ligation: The fallopian tubes connecting the ovaries and uterus are blocked, sealed, cut or tied. Costing about Rs 15,000, this is commonly referred to as “getting your tubes tied”.
Pros: Permanent and has low failure rate.
Cons: Difficult to reverse. Requires a surgical procedure under anesthesia.

Emergency contraception (morning after pills): Prevents the egg from leaving the ovary or from getting fertilised after one has unprotected sex. Costs Rs 85 onwards.
Pros: 95% effective during the first 24 hours.
Cons: Not a regular birth control option. Could cause nausea, dizziness, headache and vomiting.

A note of caution: The information has been shared in conversation with medical professionals. Please talk to your healthcare provider to find the best and safest option that will work for you.