The contraceptive pill, or simply 'the pill', is a type of hormonal contraception taken by women to prevent pregnancy. Now, even though the birth control pill is extremely effective in preventing unplanned pregnancy, it is not without some side effects. The common side effects of birth control pill include:

1. Intermenstrual spotting: Some women experience intermenstrual spotting or bleeding in the time between their menstrual cycles. This is very common in the first three months of you taking the pill. Most of the times, intermenstrual bleeding resolves itself.

2. Nausea: Some women might experience mild nausea when they take the pill for the first time. The nausea will resolve on its own after some time, but if it gets critical or persists, seek medical help. Taking your pill at bedtime or with food can aid in countering the nausea.

3. Breast tenderness: Breasts can become tender or enlarge as a result of birth control pills. Reducing salt and caffeine intake, and wearing a support bra can be beneficial.

4. Headaches: The development of migraines and headaches are the effects of the sex hormones. Different pills with varied doses and types of hormones may lead to different symptoms of headaches. Studies suggest that pills with low hormone doses are usually linked with headaches.

5. Weight gain: There is no logical link between weight fluctuations and contraceptive pills, but fluid retention (specifically in the hip and breast areas) and enlarged fat cells are common side-effects.

6. Mood changes: Women who may have suffered from depression should consult their doctors when taking the pill. A study discovered that taking pills usually leads to the thickening of the cortexes (outermost layers of the brain involved with analysing incoming stimuli and reward response). However, there is more research pending on this issue.

7. Missed periods: Skipping or missing a period is very common when you are on the pill. Factors such as stress, travel, illness and thyroid or hormonal abnormalities can influence this.

8. Decreased libido: The pills contain hormones that can lower your sex drive or libido.

9. Vaginal discharge: Some women experience differences in their vaginal discharge when they are on the pill. Vaginal lubrication can dip, which causes discomfort during sex.

10. Visual changes: Fluid retention is a side-effect of the pill, which even ends up affecting the cornea; they change shape or swell up.

Birth Control Pills - 10 Common Side Effects!

Emergency is helpful in preventing pregnancies post unprotected sexual activity. It can be used in case of contraceptive failure, in case of sexual assault, incorrect use of contraceptives and unprotected sex.

Emergency contraception can be done by three methods. These are emergency contraceptive pills, combined oral contraceptive pills and copper intrauterine devices.



The copper IUD is considered to be one of the most effective forms of emergency contraception, when it is inserted within 5 days of unprotected sexual activity.

However, the emergency contraceptive pill regimen as per WHO is:

1 dose of levonorgestrel 1.5 mg, or 1 dose of ulipristal 30 mg, taken within 5 days (120 hours) of unprotected intercourse

The Yuzpe regimen which consists of 2 doses of combined oral contraceptive pills

What is Emergency Contraception?

Emergency contraception is usually referred to as the contraception which is used to prevent a pregnancy within the first 5 days after an unprotected sexual activity. It is used post failures of contraception, coerced unprotected sex, rape or misuse of contraception.

Emergency contraception is only effective in the first few days after an intercourse and before the egg has released from the ovary, and before there is fertilization between the egg and the sperm. The emergency contraception can do no harm to an interrupted pregnancy and a developing embryo.

Who needs emergency contraception?

Any girl or woman who is at her reproductive age might need an emergency contraception in case of an unprotected sexual intercourse.

Uses
1 Breakage , slippage or displacement of barrier methods 
2. Three or more missed OCPills for more than 12 hours 
3. Missed Mini pill for more than 3 hours 
4. Missed Desoestrel pills for more than 12 hours 
5. DMPA injections taken more than 2 weeks late 
6. Miscalculated dates of last period and present ovulation side effects 
These are meant only for emergency contraception and NOT AS A REGULAR CONTRACEPTIVE. It involves pumping of a hormone inside your body at levels which are 5 times higher than normal. hence excessive and unnecessary use may cause irregularity in the period cycles and an adverse effect on the menstrual health over a period of time. Ideally it should be taken under guided medical supervision.


In what situations should emergency contraception be used?

Emergency contraception can be used after a sexual intercourse. These include:

In case of no use of contraceptives

If it is a case of rape or coerced sex, where the woman was not protected

When there is a contraceptive failure, like

breakage

incorrect use or slippage

OCPILLS,

mini pills

DMPA

3 or more missed combined oral contraceptives, progestogen-only pill (minipill) taken more than 3 hours late, desogestrel-containing pill 12 hours or more, norethisterone enanthate (NET-EN) progestogen-only injection taken more than 2 weeks late

Delay in placing or dislodgement or early removal of the skin patch or the hormonal ring

Breaking, dislodgement, tearing or early removal of cervical cap or diaphragm

Failure of withdrawal that is ejaculation the external genitalia or vagina

The spermicide tablet failure

Miscalculating the periods, failure from using a barrier on the fertile days

Expulsion of an intrauterine contraceptive device (IUD)

Methods of Emergency Contraception:

There are three emergency contraception methods:

Copper-bearing intrauterine devices (IUDs)

Emergency contraception pills (ECPs)

Combined oral contraceptive pills or the Yuzpe method



Safety of Emergency Contraception

There are two methods by which abortion can be done:

Medical Abortion - Non-surgical abortion in which medicines are used to induce abortion

Surgical Abortion - Use of transcervical procedures for terminating a pregnancy, including vacuum aspiration, and dilatation and evacuation (D and E).

Surgical or Medical Abortion for Unwanted Pregnancy

If pregnancy is lesser than = 7 weeks; medical method with Mifepristone with Misoprostol is favorable as the success rate is as high as 97%.

If pregnancy is between 7-12 weeks; surgical abortion is the only option.

If pregnancy is beyond 12 weeks - 20 weeks, then the woman needs to be hospitalized and will be given either Mifepristone followed by Misoprostol tablet or only Misoprostol tablets and woman will then abort like a miscarriage in the hospital. If any products are remaining, then it will be evacuated surgically.

Surgical abortion is preferred if patient desires concurrent tubal ligation or IUCD (CuT) insertion.

If a woman fulfills the criteria for selecting either method i.e. before 7 weeks, final choice has to be given to the woman.

Summary of choice between Surgical or Medical abortion in India

lesser than = 7 weeks - Medical method or surgical method

7-12 weeks - Surgical abortion

12 - 20 weeks - Medicines with or without surgical procedure in hospital

Advantages of Medical Abortion

Avoid surgery

Controlled by the woman and may take place at home

No need for admission to the hospital

Usually, well tolerated by women, if properly counselled and motivated

No need to take leave from work, as bleeding can be managed with menstrual pads even while in the office or at work.

Disadvantages of medical abortion

Takes time (hours to days) to complete abortion, and the timing may not be predictable. Women experience bleeding and cramping, and potentially some other side-effects (nausea, vomiting, fever, and shivering). May require more clinic visits than surgical abortion.

Advantages of Surgical Abortion

Quick procedure

Complete abortion easily verified by evaluation of aspirated products of conception

Takes place in a hospital so Sterilization or placement of an intrauterine device (IUD) may be performed at the same time as the procedure. It can be performed under local anaesthesia if woman is properly motivated and counselled

Disadvantages of surgical abortion

Requires instrumentation of the uterus

Small risk of uterine or cervical injury

Timing of abortion controlled by the doctor and hospital

Anaesthesia needs to be administered. Most doctors perform this procedure under short general anaesthesia. A woman needs to be in the hospital for at least 6 hours. Effect of sedation will be there throughout the day.

Methods of Abortion for Unwanted Pregnancy

4 Types of Contraception for Birth Control

There are a number of contraceptives available but which method of birth control suits you depends on your sexual life, preferences and your lifestyle as a whole. Professional medical help should be sought in order to understand what method of contraception sis ideal for you.

Here is a list of 4 types of contraceptives for birth control.

1. Barrier methods

Barrier methods are designed to prevent the sperm from entering the uterus. They constitute-

- Diaphragms: It is a shallow and flexible cup that is made of either latex or soft rubber. It is inserted into the vagina before the sexual intercourse where it prevents the sperm from entering the uterus.
- Cervical caps: It is a thin cup of silicone whose function is same as the diaphragm, only it is smaller in size, so less noticeable and more rigid as well.
- Contraceptive sponges: These are soft foam sponges that are filled with spermicide and are disposable. They are also inserted into the vagina before sexual intercourse in order to prevent pregnancy by killing the sperm cells or preventing them from entering the vagina.
- Spermicides: These are chemicals that can kill the sperm and hence assist in birth control.

Other methods include male condoms and female condoms.

2. Hormonal methods

Hormonal methods use hormones in order to either stop or regulate ovulation so as to prevent pregnancy. There are various methods through which hormones can be injected into the body. Some of them are-

- Contraceptive patch: It is a thin patch made of plastic that sticks to the skin and is responsible for releasing hormones into the bloodstream through the skin.
- Vaginal rings: A thin, flexible ring that is inserted into the vagina where it stays for 3 weeks and is removed after that, only to be re-inserted in the 5th week.
- Implantable rods: They are inserted under the skin of the upper arm of women where they release progestin.

Other methods include contraceptive pills and progestin-only pills.

3. Intrauterine methods of contraception

The intrauterine device is a small device, T-shaped that is inserted into the uterus in order to prevent pregnancy. The good thing about intrauterine devices is that they can remain functioning for many years at a stretch. IUDs are two types-

- Hormonal IUD(Intrauterine Device)
- Copper IUD

4. Sterilization

Sterilization is the most reliable contraceptive for birth control as it is permanent. It either prevents the release of sperm or the fertilization of the egg. Sterilization methods can either be surgical or non-surgical. Some of the sterilization techniques are-

- Tubal ligation: It is the surgical technique used in females.
- Vasectomy: It is the surgical technique of male contraception.

Other methods include sterilization implants.



4 Types of Contraception for Birth Control

Female condoms are generally pouches made of latex and polyurethane, which are used by women during sex in order to prevent pregnancy and thereby reduce the chances of infection by sexually transmitted diseases. Each end of these pouches are made of rings that are flexible. They should be inserted deep inside the vagina before sex is initiated and held in the position by utilizing the rings available at the closed end while the rings which are at the open end remain outside the vagina during sex.

Even though it can be safely used by most people, some women would find female condoms to be an inappropriate form of contraception and would not feel comfortable with their genital areas being touched. Thus, it is very important that the appropriate form of contraception be considered for you and your partner. Condoms should be used correctly. In case of need for extra protection, other options of contraception should be considered.

Pros of female condoms
1. Since the exchange of bodily fluids, such as semen and vaginal fluid is prevented, female condoms aid in offering protection against many sexually transmitted diseases such as HIV.

2. Condoms can prove to be reliable pregnancy averting methods if they are properly and consistently used.

3. Female condoms are only needed during the time of sex. Any form of advance preparation is not required, hence making them suitable for unplanned sex.

4. Prescriptions are not needed

5. The condoms are usually small in size, disposable as well as easy to carry

6. Usually, using condoms does not show any medical side effects.

7. Insertion of female condoms can be done up to a duration of eight hours before sex. The responsibility for utilizing condoms properly should be shared by the woman as well as the partner.

Cons of female condoms
1. Even though condoms are generally very strong, they are prone to splitting or tearing in case of improper use.

2. Availability of female condoms pales in comparison to the male counterparts and they are usually more expensive.

3. The outer ring might produce a cumbersome feeling.

Pros and Cons of Female Condoms

It is important that you protect yourself from various types of diseases and infections as much as possible. Female condoms are used to have protected intercourse so as to avoid contact with ejaculatory fluids. These condoms help a person to steer clear of blood, semen and vaginal fluids as well. Female condoms fall under the category of barrier contraceptives. They are considered to be less effective in comparison to male condoms, but are nonetheless good for preventing any kind of infection. Ensuring fine health through safe sex is your due responsibility. Hence, a little knowledge about these contraceptives is helpful if you wish to shun chances of unwanted pregnancy or Sexually Transmitted Diseases. 

What is it like?
A female condom looks like an ill  fitting hollow cylinder. It is a thin sheath with a closed end, that goes inside the vagina and an open end that remains outside the vagina covering other external, genital parts. The covered end has to be inserted into the vagina or into the anus. It is a misconception, that female condoms can only be used by females. It is predominantly used by females, but can also be used by any receptive partner during sexual intercourse. The ends have circular rings to keep the condom in place. 

What are they made of? 
Femidoms are usually made up of polyurethane. This material is expensive, making the product costly. The need for a cost effective product was immediately felt to encourage the use of condoms among females. Thus, the next generation of female condoms were made with synthetic Nitrile. Nitrile proved to be a competent substitute as it did away with the annoying noises polyurethane made during sex. It also reduced condom pricing considerably. Researchers have also come up with natural latex female condoms that retain the feel of a male condom. 

Benefits of using a female condom
It is a great barrier in thwarting the flow of semen into the womb. Thus, they reduce the risk of accidental pregnancy. It also protects you against sexually transmitted infections like gonorrhoea, Syphilis, and HIV. Sex partners should be careful to refrain from any sexual contact before the insertion of a female condom. Only after the condom has been placed properly, the penis should enter the vagina or the anus. Femidoms are available in varied sizes, but the average sized condom fits most females. Large sized condoms can be used by new mothers. It is advised to buy condoms that bear the CE mark on them. The CE mark represents European Safety Standards and thus, leaves you least vulnerable to accidents or diseases.

All About Female Condoms

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