Available Birth Control Methods & How To Choose The Right One

All women who are sexually active may become pregnant. Statistics have shown that for couples who have regular sex without contraception (birth control), 84% will get pregnant within a year and 92% within two years. We spoke to Dr Genevieve Quek, General Practitioner, to find out more about what birth control methods are available and which is the most suitable for you.

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Birth Control Pills

What are birth control pills?

Birth control pills are available in Singapore as combination pills. These combination pills contain one oestrogen component and one progesterone component. However, they are all different in terms of the strength or micrograms of hormones. Birth control pills, regardless of brand, are 99% effective at preventing a pregnancy. Although all birth control pills work, different pills might work for different women. 

How often do you have to take it?

You have to take it daily. Fortunately, you do not have to take the pill at the same time every day. You are recommended to take it at roughly the same time everyday. If you prefer to take the pill in the morning, stick to it. If you take the pill at night, continue to take it at night. There is a window of 12 hours for you to take the pill. Some pill packs contain 3 weeks of pills with 1 week of pill-free period while some pill packs contain 3 weeks of active pills and 1 week of inactive pills.  

Does the pill make it harder for you to get pregnant later in life?

Not at all. It is a myth that birth control pills affect fertility. In fact, pills do not affect fertility. The moment you stop the pills, the hormones get flushed out of your body. This explains why if you miss a pill, there is a risk that you will get pregnant. 

Other Methods Of Contraception 

• The most popular and known method would be the barrier method. This includes using condoms (for males) or diaphragms (for females). 
• Contraceptive patches can also be used. You have to leave the patch on for the entire week, and change the patch every week for 3 weeks. After which, you can have a week off without a patch.
• Injections, Implants or Intra-uterine contraceptive devices (IUCD) would be alternatives. However, these are invasive and require a gynaecologist to administer or insert. 

Which birth control method is right for you?

People who have already completed families usually prefer a more long-lasting option, so the IUCD and implants would be more suitable.  

For younger patients, the first choice would generally be the pill or patch. Your doctor may start you on the lowest dose and based on your symptoms, titrate the dose up accordingly.

Side Effects Of Hormonal Birth Control

Common side effects when you first start hormonal birth control include nausea, breast tenderness, spotting and headaches. In general, the side effects take time to go away and would usually stabilise within 3 months. It is therefore preferable to start at the lowest dose, as a lower dose usually translates to fewer side effects. Some people may experience acne flare-ups, but there are brands that have anti-androgenic hormones that help with acne rather than worsen it. Discuss your options with your doctor to find the best birth control method for you.

Emergency Contraceptive Pills

Emergency contraceptive pills, also known as Plan B or morning-after pills, are not ideal as they are less effective than the daily birth control pills. The efficacy is roughly only 85% compared to 99% for the daily pills.

What are the different types of emergency contraceptive pills?

There are 2 types of emergency contraceptive pills: Postinor-2 and Ella. Postinor-2 comes as two tablets while Ella is a single tablet. 

How do you choose between the two types of emergency contraceptive pills?

Nowadays, Ella is generally preferred as the effectiveness does not drop, as long as you take it within 120 hours (5 days) from your last unprotected sexual intercourse. It gives you a wider window to take the pill. For Postinor-2, you need to take the first tablet within 24 hours and the next pill 12 hours later. Assuming you take the first pill at 5pm, you need to wake up at 5am to take the next pill. There is a shorter timeframe for you to take Postinor-2.

Where can you buy emergency contraceptive pills?

In Singapore, both daily birth control pills and emergency contraceptive pills require a prescription from your doctor. You are unable to get it directly from a pharmacy without seeing a doctor. 

Do you need parental permission to buy emergency contraceptive pills?

In Singapore, as long as you are 16 years old and above, you can get emergency contraceptive pills without a guardian, just like any other medication. In the case that you are under 16 years old, you will require a guardian to bring you to the doctor.  

Conclusion

If you are sexually active, you should definitely set some goals about having or not having children, based on your personal values and beliefs. If you are sexually active and do not have plans for a child now, we hope this article has been useful for you!

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Check out more from Dr Genevieve’s Women’s Health Chats, on vaginal health and menstruation!