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Except the natural methods, almost all other contraceptive procedures are unnatural. Therefore, they must have some side effects like nausea, abdominal pain,, breakthrough bleeding, irregular menstrual bleeding etc.

However, the major cause of these discomforts is mental burden about accepting an artificial procedure for preventing unwanted pregnancy.

Therefore, it should be kept in mind that the benefits are several times the side-effects experienced by some persons.

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Tubectomy is also a permanent sterilization process. This surgical procedure is performed on women in whom the fallopian tubes are blocked, preventing the ova or eggs from passing to the uterus. Fertilization, therefore does not take place.

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A surgical operation conducted on males is a vasectomy. It is a type of sterilization or contraception that is permanent.In order to prevent sperm from entering the ejaculate and thus prevent fertilisation, the male vas deferens are severed and then locked or sealed.

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Also known as terminal methods of family planning, these are permanent methods where there is no need of replacement or augmentation but the reversibility is poor.

These are operative procedures which block the passage of semen in males and ova in females. The techniques are also called sterilisation procedures. They are called Vasectomy in males and Tubectomy in females.

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Coming to the rescue of hundreds of thousands of couples, CSIR developed the world’s first non-steroidal once –a-week oral contraceptive drug that gave women the freedom to decide about pregnancy. Rightly named, Saheli, this drug is indeed a true friend as it helps to avoid pregnancy without any side effects.

A product of over two decades of research at the CSIR-Central Drugs Research Institute (CDRI), Lucknow, Saheli comprises a novel non-steroidal, biochemical namely, ‘centrochroman’. This drug is not only unique due to its composition and mode of action but it is also very convenient to take. The recommended dose is taken twice a week for the first three months, followed by once a week schedule. This drug was included in the National Family Welfare Programme in 1995.

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There are few common side-effects of contraceptive pills such as:

- Nausea
- Vomiting
- Upper abdominal pain
- Acidity
- Pain between the shoulders

These side-effects are quite common in women with a thin body-frame. These symptoms usually subside within a week after taking medications such as antacids or anti-nausea medication. If these symptoms persist, then a doctor should be consulted immediately.

Also, if a woman is experiencing severe abdominal pain or spotting between periods, then it is a sign to consult a doctor. Some of the adverse side-effects include a severe headache, swelling and aching of legs, chest pain, high blood pressure and thrombus (clot in the blood vessel).

Hence, it is advised that every woman must consult a gynaecologist before taking these pills.

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The pills are taken orally for 21 days in a menstrual cycle starting preferably within first five days of cycle and ending on 25th day.

However, it is advisable to restart the course after a gap of 7 days, irrespective of the onset or nonset of menstruation during the pill free days. When a pill is missed, it should be taken whenever one remembers, sometimes two at a time. This helps in keeping the hormonal level required for contraception.

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How do oral contraceptive pills work?

A woman gets pregnant when an egg released by the ovaries is fertilized by a sperm. The fertilized egg is then implanted into the uterus, which grows into a fetus and is delivered after nine months.

Oral contraceptive pills contain hormones which create an artificial hormonal environment. This interferes with the process of fertilization and implantation, which prevents conception.

The hormone progesterone prevents ovulation by blocking the release of the egg from the ovaries. It thickens the cervical mucus, which makes it difficult for the sperm to enter the uterus and fertilize the egg. It also inhibits the growth of the endometrial lining, so even if the egg is fertilized, the embryo can’t be implanted in the uterus.

The hormone estrogen suppresses the follicle stimulating hormone (FSH), which plays a key role in the ovulation. Low levels of FSH prevent ovulation which in turn reduces the chances of pregnancy.

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Also known as birth control pills, oral contraceptives are hormonal pills which are available over the counter. These pills are considered to be an effective option to prevent unwanted pregnancy in a sexually active woman.

There are two types of oral contraceptive pills available in the market:

1. Combination pills or combination oral contraceptive (COC) pills which contain the hormone estrogen and progesterone

2. Progesterone-only pills (POP) or mini-pills which contain the hormone progesterone

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Hormone releasing IUDs include progesterone IUD (e.g., progestasert) and levonorgestrel IUD (e.g. LNG-20). These devices release small quantities of hormones which suppress endometrial changes and changes in cervical mucus, cause anovulation and insufficient luteal activity.

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Commonly called Copper Ts have ionised copper which slowly diffuses at the rate of 50 μg/day. It has a local anti-fertility effect by bringing about release of cytokines. They suppress sperm motility and their ability to fertilize the ovum.

The device is to be replaced after 3-5 years when copper release becomes scanty due to calcium deposition.

Copper IUDs are designated by the exposed surface area of copper in sq mm, e.g., Cu T 200, Multiload Cu T 250, Multiload Cu T 375, Cu T 380, Cu 7.

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The inert IUDs are made of polyethylene impregnated with barium sulphate or stainless steel e.g. Lippe's Loop. The exact mechanism of inert IUD contraception is not clear.

There is impairment of sperm ascent

There is quick tubal motility resulting in premature migration of fertilised eggs into uterus before it is ready for receiving it

Histological and biochemical changes in endometrium which have gametotoxic and spermicidal effect.

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The devices are made of plastic, metal or a combination of two and are inserted into the uterus to prevent contraception. IUDs are called loops, spirals, rings, bows, shields or Ts depending upon the shape.

IUDs are of three types -

inert

copper releasing

hormone releasing

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The three methods which shall be discussed elaborately are:

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The three methods which shall be discussed elaborately are:

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The deliberate use of artificial methods or other techniques to prevent pregnancy as a consequence of sexual intercourse, is termed as contraception.

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There exist several methods of contraception -

- Natural or traditional
- Barriers
- IUDs
- Oral contraceptives
- Injectibles
- Implants
- Surgical methods