What you need to know about the contraceptives you are taking

Editors Update: We had some feedback from a reader that she felt this article didn’t do enough to emphasise the importance of access to contraceptives for women to protect themselves and take back control of their own reproductive health. The intention of this article was never to demonise contraceptives but to educate women on their options and the need to make informed decisions when it comes to choosing the right option for you and your body. The article has been amended to further reflect this intention.

I don’t know about you but the number of options when it comes to contraceptives is quite overwhelming. It is wonderful to know that women have options, we all know that access to contraceptives is key to women’s sexual and reproductive health rights and that the role they play in women taking back power and control over their bodies is immeasurable. But to what extent are decisions made based on actual knowledge.

I say this because I went on a contraceptive when I was 19-years-old to help regulate my menstrual cycle and unbearable period pains. I went to my local clinic in Soweto, had a quick introductory chat with the nurse, and she recommended the Depo shot. I consented because, well, she is the nurse. After not experiencing any pain for months after that decision, I stayed on the shot for 4 years. I went with the first, and what seemed to be, the only option I had.

Only when I could start affording private healthcare, did I learn of the vast options I could have chosen from. At this point I was experiencing terrible side effects due to the shot:

-Mood swings
-Abdominal pain
-Migraines
-Nausea

For the sake of knowing these prevention options, and the side effects, I have listed a couple below;

The Patch

Evra Patch

This is a small patch that you apply to your skin and it releases daily hormones through your pores to prevent pregnancy. The patch can be applied on clean, dry and irritation-free skin. The hormones are pumped directly into your bloodstream, and that is how pregnancy is prevented.

How it works:

The end-user would follow a 4-week cycle. The patch would be applied on the first day of their period. They would then apply the 2nd and 3rd patch on the same day every week. On the 4th week, the user would have a patch-free week. This week would probably see them going on a period, but this does not happen all the time. The second packet of patches would be opened and used, following the same process. If the same patch is applied any day other than the first day of the period, you will not be protected against pregnancy, and alternative contraception (condom or abstinence) should be used concurrently.

Possible Side Effects:

Skin irritation at the application site
Nausea
Vomiting
Headache
Bloating
Breast tenderness
Swelling of the ankles/feet
Weight change

Injectables

–   Norethisterone enanthate (NET-EN) and Medroxyprogesterone acetate (DMPA)

The NET-EN is a 2-month injection, whereas the DMPA (depo shot) is a 3-month injection.  This injection is administered into the vein in the buttocks area. It is a progesterone-only birth control method. Due to its lack of estrogen, this is a good option for women who are breastfeeding. The big difference is that it takes a shorter period to start ovulating after you have stopped using the NET-EN. The NET-EN is meant to be a short term alternative for women.

How it works

A medical practitioner would administer the injection to the woman every 8 or 12-weeks. It is injected on the buttocks and moves through the bloodstream to prevent pregnancy.

Possible Side Effects:

Spotting or breakthrough bleeding
Delayed period
Irregular or heavier bleeding
Weight gain
Headaches
Dizziness and/or nausea
Skin reactions (such as pain, rash and/or itching at the injection site

Progesterone only pills

Microval

These are progesterone-only pills that are highly recommended for breastfeeding mothers. The pills are ingested once daily, at the same time. The user needs to ensure that the pill is administered religiously to prevent pregnancy.

Possible Side Effects:

Breast tenderness
Possible mood changes
Headaches
Bloating
Acne
Decreased or increased libido (sex drive)
Nausea

Combined contraceptive pill

These pills have both hormones, and also need to be taken daily at the same time. This contraceptive alone has numerous options. These include Alesse, Apri, Aranelle, Aviane, Enpresse, Estrostep, Lessina, Levlen, Levlite, Levora, Loestrin, Mircette, Natazia, Nordette, Lo/Orval, Ortho-Novum, Ortho Tri-Cyclen, Yasmin and Yaz. Lybrel, Seasonique, and Seasonale.

See my point about an oversaturated birth-control market?

Possible Side Effects:

Intermenstrual spotting
Nausea
Breast tenderness
Headaches and migraine
Weight gain
Mood changes
Missed periods
Decreased libido

Intrauterine devices (IUD)

These devices are long-term but reversible birth control methods. They are devices that are administered once, and one forgets about them. This is because they are meant to last for years.

There are two types of IUDs:

–Hormonal IUD

A hormonal implant is a matchstick-sized tube that goes under the skin of your upper arm. It releases a small amount of progestin to stop your ovaries from releasing eggs (ovulation) and makes the mucus in the cervix too thick. This means that sperm would not be able to pass through. The hormonal IUD lasts for 3-5 years, depending on the brand you purchase and prefer. This IUD starts working immediately if inserted on the first day of the period.

-Mirena loop (up to 5 years)
-Skyla (up to 3 years)
-Kyleena (up to 5 years)
-Lilletta (up to 7 years)

The hormonal IUD is a T-shaped device that is inserted quickly into the uterus by a healthcare professional. The difference to the copper IUD is that this releases progesterone into the uterus to prevent pregnancy. They last for up to 7 years but can be removed sooner and the user ovulates soon after removal. It is not a surgical procedure and takes a few minutes.

Possible Side Effects:

Missed periods (amenorrhea),
Bleeding and spotting between periods,
Heavier bleeding during the first few weeks after device insertion,
Abdominal/pelvic pain,
Ovarian cysts,
Back pain,
Headache/migraine,
Nervousness,

-Copper IUD

This is a non-hormonal IUD that is inserted into the uterus. Its a T-shaped plastic device with copper wire surrounding the device. The copper creates a toxic reaction after insertion that creates an environment where the egg and sperm withers.

Possible Side Effects:

Pain when the IUD is put in
Cramping or backaches for a few days after the IUD is put in
Spotting between periods
Irregular periods
Heavier periods and worse menstrual cramps (Paragard)

This is not to say if you choose any of the above contraceptives you WILL experience and or all of these side effects, you may experience none, some or many. Because women react differently to these options. But if the number of negative side effects you experience outweighs the benefit then maybe you are not on the right type of contraceptive. Therefore, we need to choose an option based on what we are comfortable with, knowing the benefits and the risks.

Karabo Motsiri is a first-time mom, over-sharer, lover of life, chronic napper and married to her best friend. She loves a good party because the dance floor is her happy place. She enjoys good food, good conversations, laughs a little too hard, and cries during every episode of Grey’s Anatomy. She started her blogging journey because she wanted to share all the ups and downs of being a young modern mama in South Africa. Her blog Black Mom Chronicles has been featured on Ayana Magazine & SA Mom Blog. She has enjoyed airtime on Power FM and frequently writes for the parenting section of Saturday Citizen. She also works with MamaMagic on their Product Awards, Milestones Magazine, Heart to Heart blog, and the Baby Expo, which is South Africa’s biggest parenting expo. 

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