Your choice of family planning (4)….. By Dr~Protocol

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Last week, I explained and discussed with you some of the available contraception methods. We stopped at the injectables. This week, I will continue with implant type of family planning. Implant is, as the name implies, implanting a small device that contains hormones into the inner arm of the woman, being made invisible to the outside world. The device is slender, measures about 3cm in length, and slightly bigger than the common needle. It’s slivery in colour. Once implanted at the time of the woman’s menstrual period, it can last up to three years as a standard. The downside though is just like the injectables, small irregular vaginal bleeding may occur. The bleeding is innocent and you may not even bleed at all, depending on how individuals react to these hormones.  Implant type of family planning is gaining strength and acceptance in Nigeria. The effectiveness is about 99 per cent.

Let us now move to talk about intrauterine devices (IUCD). There are two forms of these and there is vaginal ring. Vaginal ring is not a common form of contraception in Nigeria. However, it works in similar manner as the hormones. I will not be discussing it further.  Let us give room to talk about the IUCD. The commonest in use in Nigeria is the copper -T (Cu-T). Once inserted, Cu-T may last up to 10 years.  A very effective method, the downside of Cu-T is that it may go missing by falling out or migrate into the muscle of the womb. In addition, it may cause increase in blood loss during menstrual periods. Therefore, it may not be suitable for a woman with heavy bleeding.

Another similar device is hormone-based IUCD. The presence of hormone on this IUCD makes the difference. This device with hormone, once inserted, lasts up to five years. The beauty of the device is that it may cause complete cessation of the woman’s period without a harm attached. This cessation will appeal to women who finds menstrual period a bit challenging. Further, this device saves the menstruating women some blood loss and prevents iron deficiency. On the downside, just like Cu-T, it may be expelled or lost in the womb. Women with history of cancer should not take this hormone-based IUCD.

There is a plaster-like family planning method. It looks like a small plaster in every way. This device is applied on the skin every seven days. It works like any other hormone family planning. You can swim with it and shower with it too.

There is also a surgical method of family planning for women. Tubal ligation or tubal blockage is a method to prevent the female egg from reaching the sperm. It involves a small surgery, which is done as a day case in hospitals or out -patient. Tubal ligation can also be done by laparoscopy or keyhole camera surgery.

Let us now shift our attention to men. Men too can be involved in family planning. There are few methods available. I have mentioned the popular condom. Surgery is available too and it comes in form of ligation of vas deferens (vasectomy). The operation is simple and is done on a day case. Both the female tubal ligation and male ligation are effective and reversible, though generally it should be permanent. In recent time, equivalent male hormone contraception has been developed. It works like injectable female contraception. The problem is that it is not yet available for use as the developers are undergoing final testing.

For both male and female, an unintended contraception may result from such operation as castration of either male or female for other medical reasons. Hysterectomy in a woman is a sure-bet end to her ability to bear a pregnancy of her own. These radical surgeries should not be considered as a form of routine family planning methods.

There are other forms of contraception, which I have not discussed here. Some are information technology (IT) driven and some are intended to prevent infection such as HIV. In sum, in the last four weeks, we have been discussing family planning. I hope you can now go to your doctor to discuss your choices.


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