What’s the best contraceptive for me?

Dear Dr Murage,

I am 26 years and in need of effective contraception. I have never been pregnant. What are the best contraceptive choices for me?

Flora

Dear Flora,

The market is full of many contraceptive choices, and it can be daunting to select one method over the other especially for first-time users. The availability of multiple options means there is always a contraceptive option suitable for a particular individual. Using effective contraception keeps you away from unwanted pregnancy. Some methods will even prevent sexually transmitted infections.

As you are young, and likely in good health, almost all available contraceptive methods may be suitable for you. A few things to consider though. Are you looking for a long-term contraceptive, or just protection for a short period? Long-term methods will be protective for five to 10 years. Shorter term methods will protect you from cycle to cycle, or for some months at a time. If you are not planning to get pregnant for some years to come, long-term methods may suit you better.

Think about how the contraceptive is delivered to your body, and select what appeals most to you. Orally delivered contraceptives require you take a tablet daily. If you don’t do that, you run the risk of an unwanted pregnancy. Compare this with implants or coils; once fitted, you remain protected without having to remember to swallow anything. Permanent methods are not suitable in your age group, especially when you haven’t had a family and you may be planning this at some point in the future.

Cost comes in as well. Some contraceptives will be more expensive than others. Check if your health insurance policy covers you for your contraceptive needs. But nevertheless, you want to select the most cost-effective method. Also consider potential undesirable side effects of whatever method you choose. Most side effects of common contraceptives are transient. The common misconception that contraceptives will interfere with future fertility is erroneous.

Make your way to the nearest family planning centre, or arrange to see your gynecologist for a discussion. Your prevailing health status will be reviewed and weighed against your contraceptive choices. Some concurrent medical conditions would usually warrant some precautions with certain contraceptives. But it is rare for the young and healthy to be excluded from their contraceptives of choice.

Once you select a suitable contraceptive, commence it as soon as advised. Any delays will just raise your risks of unwanted pregnancy. And remember to adhere to the recommendations given by your healthcare provider. Beware that every contraceptive has a small failure rate. Some contraceptives may, however, interfere with the regularity of your periods. But an unexpectedly missed period should prompt you to do a pregnancy test. If a pregnancy test ever turned positive whilst on contraception, immediate consultation with your gynecologist is warranted.

— Dr Alfred Murage is a consultant obstetrician and gynaecologist