Makindo Medical Notes

Contraceptives - Time Until Effective (if not started on the first day of period)

• Immediate: IUD (Intrauterine Device)
• 2 days: POP (Progestogen-only pill)
• 7 days: COC (Combined Oral Contraceptive), injection, implant, IUS (Intrauterine System)

Intrauterine Device (IUD)

• The IUD is a small T-shaped plastic and copper device placed in the uterus.
• It releases copper and is effective for preventing pregnancy for 5 to 10 years.
• Often referred to as the "coil" or "copper coil", with 99% effectiveness.
• Can be inserted at any time during the menstrual cycle, as long as pregnancy is excluded.
• The IUD can be removed at any time by a healthcare professional.
• Initial side effects may include heavier periods, but this usually settles. Infections are rare but can occur.
• Not recommended for those with a history of pelvic infections.
• It does not interrupt sexual activity and is safe for breastfeeding mothers.

Combined Oral Contraceptive (COC)

• 99% effective when used correctly. Contains oestrogen and progestogen.
• It works by thickening cervical mucus, blocking sperm, and preventing ovulation.
• Typically taken for 21 days followed by a 7-day break, or you can take 7 "placebo" pills during the break.
• While generally safe, there is a small risk of serious side effects, such as blood clots (VTE) and cervical cancer.
• Avoid in women over 35 who smoke or have other risk factors.
• Cautions:
  • History of VTE, stroke, thrombophilia, high blood pressure, or migraine with aura.
  • Personal or family history of breast cancer, gallbladder disease, or liver disease.
  • Diabetes with over 20 years duration or with risk of complications.
• Benefits include more regular, lighter, and less painful periods.
• COC also reduces the risk of ovarian, womb, and colon cancer.
• Can help with PMS symptoms, acne, and may offer protection against pelvic inflammatory disease.
• May reduce the occurrence of fibroids, ovarian cysts, and non-cancerous breast conditions.

Progestogen-Only Pill (POP)

• 99% effective in theory but closer to 91% in typical use.
• Contains progestogen, which thickens cervical mucus to prevent sperm from reaching an egg.
• The desogestrel-based POP can also stop ovulation.
• The progestogen-only pill must be taken every day at the same time to be effective.
• Suitable for women over 35, even if they smoke.
• Side effects:
  • Acne, breast tenderness, and breast enlargement.
  • Changes in sex drive, mood swings, headaches, and migraines.
  • Nausea or vomiting, and temporary ovarian cysts.

Contraceptive Methods - Advantages and Disadvantages