Family Planning

Copyright 2011 Sarawak General Hospital O&G Department. All rights served

Sarawak General Hospital O&G Department

Foreword
his contraception information booklet is printed for women who wants easy to comprehend information with regards to the various family planning methods that is currently available. It illustrates the common types of contraceptive methods along with relevant basic information such as effectiveness, possible side effects and suitability of each method. The aim of this booklet is provide adequate information so as to empower women to make the right choices for their family planning needs. The most suitable type of contraception may differ from one woman to the next and to some extent is individualized based on both clinical factors as well as personal preference. I would like to thank Dr. Sukanda and his team for their effort in preparing and publishing this booklet.
Dr. HARIS NJOO SUHARJONO HEAD OF DEPARTMENT, O&G SARAWAK GENERAL HOSPITAL

What is family planning?

amily planning or contraception helps you to plan your pregnancy as well as the size of your family. It prevents unwanted pregnancies and gives you a worry free sexual life. There are various types of contraceptive methods available in our country. There is the popular oral contraceptive pills, injectables, and implants. The intrauterine device (IUCD). The barrier method i.e the male and female condoms and also the permanent methods such as the bilateral tubal ligation (BTL) and vasectomy.

Before choosing a method which is suitable for you, take into account a few factors such as your age, health status, the contraceptive effectiveness, costs as well as your personal preference. Naturally, you should also ensure that you are not pregnant before starting on contraception. Starting the contraception correctly and following the instructions given in the information leaet as well as your nurse or doctor would ensure that the method that you choose would be effective.

Contents
4. What is family planning? 5. Oral contraceptive pills 8. Contraceptive injectables 9. Subdermal implants 10. Hormonal patch / rings 11. Intrauterine contraceptive device 13. Permanent sterilization 15. Barrier method 19. Other Methods 20. More information

Oral contraceptive pills

Can help regulate your menstrual cycle as well as reducing your menstrual blood loss Spotting can occur during the rst few months on the pill. The rst pack should be taken on the rst day of your period

#2 Progesterone only pill (mini pill)

Only contains one type of hormone which is progesterone

#1 Combined oral contraceptive pill

Probably the commonest method being used currently Contains two types of hormone: estrogen and progesterone. It works by preventing ovulation or the release of your eggs from the Ovary 99.9% effective in preventing pregnancy if taken correctly Must be taken daily at the same time each day. Might not be suitable for some who are forgetful
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Slightly less effective (98%) in preventing pregnancy compared to the combined pill Must be taken daily at the same time each day, any delay longer than 6 hours may reduce effectiveness Mild spotting can occur during the rst few months on the pill Suitable for woman who are breast feeding as it does not reduce breast milk production You can change to the combined oral contraceptive pill once you have stopped breast feeding
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#3 Emergency contraceptive pill

It contains a hormone called levonorgestrel Can be taken up to 72 hours after unprotected sex during a fertile period Not advisable to be taken repeatedly as the dose of the hormone is high Only 90% effective in preventing pregnancy Side effects includes nausea (25%) , dizziness, headaches and breast tenderness but generally resolves in 24 hours.

Contraceptive Injectables

Contraceptive injectables such as Depo-Provera contain hormones which prevents ovulation. It is given as a 3 monthly injection given at the shoulder or buttock It is 99% effective in preventing pregnancy Fertility usually returns about 4months after the last injection. Side effects include irregular spotting during the rst few months. The majority of women on injectables may stop having periods, however it should return 3 to 4 months after the last injection

Subdermal Implant (Implanon)

The Implanon is a 4cm by 2mm rod that is inserted underneath the skin of the arm and it contain the etonogestrel hormone which prevents ovulation Insertion and removal of the implanon requires a small incision on the skin It can be used up to 3 years after insertion and It is 99% effective in preventing pregnancy Fertility may return soon after the implant is removed This method is currently not available in government family planning clinics

Hormonal Patch (Ortho Evra)

Is a plastic transdermal patch containing norelgestromin & ethinyl estradiol It is a weekly application for 3 weeks Type to enter text then 1 week break for withdrawal bleed It is 99% effective in preventing pregnancy

Hormonal Rings (NuvaRing)

A flexible ring that releases a low dose of a progestin (etonogestrel) and estrogen over 3 weeks The ring is inserted into the vagina for 3 weeks followed by 1 week without the ring for withdrawal bleed 99% effective in preventing pregnancy

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Intrauterine Contraceptive Device (IUCD)

Fertility may return when the IUCD is removed from the uterus It is an excellent method of contraception for those who do not plan to get pregnant for a long duration (99% effective) Side effects include : irregular menses or prolonged menses (less than 5%) however it is usually temporary It can be inserted during your period, or anytime during the cycle providing youre on another contraceptive method Post delivery insertion is usually done 4-6weeks later

The IUCD is a small device about 3cm long that is placed inside the uterus to prevent pregnancy The IUCD works by affecting mobility of sperm and preventing them from fertilizing the egg, the device also prevents implantation of the embryo There are two types of IUCDs available : a) Copper IUCD b) Hormonal IUCD - Mirena The Copper IUCD can last either 3 or 5 years and it is available at most family planning clinics While the Hormonal IUCD (Mirena) can last up to 5 years and it is more costly and may not be easily available Fertility may return when the IUCD is removed from the uterus

Insertion of the Mirena IUCD

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Permanent Sterilization
#1 Bilateral Tubal Ligation
Bilateral tubal ligation is a small surgical procedure where the fallopian tubes are cut and tied. The procedure usually takes only 10-15 minutes It is 99% effective in preventing pregnancy It is a permanent method of contraception and is suitable for women who have completed their families It is an irreversible method of contraception The surgery will not effect with your sexual drive or physical activities

#2 Vasectomy
Vasectomy is a surgical procedure performed in men where the spermatic cord are cut and tied. It can be performed as a day procedure It is 99% effective in preventing pregnancy It is an irreversible method of contraception The surgery will not hinder with your sexual drive.

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Barrier Method
#1 Male Condom
The male condom is a barrier device made of latex that is worn by men during sexual intercourse to reduce the probability of pregnancy It has to be correctly applied in order for the condom to function However it is not recommended to be used alone for family planning as it has a relative high failure rate. The condom offers protection against sexually transmitted diseases.

#2 Female Condom
The female condom is a barrier device that is made of latex and is worn my women during sexual intercourse to reduce the probability of pregnancy It has to be correctly applied in order for the condom to function The female condom also offers protection against sexually transmitted diseases.

#3 Spermicides
Spermicide is a contraceptive substance that eradicates sperm usually, spermicides are combined with contraceptive barrier methods such as diaphragms, condoms or cervical caps The spermicides is not recommended due to higher failure rate

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#4 Cervical cap
The cervical cap ts over the cervix and blocks sperm from entering the uterus It has relatively a higher failure rate compare to other methods Usually it is used together with a spermicide It has to be properly inserted by the women herself and it is for single use only It is not popular in Malaysia

Other Methods
#1 Coitus Interruptus
Basically is means ejaculating outside the vagina It is highly ineffective and not recommended

#2 Calendar method
Its based on avoiding sexual intercourse during the fertile period The women must have very regular periods in order to use this method However, there is a higher failure rate with this method

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Practice family planning for a better & brighter future

For more information

Contact your family planning nurse or doctor in any family planning clinic in Sarawak

Editorial team
Advisor Dr. Harris Suharjono Production Manager Dr. Sukanda Jaili Editor / Graphic Designer Dr. Dalvinder Singh Contributors Dr. Nurulhuda Samsudin Dr. Yew Chung Khian Dr. Esther Sumi Dr. Jenny Kiu

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