Female Contraception: Birth Control Methods, Effectiveness & Side Effects

As a sexually active woman, you can run into the risk of unwanted pregnancies if you do not use contraception when engaging in sex with your partner. Statistics have shown that 84% of couples who have regular sex without contraception will get pregnant within a year. Another 92% will get pregnant within two years. 

As a rule of thumb, if you are a woman who wants to have only two children, you may need to prevent pregnancy for 28 years or 236 menstrual cycles. A number of factors, including age and frequency of sex, plays a part in determining how easily you can become pregnant. 

Apart from preventing pregnancy, other women like you may also choose to use contraception because of certain health conditions. For instance, some hormonal birth control methods may help to regulate your period, reduce acne or lower endometriosis-related pain. 

Other Reasons for Using Birth Control Methods

Here are other common reasons for using contraception:

• You love children but you may have decided that you do not want to have children yet or perhaps are still relishing the joys of couplehood with your partner
• You may not have a stable partner to help in parenting a child
• For financial reasons, you may not be able to take on the extra financial responsibilities that comes with having a baby
• You may feel that your family is complete, so you want to make sure that you do not become pregnant again
• You want to focus on caring for the children you already have
• It may not be safe for you to be pregnant for health-related reasons 

Types of Birth Control Methods in Singapore

One of the most common and cost-effective ways of preventing pregnancy is to use a condom, which can be easily purchased at the pharmacy, supermarket or convenience store. Condoms reduce the odds of getting or passing on STDs but are only about 85% effective in preventing pregnancies. 

Other contraceptive options that promise a higher success rate of preventing pregnancies include the following:

1. Birth Control Pills

Also known as contraceptive pills, birth control pills contain hormones (estrogen and progestin) that stop ovulation so there are no eggs for the sperm to fertilise. They also thicken the mucus in the cervix, making it harder for sperm to move. The pills also thin the lining of the uterus, making it difficult to implant a fertilised egg.

Pros & Cons of Birth Control Pills

When used correctly, birth control pills are highly effective – up to 91% in preventing pregnancies. It is also easy for you to reverse your fertility cycle simply by stopping the pill. 

If you have menstrual-related issues, the pill can also help to make your menstrual flow less heavy and more regular. It can also improve premenstrual syndrome (PMS) symptoms. 

The downside is that you have to remember to take the pill every day. It can be easy for things to get messed up if you forget to take your pill on a particular day. Medication or alcohol may also interfere with the pill’s effectiveness. 

The side effects of birth control pills can vary a lot. One of the good side effects is that it may help to control acne. This is one reason why even sexually inactive people sometimes take them. Birth control pills are suitable for you if you are 50 years old and below, do not smoke and are in good health.

Side Effects of Birth Control Pills

Side effects of taking birth control pills may include:

• Nausea
• Sore or swollen breasts
• Small amounts of blood or spotting, between periods
• Lighter periods
• Mood changes
• Mild headache

These side effects are usually manageable and should not be a cause of concern. If you are experiencing more than just mild discomfort, you should always consult a doctor.

Other side effects are less common, but are more serious and may indicate an underlying condition. These side effects can be easily remembered using the acronym ‘ACHES’, and include:

• Abdominal pain
• Chest pain
• Headache
• Eye problems
• Swelling or aching in your legs or thighs

If you experience these symptoms, consult a doctor immediately or go to the emergency room as it may indicate a more severe health problem such as liver or gallbladder problems, stroke, blood clots, high blood pressure, or heart diseases.

Cost of Birth Control Pills

Birth control pills range from $25 to $40 for a month’s supply depending on the brand you choose.

2. Evra Transdermal Patch

EVRA® patch is a thin patch that can be worn on the abdomen, thigh, buttocks or arms and works in the same way as the pill. It has a high effective rate of up to 91% to 99% if used correctly. 

Pros & Cons of an Evra Patch

An EVRA® patch is a good option for those who find popping the pill a hassle as you only need to replace the patch weekly. During each monthly cycle, you wear it for three weeks and do not wear it during the 4th week. It also has less gastric side effects than the pill. 

The disadvantage is that the patch is not transparent and you may feel a little uncomfortable wearing it due to the hot and humid weather in Singapore. 

Side Effects of an Evra patch

During the first three months of using an EVRA® patch, spotting or bleeding may occur between periods. If this continues after the third month, consult a doctor. Other common side effects include:

• Nausea and vomiting
• Bloating and abdominal cramps
• Breast tenderness headache or migraine
• Intolerance to contact lenses
• Weight changes
• Mood swings
• Skin itching and skin irritation

Cost of an Evra Patch

EVRA® patch costs about $36 to $50 per month. 

3. NuvaRing

NuvaRing® is a soft plastic ring that is inserted into the vagina and stays in there for three weeks. You can remove it in the 4th week, and replace it with a new one the following month. Like the EVRA® patch, it is 91% to 99% effective. It offers similar pros and cons to the patch.

Side Effects of NuvaRing

Common side effects include:

• Vaginal infections and irritation 
• Vagina itching or discharge 
• Headache 
• Nausea 
• Vomiting
• Bloating 
• Stomach cramps
• Changes in weight or appetite 
• Breast pain/tenderness/swelling 
• Headache 
• Dizziness 
• Tired feeling 
• Changes in your menstrual periods, and 
• Decreased sex drive

Cost of NuvaRing

It costs about $60 per month to use the Nuva ring.

4. Birth Control Injection

Your general practitioner (GP) or gynaecologist will give this shot of hormones every three months to prevent ovulation. It works like birth control pills by introducing hormones to prevent ovulation and thicken cervical mucus.

Pros and Cons of Birth Control Injections

Birth control injections are 94% to 99% effective as long as you remember to go for your jab. It is also a non-invasive method of birth control, which is preferred by some women. 

One disadvantage of birth control injections is that it takes a long time to regain fertility – usually six to 12 months – should you decide to have kids in the future. 

Side Effects of Birth Control Injections

Side effects of birth control injections include:

• Irregular periods, which are more common in the first six to 12 months after your first injection
• increased spotting and breakthrough bleeding 
• A change in appetite 
• Weight gain
• A change in sexual drive and interest
• Nausea
• Tender, sore breasts
• A headache
• Mood changes

Cost of Birth Control Injections

Birth control injections cost about $150 to $200 for three months, which translates to $50 to $67 per month 

5. Contraceptive Implant

This progesterone implant is inserted under the arm to prevent ovulation. It works by slowly releasing hormones to prevent pregnancy.

Pros and Cons of Contraceptive Implants

 It has an effective rate of up to 99 per cent. It is a long-term contraceptive option as it lasts for three years . You will also regain your fertility quickly after you stop using it.

The disadvantage is you will need to see a doctor to get it inserted. In rare cases, it may be difficult to remove the implant if it is embedded too deeply. 

Side Effects of Contraceptive Implants

Side effects include:

• Abdominal or back pain
• An increased risk of noncancerous ovarian cysts
• Changes in vaginal bleeding patterns, including absence of menstruation (amenorrhea)
• Decreased sex drive
• Dizziness
• Headaches
• Mild insulin resistance
• Mood swings and depression
• Nausea or upset stomach
• Potential interaction with other medications
• Sore breasts
• Vaginal inflammation or dryness
• Weight gain

Cost of Contraceptive Implants

A contraceptive implant costs about $400 to $600, and each implant can last up to three years. 

6. Intrauterine Device (IUD) 

Also known as the coil, an intrauterine device (IUD) is a small T-shaped copper device that is inserted into the uterus to prevent pregnancy.

Pros and Cons of an IUD

It is up to 98% effective and can be left in the womb for up to five years. It is also a good choice for breastfeeding mums. You will also regain fertility once you remove it.

However, one main disadvantage is that it may cause irregular bleeding or spotting. This is why doctors do not usually recommend this as a first choice if you are anaemic or have heavy periods. 

Complications are rare but there is a small risk that the IUD could fall out and cause an infection during the insertion. Other risks include difficulty in removing the device.

Side Effects of an IUD

Side effects of using an IUD include:

• Headache
• Acne
• Breast tenderness
• Irregular bleeding, which can improve after six months of use
• Mood changes
• Cramping or pelvic pain

Cost of an IUD

An IUD costs about $400 to $500 and can last for up to five years.

7. Emergency Contraception (Morning-after Pill)

The morning-after pill is a contraceptive taken after sex. It works the same way as the birth control pill and can be used up to 120 hours after unprotected sex. 

It is important to note that emergency contraception is not meant to be a birth control method. It serves to provide you with an alternative if you have not been using regular methods properly. For example, if you discovered a tear in the condom or forgot to take a birth control pill, you can use emergency contraception as a last resort. However, this pill may not work if you have already begun ovulation. 

Side Effects of Morning-after Pills

The side effects of morning-after pills typically last only a few days and may include:

• Nausea or vomiting
• Dizziness
• Fatigue
• Headache
• Breast tenderness
• Bleeding between periods or heavier menstrual bleeding
• Lower abdominal pain or cramps

Cost of Morning-after Pills

Each morning-after pill can cost between $40 to $50, which is quite expensive compared to the other birth control methods.

What is the best form of birth control for me?

In choosing the right form of birth control for yourself, factors such as your age, frequency of sexual activity, family history regarding certain illnesses, comfort level when using a particular method as well as your desire to be pregnant in the future are some of the key things you should consider. 

It is recommended that you talk to your doctor to find out which method works best for you. Do not feel embarrassed if you have to clarify with your doctor how each method works. Having the right information is key and you should have sufficient information to make a decision on which birth control method you feel most comfortable with. When you have more knowledge on hand, you are better-placed to take control of your sexual health.

If you feel more comfortable discussing your options with a doctor in the privacy of your home, you can engage a house call doctor or consult a doctor through a video call. Should you need a repeat prescription of birth control pills or emergency contraception, you can simply consult a doctor online and have the pills delivered to your doorstep.

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