Comprehensive Guide to Contraceptive Methods and Their Effectiveness

A contraceptive allows you to have sexual relations without risking a pregnancy and is a way to master your fertility. You can choose the contraceptive method that suits you best, change your contraception when you wish, or stop and restart it at any time, unless the chosen method is irreversible. Contraception serves a woman and a man to avoid a pregnancy during sexual intercourse, and it is important to reflect on the best means of contraception before considering sexual relations.

How Contraception Works

There are three main types of contraceptive methods. They can:

• prevent ovulation;
• prevent the meeting of a sperm and an egg;
• prevent the fertilized egg from becoming a baby.

To understand this, one must know how babies are made. Every month, an egg leaves the ovary and goes into the uterus; this is called ovulation. Fertilization occurs when a sperm meets an egg. During sexual intercourse, when a man ejaculates, sperm enter the uterus and meet the egg which is then fertilized. The fertilized egg will become a baby and grows in the woman's belly for 9 months.

Main Types of Contraceptives

Contraceptives can be classified into two large families: "mechanical" and "hormonal". There are also two other methods, neither mechanical nor hormonal: definitive contraception and spermicides.

Mechanical Contraceptives

The types of "mechanical" contraceptives that exist to date include:

• The condom: there are two kinds, the external condom (also called "male condom") and the internal condom (also called "female condom");
• The copper IUD: or "intrauterine device" (often called "copper coil");
• The diaphragm and the cervical cap;
• Fertility control methods: often called "natural traditional methods".

Hormonal Contraceptives

The types of "hormonal" contraceptives available include:

• The pills: there are two types, combined or oestrogen-progestogen pills and progestogen-only pills;
• The hormonal IUD: or hormonal "intrauterine device";
• The contraceptive implant: a small plastic stick placed under the skin that releases progestogen and lasts 3 years;
• The vaginal ring: a flexible plastic ring inserted into the vagina for 21 days;
• The contraceptive patch: a small patch stuck on the skin, changed weekly for 21 days;
• Injectable progestogens.

Effectiveness: Theory vs. Practice

The actual effectiveness of a contraceptive is different from its theoretical effectiveness and depends on its use. We speak of theoretical effectiveness when the chosen contraceptive is perfectly used and there are no interactions with other medications. This is measured by the Pearl Index, representing the percentage of accidental pregnancies over the first year of optimal use. Practical effectiveness is measured by taking into account daily usage errors, such as forgetting a dose or improper use of a condom. For example, the pill has a theoretical efficiency of 99%, while it has a practical efficiency of 91%.

Emergency Contraception

In case of a problem with your regular contraceptive or the absence of a contraceptive during intercourse, there is emergency contraception. This is a "catch-up" method for situations at risk of pregnancy. It can be oral, known as the emergency pill (hormonal), or a copper IUD (non-hormonal) placed by a doctor or midwife.

Comparison of Contraceptive Methods

A comparative table of different modes of contraception can guide you in your choice to select the means best adapted to your lifestyle.

It is necessary to use a "barrier" protection like the condom to avoid any contamination from infections sexually transmissible (STIs), as other contraceptives do not protect against them.