Contraception

Contraception, also known as birth control, is used to prevent pregnancies. Some of these can also be used as protection to ensure safe sex. There are various forms of contraception and

each has its own pros and cons. Some contraceptive methods, such as male and female condoms, can also protect you from some STDs. This section is intended only as a summary of the available contraception. If you are considering starting on contraception, visit us at ManaDr@City Gate to discuss all potential risks and benefits based on your profile

Natural Contraception

This method relies on behavioral practices and observations about the female’s body and menstrual cycle. It is the least effective of all the contraception methods.

1. Calendar method: Calculating the female’s fertile period and avoiding sex during this period.
2. Coitus interruptus: Removing the penis just before orgasm so that ejaculation occurs outside of the vagina.

Hormonal Contraception

This method prevents the ovaries from releasing eggs, thickens cervical mucus to prevent sperm penetration, and thins the lining of the endometrium. Easily reversible upon discontinuation, this is especially appealing to those who also wish to regulate their

periods because of heavy bleeding or menstrual pain.

1. The Pill: The pill is taken every day, ideally at the same time each day. Two options are routinely available: a 21-day pack and a 28-day pack. The former is taken for 3 weeks followed by a 7-day pill-free period while the latter substitutes the pill-free period with 7 days worth of sugar pills. The success rate ranges from 95%-99.5% depending on the consistency of use.
2. Nuva Ring: A small ring is put in the vagina once a month for three weeks and then replaced a week later to prevent pregnancy.
3. Depot injections: An injection of synthetic progesterone is given into a large muscle (usually the buttock or shoulder). The injections have to repeat every 3 months.
4. Implants: Rods of synthetic progesterone are inserted into the upper arm. Depending on the implant, contraception can be provided over 3 to 5 years.
5. Mirena: A small rod is inserted into the uterus by a doctor. The rod slowly releases synthetic progesterone to provide contraception. Mirena should be replaced every 5 years.

At MaNaDr Clinic @ City Gate, we offer the following hormonal contraception:

1. Diane-35 1 month supply
2. Yasmin 1 month supply
3. Implanon

Non Hormonal Contraception

BARRIER METHOD

The barrier method works by preventing sperm from reaching the female’s upper genital tract. It also protects against sexually transmitted diseases.

1. Male condom: A new condom should be used during intercourse. Before using, check that the condom is not expired and open the packet with your fingers. Avoid damaging it with your fingernails, teeth, or other sharp objects. The condom should be worn over an erect penis and should fit comfortably. Make sure to leave an air pocket at the tip of the condom for the collection of semen. Only use water-based lubricants. Adequate lubrication should be used to prevent condoms from breaking. It should be disposed of after intercourse.
2. Female condom: A new condom should be used during intercourse. The external ring sits outside of the vagina while the internal ring is inserted into the vagina to help keep it in place. It can be placed into the vagina up to 8 hours before intercourse.
3. Cervical cap and diaphragms: This needs to be fitted in place before intercourse occurs and removed 6 hours after intercourse is over.

INTRAUTERINE DEVICE

1. Copper intrauterine device: A copper rod is inserted into the uterus similarly to a Mirena. This form of contraception does not release hormones but instead, provides contraception by interfering with sperm transport and embryo implantation.

EMERGENCY CONTRACEPTION

Emergency contraception is indicated for those who want to avoid unplanned pregnancies after sex. People who might consider emergency contraception include those who have had

unprotected sex, incorrect usage of contraception, and victims of sexual assault. You should visit a doctor as soon as possible for emergency contraception. There are two main forms of emergency contraception:

1. The morning-after pill: These are hormonal pills containing either estrogen and progesterone or only progesterone. There are two pills available in Singapore: Postinor and Ella. Postinor is effective for up to 72 hours while Ella is effective for up to 120 hours post intercourse
2. Copper IUD: This is the most effective emergency contraception and has to be inserted within 5 days of intercourse.

At MaNaDr Clinic, we offer the following emergency contraception:

1. Postinor
2. Ella

About The Author

Dr. Pereira studied at the National University of Singapore on a SingHealth Undergraduate Medicine Scholarship and graduated with their MBBS in 2018. They subsequently completed their MRCP (UK) and M.Med (Int Med) in 2021. Prior to joining ManaDr, they were part of the Singhealth Internal Medicine Programme. As part of their training, they rotated through and gained diverse experiences in various medical subspecialties. Their main area of interests are in sexual health as well as gender affirming care. Dr. Pereira strongly believes in providing inclusive and evidence based care to their patients.