Oral Contraceptivess

The most effective reversible method of contraception, the pill contains hormones that prevent ovulation (or, in the case of mini pills, partialry suppress it). The combined pill contains oestrogen and progestogen and is taken for three weeks out offour, the period occurring during the pill-free week. The mini-pill contains no oestrogen and is slightly less effective than the regular pill. It must be taken every day.

The pill gives the best chance of avoiding pregnancy of any reversible method, it does not interfere with lovemaking, and periods are light and painless. Side-effects may include nausea, bloating, weight gain and headaches, all of which may be overcome by changing the brand. More serious side-effects are rare, but may include high blood pressure, venous thrombosis, liver damage and Sel'ere depression. Women over thirty-five and those who smoke.

Sterilization

Sterilization, the oniy permanent metbod of birth colttrol, may be performed on hoth men and women. In men it involves cutting and tying the vas deferens (which transport sperm from the testicles to the penis) in a quick, simple, safe operation -vasectomy - done under local anaesthetic. Recovery is rapid and tbere is no change in hormone levels or libido. In women sterilization involves closing the fallopian tubes so that fertilization is impossible. It is usually done with a laparoscope, a telescopic device introduced into the abdominal cavity through tiny incisions, underan anaesthetic. It is a more complicated procedure than vasectomy, as it involves abdominal surgery and the small risk that this entails. While not 100 per cent effective, it is far more effective than any other method of birth control. Both male and female sterilization should be regarded as irreversible, since reversal, though occasionally successful, cannot be guaranteed.

Side Effects

As the body adjusts to hormonal changes created by The Pill, women often experience some minor side effects, including:

• Irregular bleeding or spotting
• Nausea
• Breast tenderness
• Weight gain and/or water retention
• Spotty darkening of the skin
• Mood changes

Side effects usually disappear after 2-3 cycles. If your side effects are bothersome after 2-3 cycles or if heavy bleeding occurs, continue taking your pills and call the clinic for an appointment to talk about your prescription.

Disadvantages

• Does not protect against sexually transmitted infections, including HIV/AIDS.
• Must be taken every day.
• Less effective when taken with some drugs.
• Raised risk of heart attack and stroke.
• Requires a prescription.