Contraceptive methods such as pills, condoms, intrauterine devices, implants, peels, patches, or injections are increasingly used. But which do young women of today prefer? Has it changed much compared to previous generations?
More than anyone might think, young women choose condoms or the pill whenever they decide to use contraception. However, more people are realizing the benefits of long-acting contraception such as the Intrauterine Device (IUD) or hormonal implants in the arm.
Contraceptive methods used by women of reproductive age vary widely by marital status, age and region, according to a study published last year in The Lancet.
According to this research, the use of modern methods like condoms, pills, implants, use of sterilization has increased worldwide.
The Lancet
In particular, condoms and the pill were the most common methods of contraception among youth aged 15–19 years.
According to the United Nations Population Fund, the problem in many regions is a lack of sex education, which has led to the second-highest pregnancy rate among women under 20 in Latin America, after sub-Saharan Africa.
1. Wide Range of Possibilities
Gynecologist, Corina Hidalgo, medical director of the Mundo Salud Medical Center in Peru, told BBC Mundo ‘how contraception is used’.
“Currently we have many alternatives to the methods used earlier,” he said. Before we only knew about pills, ampoules and copper tea.
“We now have implants that go in the arm, for women who don’t want to use hormones, there are different non-hormonal T’s. We have copper tees, silver tees and also balloons. All these are more than 99% effective.
However, despite the wide variety, condoms and hormonal pills are the most popular methods among young women, with slight differences between countries.
In Peru, for example, hormonal ampoules are also frequently used.
Obstetrician Gabriele Zambrano told BBC Mundo that the most popular in Venezuela are condoms and the morning-after pill, which are considered emergency contraception.
2. Short-Acting Hormonal Methods
The pill contains two hormones (estrogen and progestogen – also called progestin) that prevent the release of eggs from the ovaries. This is the pill commonly known as ‘The Pill‘.
Less popularly, progestogen pills thicken the mucosa of the cervical canal, which prevents sperm from meeting the egg. Both are for daily use.
The formulation of these tablets is also available in injectable form. The monthly pill contains estrogen and progestogen and the quarterly pill contains only progestin. Along with the pill, some women choose the patch, which is applied weekly, or the vaginal patch, once a month, both of which contain a combination of progestin and estrogen.
Dr. Hidalgo of Young Women in Peru says that the contraceptive method most accepted by a young woman is actually the pill.
“The patch or ring is a good alternative for patients who forget to take the pill and who do not want long-term contraception because they want to see their period.”
3. Long-Acting Reversible Hormonal Methods
This includes the IUD, or hormonal T, which is a T-shaped plastic structure that is inserted into the uterus, where it releases the progestogen hormone every day to prevent pregnancy, which lasts three to eight days. Occurs between the years.
Isabel Lahoz is a gynecologist at the Clinical Hospital of Zaragoza (Spain). “With the hormonal IUD we get a range of benefits, such as reduced menstrual bleeding,” she told the BBC. Apart from this, the pain is reduced.
In addition to IUDs and TEZs, there is also a hormonal implant, which consists of one or two matchbox-sized flexible plastic rods that are placed under the skin in a woman’s upper arm for three weeks to five years. Lasts up to Implants release a low and regular dose of progestin, similar to IUDs.
Both IUDs and implants are what are known as LARC methods (long-acting reversible contraceptives). “The longer term means there’s more consistency with this method and the effect is better,” Lahoz says.
Dr. Zambrano sees it that way. “The advantage of implants is that they are good for women who don’t want to take birth control pills or who have a poor memory so they can’t remember to take their medication every day.“
According to Venezuelan gynecologists, long-term methods are usually chosen by older women.
4. Non-Hormonal Methods
Finally, there are non-hormonal methods including condoms (female and male), copper IUDs, silver IUDs, which are smaller than copper, and intrauterine balloons designed specifically for young women. Some have a tenure of up to 10 years.
Since they do not contain hormones, they have fewer side effects. “The only thing that can happen to you is that the blood flow changes,” the doctor explains. It’s at risk of prolapse, because it’s a foreign object that enters the body, so the uterus tries to expel it, but that happens in less than one percent of cases.’
“We always defend LARC practices,” says Lahoz. Of course, the copper IUD is more effective than other methods among non-hormonal methods and use protection (female or male condoms) where appropriate.
“This will not only prevent pregnancy but also protect against sexually transmitted diseases.”
5. Which one to Choose?
This is the big question that has no single answer. Experts recommend long-term as the most appropriate, especially in the younger population or those who do not want to get pregnant in the short term. But they make it clear that the key is to do a case-by-case analysis.
“Intramuscular injections are not recommended, for example, in very young people,” says Lahore. In addition, these injections also lead to delayed fertility. Something that doesn’t happen with any of the other contraceptive methods. Because in all of them, fertility returns only when you stop using contraception, which is why these injections are not the method we recommend as a first option.’
There is no major difference in side effects between the combined pill, which is most commonly used, and implants, although it is difficult to compare the two methods because implants contain only progestogens, so they are the same as pill progestogens. which is less popular. In this case, both methods can have menstrual irregularities as a side effect because they do not contain estrogen.
“It’s not that implants have more or less side effects than the pill, but you have to know how to select a patient for this type of implant,” says gynecologist Hidalgo.
This is where uniqueness comes into play. A pill with estrogen and progestin may be better for one user and a pill with only progestin for another. For example, for a woman with polycystic ovaries, estrogen may be beneficial, while another who smokes and is older than 35 may not.
“It’s not the same to give contraceptives to an obese patient as compared to an athletic patient,” says Hidalgo.
A spokesperson for the Spanish Contraception Society insists that ‘in contraception, individuality is very important, meaning there is no pill, no method, no IUD that works well for all women.’
6. Myths Related to Hormones
Young women seek comfort and security, but gynecologists admit that women are concerned about the effects of hormones on their bodies and have questions about if the method will work long-term. If used, they will gain weight and whether they will be able to have children later.
“Perhaps we need to figure out how to reach out to them and explain all the skepticism or fight against the old myths that the general public believes, even some professionals who are good at,” Lahoz admits. are not properly trained.’
Lack of access to reliable information in some areas in Latin America means that many women do not know what to choose and end up choosing the method their friend used.
“This is the main problem we have with taking contraceptives,” says Hidalgo.
Access to information is essential to countering the misconceptions that still circulate about the high side effects of hormones among women, who are still stuck in the past when contraceptive doses were relatively high.
“First of all, the hormones we use now are not the same hormones we used before,” Lahoz adds. And secondly, hormones aren’t bad by definition, women have hormones and more than that, a lot of our problems show up after menopause, which is when our hormones go down. But they also have many benefits in our body.
7. Great Fight to Increase Contraceptive Use
Dr. Hidalgo says, “As contraceptive methods continue to advance, the big battle remains to get women to accept the use of contraceptives.” It is a constant struggle.
The main problem is lack of sex education and family barriers, which cause many young people to not use contraceptives due to fear and ignorance or fear that their parents will find out if they do not use them.
There is an economic factor involved, because although some countries have programs that offer free contraceptives, they do not reach all women.
“If young people had family support, they would seek contraception,” says Hidalgo. In urban areas where we have a more academic culture, our first hurdle is the family structure.
“Lack of sex education is a major cause of teenage pregnancy, a phenomenon that is more common in areas far from the city and in homes with poverty,” says a Peruvian gynecologist.
“What is wrong is to think that sex is bad,” he says. Sex is great. It is up to people to decide when they want to have sex for the first time and if a child has already had sex, you cannot stop them from continuing to do so.
“It is important that you give him sex education.”
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