The topic of contraception and reproductive health is often considered taboo because it relates to female sexuality. It also seems as if the subject has been disappearing from the global health agenda, which should be alarming since it concerns most females, who, according to Ronald Fisher’s sex ratio, consist of about 50% of the world’s population.
There are a vast array of myths and fears regarding the use of birth control, especially those relating to the use of an IUD (intrauterine device), oral contraceptives and injectables. I aim to dispel some of these myths, and hopefully shed some light on the “not-so-cringe-worthy” topic.
Although new advancements in birth control are being publicised daily, the societal demand for contraceptives can be traced back to 3000 B.C when condoms were fabricated from materials such as linen sheaths, fish bladders and even animal intestines. Luckily for us, we now have a variety of safe, affordable and not-so-fishy options available to fulfil our reproductive health requirements.
It is important to realise that there is no “one size fits all” method of birth control. Health care practitioners are trained to help guide you through the process, depending on your medical history and personal preference. It’s also necessary to mention that women use contraceptives for a variety of reasons: No, not just to prevent pregnancy.
According to my anonymous survey of South African women between the age of 18 and 32, the most common method of birth control is the oral contraceptive. As well as being the most favoured method, 74% of respondents claim to prefer this particular option.
These hormonal preparations generally contain a combination of the hormones oestrogen and progestin. The combination of these hormones helps to prevent pregnancy by manipulating the brain into not releasing the hormones luteinizing hormone (LH) and the follicle stimulating hormone (FSH).
Dermatologist, Dr Dilshaad Asmal says she often prescribes “the pill” to patients who suffer from hormonal acne. This is caused by the over-sensitivity of the androgen receptors, which are to blame for excess oil production.
How to identify hormonal acne? “Typically when breakouts occur before or during your period, especially on the lower parts of the face and around the neck and jaw.”
Except for the dermatological benefits, oral contraceptives are also prescribed to patients who suffer from polycystic ovary syndrome (PCOS), iron deficiency (anaemia), menstrual migraines and premenstrual syndrome (PMS).
Obstetrician-gynecologist Dr Regina Edmond says that “the best form of birth control is the one that you’ll remember to take.” Therefore, it seems obvious why many women prefer methods such as the IUD, Implanon and injectables.
These birth control implants are tiny rod-like devices, which are inserted under the skin of the upper arm. This method is available at many South African public clinics; however, many patients remain uninformed about the long-term benefits of this device.
The Implanon contains the hormone progesterone, or etonogestrel, which inhibits ovulation and thickens the vaginal fluid to help prevent sperm from fertilising an egg. The device typically needs to be replaced every three years. The benefits of the device include the long-term effects as well as being a safe option for breastfeeding women and those who are unable to use estrogen.
IUD (Intrauterine Device)
There are different kinds of IUDs available on the market. A popular option is the Mirena, which released a very low dose of birth control hormones and can last for up to 5 years.
The copper IUD is a small plastic T-shaped device, which has been wrapped in copper and acts as a spermicide in the uterus. IUDs are particularly popular because they offer long-term and reversible contraception.
The injectable is a progestin shot, which is administered by a medical professional every two to three months.
Professional nurse, Marthanique van der Westhuizen says that “most of our patients prefer the injection, as opposed to oral contraceptives. Mainly because they don’t have to remember to take a tablet every morning, and it’s more effective for those who have to travel further to reach a public clinic. We very often get women in the clinic who seek long-term contraception which they can hide from their partners.”
The thought of women still having to hide contraceptives from their partners seems to still be a repetitive concern in the South African healthcare system.
“Power imbalances that make it difficult for some women to negotiate condom use and seeks to make contraceptive services available that will not fuel women’s vulnerability to HIV infection”. – Manyonga
Accessibility to birth control provides women with a sense of control. They are able to negotiate the terms of their own reproductive health and make choices, which are most beneficial to them and their households.
The topic of female reproductive health should not be controversial. To deny a woman access to birth control is a violation of her human rights.
“Whether we are talking about access to affordable birth control, feeling safe from violence in our homes, or being able to earn the same amount of money as our male counterparts, these are rights that all people deserve, and they are being threatened.” –Ann McLane Kuster