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Safer, Healthier Sex:

Your guide to contraception Aisling Keenan talks to Dr Jacek Kisielewicz from the Marie Stopes Clinic about family planning, sexual health and knowing what contraceptive is right for you and your body

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ontraception has never been so widely available and has never had such variety. With all the different types of contraception, many women and men find it difficult to decide on a method that best suits their needs. Dr Jacek Kisielewicz from the Marie Stopes Reproductive Choices Centre in Dublin, has specialised in family planning for the past decade. He regularly advises women about their choices regarding contraception. “I ask women about any previous experience, good or not good, with another form of contraception. We can’t match a woman with a pill on paper, it’s a game of trial and error. I would always do a threemonth trial.” When it comes to contraception, it’s not a

case of ‘one size fits all’. Every woman is different, and bodies react differently to contraceptives the same way they do with any medication. That’s why it’s so important to know all the facts.

The Combined Pill The combined pill, or simply ‘the pill’, as many people know it, is a very common form of contraception. While not suitable for everyone, many women use it successfully to prevent pregnancy. The combined pill contains two hormones, oestrogen and progesterone, combined in different amounts. It acts by thickening cervical mucus and thinning the lining of the uterus to prevent a fertilised egg implanting. Vomiting, diarrhoea or taking antibiotics can reduce its effectiveness.


Dr Kisielewicz says women come in already knowing they want the combined pill. It is one of the cheapest and least invasive contraceptives available. “If taken properly and if there’s no interference from other medication, the combined pill is 99.2 per cent effective. The usage of the combined pill lowers your chances of ovarian cancer. There is a slightly increased risk of breast cancer, but then, the pill has been in intensive usage for the last 40 years almost, and there haven’t been dramatic changes except there are fewer cases of ovarian cancer.” Apart from well-known side effects like breast tenderness, mood swings and migraines, a factor that many women find hard to deal with is weight gain. Dr Kisielewicz makes the point, however, that the pill doesn’t make you gain weight, your eating habits do. “Young ladies blame the pill for putting on weight, but the pill only increases the appetite, the weight is caused by the food you eat.” Dr Kisielewicz also says that while side effects might be inconvenient, they’re nothing compared to the life-altering experience of having an unwanted pregnancy. “A lot of doctors compare pill users to non-pill users. I prefer to compare pill users to women who have an unwanted pregnancy. Suddenly the side effects look quite good.” Apart from the combined pill, there are several other methods available. Always

follow the advice of your doctor when choosing the right contraception for you.

The Implant The implant is a rod-shaped device implanted into a woman’s arm just above her elbow. It’s invisible but can be felt with your fingertips. It protects against pregnancy for three years in most women, two years if you are overweight. Check ups are advised yearly. Removal of the implant is easy and the bruising it leaves clears up quickly.

The Mini Pill The progesterone-only pill works by thickening the mucus at the cervix and altering the lining of the womb to prevent implantation. It is 99 per cent effective when taken at the correct time each day. With this pill, timing is crucial, with the effectiveness reducing if you take it more than three hours late. It is best for women who are breastfeeding, older women, smokers and diabetics.

The Vaginal Ring This method is over 99 per cent effective if used carefully. It acts in the same way as the combined pill, thickening the mucus and thinning the lining of the uterus, but unlike the combined pill, its effectiveness is not reduced by vomiting or diarrhoea. The small, flexible ring must be inserted into the vagina, so women must feel comfortable with inserting and removing it after the three-week period. There are other forms of contraception for women, including the female condom,

the diaphragm and the injection. But what about contraception for men? After all, it takes two, and men should have to shoulder some of the responsibility.

Condoms Available from every chemist, supermarket and petrol station for those emergency occasions, condoms are 98 per cent effective at preventing pregnancy, and are the only form of contraception that prevents against the dreaded sexually transmitted infection, or STI. Care is needed in the use of condoms, and some men complain of reduced sensitivity. However, if you weigh up reduced sensitivity and an unwanted pregnancy, the former would win in most cases. Dr Kisielewicz believes men are not motivated to take a daily contraceptive, and that is why condoms often are the only option for men, despite the development of medicated male contraception. “The males are not becoming pregnant. What motivation are people between 15 and

30 going to have to take a pill everyday? As for condoms, boys think they know everything, so they don’t see the point in reading the instructions. That’s why there are so many accidents. Nobody teaches them.” Knowing what’s going on with your body is crucial in having good sexual health. The healthier and safer your sex life is, the better it is for you and your body. For more, visit www.reproductivechoices.ie.



Sexual Health