The commonest form of contraception is the combined oral contraceptive pill so called combined because each pill has two drugs in it: a progesterone and an oestrogen. This combination works by making the pituitary in the brain think that the individual is pregnant and thus stop the hormone responsible for ovulation. Although the individual doses of the drugs have decreased over the time, the pill has essentially remained unchanged and has been around for the best part of 40 years. When taken correctly it remains one of the most successful contraceptives available. Not all women either suit the pill or can take it. Others, because of smoking or increasing blood pressure are not suitable to remain on it beyond the age of 35.
We see patients on an annual basis to review the pill prescription. If happy that this is still safe, a prescription covering the next year of pills may be given. For some women who suffer from acne, and require effective contraception, we prescribe dianette, which acts as a contraceptive but is very beneficial for the acne often reducing the spots to an acceptable level. However under current guidelines from the data sheet, if is not possible to remain on this drug indefinitely, but it is possible sometimes to alternate with a more standard oral contraceptive. We advise when starting the pill to start on the first day of the period and try and take the pill at the same time of the day throughout the 21 days. The most important time not to miss a pill is during the first seven days of the new pack. After the first seven days, a late or missed pill is unlikely to result in pregnancy but may produce some unwanted spotting or breakthrough bleeding.
Condoms are available from the practice nurse They are supplied free from the HA. Condoms are a useful not only as a contraceptive, but give some protection against sexually transmitted diseases. No person who is not sure of his or her partner’s sexual history should ever take a risk of intercourse without a condom.
A three monthly injection is available from our practice nurse. The injection is very safe against pregnancy and one third of women stop having periods with it within six months. This can sometimes worry patients, as they do not have their monthly bleed. It can be a good choice for many that have a complicated life where taking a pill at a regular time is difficult. It can also be a good choice in those with diseases such as diabetes.
Coils or intra uterine devices are probably best for women who have a regular partner, and following a pregnancy want to have a gap of two to three years. There are various devices available including MIRENA This is a device that has levonorgestrel added. It is an improvement on the older types because it results in fewer pregnancies, it can reduce the frequency of periods and also the menstrual loss. We feel that the doctor who fits IUCD should do this regularly and we therefore refer all patients, who wish to be considered for this device, to the Newcroft Centre. The device usually stays in the womb and is effective for five years or more.
All the doctors are trained to give contraceptive advice.