Find the Right Birth Control Method in Singapore

How do these Methods of Birth Control Work?

Male Condoms

The male condom basically acts as a barrier, preventing sperm from coming into contact with an egg, thus preventing pregnancy. In addition, condoms can protect you from sexually transmitted infections (STI). To ensure that a condom is used correctly, you should ensure that your or your partner’s penis does not touch the other’s vagina before putting on a condom. You will also need to take out the penis from the vagina while it is still erect after sex to prevent any spillage of semen. People with latex allergies should use polyurethane or polyisoprene condoms instead.

Female Condoms

The female condom works similarly to the male condom but is inserted into the female vagina before any contact with the penis.

Pros and Cons of using condoms

Advantages of using condoms include:

• Preventing pregnancy and STIs when used correctly.
• Only used when having sex, advanced preparation is not required.
• No medical side effects for most cases.
• Purchasing condoms does not require a doctor’s prescription.

Disadvantages of using condoms:

• While uncommon, condoms can sometimes split or tear, especially when not used properly.
• The male is required to pull out while still erect after ejaculating to ensure that the condom works properly.
• Condoms cannot be reused.

When used correctly, the estimated effectiveness of a male condom can be up to 98% while a female condom’s can be up to 95%.

Diaphragm

A contraceptive diaphragm works by blocking off access to the cervix. This prevents sperm from entering the uterus. The diaphragm is made of thin, soft silicone, and is inserted into the vagina before sex. The diaphragm can be inserted any time before sex but will need to be left in place for at least 6 hours after sex. Spermicide will need to be used along with the diaphragm. Spermicide will need to be reapplied if:

• You have sex again with the diaphragm in place
• The diaphragm has already been in place for 3 hours or more before you have sex.

You should not take the diaphragm out when reapplying spermicide. For optimal results, you will need to use a diaphragm with a size that fits you. This may change after significant weight gain/loss or after having a baby, miscarriage or abortion. The diaphragm, unlike a condom, can be reused. You may replace the diaphragm, usually after a year. You can wash it with warm water and mild soap before leaving it to dry.

Do note that a diaphragm may not be suitable for you if:

• Have an unusually shaped or positioned cervix or are unable to reach your cervix
• Have weak vaginal muscles that are unable hold a diaphragm in place (possibly weakened as a result of giving birth)
• Have a sensitivity or an allergy to latex or the chemicals in spermicide
• Have ever had toxic shock syndrome
• Have repeated urinary tract infections (UTIs)
• Have a vaginal infection (wait until your infection clears before using a diaphragm or cap)
• Have a high risk of getting an STI – for example, if you have multiple sexual partners

Pros and Cons of using a contraceptive diaphragm

Advantages of using a contraceptive diaphragm include:

• Only having to use it before sex
• No severe associated health risks or side effects

Disadvantages of using a contraceptive diaphragm include:

• You need to use it before sex
• No reliable protection against STIs
• Learning how to use the diaphragm correctly may take time
• There is a risk of cystitis (bladder infection) when using a contraceptive diaphragm
• Latex and spermicide may cause irritation for some users

When used correctly with spermicide, the estimated effectiveness of a contraceptive diaphragm can be up to 94%.

Cervical Cap

A cervical cap works similarly to a diaphragm but can be left in place longer. A cervical cap stops sperm from entering the uterus by blocking the cervix. Spermicide can be added to the cervical cap for increased protection. The cervical cap comes in different sizes and will need to fit you so that it stays in place during sex. You will require a refitting if you have:

• A pregnancy with vaginal birth
• Abortion or miscarriage
• Pelvic surgery
• Significant weight loss or gain

The cervical cap can be inserted up to 6 hours before sex and will need to be left in place for at least six hours after sex. The cap should not be left in place more than 48 hours. During this period, if you want to have sex again, you should use a new dose of spermicide. Spermicide should be reapplied each time you have sex. Like the diaphragm, a cervical cap can be reused. Make sure to clean and wash it after use, and check for signs of wear. A cervical cap can last up to two years.

Do note that you should not use a cervical cap if you:

• Have had certain types of pap test abnormalities
• Have cervicitis
• Have pelvic inflammatory disease
• Have reproductive systems infections
• Have had toxic shock syndrome
• Have had surgery on your cervix or vagina
• Have an irregularly shaped cervix
• Are allergic to silicone or spermicide
• Are on your menstrual period

Pros and Cons of using a cervical cap

Advantages of using a cervical cap include:

• Cervical caps can be reused for up to two years
• Cervical caps can be used for repeated sexual intercourse within 48 hours
• Easily reversible
• Hormone-free method

Disadvantages of using a cervical cap:

• May irritate your vagina
• Must be removed after 48 hours
• Does not offer protection against STIs

When used correctly with spermicide, the estimated effectiveness of a cervical cap can be up to 91% for women who have not given birth, and up to 74% for those who have given birth before.

Sponges

The birth control sponge is a small doughnut-shaped device, with an indentation in the middle. The sponge is coated with spermicide. The sponge works by trapping and absorbing sperm, killing sperm with spermicide, and covering the cervix to prevent sperm from entering the uterus. The sponge can be inserted into the vagina, up to 24 hours before sex. The sponge will need to be kept in place for at least 6 hours after sex, and up to 30 hours in total. Do note that the birth control sponge is not reusable and must be discarded after use.

You may wish to use an alternative form of contraception if you:

• Have recently given birth
• Have had a recent abortion or pregnancy loss
• Have an allergy to spermicides, sulphites, or polyurethane
• Have a vaginal infection or an infection near the vagina
• Have had toxic shock syndrome

Pros and Cons of using a birth control sponge

The advantages of using a birth control sponge include:

• Hormone-free method
• Can be used for repeated sexual intercourse within 24 hours without requiring replacement
• Does not affect breastfeeding

The disadvantages of using a birth control sponge include:

• You may find difficulty removing the sponge
• Cannot be reused
• Does not offer protection against STIs
• Leaving a sponge in place for too long may lead to toxic shock syndrome
• The sponge’s spermicide may cause vaginal irritation, increasing your chances of contracting HIV and STIs

When used correctly, the estimated effectiveness of the sponge can be up to 88% for women who have never given birth. For women who have given birth, the estimated effectiveness can be up to 80%.

Spermicide

Spermicides work by preventing sperm from reaching an egg to fertilise it. The chemicals within spermicides damage sperm, stopping it from swimming to an egg. Spermicides come in many forms, including gels, creams, foams, and suppositories. Spermicides must be placed in the vagina at least 10 to 15 minutes before sex. Spermicide is often used in addition to another contraceptive method as it is unreliable when used alone. Spermicide needs to be reapplied every time you have sex and is generally only effective for 60 minutes.

Spermicides work the same way but come in different forms with different application methods. You can pick the option that works the best for you. Remember to follow the instructions on the package to ensure that it is used correctly.

Pros and Cons of using spermicides

The advantages of using spermicides include:

• Easy to use and apply
• Can be used right before intercourse, without much preparation
• Can be used in combination with other types of birth control
• Does not affect breastfeeding
• Hormone-free birth control method

The disadvantages of using spermicides include:

• Will be less effective in comparison to other types of birth control if used on its own
• May cause irritation or allergic reactions
• Offers no protection against STIs
• May need to be reapplied during sex

The estimated effectiveness of spermicide can be up to 82%, with effectiveness greatly increased when used together with a barrier type of birth control.

Oral Contraceptives

Oral contraceptives, or birth control pills, work by preventing ovulation. These pills contain small amounts of oestrogen and progestin, hormones that the body naturally produces. These hormones cause your body to stop ovulating, thicken your cervical mucus, making it harder for sperm to get past your cervix and reach your eggs, and thin the lining of your womb, reducing the chances of fertilised eggs being implanted.

To ensure effectiveness, contraceptive pills need to be consumed on a daily basis, at the same time. If you miss a day or consume the pills at different times, the effectiveness of the contraceptive pills may be reduced. The effects of contraceptive pills are reversible, meaning that you can simply stop taking them if you decide that you want to get pregnant.

Do note that you may not be suitable for oral contraceptives if you:

• Are a smoker above the age of 35
• Have had blood clots in your arms, legs, or lungs
• Have had cancer of the uterus
• Have high blood pressure that is not well-controlled
• Have had a history of stroke, heart disease, circulation problems, or breast cancer
• Are breastfeeding
• Have migraine headaches with aura
• Have diabetes-related complications
• Recently had surgery
• Have liver disease
• Have uterine bleeding

Pros and Cons of Oral Contraceptives

The advantages of using oral contraceptives include:

• Oral contraceptives are easy to use.
• Oral contraceptives can help to regulate your menstrual cycles, reducing your chances of cramping and heavy bleeding.
• Oral contraceptives may reduce the risk of ovarian and endometrial cancer. In addition, symptoms of conditions such as acne and premenstrual syndrome (PMS) can be improved.

Oral contraceptives are very effective if used correctly. The estimated effectiveness of oral contraceptives can be up to 99% when used as directed.

The disadvantages of using oral contraceptives include:

• Side effects. Some users of oral contraceptives may experience side effects such as nausea, headaches, and changes in menstrual bleeding patterns.
• Oral contraceptives do not offer any protection from STIs.
• Risk of blood clots. Birth control pills have been linked to an increased risk of blood clots.
• Oral contraceptives may require regular check-ups with a healthcare provider to check for potential side effects

As mentioned earlier, the estimated effectiveness of oral contraceptives can go up to 99% when used correctly.

Hormonal Patches

Hormonal patches contain oestrogen and progestin and work similarly to birth control pills. Releasing these hormones into your bloodstream helps to prevent ovulation, thickens cervical mucus to prevent sperm from reaching the eggs, and thin the endometrium to reduce chances of implantation of fertilised eggs. The patch is placed on your skin and is worn for a total of three weeks every month. The patch is not worn during the fourth month of the week, allowing menstrual bleeding to occur.

Hormonal patches may not be suitable for you if you:

• Are a smoker above the age of 35
• Have chest pain
• Have a history of heart attack, stroke or severe high blood pressure
• Have a history of blood clots
• Have a history of breast, uterine or liver cancer
• Weigh more than 90kg
• Have liver disease
• Have migraines with aura
• Have diabetes-related complications
• Have unexplained vaginal bleeding
• Have developed jaundice during pregnancy or past instances of taking hormonal contraceptives
• Have a major surgery planned

Pros and Cons of Hormonal Patches

The advantages of hormonal patches include:

• Easy application and only needs to be applied once a week
• Regulates menstrual cycles
• Reduces the risk of ovarian and endometrial cancer, as well as improving symptoms of conditions such as acne and PMS

The disadvantages of hormonal patches include:

• Skin irritation or allergy near the area where the patch is applied
• The patch may fall off
• Does not offer protection against STIs
• Risk of blood clots

When used correctly, the estimated effectiveness of hormonal patches can go up to 99%.

Vaginal Ring

Vaginal rings are a type of hormonal contraceptive. They work by releasing hormones oestrogen and progestin into your bloodstream through your vaginal wall. Releasing these hormones into your bloodstream helps to prevent ovulation, thickens cervical mucus to prevent sperm from reaching the eggs, and thin the endometrium to reduce chances of implantation of fertilised eggs. The ring is put into the vagina and left in place for three weeks. On the fourth week, the ring is removed so that your menstrual period can resume. Inserting and removing the ring at the same time every month will help to ensure its effectiveness.

Do note that a vaginal ring may not be suitable for you if you:

• Have inflammation in the veins
• Have deep vein thrombosis (DVT)
• Have vascular or coronary artery disease
• Heart disease
• Very high blood pressure
• Diabetic complications that affect the veins
• Headaches with neurological symptoms
• Have had recent surgery that caused immobilisation
• Have breast cancer or cancer of the reproductive organs, such as the uterus, cervix, or vagina
• Have abnormal genital bleeding
• Have jaundice
• Are pregnant
• Are a smoker
• Have liver disease

Pros and Cons of Vaginal Rings

The advantages of using a vaginal ring include:

• Convenience. The vaginal ring only needs to be inserted once a month.
• Regulates menstrual cycle.
• Reduces the risk of ovarian and endometrial cancer, as well as improving symptoms of conditions such as acne and PMS.

The disadvantages of using a vaginal ring include:

• The ring may fall out
• Does not offer protection against STIs
• Risk of blood clots
• Some users may feel discomfort from the ring, especially during intercourse

When used correctly, the estimated effectiveness of a vaginal ring can go up to 99%.

Hormonal Injections

Hormonal injections deliver the hormone progestogen into your bloodstream via injections. Releasing these hormones into your bloodstream helps to prevent ovulation, thickens cervical mucus to prevent sperm from reaching the eggs, and thin the endometrium to reduce chances of implantation of fertilised eggs. These hormonal injections are usually given every 12 to 14 weeks by a healthcare provider and are effective upon injecting.

You may not be suitable for hormonal injections if you:

• Have unexplained vaginal bleeding
• Breast cancer
• Liver disease
• Allergy to any components of the injection
• Are at higher risk for osteoporosis
• Have a history of depression
• Have a history of heart attack or stroke

Pros and Cons of Hormonal Injections

The advantages of using hormonal injections include:

• Is long acting, only requiring injecting every 3 months
• May improve heavy or painful periods, reducing cramps and pain
• Reduces the risk of endometrial cancer

The disadvantages of using hormonal injections include:

• The effects of hormonal injections are reversible but may take approximately 10 months or more before you begin ovulating again.
• Does not offer protection against STIs
• May reduce bone mineral density
• May have side effects, especially within the first few months of use

When used correctly, hormonal injections are high effective. The estimated effectiveness can go up to 99%.

Contraceptive Implant

A contraceptive implant is a small, flexible plastic rod that is placed under the skin of your upper arm. The implant constantly releases a low dose of progestational hormone, which thickens your cervical mucus while thinning your endometrium. It is common for contraceptive implants to suppress ovulation as well.

Contraceptive implants may not be suitable for you if you:

• Are allergic to the components of the implant
• Have a history of blood clots, heart attack or stroke
• Have liver disease or tumours
• Have a history of breast cancer or suspected breast cancer
• Have had abnormal genital bleeding

Pros and Cons of using Contraceptive Implants

The advantages of using contraceptive implants include:

• Long-lasting. Can generally be left in place for up to three years after insertion.
• Convenience. The user is not required to do anything once the implant has been inserted.
• The implant can be removed at any time if required.

The disadvantages of using contraceptive implants include:

• Irregular bleeding. Some users may experience heavier or irregular menstruation when using the implant.
• Does not offer protection against STIs
• Side effects. Some users may experience side effects from using the implants, such as headaches, acne, or changes in mood.

Contraceptive implants are more than 99% effective.

Sterilisation

Sterilisation refers to a type of birth control that is permanent and irreversible.

Male Sterilisation (Vasectomy)

Male sterilisation, also known as a vasectomy, is a surgical procedure in which the tubes that carry sperm from the testicles are cut or blocked so that sperm is unable to reach the semen. The procedure is done under local anaesthesia, at a doctor’s office or clinic.

Female Sterilisation (Tubal Ligation)

Female sterilisation, also known as tubal ligation, is a surgical procedure in which the fallopian tubes are cut, tied, or blocked. This prevents eggs from reaching the uterus, which renders pregnancy impossible. Similarly, this procedure is done under local anaesthesia, at a doctor’s office or clinic.

Both sterilisation methods are permanent and cannot be reversed, so it is important that you consider your decision carefully prior to the procedure.

Pros and Cons of Sterilisation

The advantages of sterilisation include:

• Long-lasting. Once the sterilisation procedure is completed, it is permanent. You will not need to use additional contraceptive methods to prevent pregnancy or carry out any form of maintenance.
• Sterilisation is a hormone-free method

The disadvantages of sterilisation include:

• Non-reversible. Once the procedure has been completed you will not be able to reverse the effects.
• Side effects. You may experience side effects such as pain or infection after procedure.
• Does not offer protection against STIs

Sterilisation is a highly effective contraceptive method, with more than 99% effectiveness at preventing pregnancy.

Fertility Awareness

Fertility awareness, sometimes referred to as natural family planning or the rhythm method, works by tracking the woman’s menstrual cycle to avoid having unprotected sex during their fertile period. Indicators such as changes in cervical mucus or basal body temperature can help with the tracking process.

Pros and Cons of Fertility Awareness

Advantages of using fertility awareness as a contraceptive method include:

• No side effects
• Does not require medication
• Inexpensive and accessible to all
• Does not require a doctor visit or prescription

Disadvantages of using fertility awareness as a contraceptive method include:

• Requires user to constantly monitor the body for signs of ovulation
• Equipment such as a digital thermometer may be needed to measure your basal body temperature
• The tracking requires the user to have a regular or predictable lifestyle
• The user needs to have sufficient knowledge regarding the menstrual cycle to effectively monitor their fertility
• Not as reliable in comparison to other methods
• Does not offer protection against STIs

The fertility awareness method can be up to 99% effective is used consistently and correctly. However, the user does not follow the instructions carefully, the effectiveness may be heavily reduced.

Emergency Contraceptives

Emergency contraceptives can be used to prevent pregnancy after unprotected sex or in instances where your choice of contraceptive has failed. For example, a condom breaking during intercourse, or missing a day of oral contraceptives.

There are 2 types of emergency contraception:

• The emergency contraceptive pill, which is sometimes referred to as the “morning after” pill
• The intrauterine device (IUD)
• Emergency Contraceptive Pill

Depending on the type of pill, the emergency contraceptive pill works by either:

• Postinor: works by thinning the uterine lining so that a fertilised egg is unable to attach to the uterus.
• Ella: Works by preventing sperm from fertilising eggs and stopping the ovaries from releasing any more eggs

If you are using Postinor, the tablets should be taken within 3 days of intercourse. If you are using Ella, the tablets should be taken within 5 days from intercourse. For both types of emergency contraceptive pills, the earlier you take them, the more effective.

Generally, there are no severe or long-term side effects as a result of using emergency contraceptive pills. However, you may experience mild side effects such as:

• Headaches
• Stomach aches
• Changes to your next period
• Feeling sick

Intrauterine Device (IUD)

The intrauterine device is a small, T-shaped device that is fitted inside your uterus. It prevents pregnancy by preventing sperm from reaching and fertilising eggs. There are two types of IUDs, a hormonal IUD and the copper IUD. In addition, the copper IUD can be used as an emergency contraceptive method if inserted within 5 days of unprotected sex.

Hormonal IUD

A hormonal IUD works by releasing small amounts of progestin into the body. The hormones released cause the cervical mucus to thicken, making it difficult for sperm to reach the egg. It also thins the lining of the uterus which makes it harder for a fertilised egg to implant. Hormonal IUDs can stay fitted in the uterus for up to 3-5 years, with an effectiveness of more than 99%.

Copper IUD

The copper IUD releases copper ions into the uterus. These copper ions produce an inflammatory reaction that is toxic to sperm and egg, preventing pregnancy. The copper IUD can be used for up to 10 years once it is inserted, with an effectiveness of more than 99%. The copper IUD can work as an emergency contraceptive method as well.

IUDs may not be suitable for you if you:

• Have had an STD
• Have had a recent pelvic infection
• Are pregnant
• Have cancer of the cervix or uterus
• Have explained vaginal bleeding

For Hormonal IUDs in particular, you should not use them if you:

• Have liver disease
• Have breast cancer
• Are at a higher risk of breast cancer

For Copper IUDs in particular, you should not use them if you:

• Are allergic to copper
• Or have Wilson’s disease

Pros and Cons of IUDs

The advantages of using an IUD include:

• Long-lasting. The hormonal IUD can be used for up to 5 years while the copper IUD can be used for up to 10 years.
• Hassle-free. The user is not required to do anything once the IUD is inserted.
• IUDs are safe for breastfeeding users.
• IUDs are effective immediately after insertion

The disadvantages of using IUDs include:

• Heavier, longer, more painful periods, especially during the first few months after insertion
• Does not offer protection against STIs
• There is a risk of infection during IUD fitting, which may lead to a pelvic infection if left untreated
• Vaginal bleeding and pain are possible side effects