Contraception

What is contraception?

Contraception (Dutch: anticonceptie) is the umbrella term for all the means and methods you use to prevent a pregnancy. One method stops ovulation, another keeps sperm and egg apart. Almost every form only prevents pregnancy; the condom is the only one that also protects against an STI.

What contraception looks like in practice

Choosing starts with the question of what matters to you. Do you want to think about it as little as possible, or would you rather avoid hormones? Take a woman of forty who is done remembering a pill every day. She is torn between a hormonal IUD, which stays in for years, and a copper IUD, which does the same but without hormones. That is a real conversation at the GP, not a choice you pick off a list on the internet. According to Thuisarts.nl there are methods with hormones, like the pill, the hormonal IUD and the shot, and methods without, like the condom and the copper IUD. Which one suits you depends on your health, your age, whether you still want children and simply what feels right in your own body, and that is exactly why no method exists that is best for everyone. There is only a best choice for you.

How reliable the methods are

Reliability varies a lot, and there is a difference between perfect use and ordinary use. The World Health Organization expresses it in pregnancies per hundred women per year. An IUD or an implant stays under one, even as most people use them in practice. With the pill it comes to around seven once you measure it against how it is really taken, forgotten doses and all. With the male condom it is thirteen. That is a big gap. Roughly speaking, the methods fall into three tiers.

• The most reliable. The IUD, the implant and sterilization. There is nothing to remember, and that is exactly why little goes wrong.
• Reliable, as long as you pay attention. The pill, the ring, the patch and the shot. They work well, as long as you use them on time.
• Variable. The condom and the natural methods leave more room for a slip, though the condom is the only one that is also a shield against STIs.

Thuisarts.nl sums up the top of the list simply: the IUD, the pill, the minipill, the shot, the implant, the ring and the patch protect best against getting pregnant, and natural methods protect far less well. The difference is not in the method on the packaging. It is in how little can go wrong in daily life.

Why women choose it

The heart of it is control. Contraception lets you decide for yourself whether and when you get pregnant, and that changes how sex feels: less of a gamble, more of a choice. For you there can be something else on top. Hormonal methods are also used because they regulate menstruation and ease the complaints around it, something that with the pill was not even the original main aim. Thuisarts.nl simply calls it an advantage: with hormones you often lose less blood and have less pain during your period. For many women that weighs just as heavily as the pregnancy side. What contraception does not do, with one exception, is protect against STIs. Anyone who wants that covered too ends up at the condom either way, or combines a reliable method with a condom. That last one is not overkill. Belt and suspenders. It is the safest combination there is.

What contraception is not

“The pill also protects against STIs.” No. According to Rutgers the condom and the female condom are the only forms of contraception that also protect against an STI. The pill does not.

“A natural method is just as reliable.” Not in practice. Methods that lean on your cycle or your temperature leave far more room for a slip than an IUD or a pill.

“Contraception is the woman’s job.” Often how it has gone historically, but no law. The condom, the conversation and the trip to the doctor can be shared.

Where you can turn

This is a medical topic, and the choice belongs with a doctor, not with a page like this one. If you want to choose a method or switch, make an appointment with your GP. Your GP knows your health, knows which methods are less wise for you, for instance hormones with a raised risk of thrombosis, and can weigh in on what counts for you. That conversation is half the work. On Thuisarts.nl there is an overview and a choice card you can fill in before you go, so the conversation gets straight to the point. If you want to stay ahead of both pregnancy and an STI, read on at safer sex.

Further reading

• Safer sex explains why a condom alongside contraception also protects against STIs, and what “safer, not safe” means.
• Zorgen dat je niet zwanger wordt: anticonceptie on Thuisarts.nl gives a separate explanation per method and a choice card.
• Anticonceptie at Rutgers lays out the methods and the shared responsibility.

Where this fits on this site

Contraception is not mine to decide. That belongs with your GP and with Thuisarts.nl. What does belong with me is that we agree in advance how we keep things safe and discreet, and that a condom is a given. Curious how a meeting goes? Take a look at my services. You can always ask a question first, with no obligation.

Sources

• Ik wil voorkomen dat ik zwanger word. Wat kan ik kiezen?. Thuisarts.nl. Provides the distinction between methods with and without hormones, that the IUD, the pill, the minipill, the shot, the implant, the ring and the patch protect best against getting pregnant, and that natural methods protect far less well.
• Family planning and contraception methods. World Health Organization (WHO). Provides the reliability per method in pregnancies per hundred women per year: under one for the IUD and implant, about seven for the pill and thirteen for the male condom as they are typically used.
• Anticonceptie. Rutgers. Provides that the condom and the female condom are the only forms of contraception that also protect against an STI, and that combining a reliable method with a condom is the safest choice.

Related terms

• Safer sex. The parent of this term: everything that lowers the chance of an STI or a pregnancy, of which contraception covers the pregnancy side.
• Menopause. Around menopause the question of whether and which contraception is still needed changes.
• Libido. The desire for sex, which for some women changes under the influence of hormonal contraception.