Beyond The Pill: What’s New In Contraceptives?

Posted: March 29, 2013

The variety of contraceptives for women in India has always been somewhat limited. Here is information on more contraceptive options for women.

Are you on the pill and hating it? Or worse, are you forgetting to take your pill every other day and constantly worrying about getting pregnant? Then it’s time to introduce you to a whole new range of advances in the field of contraceptives and their impact on women’s health.

Contraceptives in India are still not a widely discussed subject often leaving Indian women with little or no choice in the matter. Why not be better informed so you can make the right choice? So without much ado, here’s a look at all that’s new in birth control.

Newer generation intrauterine devices (IUDs)

IUDs are devices that are inserted into the uterus. Their presence renders the environment within the uterus unfavourable for pregnancy, making them effective contraceptive agents. For most Indian women, Copper-T is the most popularly used IUD.

The newer generation IUDs contain hormones that are slowly released into the uterus. Mirena is one such and contains the hormone levonorgestrel. Unlike some of the other newer birth control methods, Mirena does not affect one’s periods and instead actually reduces heavy bleeding. In India, it is often used in the treatment of dysfunctional uterine bleeding, a condition that causes women to have very heavy flow during their periods.

Unlike some of the other newer birth control methods, Mirena does not affect one’s periods and instead actually reduces heavy bleeding.

You can’t insert an IUD by yourself but it only involves a very minor procedure performed by the doctor. And the best part is that once in place, it works for almost 5 years.

Birth control ring

This is a soft, flexible ring that has to be inserted into the vagina and works by releasing hormones similar to those in the pill. But unlike the pill, the ring is effective for 3 weeks, so it does not have to be changed every day. Also, you can insert it yourself – since it does not work as a barrier method, its position is not critical to its effectiveness.

A new ring is inserted every 3 weeks and the fourth week left ring-free so periods can occur. But if you choose not to have your cycle, then the next ring can be inserted immediately instead of waiting the week out. One of the problems reported with this device is that it sometimes slips out. But that is easily resolved by reinserting it after a wash or using a new one instead.

Depot contraceptive injections

Instead of taking a pill every day, contraceptive hormones are given as intramuscular injections. Depot Provera, an injection containing medroxyprogesterone for instance, is effective for about 150 days. Periods do not occur while on this birth control method.

Other contraceptive methods for Indian women

Imagine not having to take a pill everyday but being able to wear it on your sleeve instead. That’s almost what the birth control patch is about. It’s a small, skin-coloured patch that you can wear on the skin of your arms or back and releases the same hormones as the pill that are absorbed through the skin. A patch worn once works for a week, so you don’t have to remember to change it every day.

Birth control patches are generally worn over three weeks with a break over the fourth week so periods can occur. But if you don’t want your periods then you just continue wearing a patch. Do these patches have any adverse effects on women’s health? Although associated with the same risks as those with using the pill because of their oestrogen content, no increased risk of heart attack or stroke has actually been reported with their use.

Birth control patches are generally worn over three weeks with a break over the fourth week so periods can occur. But if you don’t want your periods then you just continue wearing a patch.

The birth control implant is another new method with promising results. A small piece of metal containing progesterone is surgically inserted into the arm from where it slowly releases the hormone so it can exert its contraceptive effect. The implant works for three years after which it has to be replaced. Although it may cause some spotting or minor bleeding, some women using it have no period at all. Also, the device helps avoid all the health risks associated with oestrogen as it only contains progesterone.

Both the patch and the implant have not yet emerged in the Indian market, although one can expect them to be introduced in the future.

Long term or permanent birth control is usually achieved by tying off the Fallopian tubes, the tubes that help transport the egg. A similar and newer method involves a small procedure performed in the doctor’s office to insert a spring-like device into the fallopian tubes. This method of birth control works similar to tubal ligation and is a reliable method of contraception that does not affect the periods in any way as there are no hormones involved.

What about male contraceptives?

The male pill still seems to be a myth. Although this concept has been doing the rounds for years now, the solution to reduce sperm production without affecting libido seems to keep evading researchers, so vasectomy seems to be the only viable answer so far (apart from condoms, of course).

Choosing the right contraceptive

Choosing the birth control method that is optimal for you will depend on a lot of factors that include your age, life style and needs. Are you just trying to postpone pregnancy, spacing between children or have you already ‘completed’ your family? For a young woman having no intentions of starting a family in the near future, the pill is usually considered the best option. Unfortunately, not all the newer alternatives to the pill are freely available in India and may be on the expensive side even if they are accessible. It is best to discuss these options with your gynaecologist.

The pill is not a good idea if you are a nursing mother. Breast feeding itself is supposed to exert a contraceptive effect but is not completely reliable as a method of birth control. Depot Provera injections are a good solution at this stage and can also be used effectively to space children. Intrauterine devices, with or without hormones, are also safe and effective in this phase.

Besides not being talked about openly, contraceptives in India are also surrounded by many myths only adding to the problems of Indian women. The solution lies in being informed and finding out what’s right for you.

*Photo credit: e-magine art (Used under the Creative Commons Attribution License.)

Dr. Lakshmi Ananth is a doctor and a writer who wields both scalpel and pen

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9 Comments


  1. Concerned Reader -

    Why is it that contraception for women, whether in the form of the pill or IUDs, patches, injections or any of the methods described above, is hormone-based? Why does this article speak of Depo-Provera without mentioning its major and minor side-effects? Why has this article bought into the developmental logic aggressively supported by the government that birth control has to work through women’s bodies, no matter what the cost to women’s health? Why is it that side-effects of hormonal contraceptives are not even explicitly revealed, either by governmental advertisements or by doctors and hospitals promoting their use? And lastly, why is such a non-nuanced article promoting hormonal contraception for women published on a “women’s website”?

    • Dr. Lakshmi Ananth
      Dr. Lakshmi Ananth -

      I appreciate your comment and understand your point of view, but this article was just meant to be an introduction to some of the alternative methods of contraception available today. It does not advocate or promote any method of birth control, hormonal or otherwise. Nor does it imply that women should be responsible for contraception. But women need contraception and should be aware of all the options available to them. I understand your views on male contraception, but again, this is only an update on things as they are and not as they should be.

  2. Concerned Reader -

    Adding to my previous list of questions, here are some more: why does all talk of male hormonal contraception focus almost exclusively around not reducing libido? Is that even a consideration when women’s hormonal contraception is promoted? What sort of a double standard is this, where women’s contraception is allowed to wreak havoc with their health, but promotion of male hormonal contraception is held back by concerns over affecting their libido?

  3. Any contraceptives for breast-feeding mothers who want birth spacing but husbands do not agree.

    I am told there are vaginal insertable pill and cream for women. Could you please let me know. The mother who needs help is 22, illiterate & mother of 2 boys but her husband wants a girl now. He is also very demanding and won’t listen to reason. Help!

  4. what is the trade name of birth control patch in india

  5. Is the Government planning to supply Mirena free of cost, like the Cu T?

  6. Where is the birth control implant done in Mumbai?

  7. Which one is the best option among all with no side effects?

  8. Hi Dr. Ananth,

    I was married ten months ago and a week ago I went through an abortion (4+ weeks) Me and my husband are not willing to have a kid right now. Can you please suggest and pill which does not leads to weight gain or fatigue. Prior to this I was taking ‘Saheli’. Please help.

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