There’s no one way to navigate the topic of sexual health in Asia. Growing up, our curiosity is hardly fed; we puzzlingly stare at cold screens in classrooms; we listen in on adult conversations that barely make sense; we consume what the Internet has to give us. Add Asian taboos surrounding the topic to the mix and you’ll have a tricky time learning anything worthwhile from the people closest to you. So much so that most of us often tiptoe cautiously around the subject, avoiding any honest-to-goodness conversations about our sexual lives and our bodies. Before we know it, some of us are staring down at two red lines, and crying in front of our bathroom mirrors, praying for someone to throw a lifeline down our way—preferably with a sliver of empathy—especially when it may significantly redirect the course of our entire lives.
For any sexually-reproductive woman out there, the fear of an unwanted pregnancy is a very real and valid concern. Yet, when it comes down to actually choosing a form of birth control that works best for one’s body, the prevailing Asian mentality of shame and fear of being perceived still seems to cloud much of our judgment. “It’s dependent on the age group but the majority of women in Singapore uses oral contraceptive pills or just regular condoms,” explains Dr Michelle Chia of feminine health clinic Ezra Clinic.
And whilst condoms may be the least invasive method of birth control—and is more of a shared responsibility—there’s no denying that there’s still a certain degree of risk that comes with it. As for the trusty pill? Beyond the hormonal impact it can also have on one’s body, Dr Chia explains that it’s also highly dependent on the user: “The user needs to remember to take the pill; its efficacy will drop significantly if they forget to take their pills on time.”
The information fatigue surrounding the different types of birth control—plus what each of them can do to our bodies—is one we wish was an easier topic to internalise. But it’s your body, and you should know all the facts. Here, a summary of the alternative birth control options to consider, including how they may or may not affect your internals. At the end of the day, it’s imperative to book a visit with a doctor you trust, for them to best advise you on the suggested route.
Hormonal types of birth control
On a broader scale, there’s plenty of misinformation when it comes to hormonal contraceptives. “Common concerns are weight gain, or whether birth control will affect their future fertility, so more needs to be done to improve education and awareness in Singapore as a whole,” says Dr Chia. “There are no particular signs to look out for (as to whether it will affect one’s hormones), so we usually look at their medical history whether they have any contraindications to using hormonal methods or not.”
Birth control implants
A small, thin and flexible plastic rod (similar to the size of a matchstick), the birth control implant is meant to be inserted just under the skin in the upper arm. It’s ideal for women who want a more long-term form of birth control, as it can last for three years. A progesterone-based type of contraception, inhibiting ovulation from taking place by keeping the uterus lining thin.
On why women would usually opt for implants? “Some people are more comfortable with the idea of having an implant in the arm versus the idea of having something inserted into the womb. The IUD procedure also tends to be more uncomfortable while the implant is usually painless as it utilises a local anaesthetic,” Dr Chia adds.
Hormonal IUDs
If it’s long-term contraceptives you’re on the lookout for, then the Intra-Uterine Device (IUD) is usually the preferred alternative, especially if you want to stick to a form of low maintenance and highly-effective birth control that can last for years to come. A tiny plastic T-shaped device inserted into the womb, this progesterone-based contraceptive may not be suitable for women with underlying conditions surrounding the anatomy of their uterus, or if their cervical canal is blocked by fibrous tissues and structures. Does it change after childbirth? Not to fret—IUDs can be safely used in both women who have given birth and women who have never gone through childbirth before.
Whilst it is sometimes used to mitigate heavy menstrual periods, a doctor consultation and concurrent scan will be best to determine if you are suitable for this option.
Contraceptive patches
In terms of ease, the contraceptive patch offers up convenience in spades—and is applied to clean, dry skin once every week, before pausing for the week of your menstrual cycle. It is commonly placed on the buttock, abdomen, hips or upper back. The estrogen and progesterone hormones are absorbed into the body through the skin, and works similarly to the pill to prevent ovulation and hence pregnancy. On the whole, it’s a shorter-term form of contraception that is both discreet and non-invasive, and even preferred over pills if someone would prefer to avoid popping a pill every day. Some people may suffer from skin irritation, rashes, headaches, bloating and mood changes, as a result of hormonal changes.
Contraceptive injections
Unlike the pill and the patch, the contraceptive injection is a progesterone-only form of hormonal birth control—and each jab only needs to be done once every 12 weeks, which reduces the anxiety of missing out on the daily pill. By increasing progesterone levels in your body, not only will an unfavourable environment for the sperm be created, but internal signals will also be sent to your brain to prevent ovulation from happening.
As it is a progesterone-only form of contraceptive, its side effects will differ to contraceptive options that contain both hormones. Things like irregular bleeding, lighter menstrual periods, headaches, weight changes, water retention and potential reduction in bone density may be par for the course—the latter is only if its been used for a prolonged period of time, however.
Non-hormonal types of birth control
Copper IUDs
The copper IUD’s plus point is that it is the only form of birth control that is non-hormonal. Instead, the copper intra-uterine device releases copper ions which are toxic to the sperm and makes the cervical environment unfavourable for fertilisation. Similar to the hormonal IUD, it is an effective, long-term form of birth control, but for anyone facing menstrual issues, it may pose additional concern. “Copper IUDs can make one’s periods more heavy or more painful, so it is dependent on what the patient prefers and is comfortable with,” adds Dr Chia.
The insertion process does not require any form of anaesthesia or sedation, and should take no more than 10 to 15 minutes if done by an experienced doctor. Some discomfort and cramping is to be expected, but it is best inserted during your menstrual period so arranging an appropriate date according to your monthly calendar is best.
