Life can change suddenly: you might have met a new man, or you've just had a baby. Exciting events in your life often means contraceptive considerations are low down on your priority list.
Whether you have just met the man of your dreams, decided to settle down, had a baby, completed your family or had some disorder diagnosed, you will have to reconsider your method of contraception.
An unwanted pregnancy can complicate your life enormously. If you think you are too busy to think about contraception, compare it to how busy you would be if you have to get up at 3am to change yet another nappy.
Becoming sexually active for the first time
The younger you are, the more likely it is that having sex for the first time will be an unplanned event. The rule of thumb, however, should be, that if you are responsible enough to consider having sex, you should be responsible to take precautions against STIs and pregnancy. How much trouble can it be to carry a few condoms?
These protect against both STIs and unwanted pregnancy – if used correctly.
Ending a relationship or changing partners
Whether we like it or not, a new partner does mean greater exposure to STIs. Latex condoms provide adequate protection. Women are at greater risk of being infected with an STI than men are.
When considering settling down, other hormonal contraceptives can be considered, such as the pill or the contraceptive injection. It is advisable for both you and your partner to be tested for any STIs before having any unprotected sex. The grim reality is that failure to do so could carry the death sentence in the form of an HIV infection.
Settling down with one person
If both of you are monogamous by choice and tested clear for STIs, the focus now moves on to preventing pregnancy if you're not ready for parenthood quite yet. The pill, the IUD (intra-uterine device), condoms, spermicidal jelly or the contraceptive injection – the choice is yours.
Forget about the rhythm method – there is a joke that goes: “What do you call people who use the rhythm method? Parents.”
Doctors recommend that women go off the pill two or three months before trying to conceive. This re-establishes the natural cycle. It can also take a couple of months for the natural cycle to re-establish itself if you stop using the contraceptive injection.
Just remember that If you are using any of the barrier methods, you will become fertile the minute you cease using it.
Unless you want to have another baby very soon, it is advisable to pay particular attention to contraception after you have given birth. Most women prefer to have a bit of a break between babies – it is hell trying to cope with four-hourly feeds and morning sickness at the same time. Don't rely on the protection breastfeeding is supposed to provide.
It might be a good idea to always use condoms until your hormones have settled down.
When you've had all the children you want
You could consider sterilisation or your husband a vasectomy. A vasectomy is a considerably more simple procedure than sterilisation. The only drawback to both of these is that they are rather permanent decisions. Reversal surgery cannot guarantee any regained fertility. Condoms, the pill or the injection are also possibilities.
The onset of menopause
Once menopause sets in, periods can become very irregular. This does not mean that you no longer ovulate now and then - only thing is that you will have no idea when. There is a word in Afrikaans for babies conceived during this time of a woman's life: a 'laatlam'.
A change in health status
High blood pressure or diabetes, for instance, might force you to change your contraceptive method if you are on the pill. The high oestrogen levels contained in the contraceptive pill might exarcebate your condition. Non-hormonal methods are recommended, such as condoms or an IUD. The progestin-only mini-pill could also be a solution.
(Susan Erasmus, Health24, updated October 2011)
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