Dr Caroline Cooper
Following on from our What’s The Best Contraception? article, we’ve spoken to Dr Caroline Cooper, Women’s Health Specialist, to bust myths about the Pill and find out if there really is a ‘best’ contraception.
Different contraceptives work differently for different people but which one is the best?
Dr Caroline – "I think it really depends on what you want. Women are going to want different things at different times in their lives, so if you want something that’s going to be effective, one of the long acting ones such as the implant, injection, hormonal coil or IUD would be good as they do not have to be remembered every time you have sex or every day as you do with the Pill. But if you’re thinking about having something that will give you contraception but also some health benefits such as treating heavy periods, then the hormonal coil and the Pill can be effective. Certain Pills can help you with acne and spots. It’s impossible to say what’s best but as an individual woman, you’ll be able to find what’s best for you."
It’s advised that you shouldn’t stay on the pill for an extended amount of time. Why is it that you should take a break from it?
DC – "This is such a myth that I can’t believe that it’s still going round, because there’s absolutely no evidence at all of that. The pills that we have now are rapidly reversible so the only reason you would stop would be because you were having side effects or if you wanted to get pregnant. What’s happening is a lot of women are hearing that myth, stopping the Pill and because it’s so rapidly reversible, they’re getting pregnant and not meaning to. So I’d definitely say don’t take a break! Take it for as long as you need and stop when you want to."
Do you feel that young people are more or less concerned about their sexual health than in previous years?
DC – "I think they’re more concerned, they seem to be very aware. I see people of all ages and certainly, the older people seem less aware, as last year’s abortion statistics show. The number of abortions in all age groups aged 20 and over increased, while teenage levels continued to fall. Young people are definitely more aware, they’re getting messages about chlamydia and that seems to be getting through and they’re having screenings for STIs. A lot of young women, although they are concerned about sexual health and preventing pregnancy, have got a lot of concerns about future fertility because they’re hearing a lot about women having problems later on."
If you were going to come off contraception to become pregnant, how would you proceed with that? Do you come straight off it or are there things you should be doing to prepare yourself?
DC – "Well, a lot of them are rapidly reversible, but obviously if you have a medical condition you should discuss it with your doctor. Take folic acid and make sure you’re doing all the pre-pregnancy things, stop taking your contraception and often your fertility will come back straight away. Sometimes women like to wait for a normal period to come back so that they know they are having a normal cycle, but there’s no medical reason for that. The only one that I would suggest stopping a while before is the contraceptive injection because that can take up to a year for your fertility to come back."
If you’ve already had children are there any specific types of contraception you should, or shouldn’t, be using?
DC – "From three weeks after having your baby you can start using contraception. The combined Pill is not suitable for women who are breastfeeding, particularly in the first six weeks, so you’d be better to avoid that. Again, it depends on what you want. If you’re planning another pregnancy in the next couple of years then you’d want something reversible such as a hormonal coil or IUD. If you’ve finished your family then you’d want something really effective and the long acting reversible methods are very effective. One of the things that I thought people might not be aware of is that if you’re breast feeding and you’ve got a baby that’s six months old – and you’re exclusively breast feeding and your periods haven’t come back, then that’s a contraceptive in itself. It’s an old fashioned method I guess, but I think it’s around 98 per cent effective, as effective as a lot of the Pills are. I think doctors don’t advise it because we’re always saying you need to use contraception, and also because a lot of women don’t exclusively breast feed for a long time, so they’d be giving them other drinks or additional feeds."
If you had an STI such as Herpes or HIV, ones that can’t be cured, would getting pregnant be a possibility?
DC – "There’s no reason that you can’t get pregnant, but I would certainly say it would be worth discussing with your doctor first of all so that you could have a treatment that would prevent you passing it on. There’s also artificial insemination, but I think with something like that, certainly it would be something that you would discuss with your doctor and get the most up to date advice."
Cara Mason @FemaleFirst_UK
tagged in Pregnancy Sexual Health Sexual Health Education