Birth Control

You should consider the following factors in your decision:

• Your age
• Frequency of sex
• Smoking or alcohol use
• Your weight 
• Personal medical history (and any long-term medications you may be on)
• Family history 
• The interval from your last childbirth
• Timeline for future pregnancy plans (if any)
• Personal and partner preference

Broadly, methods can be classified as hormonal or non-hormonal, as well as short-acting or long-acting. They work through a variety of ways, including preventing egg release from the ovary (ovulation), preventing sperm from getting into the womb (either by thickening the cervical mucus or as a physical barrier), preventing fertilisation of egg or  preventing fertilised egg from implanting into the womb. 

Here are the birth control options available in Singapore: 

It is a soft plastic, thin, 4cm rod that is injected just underneath the skin of your inner arm under local anaesthesia, where it release progesterone hormone slowly over 3 years. It is a birth control method that is 99% effective in preventing pregnancy by prevent egg release (ovulation) and thickening the cervical mucus. It also has additional functions of treating heavy periods and bad menstrual cramps.

It can be inserted (or removed) in the clinic as long as you are not pregnant, and takes 7 days to start working. It has not been shown to be associated with weight gain. 

The implanon does not protect you against sexually transmitted infections (STIs) – you should use condoms in addition for that.

It is a small, inert, T-shaped device that is inserted into the uterus. It sits in the cavity of the uterus, with 2 short threads attached to its end that passes out through the cervix for easy removal. An IUD lasts for 5 years, and prevents pregnancy by thickening the cervical mucus, preventing fertilisation of the egg and making it difficult for implantation of a fertilized egg. Only 1-2 out of 100 women on IUD will become pregnant over 5 years, which makes it a highly effective birth control method. 

There are 2 types of IUD – the copper IUD (known as the copper-T or copper coil), and the Mirena IUD (this contains progesterone hormone). The copper IUD works immediately after insertion, while Mirena takes 7 days to start working. Both are as effective for birth control, but the Mirena IUD has additional functions of treating heavy periods, bad menstrual cramps and endometriosis.

Both can be inserted (or removed) in the clinic if you have had sex and/or given birth before. IUD can also be inserted together with other surgeries e.g. hysteroscopy dilation and curettage, surgical abortion.

The IUD does not protect you against sexually transmitted infections (STIs) – you should use condoms in addition for that.

a. Morning after pill

There are 2 different morning after pills: ellaOne and Postinor-2.

ellaOne has 1 tablet that should be taken as soon as possible within 120 hours (5 days) after sex. It is up to 98% successful if taken correctly. Its effectiveness drops after 120 hours from sex.

Postinor-2 has 2 tablets – the first should be taken as soon as possible within 72 hours after sex and the second should be taken 12 hours after the first tablet. It has a 85% effectiveness in preventing pregnancy, but this is time dependent. If the first tablet is taken within 24 hours after sex, it is 95% effective. If it is taken between 48 to 72 hours after sex, it is 58% effective.

Vomiting is a side effect of the morning after pill and you should take another tablet as replacement and see your doctor if another dose is needed. Other side effects include headache, breast tenderness, dizziness or fatigue.

There are certain medications that can reduce its effectiveness e.g. medicines for epilepsy, tuberculosis, acid reflux.

If you have another episode of unprotected sex after taking the morning after pill, the pill will not stop you from becoming pregnant.

It is crucial that you talk to a trusted doctor who will evaluate your medical history and current condition before recommending the pill to you.

b. Copper T (IUD)

This small T-shaped device that is put into the uterus. It should be inserted as soon as possible within 120 hours (5 days) after sex, or up to 5 days after the earliest time you may have ovulated. This can be done in the clinic. It is more effective than the morning after pill in preventing pregnancy (99% success), and can be left in to be used as your regular birth control method.

• Emergency contraception does not work if you are already pregnant
• Morning after pills should not be used as your regular method of birth control
• Emergency contraception does not protect you against sexually transmitted infections (STIs)
• Although it is common for your next period to be a few days late, you should do a pregnancy test anytime you suspect you may be pregnant and see your gynaecologist