Contraception and Fertility: Options and Common Myths

The ability to decide whether and when we want a pregnancy is one of the pillars of female health and autonomy. However, both contraception and fertility are surrounded by a wealth of information, often contradictory and riddled with myths.

In this "For Them" episode, we'll address the available options with clarity and scientific evidence and debunk common misconceptions so you can make informed decisions about your body and your future.

Part 1: Contraception - The Power of Choice

Choosing a contraceptive method is a personal decision that should consider your lifestyle, health, and future plans. There is no universal "perfect" option; rather, it is the option that best suits you at this stage in your life.

Modern Contraceptive Options

Science offers us a wide range of highly effective methods. Here we group them by their mechanism of action:

Hormonal Methods: These are the most commonly used due to their high effectiveness. They work primarily by preventing ovulation.

Birth control pills: Combined (estrogen and progestin) or progestin-only. They require a daily dose.

Contraceptive patch: It adheres to the skin and is changed weekly.

Vaginal ring: It is inserted into the vagina and changed monthly.

Contraceptive injection: It is administered monthly or quarterly.

Subdermal implant: A small rod that is inserted under the skin of the arm and lasts for several years (3 to 5).

Hormonal Intrauterine Device (IUD): A small T-shaped device that is placed in the uterus by a gynecologist and releases a low dose of hormones, lasting up to 5-7 years.

Barrier methods: These physically prevent sperm from reaching the egg. They are the only ones that also protect against sexually transmitted infections (STIs).

Male and female condoms: Essential for comprehensive sexual health.

Diaphragm: A silicone device that is placed in the cervix before sexual intercourse.

Copper Intrauterine Device (IUD): Hormone-free. The copper T creates a hostile environment for sperm, preventing fertilization. It can last up to 10-12 years.

Permanent Methods:

Tubal ligation: Surgical procedure for women.

Vasectomy: Surgical procedure for men.

Common Myths about Contraception

Myth: "Hormonal contraceptives make you gain weight."

Fact: Large-scale scientific studies have not found a direct causal relationship between modern hormonal contraceptives (at lower doses) and significant weight gain. Some women may experience temporary fluid retention at first, but not an increase in body fat.

Myth: "Using birth control for too long causes infertility."

Fact: FALSE. This is one of the most widespread concerns and has no scientific basis. Fertility usually returns to its natural state shortly after discontinuing the method. The perception of "delay" is sometimes due to the fact that the age at which the method is discontinued is later than when it was started.

Myth: "The IUD is only for women who have already had children."

Fact: Modern IUDs, both hormonal and copper, are safe and effective for nulliparous women (who have not had children). International gynecological guidelines recommend them as an excellent long-term option for a wide range of women.

Myth: “Contraceptives are abortive” (LET THE AGENCY DEVELOP IT)

Part 2: Fertility - Understanding the Paths to Motherhood

Fertility is a spectrum, and the ability to conceive depends on multiple factors for both women and men. Discussing infertility (the inability to achieve pregnancy after a year of trying without protection) requires a medical diagnosis and should not be based on assumptions.

Options to Assist Fertility

When natural conception is difficult, reproductive medicine offers various alternatives:

Ovulation induction: Medications are used to stimulate the ovaries and ensure the release of eggs.

Artificial Insemination (AI): A semen sample is processed in the laboratory to select the best quality sperm and introduced directly into the woman's uterus at the time of ovulation.

In Vitro Fertilization (IVF): This is a more complex procedure in which eggs are extracted and fertilized with sperm in a laboratory. The resulting embryos are cultured for a few days before one (or more) are transferred to the uterus.

Fertility preservation (Egg vitrification): Allows women to freeze their eggs at their most fertile age for future use, an option increasingly considered for personal or medical reasons.

Common Myths about Fertility

Myth: "If I have my period every month, I'm fertile."

Fact: A regular cycle is a good sign, but it doesn't guarantee fertility. Ovulation may not occur every cycle (anovulatory cycles), and other factors, such as egg quality or fallopian tube patency, are crucial.

Myth: "Infertility is primarily a female problem."

Fact: The statistics are clear. Approximately 30-40% of infertility cases are due to male factors, 30-40% to female factors, and the remainder to combined or unexplained causes. A couple's assessment is always essential.

Myth: "Relaxing and 'not thinking about it' is the best solution for getting pregnant."

Fact: While chronic stress can affect hormonal balance, infertility is a medical condition with biological causes. If you've gone the recommended amount of time without achieving pregnancy, seeking medical evaluation is a proactive and necessary step, not a sign of impatience.

Conclusion: Information to Decide Freely

Both contraception and trying to conceive are deeply personal journeys. The best tools we have are accurate information and the support of a healthcare professional.

We invite you to talk to your gynecologist, ask questions without fear, and choose the path that best aligns with your life plan.