Alternative methods  of birth control

Alternative methods of birth control

For those ladies who cannot use or do not wish to use the birth control pill, other options are available.


This is a barrier method of birth control that prevents sperm from coming into contact with egg cells. Both male and female condoms are widely available.

Intrauterine devices (IUDs), locally known as “Loop’’

Intrauterine devices offer an alternative to the birth control pill.
A small device made from plastic and copper is inserted into the uterus at the hospital. IUDs can be hormonal or non-hormonal.
Hormonal IUDs thicken the cervical mucus and suppress ovulation. Non-hormonal IUDs produce an inflammatory response in the uterus that is toxic to sperm. It lasts for up to 10 years and is highly effective at preventing pregnancy.
Adverse effects include inter-menstrual spotting and irregular menses. Some IUDs can lead to heavier periods with worsened cramps.

The injections e.g Depo-Provera and Nur-isterate

Having a shot of contraceptive hormones can be a more reliable way of preventing pregnancy than using a pill, as the user does not have to remember to take it at the same time every day.
Both Depo-Provera and Nur-Isterate suppress ovulation and thickens cervical mucus to reduce the chances of sperm from reaching egg cells, just as the birth control pill does. They are progestin-only contraceptive (POC).
The advantage of the injection is that you do not have to take it every day, but you do have to remember to have another shot after three months for Depo Provera, and two months for Nur-isterate.
Some of the shot’s side effects are similar to those of the birth control pill.
Anyone who has had breast cancer is advised not to use it. People with a history of heart diseases, diabetes or stroke are discouraged from using the injection.
Depo-Provera has also been linked to a loss of bone mineral density, increasing the risk for osteoporosis and bone fracture in later life.

Contraceptive implants

A small, plastic rod is implanted into the upper arm during minor surgery. For the next three years, it releases a hormone to thicken cervical mucus, thin the endometrial lining and suppress ovulation. It is highly effective.
Side effects are similar to those of the birth control pill.


This is a shallow, dome-shaped rimmed cup that is placed in the vagina to block the cervix. Used with spermicide, it prevents the sperm and egg from meeting. Disadvantages include possible urinary tract infections and vaginal irritation. The irritation may stem from a reaction to the material the diaphragm is made from or the spermicide.

NuvaRing (vaginal ring)

A plastic ring is inserted into the vagina, and it releases hormones to suppress ovulation. Each month, it is inserted for three weeks and removed for one week, during which menstruation occurs. These hormones are very similar to the pill, so similar side effects can occur, including inter-menstrual spotting, headache, and reduced libido.

Surgery is carried out that blocks the fallopian tubes. This is normally permanent, although some new developments are in place to ligate the tubes back together, costly procedure.

NB: Only the condom offers protection against sexually transmitted diseases (STDs), including HIV/AIDS. None of the above methods offer protection against STDs.

  • Retšelisitsoe Nkhahle is a Mosotho pharmacist based in Botswana. She is pursuing an Msc.
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