Hormonal VS Non-Hormonal: Your Birth Control Pill Alternatives In Malaysia
Remember how, on top of toilet paper, condoms were running out of stock in the wee hours of the COVID-19 pandemic? Turns out, people were already predicting that they were going to need it more than they might need toothpaste.
Recently, the United Nations Population Fund (UNFPA) – in collaboration with Avenir Health, Johns Hopkins University (USA) and Victoria University (Australia) – released an estimate of the number of unintended pregnancies as a result of COVID-19 forcing people indoors and in quarantine. While this might just be a rough estimate, the number is astounding.
It is estimated that over 7 million additional unintended pregnancies could happen because of the isolation period that is getting people to stay indoors.
This is scary. In these already difficult times, an unexpected pregnancy might lead to further stress from already having to adjust to “the new normal”. The statistic is based on the fact that over 47 million women in low- and middle-income countries are unable to use or have access to modern contraceptives. And to be honest, a lot of this is the result of not enough talk about the different options available to women for contraceptives. In Malaysia itself, there are over 6 different options available – and this does not include The Pill or Plan B. While condoms are the only type of contraception that also protect you from sexually transmitted infections, there are quite a few that can stop you from getting pregnant.
Here are some of the lesser-known, longer-term options (with costs!) available right here in Malaysia –
- The Patch [91% effective] (Cost: N/A)
Like the combination pill, the Patch stops ovulation and thickens the cervical lining. Unlike the Pill, it doesn’t require a strict daily regimen—the Patch is a once a week affair and it is applied (patched) onto the skin for a week then replaced with another patch. This method offers the benefit of bypassing the liver, so it is preferred in patients with liver disease. It’s also nearly as discreet as the Pill, as it’s no more obtrusive than a square adhesive bandage. However, it is not very popular in this country because of our weather (high humidity). This causes the patches to detach easily and there is a slightly higher incidence of skin reactions.
- Implant [91-97% effective] (Cost: RM500.00)
An implant is a tiny rod (like a matchstick) that is inserted under the skin of your upper arm. The whole procedure takes five minutes and you’re protected from pregnancy for up to 5 years. Implants keep your ovaries from releasing eggs through the release of progestin from the rod. It also thickness the mucus in your cervical, effectively creating a barrier to your eggs.
- IUD [98 – 99% effective] (Cost: RM800.00 – RM1,100.00)
Intrauterine devices (IUD’s) are available in two different forms – hormonal and non-hormonal. The IUD is “T”, shaped, not that much bigger than a 5 cent coin and fits inside your uterus. Hormonal IUDs contain different levels of progestin, which also acts to suppress ovulation and thicken cervical mucus. Not only is the failure rate at 0.2%, but hormonal IUDs can also last up to 5 years. Plus, you can try having a baby right after removing it – there is no need to wait (some birth control render it impossible for you to conceive for up to 10 months after removal.
Women have reported feeling the side effects of hormonal contraception (including breast tenderness, nausea, cramps while menstruating, headaches) but these usually go away after a few weeks and differ from person to person. It is always safer to speak to a professional before choosing to use a hormonal contraceptive. Alternatively, there are non-hormonal methods to choose from –
- Female condoms [95% effective] (Cost: RM15)
Everyone knows about condoms for men, but what about condoms for women? A female condom is a small pouch with two soft rings on each end. It is usually made from plastic that can fit inside the vagina and cover some parts of the vulva to prevent the fluid exchange between two partners. One ring stays on the outside and one sits near the cervix to keep the condom from sliding out. Female condoms reduce the risk of pregnancies and sexually transmitted infections (STIs) including HIV, herpes and genital warts. They fit all women and can be used even when you’re menstruating. They are also known as the “double-protection” barrier method.
- Monitoring your natural cycle [76-88% effective] (Cost: free)
Now, this is a tricky, more risky option. The Fertility awareness methods (FAMs) (aka “natural family planning”) works by having you track your own menstrual cycle so you’ll know when your ovaries release an egg every month (this is called ovulation). When this happens, which can be up to 10 days, you are meant to avoid unprotected sex. The most effective way of employing FAM is to track a few different measures (which a lot of apps can help with!) – by taking your body temperature every day (to spot spikes), looking for stretchy “egg white” cervical mucus, and charting your cycle on a calendar. But, again, you have to be dedicated to tracking everything in order to know when to avoid having sex and when to use other forms of birth control if you do want to. It is also very difficult to use if you have irregular periods or ovulation patterns.
- “Copper Coils” IUD [98 – 99% effective] (Cost: RM600)
The difference between a normal IUD (hormonal one) and a copper IUD (often called a copper coil) is that, instead of using hormones, the T-shaped device is wrapped in copper. The copper is a natural spermicide, killing off sperm before they reach the egg and preventing implantation even if they get to the egg. A copper IUD has a 0.8% failure rate – meaning less than 1 in 100 women will become pregnant while using the copper IUD. It can also last for years and when you decide to remove it, you can get pregnant right away. Not only that, but it is also an option for emergency contraception (like a more permanent Plan B).
Of course, the different hormonal contraceptives have their own side effects (nausea, cramping, bloating) and the non-hormonal options may not suit your body (for example, using a condom might be painful or irritating for the skin). Don’t try to cut corners by buying cheaper options off of the internet – this is your body and your hormones you might be messing with. Consult a specialist to find the best method of contraceptive that will work for you and your body.
*Cover image credit: Reproductive Health Supplies Coalition on Unsplash