Choosing the right birth control option to suit your own life and body can be hard enough when you're in your home country, but trying to figure out your possibilities in Beijing can add a whole other layer of confusion.
READ: Protect Yourself With These Chinese Phrases for Condoms and Birth Control Pills
In comes Dr. Yidan Zhou, a new obstetrics and gynecology (OBGYN) doctor at the Kerry Center's Vista Medical Center. We spoke to her about the options that Vista Medical Center can provide and the details about how your body is likely to respond to each option.
What is your personal background, your education, and how did you end up becoming an OBGYN?
I graduated from Peking Union Medical College and got my MD degree in 2001. I studied under the distinguished academician Lang Jinghe of Peking Union Medical College Hospital's (PUMCH) OBGYN department.
I started working in the Gynecologic Oncology department in the Cancer Hospital of The Chinese Academy of Medical Sciences in 2009. Then, in 2015, I went to Houston Methodist Hospital and the MD Anderson Cancer Center in the United States as a visiting scholar of scientific research. After returning to China, I chose to join Vista Medical Center as an OBGYN.
What are the most commonly used contraceptive methods? Could you elaborate on each option, why people tend to choose this option, how long it lasts, and whether there are any severe side effects?
As no method of contraception is perfect, each woman must balance the advantages of each method against the disadvantages and side effects, and decide which method she prefers.
At Vista Medical Center, if you have the need for contraception, you'll get a professional consultation with an OBGYN before any decisions are made. Women are counseled to choose the most effective method for their circumstances and situation. The table below lists some of the most frequently chosen options.
| Copper IUD | Levonorgestrel-releasing IUD | Etonogestrel implant | Contraceptive pill | |
| Duration of efficacy | 10 years | Three to five years (depending on type) | Three years | Use daily |
| Hormonal exposure | None | Progestin | Progestin | Estrogen and progestin |
| Effect on menses | May be heavier | Lighter, irregular. Especially in the first three to six months | Lighter, irregular | Lighter, regular, predictable withdrawal bleeding with cyclic use |
| Unscheduled bleeding/spotting | Yes | Yes | Yes | Yes |
| Not a good choice for otherwise healthy women* with: | Heavy or painful periods, iron deficiency anemia, severe distortion of uterine cavity, copper allergy or Wilson's disease, active pelvic infection | Severe distortion of uterine cavity, active pelvic infection, poor tolerance of amenorrhea or unscheduled bleeding, sensitive to hormonal side effects | Poor tolerance of amenorrhea or unscheduled bleeding | Contraindications to using exogenous estrogen or who are sensitive to estrogen-related side effects (eg, nausea, breast tenderness, headaches, etc), women over 35 years who smoke |
| Selected adverse events | Uterine perforation, expulsion, increased risk of pelvic infection in the first 20 days after insertion | Uterine perforation, expulsion, increased risk of pelvic infection in the first 20 days after insertion | Infection or scarring at insertion/removal site, difficult removal | Increased risk of venous thrombosis, hepatic adenoma |
| Selected advantages | Highly effective long-acting method that can be used by women who must or choose to avoid exogenous hormones | Reduction in menorrhagia, dysmenorrhea, and endometrial hyperplasia | Highly effective long-acting method that can be used by women who must or choose to avoid estrogen | Benefits of estrogen include a reduction in dysmenorrhea, menorrhagia, acne vulgaris, and vasomotor symptoms (perimenopausal women) |
| Access | Must be inserted and removed by a clinician | Must be inserted and removed by a clinician | Must be inserted and removed through a tiny skin incision by a clinician with special training | Prescription |
Which are the most frequently selected options?
We find that the most frequently selected options at our clinic are both the contraceptive pill and the levonorgestrel-releasing IUD.
Do you find there is a difference between Chinese and Western women?
In China, women tend to choose an IUD more frequently, but Western women tend to prefer to choose the oral contraceptive pill. We believe this is probably because Westerners are more used to medication and taking it on a daily basis.
What are the most common oral contraceptives available in Beijing? Are these readily available?
The most common oral contraceptives available in Beijing are "Yasmin" and "Diane35." Both of these contraceptive pills contain estrogen and progestin components. These medicines are all readily available.
What factors can make a contraceptive ineffective?
Contraceptive efficacy is expressed as both the theoretical and the actual effectiveness. The former refers to the pregnancy rate among those who use the method correctly on every occasion; actual effectiveness is usually lower due to inconsistent or incorrect use. Actual effectiveness is also influenced by frequency of intercourse, age, and regularity of menstrual cycles.
As the statistics show, the effectiveness of contraceptive pill when used typically is nearly 90 percent, but is more than 99 percent when used correctly. Among users of hormonal contraception, forgetting or mistiming doses is common, and plays a factor in unintended pregnancy.
READ: How to Navigate Buying Medicine at a Local Pharmacy
For healthy women, most contraceptives can be started on the same day as the visit, and require minimal examination or testing prior to initiation, but pregnancy should be excluded. Women who have not taken hormonal contraceptives for the previous menstrual cycle should start taking medication on the first day of their menstrual cycle. If you start taking them between the second and fifth day of your menstrual cycle it is recommended to also use other types of contraception for the first seven days.
This post is paid for by Vista Medical Center.
Photos: abrilmundoestranho.files.wordpress.com, courtesy of Vista Medical Center, imgarcade.com
IUD is also popular in Pakistan. And the best thing is government provides it for free. Only Doctors charge their consultation fee around Rs. 1000/= but in villages (where income capacity is on a lower side), doctors charge less from Rs. 300 to 500.
The problem with pills is that you have to be dispciplined, as its the matter of daily routine.
Therefore, we go for the copper thing, it's bit problematic in the first month, but then its feels alright. Also, it works on 98% of the women.
