Contraceptives in the Philippines: What to use, where to get

 MANILA, Philippines – Once you start becoming sexually active, responsibility should accompany it.

It doesn’t sound too sexy but if having a kid can’t be found anywhere in your 5-year plan, you’ve got to take your bedroom fun a little more seriously.

In the Philippines, contraceptives are available for people with all kinds of lifestyles and all kinds of plans. Whether you’re single or married, whether you never want to have kids or you want to have children come next year, you’ve got your options.

Rappler lists what’s available to you, where to get them, and why these methods are, or are not, for you.

Birth control pills

 

How does it work:  Prevents ovulation

How often do you use it: Take one pill a day.

Effectiveness with regular use: >99%

Where to get them: Public health centers, drug stores

What most of us know and use as birth control pills are more formally known as Combined Oral Contraceptive Pills (COCs). The pill gives you a blend of two hormones: progestin and estrogen. Each kind of birth control pill contains a different proportion of progestin and estrogen, and though it prevents unwanted pregnancies for all women, some pills can cause weight gain, a change in your menstrual cycle, increased or decreased acne, and so on.

If you’ll be using birth control pills for an extended period of time, it’s best to seek a prescription. Some up-sides to using COCs are decreased dysmenorrhea, regularizing your menstrual cycle, and a possible lessening of nasty PMS.

If you’ve recently given birth and are breastfeeding, don’t use COCs – especially if it’s been less than 6 weeks since the time you’ve given birth. Going on the pill can affect your body’s ability to produce breast milk for your baby.

Extended use of the pill is safe but expect that it can delay, or stop your menstruation altogether. Once you stop using the pill, fertility returns almost immediately. If you’re on the pill and you forget to drink one for more than 3 days, you’re liable to get pregnant.

Below is an overview of COCs you can get in drug stores in the Philippines. 

Generic brand name	Brands	No. of tablets in a pack	Can be used as an ECP
Cyproterone/ Ethinylestradiol (EE)	Althea, Ancea, Crimson, Diane-35	21
Desogestrel / EE	Mercilon	21
	Marvelon 28	28
Drospirenone / EE	Yaz	28
	Yasmin	21
Gestodene / EE	Gestodene, Gynera
Norethisterone / EE	Micropil	21
	Micropil Plus	21
Levonorgestrel / EE	Nordette	28
	Microgynon 30	21
	Trust Pill	21
	Cazul, Charlize, Femme, Lady, Seif, Blush	28
Norgestrel / EE	Logentrol	28
BIPHASIC Desogestrel / EE	Gracial	22
TRIPHASIC Levonorgestrel / EE	Logynon, Trinordiol	21
QUADRIPHASIC Estradiol valerate and Dienogest	Natazia	28

Source: Clinical Practice Guidelines from the Philippine Society for Responsible Parenthood, 2002

 

Microgynon 30 and to an extent, Marvelon 28 are available in public health centers for free. Microgynon 30, as well as Nordette and Trust Pill can all be used as emergency contraceptives (ECPs) in cases where you’ve had unprotected sex or whenever mishaps with the use of condoms happen. 

If your body can’t handle estrogen, talk to your doctor or a women’s heath clinic about progestogen only pills or POPs.

Injectables

 

How does it work:  Thickens the mucus in the cervix, preventing the sperm from reaching the egg, also prevents ovulation

How often do you use it: Get one injection every 3 months

Effectiveness with regular use: >99%

Where to get them: Public health centers, private clinics, women’s health clinics with trained service providers

Injectables available in the Philippines are limited to progestogen only injectables, also known as depot medroxyprogesterone acetate (DMPA). If you’re with a regular partner, it’s a reliable way to prevent unwanted pregnancies that don’t include any daily tasks on your part. The Likhaan Center for Women’s Health (Likhaan) says this method is quickly growing in popularity in the country.

Be prepared for possible side effects such as weight gain and changes in your menstrual cycle. For many women, the more regularly they use injectables, the more likely they are to have amenorrhea or an absence of menstruation. Don’t worry, not having your monthly period doesn’t mean you’re unhealthy or infertile.

A more serious risk when it comes to DMPAs is the possible loss of bone mineral density, making it more advisable for women who’ve reached or are near to reaching their peak bone mass. It’s been observed that women who use DMPA injectables for up to 5 years experience the kind of bone loss usually associated with breastfeeding. The good news is a 2008 study says that the bone loss is reversible, once you stop using DMPAs.

If you have hypertension, or you’ve experienced a cardiovascular disease like a stroke, and if you’re breastfeeding, stay away from DMPAs.

Once you stop using the injectables, fertility remains almost immediately but it depends on the length of time you’ve been receiving injectables for birth control. The longer you were on injectables, the more time it will take for your body to be fertile again. If you go without your DMPA for more than 4 weeks, you could get pregnant.

Injectables are free in public health centers as long as they have trained service providers who can administer the injection. They’re also available in private clinics and women’s health organizations who have trained health workers. A specific brand of DMPA, Depo Trust, is also available in drug stores. You can buy them by the vial – one vial is good for one dosage. To administer them, you will still have to go to a trained service provider. 

Implant

How does it work:  Thickens the mucus in the cervix, preventing the sperm from reaching the egg, also prevents ovulation

How often do you use it: Get one implant every 3 years

Effectiveness with regular use: >99%

Where to get them: Private clinics or women’s health centers and organizations such as Likhaan

Implants are exactly what they sound like. A small rod the size of a matchstick containing progestogen is inserted into your non-dominant arm where it’ll stay for 3 years, after being implanted in just a few minutes. The progestogen, a female hormone, is released into the body little by little throughout the 3 years, stopping eggs from being released into your ovary – the same way it works with DMPAs. 

Ranging from a time period of either a week or two months from when you’ve been implanted, you’ll have irregular menstruation until it stops completely. Once the implant is removed, most women begin ovulating again within 3 weeks to 3 months.

As of today, you can get implants in private clinics and women’s health centers like Likhaan. According to Likhaan, public health center workers in Metro Manila are still being trained to administer this long-term contraceptive.

If you have pulmonary tuberculosis, or you’re living with HIV, choose another form of contraception.

What will your reproductive health calendar look like if you choose one or the other? Likhaan shows the women who come to them this table, prompting them to look 20 years into the future.

Contraceptive method	Frequency in 20 years
Birth control pills (COCs)	7,300 pills
Injectable DMPAs	80 injections
Implants	7 implants

Finally, before making the decision, know if your preferred contraceptive method is good for your body or not. The World Health Organization provides a medical eligibility criteria wheel that shows whether COCs, DMPAs and implants are advisable or not. Here’s some general information you can get from the wheel:

Legend:

1 = Yes: Use the method in any circumstance

2 = Yes: Generally use the method

3 = No: Use of the method is not usually recommended unless other more appropriate methods are not available or acceptable

4 = No: Method NOT to be used

Condition		COCs	DMPAs	Implants
Age	First menstruation to older than 18 yrs	1	2	1
	40 yrs old and older	2	1-2	1
Smoking	Less than 35 yrs	2	1	1
	35 years old or older	3	1	1
Hypertension	140-159, 90-99	3	2	1
	>160/>100	4	3	2
Headaches	No migraines	1	1	1
	Migraines where the person sees a bright spot in her vision before the headache	4	2	2
Diabetes		2	2	2
Obesity		2	1	1
Postpartum breastfeeding	Up to 6 weeks	4	3	3
	6 weeks to 6 months	3	1	1
Cancer	Breast cancer, current	4	4	4
	Cervical cancer, pre-treatment	2	2	2

If you’re still looking for something more long-term than 3 years, ask a doctor or a women’s health center about copper-bearing intrauterine devices (IUDs). IUDs are very small T-shaped plastic structures with copper on their stem and ovaries. It’s easily inserted into the uterus and can be removed just as easily. The copper prevents sperm from meeting a female egg. It’s effective for 10-12 years, the most long-term of all contraceptive methods available in the country. This can only be administered by trained service providers, such as Likhaan.

Whatever you choose as the best method for you, remember that contraceptives aren’t replacements for condoms as protection from sexually transmitted diseases. 

Sex is not just something you do for fun. If you want to stay healthy and accident-free, do away with the carelessness and get to know your contraceptives. – Rappler.com

Sources:

World Health Organization

Association of Reproductive Health Professionals

Likhaan Center for Women’s Health