Contraception 101 in Malaysia | By Jeypraba Veerapan
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| Illustration by Jessica Peggy Riekert. |
World Contraception Day is celebrated on 26 September every year to raise awareness about the different types of contraceptive methods available. This occasion reminds young people to make informed choices on their sexual and reproductive health.
First of all, contraception is the prevention of pregnancy using birth control methods such as condoms. In Malaysia, contraception is widely available in urban areas through medical service providers and pharmacies, but contraceptive uptake levels remain seriously low even among women who experience multiple unwanted pregnancies. A negative perception towards the use of modern contraception is still prevalent in Malaysia due to lack of awareness, stigma, inadequate family planning programmes and lack of media coverage.
According to the International Federation of Gynecology and Obstetrics, the growing use of contraceptive methods has led to a reduction in maternal and infant mortality, improvements in socio-economic conditions and increased schooling for girls and women worldwide. In conjunction with World Contraception Day today, let’s take a look at the different types of contraception methods available in Malaysia along with their pros and cons so you can choose the right one for yourself and your partner.
#1 Condoms
Male condom
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| Source: Ally Thatcher on Dribble. |
What is it and how is it used?
A male condom is a rubber or latex cover placed over the penis during sex and it should be put over your partner’s erect penis.
You can check out this step-by-step video by Durex UK for the proper way of putting on a condom.
Pros
Condoms are typically 82% efficient in preventing pregnancy. If used correctly according to instruction, its efficiency rate can go up to 98%. Male condoms also offer protection against sexually transmitted infections (STIs) such as HIV, are relatively cheap and easy to use.
Cons
Male condoms may interrupt sex and occassionally, it can tear or slip off during intercourse and removal.
Price range
Ranges from RM6.00 for a pack of three to RM20.00 for a pack of six. Condoms are priced at RM1 for 3 pieces and RM4 for 12 pieces at government clinics.
Availability
Male condoms are easily available in pharmacies and convenient stores as well as online shopping platforms such as Lazada and Shopee. Male condoms can be obtained at government clinics as well.
Female condom
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| Source: American Health Association. |
What is it and how is it used?
A female condom is a rubber or latex sheath with flexible rings at each end and it is inserted into the vagina during intercourse. The ring at the closed end holds the sheath inside while the ring at the open end stays outside the vaginal opening. Female condoms collect semen before, during, and after ejaculation, thus preventing sperm from entering the vagina.
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| Step-by-step instructions on how to wear a female condom. Source: Avert. |
Pros
Female condoms are typically 79% efficient in preventing pregnancy and if used correctly according to instruction, its efficiency rate can go up to 95%. Besides preventing pregnancy, female condoms also protect against most, but not all STIs.
Cons
Female condoms require practice to be inserted correctly. The outside ring may slip into the vagina during intercourse. The size and hardness of the inner ring may be uncomfortable to some users and could cause vaginal irritation. It is not as easily available as male condoms as it is not a popular type of contraception.
Price range
Usually more expensive than male condoms at about RM15 for one female condom.
Availability
Not as widely available as male condoms, but can be easily purchased on online shopping platforms.
#2 Diaphragm & cervical cap
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| Cervical cap. Source: Getty Images. |
What is it and how is it used?
A diaphragm is a small dome that is placed over the entrance to the womb by the woman to stop sperm from entering. A cervical cap is used the same way as a diaphragm but it is smaller in size.
Check out this link for the proper way of inserting a diaphragm.
Pros
Diaphragms are typically 88% efficient in preventing pregnancy and if used correctly according to instruction, its efficiency rate can go up to 94%. Cervical caps meanwhile, are typically 84% efficient in preventing pregnancy and if used correctly according to instruction, its efficiency rate can go up to 91%.
Cons
A doctor needs to be consulted to determine the right size and users need to learn and practice how to use them at first. They need to be washed and cleaned after use and require careful storage. They might interrupt sex. Diaphragms and cervical caps do not offer protection against STIs and can cause an increased incidence of urinary tract infection.
#3 Intrauterine Contraceptive Device (IUCD)
What is it and how is it used?
It is a T-shaped device containing copper that is put into the uterus by a doctor. IUCDs are placed in through the vagina up the cervix and this process can be done in clinics. A small string hangs down from the IUCD into the upper part of the vagina and it can be felt by the user. It can be attached with a copper or hormonal rod. It occupies the uterine cavity for about three to five years and decreases the lifespan and movement of the sperm. With a hormonal rod added to the device, it changes the lining of the uterus to prevent a fertilized ovum from attaching to the uterine wall.
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| Source: The Family Planning Association of Hong Kong. |
Pros
IUCDs are highly effective. When used with 100% accuracy, not relying on self-administration and used exactly according to instruction, it has an efficiency rate of 99%. It is also long-acting and reversible. It is safe to use for 3-5 years, depending on the type and the device can be removed any time at the clinic with little to no pain.
It requires no daily attention and is immediately effective.
Cons
IUCDs may cause heavier bleeding or cramping and they do not protect against sexually transmitted diseases.
Price range
Hormonal IUCDs may cost between RM800 to RM1,100 while copper IUCDs may cost RM600.00 at a specialist centre. It is either free or priced at RM1 at government clinics.
Availability
Available at private clinics and government clinics.
#4 Birth control pill (The Pill)
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| Source: Vogue India. |
What is it and how is it used?
The pill is a small tablet containing hormones (oestrogen and progestin) that needs to be swallowed by the user at the same time every day. Pills need to be taken for 21 days and then not taken for the next seven days, so the user can get her period. The pills stop the release of ovum and this prevents pregnancy.
Pros
Birth control pills are highly effective, widely available, and easy to use. The pill is typically 91% efficient in preventing pregnancy and if used correctly according to instruction, its efficiency rate can go up to 99%. It also helps to regulate periods, and it is especially good for those with heavy periods as the pill could help reduce period pains.
Cons
The pill needs to be taken every day and it does not offer protection against STIs. It may, for some women, cause side effects such as nausea, headache and breast tenderness. It is also not suitable for women with history or family history of blood clots in the veins.
Price range
Birth control pills may cost anywhere between RM10 to RM55 per pack at pharmacies and it is either free or priced at RM1 at government clinics.
Availability
Birth control pills are usually available at pharmacies and government clinics.
#5 Depo-provera injection
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| Source: Luton Sexual Health. |
What is it and how is it used?
A hormonal (progestin) injection into the muscles that a woman gets every three months. An injection is given either in the arm or upper buttocks/lower back at any time during the first five days of a woman’s period. After the initial shot, a shot is given every 11 to 13 weeks. The hormone thickens the mucus at the uterine opening, making it difficult for sperms to pass through. It also causes the lining of the uterus to thin out, preventing pregnancy to happen.
Pros
The depo-provera injection prevents pregnancy for three months at a time. It is immediately effective, widely available, slowly reduces menstrual flow and may stop periods altogether. It is typically 94% efficient in preventing pregnancy and if used correctly according to instruction, its efficiency rate can go up to 99%.
Cons
It does not protect against STIs. It may also cause irregular periods or spotting, slight weight gain, possible decrease in bone density, and side effects do not wear off until 12 to 14 weeks after a woman stops getting the injection.
Price range
Depo-provera injections cost RM18.00 to RM36.00 per shot and it is either free or priced at RM1 at government clinics.
Availability
Available at private clinics and government clinics.
#6 Hormonal implant
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| Source: Cleveland Clinic Health Essentials. |
What is it and how is it used?
An implant containing hormone (progestin) inserted beneath the skin over the inner side of the upper arm. It releases a small amount of hormone over three or five years to prevent ovulation, thicken the mucus at the uterine opening and thin out the uterine lining.
Pros
A hormonal implant prevents pregnancy over years and the user does not have to remember taking pills every day. It is highly effective and reversible. When used with 100% accuracy, not relying on self-administration and used exactly according to instruction, it has an efficiency rate of 99%.
Cons
It requires trained medical personnel to be inserted and it can be costly. It may initially cause a change in period bleeding patterns.
Price range
Inserting a hormonal implant costs around RM500 and removing it will cost approximately RM100 at government clinics.
Availability
Private clinics and government clinics.
#7 Morning-after pill
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| Source: Sienna Health. |
What is it and how is it used?
Morning-after pills are divided into two groups - either a combination of estrogen and progestin, or progestin-only. They can be taken up to five days after unprotected intercourse, but they work best when taken within three days. It is a second chance to prevent pregnancy if other contraception has failed.
Pros
It is highly effective when used as directed and provides emergency care. It is also widely available.
Cons
It contains very high doses of hormones and cannot replace regular contraception because it does not prevent pregnancy as well as other methods of contraception, such as IUCDs and hormonal rings. Taking the morning-after pill over and over again is usually more expensive and less convenient than being on a regular method of birth control.
Price range
Costs between RM5 to RM53.
Availability
Pharmacies.
How to choose the right type of contraception?
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| Illustration by Maliheh Rahrovan from Reporter Magazine. |
In choosing the right form of birth control for yourself, consider a few key factors such as your age, frequency of sexual activity, family history regarding certain illnesses, comfort level when using a particular method as well as your desire to be pregnant in the future. Talk to your doctor to find out which method works best for you. Do not feel embarrassed if you have to clarify with your doctor on how each method works. Having the right information is important and you should have sufficient information to decide on which birth control method you feel the most comfortable with.
Information provided in this article is for informational purposes only and is not meant to be a substitute for advice by a registered medical practitioner. This information should not be used for diagnosing health problems or for self-medication. Please see your doctor if you have any health concerns. Etc. Magazine and Taylor’s University shall not be responsible for any damages or losses arising out of access to or use of information provided.
Sources:
- ‘Contraception at a Glance’ (How u Know)
- ‘Contraception Methods’ (My Choice)
- Dr. Harlina Halizah bt. Hj. Siraj, ‘Contraception’ (MyHealth Kementerian Kesihatan Malaysia, 27 April 2012)
- ‘Family Planning Services and Fertility Treatment’ (LPPKN)
- Homage Team, ‘Female Contraception: Birth Control Methods, Effectiveness & Side Effects’ (Homage)
- May Vin Ang, ‘Here are the Types of Birth Control Available in Malaysia and How Much They Cost’ (SAYS Malaysia, 3 December 2020)
- Suraya, ‘The Comprehensive Guide to Cost of Birth Control in Malaysia’ (Ringgit Oh Ringgit, 4 September 2019)
- Suraya, ‘What is birth control costing you?’ (Free Malaysia Today, 20 September 2019)
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