Birth control is a topic that's still not commonly discussed in Singapore.
However, with the increase in sexual awareness and activity amongst the younger generation in Singapore, it's important to raise the awareness of reliable birth control methods.
Going through a situation when an unwanted pregnancy happens can be really stressful and emotional. You must know that this situation can easily be avoided!
How much do you know about birth control methods?
I conducted a study in 2017 on 300 women who were undergoing a termination of pregnancy in Singapore.
The study was specially aimed at looking at the knowledge and the contraception practices amongst these women.
What this study revealed was that a vast majority of women in Singapore have very limited knowledge of the birth control methods available. Many of them also had several unfounded misconceptions!
This is something I strongly hope to improve amongst all women in Singapore and hence the aim of this article is to help break down this information and dispel some longstanding myths on birth control.
Let's start with the age-old question on everyone’s mind…
Is birth control safe?
The answer is yes! Birth control is generally very safe.
Whilst each type of method may have its own minor side effects, most methods can be safely used. To find the most suitable method for your body, go for a consultation with an experienced doctor.
Does birth control affect your future fertility?
This is another very common question that I get from my female patients, ranging from those in their late teens to even their mid-thirties.
For some reason, there's a very widespread misconception that birth control will impair a girl’s future fertility. Many women would rather take the risk and not use any form of contraception.
The most crucial thing to highlight is that most forms of birth control do not affect your long-term fertility and are completely reversible. They can be stopped anytime you wish to get pregnant.
You should also be aware that procedures such as abortion may cause scarring of the womb. That can lead to infertility in the future.
Are there permanent birth control methods?
The only permanent birth control method that will affect your future fertility is tubal ligation. This method is irreversible.
How do these birth control methods prevent pregnancy?
- Hormonal methods: Pills, Injection, Patch, Implanon
The hormones work by preventing ovulation in women who take them. Additionally, they can also cause changes in the cervical mucus. This means that they make the environment more ‘hostile’ for the sperm to reach the egg.
- Non-hormonal methods: IUD
The IUD works by preventing the sperm from meeting the egg. It also causes changes in the cervical mucus creating a ‘hostile’ environment for the sperm. It also makes implantation of a fertilized egg difficult.
- Permanent methods: Ligation, vasectomy
Imagine you are a car driving on a one-way narrow road, and a huge boulder is permanently placed on that narrow road blocking the entire passage. There’s no way you can move forward right?
That’s how these methods work. The fallopian tubes are clipped or the vas deferens is tied, with the clip and the tying off acting as these so-called ‘roadblocks’.
As a result, the egg cannot be released into the uterus, and the sperm cannot be released as well.
What are the different birth control methods available in Singapore?
There are a variety of birth control methods to suit your preferences and needs. It ranges from short term to long term solutions, hormonal or non-hormonal.
|Long-acting reversible methods||How long is it effective for|
|Hormonal Intrauterine contraceptive device||5 years|
|Non-hormonal intrauterine contraceptive device||5 years|
|Hormonal Implant – Implanon||3 years|
|Shorter-acting reversible methods||How often it has to be administered/taken|
|Hormonal injection – IM Depot Provera||3 Monthly|
|Birth Control Pills||Monthly|
|Permanent method||How long is it effective for|
|Vasectomy (for males)||Irreversible|
Emergency Contraception – this is NOT and should not be used as a form of birth control
- Ella (1 pill)
- Postinor (2 pills)
- This is additional protection against sexually transmitted diseases. However, it is unreliable as a birth control method.
Where can I get birth control in Singapore?
- Birth control pills
These can be obtained from most general practitioner clinics. However, do note that several general clinics that do not specially cater to women’s health do not actually stock the full range of birth control pills available on the market. They usually carry 1 or 2 common brands of contraceptive pills.
- Contraceptive patch and Contraceptive injection
The patch can usually be found in general clinics as well, however again, there are several clinics that may not have these.
You may choose to get them from a women’s health clinic.
- Intrauterine contraceptive device or IUD
An IUD insertion requires a doctor with the relevant experience or expertise to perform this for you. Reason being, this is considered an invasive procedure.
You should look for a doctor who has adequate experience with an IUD. Before you decide to insert it, speak to them about the risks, suitability, as well as the potential side effects.
An IUD insertion can be done at a women’s clinic.
- Implanon or Contraceptive implant
The Implanon is usually inserted into the arm. The insertion and removal of this device are also considered an invasive procedure. It has to be performed by a women’s doctor with adequate and relevant expertise.
You should go to a women’s clinic if you are looking to have an Implanon inserted.
- Tubal ligation or Vasectomy
Tubal ligation involves the surgical clipping of your fallopian tubes (for females) while vasectomy involves the tying off of the vas deferens (for males).
These are permanent forms of birth control and require surgery.
They can only be performed by your gynaecologist (for females) or your urologist (for males).
What are the side effects of each form of birth control?
This is another very common question that I get asked all the time.
In my practice, a large majority of my patients fall into the age group of the early 20s to mid-30s, when they are sexually active.
However, not all of them may be ready or planning for pregnancy yet. A huge majority of them also have very limited knowledge of proper birth control methods.
The truth is, each type of birth control method has its own minor inconvenience or side effects. However, these side effects are definitely better than ending up with an unwanted pregnancy.
All of them usually agree with me on this point.
Common side effects of different types of birth control
Here is a breakdown on the common side effects and inconveniences you may experience with each contraception method:
Birth Control Method
Common Side Effects
Birth control pills
Headaches, bloating, initial breakthrough bleeding
A small proportion of girls may experience mood swings or weight changes
Side effects similar to birth control pill (similar hormonal types)
May also get mild skin irritation if you have sensitive skin
Weight gain, headaches, bloating, mild acne, irregular spotting, no menses (after prolonged use)
Non-hormonal IUD (Copper)
Heavier periods, infection, migration or expulsion of IUD
Hormonal IUD (Mirena)
Irregular spotting, very light periods or no menses, infection, migration or expulsion of IUD
Weight gain, headaches, bloating, mild acne, irregular spotting, no menses (after prolonged use)
Permanent and irreversible, increased risk of ectopic pregnancy if failed, risks of surgery and general anaesthesia
(Do note: Side effects listed vary according to the individual and may not apply to everyone using it)
What is the safest form of birth control?
There is no one ‘safest’ method of birth control. Most contraception methods are generally very safe.
However, methods such as the IUD or Implanon are more invasive procedures. Hence, they may carry a slightly higher risk, which is very rare.
Ligation also carries the risk of surgery and general anaesthesia.
Which is the most effective birth control method?
The efficacy of all the proper birth control methods listed above is at least 90%.
On the other hand, condoms, withdrawal or menstrual cycle counting only have an effectiveness of 60 - 70%, with lots of room for “accidents” to happen.
Many people also have the misconception that reliable birth control has to be expensive. Thus, many of them, especially girls who are still in school and not working think that they are unable to afford them.
When I tell my patients that reliable birth control can be available from as low as less than $10 per month, most of them are very surprised.
Cost of different types of birth control in Singapore
Here are the approximate figures on the efficacy and cost of each form of birth control:
1.Withdrawal / Menstrual cycle counting
60 - 70%
$15 - $30 per box
3. Birth control pills
> 95% if taken correctly
$8 - $40 per pack for 1 month
4. Hormonal patch
> 95% if used correctly
$30 - $40 per pack for 1 month
5. Hormone injection
$40 - $50 per shot (for 3 months)
6. Hormonal implant (Implanon)
98 - 99%
$400 - $500 (for 3 years)
7. Intrauterine contraception device (IUD)
98 - 99%
Copper - $150 - $300
Hormonal - $ 500 - 600
(both for 5 years)
8. Surgical sterilization/ligation
$1500 - $3000
Disclaimer: Prices listed are just a rough estimate on the average cost and do not reflect the prices of any particular clinic. Different clinics will have a variation of their cost and charges.
Prices will also differ between public hospitals/polyclinic VS private clinics. Prices listed also do not include consultation cost and procedure fee.
Which is the most common type of birth control used in Singapore?
The contraception awareness study that I conducted in 2017 included 300 Singaporean women. The results of this showed that almost 70% of them were not using any form of birth control, while 25% of them were using just male condoms.
Only a mere 8% or less were using reliable birth control methods, of which birth control pills were the most common choice (5%).
While the statistics in this study certainly may not be reflective of all Singaporean women, it does show that many of us are still not aware of proper birth control methods available.
Can you still get pregnant even if you are on birth control?
Unfortunately, the answer is yes. You might have noticed that none of the birth control methods, including permanent ligation, give a success rate of 100%.
The only way to 100% guarantee a zero chance of pregnancy is through abstinence.
What about males? Are there any birth control methods for men?
The only 2 methods available now are:
- Male condom
- Vasectomy (permanent)
Are there any other added benefits of birth control?
I am pretty sure most of you reading do not know this: many hormonal birth control methods are prescribed by doctors for other female-related problems that do not involve family planning.
- Birth Control Pills
They are very useful for regulating your periods, especially for women with Polycystic Ovarian Syndrome (PCOS). On top of this, they also reduce your menstrual flow, reduce menstrual cramps, improve acne and even provide protection against cancer!
Yes, you heard right. Birth control pills can reduce your risk of developing ovarian and womb cancer in the long run.
- Hormonal IUD
The hormonal IUD, commonly known as Mirena, is very commonly used to treat women with heavy menstrual periods or bad menstrual cramps. Additionally, Mirena can also be used as a form of treatment for endometrial hyperplasia (a pre-cancerous cell change in the womb)
- Hormone injection
This is also useful to reduce heavy and painful periods.
How do I decide which type of birth control to go for and what should I consider?
First and foremost, you need to get a consultation with a doctor.
My advice is to speak to someone who is well versed and experienced with all the various types of birth control. He/she will then be able to adequately weigh the pros and cons of each option for you.
From there, you can decide on the most suitable type of birth control for you.
Personally, I usually base my discussion with my patients on a few key factors:
- Duration of birth control/family planning desired
- Patient’s lifestyle and medical history
- Hormonal vs non-hormonal
- Type of side effects or inconvenience deemed acceptable to the patient
- Financial budget
Are there any limitations to these birth control methods?
Whilst the various birth control methods discussed above are extremely effective in preventing an unwanted pregnancy, they, unfortunately, do not protect against sexually transmitted diseases (STD).
STDs can only be prevented with the use of condoms.
A few main takeaway points I wish to reiterate from this guide:
- There are many birth control options available of which many options have not been heard of by many people: it is possible to find an option that is suitable for you
- Always use some form of reliable birth control if you are sexually active and not planning to get pregnant
- Birth control is safe!
- It does not necessarily cost a bomb to use birth control
- Always speak to an experienced doctor to obtain reliable information to make the right choice!
Dr Michelle Chia graduated from the National University of Singapore. She subsequently underwent her post-graduate training in Obstetrics and Gynaecology in Singapore’s largest women’s hospital, KK Women’s and Children’s Hospital, and Singapore General Hospital.
She has extensive experience in managing a variety of women’s health, general gynaecology issues and antenatal care for pregnancy and aims to provide holistic well-rounded care for all women’s health problems.