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Gynae Clinic

Reversible Contraception Options available in Malta

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By Dr Sarah Sultana Grixti our resident Gynaecologist at National Pharmacy, Hamrun.

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A big Happy First Birthday to The Cloth Nappy Company and a big thank you the for the opportunity to guest post on this achievement!

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So your bundle of joy is finally here! Congratulations and by the way what a fantastic job you mums have done this far!

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Now what’s next mama? Are you gonna dive in straight into further baby making? Or are you gonna delay that for a bit for now? If you’re not up to further baby making for now, I can only hope that this will be your ultimate guide to reversible contraception options available in Malta. Yes, this means that when you stop using either of these methods you can get pregnant again. 

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When it comes to choosing the contraceptive method that is most suited for you - you would need to ask yourself a few questions:

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  • Are you still breastfeeding?

  • Will your lifestyle permit you to choose a method that needs to be taken regularly and on time? Or would you prefer a “do and forget”?

  • How long do you need contraception for? A few months / 3 years / 5 years / 10 years?

  • Do you have any medical conditions that preclude one or the other?

 

So what are the available reversible contraceptions options in Malta?

The Combined Oral Contraceptive Pill (COCP) - This is what we generally refer to when we talk of the “pill”. It contains artificial versions of BOTH the female hormones: oestrogen and progesterone. A pill needs to be taken daily. Generally avoided if breastfeeding.

 

The Mini-Pill (POP) - Once again this involves taking a daily pill. This time there is no break. It contains only one hormone (an artificial version of progesterone). You may continue breastfeeding whilst on the mini-pill.

 

Vaginal Ring - This method involves a ring that needs to be placed in the vagina by the user for 3 weeks. After 7 days a new ring is inserted in the vagina. It contains artificial versions of BOTH the female hormones: Oestrogen and progesterone. Generally avoided if breastfeeding.

 

Implant - This method involves a small plastic rod that is placed by your doctor on the underside of your arm under a local aesthetic. It releases an artificial version of the female hormone progesterone. It is safe to use during breastfeeding and can be inserted immediately after delivery. It lasts for 3 years.

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Injection - This method involves an injection that needs to be administered by your doctor every 13 weeks. You need to remember to take the injection every 13 weeks. Fertility may also take up to 1 year to return back to normal after the last contraceptive injection.

 

Intra-Uterine Systems (Hormonal coil) - This method involves a small hormone releasing T-shaped plastic device that is sited in the uterus by your friendly gynaecologist. Similar instruments as those used whilst doing a smear test are used. It is safe to use during breastfeeding. It can be sited as early as 4-6weeks after delivery. Various options available on the market. They last 3 or 5 years.

 

Intra-Uterine Device (Non-hormonal coil) - This method involves the siting of a T-shaped non-hormonal device in the uterus in a similar fashion as to hormonal coil described above. Various options are available on the market, one of which lasts up to 10 years. They can be sited 4-6weeks after delivery. They are safe to use during breastfeeding.

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You can get pregnant as early as 21 days after having your baby, especially if you are not breastfeeding. Sometimes a bridging method may be necessary until you opt for a definite method such as the coil. You should also be aware that barrier contraception remains the only method to prevent sexually transmitted infections. So please do use barrier contraception (condoms) if you feel you are at risk of sexually transmitted infections.

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I really hope this above has helped you amazing mums! Please do consult with your doctors before opting for any of these methods. Your doctor will surely inform you in more detail about the mechanism of action of the method that interests you the most and its associated side-effects.

Keep well and stay safe!

Sarah :)

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Dr Sultana Grixti graduated in medicine from the University of Malta in 2011. She has been working in Obstetrics and Gynaecology since 2013. She was admitted as a member of the Royal College of Physicians in 2016 and the Royal College of Obstetricians and Gynaecologists in 2018. She has also graduated with a Masters degree in Reproductive Health from the University of Malta in 2016 and was awarded a Postgraduate Certificate in Internal Medicine from the University of Edinburgh in 2013. Dr Sarah Sultana Grixti has worked at Mater Dei Hospital Malta and the Royal London Hospital – Barts NHS London, UK. She has a special interest in Maternal Medicine and thus dealing with both medical disorders that predate pregnancy and medical disorders that arise in pregnancy. 

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Dr. Sarah Sultana Grixti MD MRCP(UK) MRCOG MSc (Rep. Health) PgC (Int. Medicine)

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