Women have several contraceptive options to choose from, but the method used should depend on how it works, how often it is needed and an individual’s health, fertility expert Dr Paul Koigi has said.
The consultant obstetrician and gynaecologist, speaking on Radio Generation on Thursday, explained the different methods available, including emergency contraceptive pills, daily pills, skin patches, injections, condoms and intrauterine devices (IUDs), commonly known as coils.
Dr Koigi particularly cautioned against treating emergency contraceptive pills as a routine family-planning method, saying they are designed for situations where regular contraception was not used or has failed.
“Usually we don't recommend that you take the emergency pill the way people are taking them. There are people who take them every Friday. This is the E-pill now. It's an emergency, you know. You don't have emergencies every week,” he said.
Emergency contraceptive pills, often called the morning-after pill, are used after unprotected sex, contraceptive failure or sexual assault. The World Health Organization says they should be taken as soon as possible and can be used within five days of unprotected sex.
The pills mainly work by preventing or delaying ovulation. A copper IUD can also be used as emergency contraception and is more than 99 per cent effective when inserted within 120 hours.
Dr Koigi, however, defended the availability of emergency contraceptive pills without a prescription, saying easy access can be important for survivors of sexual violence who may face difficulties seeking specialised help.
He said some women may lack the money, information or ability to report sexual violence or travel to a gender-based violence recovery centre, making access through pharmacies an immediate option.
For women seeking regular contraception, Dr Koigi discussed several hormonal methods, including combined oral contraceptive pills containing estrogen and progestin and progestin-only pills.
He said hormonal contraception may not be suitable for every woman and that medical history should be considered before choosing a method. Conditions such as a previous blood clot, for example, may affect which contraceptive is appropriate.
WHO also advises that contraceptive choice should take into account a woman's health, preferences and circumstances, with healthcare providers helping users identify methods that are medically suitable.
Dr Koigi also highlighted the contraceptive patch, which is placed on the skin and is generally changed every week, as well as the contraceptive injection, which provides protection for three months without requiring daily use.
For women looking for longer-term protection, he pointed to IUDs, which are available in hormonal and non-hormonal forms.
According to WHO, hormonal IUDs can remain effective for between three and eight years depending on the product, while copper IUDs can protect against pregnancy for up to 10 to 12 years. Both types are highly effective, with fewer than one pregnancy occurring among every 100 women during the first year of use.
Condoms, Dr Koigi said, remain important because they offer protection against sexually transmitted infections in addition to preventing pregnancy.
“The condom is the only method of contraception that reduces the risk of sexually transmitted infections.”
WHO states that condoms are the only contraceptive method that protects against both unintended pregnancy and sexually transmitted infections, including HIV, when used correctly and consistently. However, they do not completely prevent infections spread through uncovered skin or lesions.
The discussion comes as contraception remains an important part of reproductive health and family planning in Kenya.
The 2022 Kenya Demographic and Health Survey found that 63 per cent of currently married women were using a contraceptive method, with 57 per cent using modern methods and six per cent using traditional methods.
The survey further showed that 14 per cent of currently married women had an unmet need for family planning, while 76 per cent had a demand for family planning.
Among sexually active unmarried women, 70 per cent were using a family-planning method, with 59 per cent relying on modern methods.
The range of options means women and couples can choose between methods that provide short-term, emergency or long-term protection, while medical advice can help determine which option fits an individual's health, circumstances and family-planning needs.