Long-term hormonal contraceptive methods

There are 3 main types: the coil, the pill and the injection

If you’re thinking about long-term hormonal contraception, there are three main choices: the coil (sometimes called an IUS), the implant, and the contraceptive injection. Before making your choice, it’s essential to understand a bit more about how hormonal contraception works, and the advantages and disadvantages of the different long-term options.


How does hormonal contraception work?

Hormonal contraception works as it introduces additional synthetic forms of the female sex hormones oestrogen and/or progestogen into the body. These synthetic hormones send signals to the body to reduce your chances of conceiving. Progestogen-only contraception does this by:

  • Thickening the entrance to the womb, stopping sperm from entering.
  • Thinning the lining of the womb, making it difficult for a fertilised egg to implant itself.

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Forms of hormonal contraception containing oestrogen as well as progestogen, such as the combined pill, will also stop you from ovulating so that no egg is released. 

It’s important to note that hormonal contraception will not protect against sexually-transmitted infections (STIs), so if this is a concern you may need to use a barrier method, such as condoms, too.


The advantages of long-term hormonal contraception

Short-term forms of hormonal contraception, such as the pill, mini-pill and contraceptive patch, are taken or renewed daily or weekly. But long-term hormonal contraception may be more suitable if any of the following apply to you:

  • you are in a long-term relationship or having sex regularly
  • have a disorganised lifestyle, and would struggle to remember to take a pill every day
  • you like the idea of not having to think about contraception on a day-to-day basis.

Which type of long-term hormonal contraception is right for me?

Every body is different, so there is no one-size-fits-all answer to this question. Here are some considerations when choosing long-term hormonal contraception:

  • How effective is it in protecting against pregnancy?
  • How long does it last?
  • Do you need surgery or medical intervention to put it in and take it out?
  • How quickly does your fertility return once you stop using it?
  • Are there any additional benefits, such as reducing the pain or heaviness of periods?
  • What are the side effects, if any? 

Contraceptive injection

  • The contraceptive injection is a progestogen-only form of contraception. 
  • It’s 99% effective when used correctly (and renewed on time). If you have the injection after day 5 of your menstrual cycle, you must use additional contraception for 7 days
  • You’ll need to see a nurse every 2 or 3 months to get a new injection
  • Fertility may take up to 1 year to return
  • It can affect your periods, but they may become either heavier or lighter
  • Side effects may include mood swings, headaches, hair loss and acne
  • It may affect your sex drive
  • It has been linked with weight gain when used for 2 years or more.

Intrauterine system (the coil)

The intrauterine system (IUS) is a hormone-releasing intrauterine device. It’s commonly known as the coil, or Mirena coil, and other brands licenced for use in the UK are Jaydess and Levosert. It works by slowly releasing progesterone into your body to prevent pregnancy.

  • It’s more than 99% effective if inserted correctly. You will be protected against pregnancy straight away
  • The Mirena coil is will last for 5 years; Jaydess lasts for 3 years
  • It needs to be inserted by a medical professional in a medical facility
  • You can get pregnant straight away, as soon as it is removed.Your fertility is not impaired
  • It may make your periods lighter and they some may stop altogether
  • Side effects may include tender breasts, mood swings, skin problems such as acne and  headaches
  • There is a small risk of infection when the coil is fitted.

Contraceptive implant

The contraceptive implant is a small, plastic rod, about 4cm long. It is inserted under the skin in your upper arm and releases progesterone into the bloodstream to prevent pregnancy.  

  • The contraceptive implant is more than 99% effective when used correctly. If fitted after day 5 of your menstrual cycle, you must use additional contraception for 7 days
  • It lasts up to 3 years
  • It is inserted and removed by a medical professional in a medical facility
  • Your fertility will return quickly after the implant is removed
  • Your periods may be affected; they may become lighter or heavier, or they may stop altogether
  • Temporary side effects may include nausea, headaches, tender breasts and mood swings. These normally clear up after the first few months
  • Another unwanted side effect is acne.
     

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