Which contraceptive is right for me?

There are so many, how do I choose?

Choosing the right method of contraception for yourself can be overwhelming as there are 15 different methods to choose from in the UK. There are many factors to consider, so you should take your time and review the options available to you before making a decision. 

What are the different types of contraception available?

There are different types of contraception that work in a manner of ways to prevent pregnancy. The main two types are barrier methods or hormonal contraceptives. 

Barrier methods include: 

  • Male condoms 
  • Female condoms 
  • Diaphragms 
  • Caps 
  • Contraceptive sponge 

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Hormonal methods include: 

  • The combined pill 
  • The mini pill 
  • Vaginal ring
  • Contraceptive patch
  • Contraceptive injection 
  • Contraceptive implant 
  • IUS (hormonal coil) 

Aside from these, there is also the IUD (copper coil), natural family planning and male and female sterilisation. 

Which method of contraception is most effective? 

The copper coil and most hormonal contraceptives are over 99% effective. Barrier methods like condoms and diaphragms tend to be less effective, but this can be strengthened by using another contraceptive option, or combing a diaphragm or cap with spermicide. No contraceptive method is 100% effective as there are factors that can affect their efficacy. 

The different methods of contraception include: 

  • IUD (copper coil): more than 99% effective 
  • IUS (hormonal coil) more than 99% effective 
  • Contraceptive implant: more than 99% effective 
  • Combined pill: 99% effective with correct use. 95% effective with typical use 
  • Contraceptive injection: 99% effective if renewed on time 
  • Mini pill: 99% effective if used correctly. 91% effective with typical use
  • Contraceptive patch: 99% effective when used correctly 
  • Vaginal ring: 99% effective when used correctly 
  • Natural family planning: 99% effective if the instructions are followed correctly and temperature is measured daily 
  • Male condoms: 98% effective 
  • Female condoms: 95% effective 
  • Diaphragm: 92-96% effective 
  • Cap: 92-96% effective 
  • Sponge: 88% effective

How long does each contraceptive last? 

Some contraceptives are single-use and require placing them over the penis or inside the vagina every time you have sex, while others are long term and only require occasional attention. 

Single-use: 

  • Male condoms
  • Female condoms 
  • Diaphragm 
  • Cap 
  • Sponge

Daily: 

  • The combined pill (taken every day for 21 days before having a seven-day break) 
  • The mini pill (taken every day) 

Weekly: 

  • The contraceptive patch (replaced every week with a patch-free week after 21 days) 

Monthly: 

  • The vaginal ring (replaced once a month) 

2-3 months: 

  • The contraceptive injection 

3 years: 

  • Contraceptive implant 

5 years: 

  • IUS (hormonal coil) 

10 years: 

  • IUD (copper coil) 

Permanent: 

  • Male vasectomy 
  • Female sterilisation 

How does each contraceptive work? 

Barrier methods of contraception work by preventing sperm from entering the vagina, stopping the egg from being fertilised. Hormonal contraceptives work by replacing your natural menstrual cycle to stop ovulation from occurring. They also alter the lining of the womb and the mucus surrounding the cervix to make it difficult for sperm to enter. 

The combined pill 

The combined pill contains synthetic versions of estrogen and progesterone hormones. It's taken once a day for three weeks before having a pill-free week. You then start the next pack of pills after 7 days. Missing a pill, vomiting and taking certain medications can make it less effective. 

The mini-pill (progesterone only pill) 

The mini-pill only contains one type of hormone; progesterone. You take it every day without a break, and it needs to be taken at the same time each day. Taking it too late, missing a pill and vomiting will make it less effective. 

The patch 

The patch resembles a square plaster in appearance. It's very sticky and is applied to a dry, hair-free area of the body and replaced after one week. It releases estrogen and progesterone hormones into the bloodstream. 

The vaginal ring 

The contraceptive ring is a small, soft plastic ring that is inserted into the vagina. It sits around the top of the vagina against the entrance to the cervix and releases hormones into the womb. Each one lasts for 21 days before being removed, a new one inserted after 7 days. 

Condoms 

Male condoms are placed over the penis before sex and are discarded after use. Female condoms work in the same way, except they are inserted inside the vagina. 

Diaphragm or cap

A diaphragm is a soft, silicone dome-shaped device that is inserted inside the vagina before sex. Spermicide should be applied to it before use. It can be put in at any time before sex and must be left in for up to 6 hours afterwards. You can then wash and reuse it.

Contraceptive sponge

The contraceptive sponge is a soft, spongy piece of plastic that contains spermicide. It is inserted into the vagina before sex to stop sperm from entering the womb. Each one can be left in for a total of 24 hours and must be left in for up to 6 hours after having sex.

The contraceptive injection 

The injection is administered by a doctor or nurse, containing a dose of progesterone hormones. Each dose lasts for 8-13 weeks, depending on the type. You will need to attend an appointment every 8-13 weeks for repeat injections. 

The contraceptive implant

The implant is inserted into your upper arm, and it resembles a small plastic rod that releases the progesterone hormone into your bloodstream. The procedure is performed by a doctor and involves making a small incision to your upper arm, which is done under a local anaesthetic. Once the implant has been inserted, it will last for 3 years. 

The IUD

The IUD, or intrauterine device, is also known as the copper coil. It is a small T-shaped plastic and copper device which is inserted into the womb by a trained doctor. It works by releasing copper into the womb which kills off sperm. The procedure can be uncomfortable, and you will usually experience painful cramps afterwards, but this will ease off after a day. Once inserted, the IUD lasts for 10 years. 

The IUS

The Intrauterine system is a hormonal version of the coil, available as the brand name Mirena in the UK. It involves the same procedure as the IUD to have it inserted. It contains the progesterone hormone which is released into the womb to prevent pregnancy. It lasts for 5 years after it has been inserted. 

Natural family planning 

Natural family planning involves monitoring your cycle to determine when you are ovulating, either avoiding sex or using condoms during the times when you are fertile. This can take months to get right, and you can be taught how to do this via classes at a family planning clinic. 

What does contraception do to my body? 

Condoms, diaphragms, sponges and the IUD do not produce any side effects. Hormonal contraceptives can cause a range of possible side effects; however, and it's important to be aware of the possible risks and changes they can cause in your body before using them. 

The combined pill, patch and ring 

Combined hormonal contraceptives increase the risk of blood clots. This is rare, but certain people are more at risk than others, which is why some women are unable to use combined hormonal contraceptives. For example, if you have high blood pressure, other at-risk conditions or are a smoker over the age of 35. 

Common side effects of taking the pill or using the patch or ring include: 

  • Nausea 
  • Abdominal pain 
  • Headaches 
  • Migraines 
  • Mood changes 
  • Depression 
  • Breakthrough bleeding 
  • Spotting 
  • Changes to your period 
  • Breast tenderness or pain 
  • Lowered sex drive 

Not everyone will experience all of these side effects, but it's common to experience some of them when you first start using hormonal contraceptives. If they don't ease off after a couple of months, then you should see your GP as you may want to try switching to a different type. This is particularly important if you experience symptoms of depression after starting the pill. 

The mini pill, injection, implant and IUS 

Side effects are less prominent with progesterone-only contraceptives, and they do not produce the same health risks as the combined pill, patch and ring. 

You may experience: 

  • Headaches 
  • Migraines
  • Breast pain or tenderness 
  • Acne 
  • Mood changes 
  • Nausea 
  • Vomiting 

If you do experience symptoms, they will usually disappear after a few months. The mini pill and IUS are less likely to produce side effects as they contain lower doses of hormones. 

IUD

The copper coil does not contain hormones, so it doesn't produce any side effects. However, there are some rare risks involved: 

  • Infection after insertion 
  • Pelvic inflammatory infection 
  • Damage to the womb 
  • Ectopic pregnancy 

Are hormonal contraceptives suitable for me? 

The combined pill, patch and ring are generally safe to use for women in good health, who do not smoke and aren't overweight. If you have an underlying medical condition or history such as the following then you should not use combined hormonal contraception: 

  • Blood clots
  • Heart problems 
  • A previous stroke or heart attack 
  • Any condition which affects your blood clotting 
  • Migraines with aura 
  • Unexplained vaginal bleeding 
  • Being very overweight 
  • If you need an operation 
  • High blood pressure 
  • Being over 35 and smoke 
  • Liver problems 
  • Breast cancer 
  • Diabetes with complications 

Certain medications interfere with the way the hormones in the pill, patch and ring work. If you are taking any of the following, you may not be able to take the pill: 

  • HIV medications 
  • Epilepsy medications 
  • Hepatitis C medications 
  • Griseofulvin 
  • Modafinil 
  • Rifabutin 
  • Rifampicin 
  • St John's wort 

If any of the above circumstances affect you, then you still have the option of using progesterone-only contraceptives. These include the mini-pill, injection, implant and IUS. 

How soon can I have a baby after using contraception? 

Contraception temporarily prevents pregnancy while you are using it. Barrier methods of contraception do not affect your fertility. With hormonal contraception, your natural menstrual cycle can take a month or two to return after you stop using them. Your fertility will return immediately after having the IUD removed. After having the contraceptive injection, it can take up to a year for your fertility to return.  

Ultimately, the contraception that's best for you will depend on your preferences, lifestyle, health and relationship circumstances. Condoms are the only method of contraception that protect against sexually transmitted infections. The pill is readily available and is easy to start taking, whereas the longer-term contraceptives require getting an appointment and going through a more invasive procedure. If you think you'd struggle to remember to take the pill every day, something like the patch or ring might be more suitable. You can also stop using these at any time. You can discuss your options with a GP or family planning clinic.

 

View our full range of contraceptive pills.

Sources: 

NHS > Which Method of Contraception Suits Me?

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