Contraception

Please note that this advice has been taken from the NHS and medical websites, but we are not doctors. You should always consult with a medical professional and ask for their advice before taking contraception.

THE PILL

There are two types of pills, the combined pill and the progestogen pill.

The combined pill:

It introduces hormones into your body which prevent ovulation. It also thickens the mucus in the neck of the womb, to prevent sperm from travelling through the uterus, and it thins the lining of the uterus which means implantation is less likely to occur. You take a hormone pill 21 days of your cycle, and then a placebo for the remaining 7.

The advantages:

It is 99% effective.
It can help with heavy, irregular periods.
It does not interrupt sex.

The disadvantages:

There are side effects such as mood swings, nausea, breast tenderness, and headaches.
It has been linked to depression.
It does not protect against STDs.
It is not effective if you vomit and/or have diarrhoea.

The progestogen pill:

The progestogen pill works by thickening the mucus in the womb to prevent fertilisation. There are also versions of this pill which prevent ovulation. You must take a pill every day and there is no break in between packets, unlike the combined pill. Depending on the type of progestogen pill, it must be taken with a window of time for it to be effective; for example, the 3-hour progestogen-only pill must be taken within three hours of the same time every day for it to be effective.

The advantages:

It is 99% effective in theory. Although, it is 92% effective based on how it is taken.
It can be taken by women who cannot take oestrogen.

The disadvantages:

It can cause irregular periods.
It can cause spots and acne.
It must be taken on a strict timetable for it to be effective.
It does not protect against STDs.
It is not effective if you vomit and/or have diarrhoea.
It is hormonal. This means your mood and your hormones can be affected by this pill.

THE IMPLANT

This is essentially a more permanent form of the progestogen-only pill. It is a small plastic rod which is placed under the skin in the arm by a nurse or doctor. It releases the hormone progestogen and is effective for 3 years.

The advantages:

You do not have to remember to take a pill.
It is more than 99% effective.
It does not interfere with sex.
When it is removed, your natural fertility returns quickly.
It is effective for 3 years.

The disadvantages:

It can cause or worsen acne.
It can cause heavy, lighter, longer, more painful or more irregular periods.
It can cause nausea, mood swings, headaches and breast tenderness.
Amenorrhea is a fairly common side effect. This means that your periods may stop altogether. This is not necessarily bad but you should be aware of this effect.
You have to undergo a small procedure to be fitted with the implant.
It does not protect against STDs.

THE IUS

The IUS (Intrauterine system) is similar to the IUD but it releases the hormone progestogen instead of copper. It performs similarly to the progestogen-only pill but it is a more permanent measure (it can be removed at any time) and you do not have to worry about taking a pill.

The advantages:

It is effective for 3-5 years.
Your fertility returns to normal as soon as you remove it.
It is more than 99% effective.
It does not interfere with sex.
You may experience lighter periods. Sometimes, amenorrhea (periods stopping all together) will occur.

The disadvantages:

It is hormonal and therefore there are side effects. These include acne, headaches, breast tenderness. You may also experience a lower sex drive and mood swings.
Your periods may become more irregular.
Sometimes small fluid filled cysts may occur, these are usually harmless and will disappear without treatment.
You will have to undergo a short procedure to have it placed in your womb. This lasts about 20 minutes and can be done under local anaesthetic. It is similar to a smear test.

THE VAGINAL RING

The vaginal ring is placed inside the vagina and it releases a steady stream of oestrogen and progestogen into the body. It is kept in for 21 days and then removed for 7 days (you are protected against pregnancy during this time). One ring can be used for one month. It thickens the mucus in the uterus and prevents implantation and fertilisation.

The advantages:

It has no long term effect on fertility.
It is more than 99% effective.
It does not interfere with sex. Although sometimes it can be felt during sex.
You may experience lighter period-type bleeding, more regular and less painful.
It reduces the risks of some cancers.

The disadvantages:

It is hormonal and therefore there are side effects. These include vaginal discharge, headaches, nausea, breast tenderness and mood swings.
You may experience spotting and bleeding in the first few months.
You have to remember to change it monthly.
Some may feel uncomfortable with placing the ring in their vagina by themselves.
Some medicines may make the ring less effective.
It does not protect against STDs.
There are health risks: blood clots are very rare but do occur, the risk of developing cervical cancer exists with prolonged use of oestrogen and progestogen hormonal contraception, the risk of developing breast cancer increases but it decreases again when you stop using the ring.

THE CONTRACEPTIVE INJECTION

The injection is administered every 8 or 13 weeks depending on the type and it works by releasing progestogen into the bloodstream. It prevents the release of an egg and thickens the cervical mucus to prevent fertilisation, and thin the lining on the uterus so a fertilised egg will struggle to implant.

The advantages:

It is effective for 8 or 13 weeks.
If you cannot use oestrogen-based contraception, it is a useful option.
It is more than 99% effective.
It does not interfere with sex.
It can reduce premenstrual symptoms and heavy, painful periods.
You do not have to remember to take a pill.
It is unaffected by other medicines.

The disadvantages:

It is hormonal and therefore there are side effects. These include acne, headaches, hair loss. You may also experience a lower sex drive and mood swings. Side effects can continue for some time after you stop injections.
Your periods may become more irregular, heavier, shorter, lighter or stop altogether. They may not return to normal for a while even after you stop the injections.
There can be a delay of up to a year before your periods return to normal and you can become pregnant.
Some people experience weight gain when they use Depo-Provera or Sayana Press.
It does not protect you against STDs.

THE CONTRACEPTIVE PATCH

The patch works in the same way as the combined pill. It releases hormones (oestrogen and progestogen) to prevent conception. It has to be changed every week and every three weeks it is removed and a period-type bleed occurs. You can place the patch in most places on your body, not the breasts and not hairy parts of the body, and it does not come off after showers or baths. If it does fall off, you can replace it with another patch without any side effects.

The advantages:

It may reduce the risk of certain cancers.
It may reduce the risk of fibroids, ovarian cysts and non-cancerous breast disease.
It is more than 99% effective.
It does not interfere with sex.
It can reduce premenstrual symptoms and heavy, painful periods.
You do not have to remember to take a pill.
It still works even if you have diarrhoea or vomit.

The disadvantages:

It is hormonal and therefore there are side effects. These include nausea, headaches, breast tenderness. You may also experience and mood swings.
It is visible.
It can cause skin irritation, itching and soreness.
You may experience spotting and bleeding between periods.
Some medicines can make the patch less effective.
You have to remember to change it every week.
There are health risks: blood clots are very rare but do occur, the risk of developing cervical cancer exists with prolonged use of oestrogen and progestogen hormonal contraception, the risk of developing breast cancer increases but it decreases again when you stop using the ring.
It does not protect you against STDs.

CONDOMS

Condoms are a barrier method. When ejaculation occurs, the sperm is not released into the vagina and cervix. This means that ovulation cannot occur. Condoms are usually made of latex and are very common. They are essentially a sheath fitted around the penis which prevents the spread of ejaculate.

The advantages:

They are 98% effective when used correctly in theory, in reality they are only about 85% effective.
They are relatively cheap and can be bought from pharmacies and supermarkets.
They protect against STDs.
They are non-hormonal so they do not have any side effects.
There are lots of different flavours and textures which can improve the sexual experience.

The disadvantages:

They can only be used once.
They can break and if used incorrectly, they are not effective.
They must be used during sexual intercourse and therefore, they can interrupt sex.
You must not use an oil-based lube as this can interfere with the latex.

THE FEMALE CONDOM

These are made of a soft, thin, synthetic latex or latex. They are placed inside the vagina and are only used during sex. They prevent ejaculate and sperm from entering the vagina and cervix.

The advantages:

They are 95% effective when used correctly.
They protect against STDs.
They are only used during sex.
They have no serious side effects.

The disadvantages:

They can be tricky to use.
If sperm makes contact with the vagina before the female condom is in place, this may cause pregnancy or STDs.
They can only be used once.
You must use a female condom with the CE mark or the BSI Kitemark on the packet.
They are not as common as condoms and so they are more difficult to find in pharmacies. Sexual health clinics will usually have them.
They can interrupt sex as the female condom needs to be inserted during sex.
You must not use an oil-based lube as this can interfere with the latex.

DENTAL DAMS

These are made of a soft, thin, synthetic latex or latex. They are simply a thin sheet of latex which can be used in oral sex, they are laid across the vulva and anus as a protective sheet. They prevent STDs orally transmitted, such as gonorrhoea, chlamydia etc.

The advantages:

They prevent STD infection via discharge.
They come in multiple flavours which can heighten sexual pleasure.
They are only used during sex.
They have no serious side effects.
They are easy to use.
They are easy to find in pharmacies alongside condoms.

The disadvantages:

Many people are unfamiliar with them.
They can only be used once.
You must not use an oil-based lube as this can interfere with the latex.

DIAPHRAGMS/CAPS

Diaphragms and caps are made of latex and are used in conjunction with spermicide. They are placed into the vagina before sex and they act as a barrier method to prevent the sperm from reaching the uterus by covering the cervix. You usually have to be fitted with one by a healthcare professional in order to ensure that it works properly for you. Spermicide is a fluid which kills any residual sperm in the vagina.

The advantages:

There are no serious health risks or side effects.
You only have to think about it when you are planning on having sex.
It can be placed into the vagina up to 6 hours before sex (but if more than 3 hours before, you must add extra spermicide)
It is 92-96% effective, depending on correct use.

The disadvantages:

It can be tricky to use when you are learning and it is not always suitable for those who struggle to touch their own vagina.

FERTILITY AWARENESS METHODS

This is a natural form of contraception. This involves tracking your menstrual cycle by monitoring your temperature and other symptoms in order to determine when you are ovulating. This can be highly accurate and there are specific apps developed to track and monitor your fertility.

The advantages:

No side effects.
Does not interrupt sex.
It is 93% effective with typical use and 98% effective with perfect use.
Low cost. You may have to subscribe to an app such as Natural Cycles but it can be done independently.

The disadvantages:

There are days where you will not be able to have unprotected sex.
Does not protect you from STDs.
You have to be aware of your menstrual cycle and you must monitor all your symptoms and even your temperature.

THE IUD/COPPER COIL

The IUD (Intrauterine Device) is a T shaped device placed into the uterus by a doctor or nurse. It releases copper which alters the cervical mucus and prevents sperm from fertilising an egg; it also makes it more difficult for a fertilised egg to implant in the uterus.

The advantages:

It is effective for 5-10 years.
It is non-hormonal.
Your fertility returns to normal as soon as you remove the coil.
It is more than 99% effective.
It does not interfere with sex.

The disadvantages:

It can cause heavier and longer periods for the first six months.
Does not protect you from STDs.
You will have to undergo a short procedure to have it placed in your womb. This lasts about 20 minutes and can be done under local anaesthetic. It is similar to a smear test.

HOW TO DECIDE WHICH CONTRACEPTION TO USE:

Why are you using contraception?
- To prevent pregnancy?
- To prevent the risk of STDs?
- To make your periods more manageable?
- To manage premenstrual symptoms?
Are you willing to use hormonal contraception? If you are, are you prepared for the side effects?
Are you in a long term, monogamous relationship? Is there an STD risk?
What does your healthcare provider offer?
Are you good at remembering to take medication, switch patches, change your ring?
Are you comfortable touching your vagina?

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