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Guide to contraception

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With so many choices available, contraception can sometimes appear to be confusing. How do you know which method is best for you?  Your decision will be influenced on personal preference as much as your age and lifestyle and it’s likely you’ll modify your method of contraception at least once as your circumstances change.

Condoms

Condoms are the only form of contraception that protect against sexually transmitted infections (STIs) so if you have a new partner or if one of you has an STI it is important to use condoms alongside any other contraceptive used to avoid pregnancy. There are two types of condom – male, which is worn on the penis and is 98% effective and female, which is worn inside the vagina and is 95% effective. The condom stops any sperm from entering the woman’s vagina and therefore reaching an egg.

Combined pill

Usually just referred to as ‘the pill’, the combined pill is a small tablet taken orally that releases hormones that stop ovulation and make it more difficult for sperm to reach any eggs that are released. One pill is taken daily for 21 days followed by seven days with no pill, during which you’ll experience a period-like withdrawal bleed. When taken correctly it is over 99% effective.

Progestogen-only pill (POP)

Like the combined pill, POP is an oral tablet taken at around the same time each day. The difference is that POP doesn’t contain oestrogen and there is no break between packs. It works by thickening the mucus in the cervix, stopping sperm from reaching an egg. Some progestogen-only pills also stop ovulation.  When used correctly POP is over 99% effective and can be used while breastfeeding.

Contraceptive patch

This form of contraception, which looks like a nicotine patch, works in the same way as the combined pill but instead of taking it orally you wear it and the hormones are absorbed through your skin. The patch is changed once a week for three weeks, after which you take it off for a week before starting again. Patches can be worn in the bath or swimming pool, are more than 99% effective and mean you don’t have to remember to take a pill every day. They can also help with heavy or painful periods.

Contraceptive injection

contraceptionThere are two types of injection available – one lasting 12 weeks and the other for eight. The injection contains progestogen, which is released into your bloodstream to thicken cervical mucus and thin the lining of the womb. The injection is more than 99% effective but it can take some time for fertility to return to normal once you stop taking it, so if you are planning to try for a baby soon you may wish to use a different form of contraception.

Contraceptive implant

The implant is a small tube that is inserted under the skin of your upper arm. It is more than 99% effective and lasts up to three years. It works by stopping eggs from being released, thickening the mucus in your cervix and thinning the lining of the womb.  The implant can be used right up to the menopause and is safe for breastfeeding mothers.

Vaginal ring

A vaginal ring is a small plastic circle that releases hormones to avoid pregnancy. You insert the ring inside your vagina and leave it there for three weeks then have a week without wearing it. You have sex with the ring inside you and you don’t have to think about contraception every day. It is more than 99% effective and can help with pre-menstrual symptoms. However, some women do experience side effects including headaches, breast tenderness and vaginal discharge although these are usually temporary.

Diaphragm

Diaphragms are inserted into the vagina before sex and cover the cervix so that sperm can’t reach the womb. After sex the diaphragm must be left for at least six hours before being removed. You’ll be fitted for a diaphragm by a trained doctor or nurse to ensure you have the correct size. They are 92-96% effective and are reusable after washing.

Cap

Working in a similar way as the diaphragm, the cap is a silicon dome that is inserted into the vagina before sex. Again it must be left in for at least six hours after sex and you’ll need to get the correct size from a doctor or nurse. When used with spermicide the cap is 92-96% effective.

Intrauterine device (IUD)

contraceptionAlso known as the coil, IUD is a small plastic and copper T shape that is inserted into the womb. It works by stopping eggs and sperm surviving and can prevent a fertilised egg from implanting. Depending on the type used, IUDs are up to 99% effective and last five to 10 years.

Intrauterine system (IUS)

Similar to the IUD, the IUS is made of plastic and works by releasing hormones.  It works for five years, is more than 99% effective and can make periods lighter or shorter. Fertility returns to normal shortly after having the IUS removed.

Natural family planning

Also called the ‘rhythm method’ natural family planning involves tracking the dates of your menstrual cycle as well as fertility signals such as body temperature and cervical mucus so that you can avoid having sex around the time of ovulation. The effectiveness of natural family planning varies hugely depending on how closely instructions are followed. While this method can be 99% effective when used meticulously, the average figure is closer to 75% when taking mistakes and illness into account. If you definitely don’t want to get pregnant then you will probably want to consider another method of contraception.

Vasectomy (male sterilisation)

A vasectomy is a minor operation, usually done under local anaesthetic, during which the tubes that carry sperm are cut, sealed or blocked. Semen will still be produced but it won’t contain any sperm and so isn’t able to fertilise an egg. While it is possible to reverse a vasectomy, this isn’t usually carried out on the NHS and isn’t guaranteed to work. Therefore, a vasectomy should be considered permanent and only carried out when both partners are sure they don’t want any more children. Male sterilisation is over 99% effective.

Female sterilisation

Female sterilisation involves the fallopian tubes being blocked or sealed to stop eggs reaching the womb. The operation is carried out under a general or local anaesthetic and is considered permanent. Unless there is a medical reason, many GPs are reluctant to refer childless women under the age of 30, as the procedure is very difficult to reverse. Women who have been sterilised still have periods and only one in 200 sterilised women will become pregnant in her lifetime, making it over 99% effective.

Emergency contraception

If your method of contraception has failed or if you’ve had unprotected sex you may wish to use emergency contraception to avoid becoming pregnant. There are two types available – the IUD (as above) and the morning after pill. The IUD is effective if fitted up to five days from having unprotected sex and fewer than one in a hundred women using this method will become pregnant. Two types of morning after pill are available, one of which has to be taken within 72 hours and the other which can work up to 120 hours after sex. However, the sooner you take the pill the more likely it is to be effective.

 

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About Maria Brett

About Maria Brett

Maria is a freelance writer with over 10 years' experience producing content for a variety of publications and websites. When not working or looking after her two gorgeous sons, she can usually be found playing flugelhorn in a brass band, helping out at her local hospital radio station, shouting at the television while watching Formula 1, at the cinema or plonked on the couch with a cold glass of wine.

Website: Maria Brett

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