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When you think about contraception, the options that probably spring to mind are condoms and the pill. However, there are lots of other choices out there.
Finding the right contraception can be a very personal process. Some factors that you might want to consider when comparing the options include:
Most forms of contraception can be divided into two basic types: barrier methods and hormonal contraceptives. Barrier contraception works by physically blocking the path of the sperm so that it can’t reach the egg. Hormonal contraceptives use synthetic versions of the female hormones that control the menstrual cycle. The hormones they contain can prevent ovulation so that there is no egg available to be fertilised by the sperm.
Barrier contraception comes in several different forms. The most commonly used is the male condom, but there are other choices if you want to avoid taking a hormonal contraceptive.
Most of us will make the occasional mistake, so contraception tends to be a little bit less reliable in real life. For a typical user, the effectiveness will be about:
Hormonal contraception is currently only available for women. It uses the synthetic female hormones oestrogen and progestogen to prevent pregnancy and cannot protect you against STIs. Some hormonal contraceptives only contain progestogen. It can be safer to take a progestogen-only contraceptive if you smoke, are over 35, are overweight, or have certain health conditions such as migraines or a high risk of blood clots.
Hormones can have a dramatic impact on your body. Your periods could be lighter or might even stop altogether. You might experience other side effects too, including headaches, mood changes, breast tenderness, nausea, and changes in blood pressure. If you experience serious side effects or they don’t go away within a few months, you may need to change to a different contraceptive. Sometimes another type of hormonal contraception will be a better fit for you.
Various different types of contraception are available that deliver the hormones in different ways:
The contraceptive pills, patch and ring can prevent more than 99% of pregnancies when used correctly. With typical use, they are still about 91% effective. The contraceptive injection is 94% effective with typical use.
Long-acting reversible contraceptives (LARCs) can be very effective and convenient. Once fitted, they can provide long-term protection. The effects will disappear immediately when they are removed. Hormonal LARCs come in two forms, both of which rely on progestogen alone.
The IUS and implant are more than 99% effective. Since you don’t have to do anything to ensure they are working, there is no risk that you’ll forget your contraception or use it incorrectly. This makes LARC methods the most reliable.
The Intra-Uterine Device (IUD) is unique because it doesn’t fit into either category. It isn’t a barrier, but it doesn’t use hormones either. Instead, it releases small amounts of copper that make it harder for sperm to reach the egg or for fertilised eggs to implant in the womb. Like the IUS, it is a small device that sits inside the uterus. It can work for up to 10 years, is more than 99% effective and can be used as a form of emergency contraception.
If none of these options feel right for you then there are some less common choices that might help:
The best contraception for you will depend on many factors, from how good you are at remembering to take the pill to the way your body responds to the hormones. If you need help choosing then it’s a good idea to get contraception advice from a doctor who can help you find the best fit.
Which factors matter most to you when you’re choosing contraception?