Sexual health
How to protect yourself with safe sex. From a choice of contraception to knowing the signs of common sexually transmitted infections (STIs).
How can we help you?
Being safe during sex
What protection could work best for you
Keep you and your sexual partner safe from specific STIs with a choice of contraceptives. These aim to protect against pregnancy too.
After getting the contraceptive implant
Find out how soon you can have sex, any problems to look out for and details about getting yours removed or replaced.
After getting a contraceptive coil
Get advice on when the coil starts working, how to check it's okay over time and when to get it replaced.
Sexual health: your questions answered
Dr. Rebecca Rohrer answers questions about sexual health and practising safe sex.
Transcript
Who are you and what is your background?
My name's Dr.
Rebecca rra. I'm a doctor practising clinically
and a medical director at Bupa,
and I've got a passion for supporting women's health.
What is contraception?
Contraception or birth control is ultimately designed
to prevent pregnancy,
and in some cases can also help
to prevent sexually transmitted infections or STIs.
It does that in a couple of ways:
it can prevent eggs being released by the ovaries,
it can thicken cervical mucus to stop sperm getting
through into the womb,
it can also act as a barrier
to stop sperm entering the vagina in the first place.
So there's lots of different options for you.
What does contraception do?
So contraception or birth control is ultimately designed
to prevent pregnancy,
and in some cases can also be used to prevent
sexually transmitted infections.
It's good to think about
contraception in two different groups.
Reversible contraception, which provides that temporary
prevention of pregnancy or sexually transmitted infections
and non-reversible forms where fertility won't return,
and that, for example,
includes surgical options like sterilisation.
Also, really important to remember that some forms
of contraception can be used
to treat medical conditions like endometriosis, acne,
and polycystic ovarian syndrome.
What does 'safe sex' mean?
Safe sex is sex
that ultimately means that you and your partner
or partners aren't at risk of
contracting a sexually transmitted infection
or having an unplanned pregnancy.
That means sex that doesn't allow you to share blood, semen
or vaginal fluids between each other.
The opposite of that is unprotected sex,
where you are at risk
of developing sexually transmitted infections
or having an unplanned pregnancy.
Who can use contraception?
Contraceptive services are free
and confidential to anybody who's sexually active.
The legal age to have sex in the UK is 16,
and we'd recommend that anybody who wants
to talk about contraceptive services
or to ask about them to go
and see a specialist sexual health nurse or their gp.
What are the most common types of contraception?
I like to think about contraception
in different categories.
Firstly, there are medicines.
This is most commonly known
as the birth control pill typically taken by women.
That can include an oestrogen and progesterone pill,
or just a progesterone only pill.
There are also devices, things like the implant,
which is a soft, flexible device put into the top
of the arm, and things like the coil,
which are inserted into the neck of the womb.
There's also options like condoms, which can be used by men,
and female condoms, which can obviously be used by women.
Finally, there are surgical options, which include female
and male sterilisation.
What types of contraceptive pills are there and how do they work?
So broadly, there are two kinds of contraceptive pills.
There's the combined oral contraceptive,
which contains oestrogen and progesterone.
That's the one that many women will be familiar with.
That works by stopping your ovaries from
producing an egg each month,
and it also thickens the cervical mucus to prevent
sperm reaching the egg in the first place.
There's also the progesterone only pill.
Some people know that as the mini pill,
and that mainly works by thickening the cervical mucus again
to stop sperm reaching the vagina
and some forms of that pill can also prevent ovulation.
Do you have to take the pill at the same time everyday? What happens if you don't?
My first piece of advice is that each pill is different
and has different instructions in terms of how to take it.
So please speak to your sexual health nurse or your gp.
It's really important that you follow these instructions
to prevent pregnancy.
That's because things like the mini pill
or the progesterone only pill have a really narrow window,
so actually you have to be very
strict about when you take it.
That matters less for other pills,
but we know that some women can forget the pill sometimes,
and so actually getting into a regular habit in terms
of when you take it is only going to improve effectiveness.
In terms of if you forget a pill,
again, each pill is different, so it's really important
that you discuss this when you get the pill
with your sexual health nurse
or your GP so that you are very clear about what
to do if you do miss pills.
How many days do women usually take the pill?
Every pill is different.
Lots of women will be familiar with the traditional pattern
of taking the pill for 21 days
and then having a break for seven days
during which you have a bleed.
There are actually lots of other options
and I'd really recommend that you discuss that with your GP
or your sexual health nurse.
Some other options are taking packets back to back so
that you don't have a bleed.
There's also options that you can finish a pack,
have a break for four days, and then start another pack.
But as I mentioned, every pill is different.
So please do discuss, with whoever prescribes the pill,
what's going to best work for the pill instructions
but also for you in your life.
What are condoms and how do they work?
Condoms are a form of contraception,
and importantly, they're the only form of contraception
that can be used to prevent the transmission
of sexually transmitted infections.
That's because they form a barrier
that stops the sperm reaching an unfertilized egg.
A couple of considerations that are important.
They're usually made of latex,
which some people are allergic to,
but there are lots of other alternatives,
so always worth speaking to your GP
or sexual health nurse if you've had a bad reaction
to a latex condom.
How does the implant work?
The implant is a really small, flexible plastic device
that is inserted into your upper arm.
It works by releasing small amounts
of progesterone into your bloodstream
and lasts for three years.
Now, how it actually acts as birth control
is kind of twofold.
Firstly, it thickens the cervical mucus
to stop sperm reaching an
unfertilized egg in the first place,
and it also thins the lining of the womb
to make it less likely that a fertilised egg would implant
and develop into a pregnancy.
What is the coil?
You might've heard some people talk about the coil
as any device that sits inside the neck of the womb
and prevents pregnancy.
Actually, the coil is known as the intrauterine device
or an IUD, and some people might know it as the copper coil.
So they're one and the same thing
What are the longest lasting contraceptive options?
Lots of people will be familiar with contraceptive options
that are inserted through the vagina
and sit in the neck of the womb.
Those are really long lasting, lasting up to five years.
Now, there are a couple of different options here.
They're both T-shaped flexible plastic devices
that are inserted through the vagina,
sit in the neck of the womb.
The difference between them is what they contain.
Lots of people have heard of the copper coil.
That's where there's copper wrapped around the top of
that device that sits in the neck of the womb.
The copper's released slowly over the course
of the time period and it changes the cervical mucus
to make it less likely for a sperm to be able
to enter the womb and fertilise an egg.
And it can also prevent the implantation
of a fertilised egg in the first place.
The second kind contains the hormone progesterone.
Some people will know it as the Mirena. Now
that thickens the cervical mucus
to stop the sperm coming into the vagina to fertilise the egg.
It also thins the lining of the womb to make it less likely
that a fertilised egg can implant,
and in some people it'll prevent the ovulation
or the production of an egg to be fertilised
on a monthly basis.
Can putting in contraceptive devices be painful?
So when we think about the contraceptive devices
that need a procedure to put them in,
what we're really talking about is the implant
and also the contraceptive devices that go
through the vagina and sit in the neck of the womb.
In terms of the implant, it shouldn't be painful,
but it might be a bit uncomfortable.
What it involves is some local anaesthetic in the arm,
a very small cut just to pop the implant in.
And then obviously as that local anaesthetic wears off,
it might be a bit sore.
But bear in mind that procedure's going to be done
by somebody who's really experienced,
you can take some pain relief around that,
and then what you have is, hopefully, a really long lasting,
effective form of contraceptive for you.
In terms of the ones that are put in through the vagina,
that's usually done in a GP setting
or a sexual health clinic setting, again,
by a really experienced practitioner,
and that'll involve opening up the vagina
and then a very small, thin plastic tube being inserted
through the neck of the cervix just into the
opening of the womb.
That can be a little bit uncomfortable,
but again, with a really experienced practitioner,
some good pain relief on board,
it's done very, very quickly.
And what we don't want is for women
to be put off having these kinds of contraceptive,
which are really long lasting and really effective
because they're worried about it.
So if you're worried about it, please speak to your GP
or your sexual health nurse.
How do I reduce the risk of pregnancy without the use of contraception?
Fertility awareness
or natural family planning can be
considered a form of contraception.
Essentially, what it allows you to do is
to monitor changes in your body during your monthly cycle to
identify when you're at your most fertile,
and then to avoid unprotected sexual intercourse
during that time.
And that in theory, allows you
to prevent pregnancy without the use
of any other medicines or devices.
If it's done really carefully, it can be effective,
but it takes time, commitment, and practice.
So I'd really recommend that you speak
to a specialist advisor, your GP or sexual health nurse
before you start trying this method.
How can I keep track when using natural family planning or fertility awareness?
Natural family planning
or fertility awareness involves people measuring three
different things, firstly, when their periods start and end.
Secondly, their daily body temperature
and thirdly, their vaginal secretions.
They can record those things in a diary
or an app-based system, and taken together
it can form a picture of where in the cycle you are going
to be at your most fertile
and then when you can avoid any unprotected
sexual intercourse.
It takes a lot of time commitment
and a lot of practice to get this right.
So I'd really recommend getting some specialist advice on
board from an advisor from your GP or sexual health nurse
before you start this approach.
What are some side effects of different contraception?
So any contraception that you take, in the form
of a medicine or a device, will have some side effects.
The important question is whether those side effects are
okay in terms of minimising its impact on your quality
of life and whether you can live with them.
So hormonal contraceptives, things like the pill
or the implant, or the hormone releasing intrauterine system,
can have side effects like bloating,
acne, can have an impact on mood,
can also increase your appetite, and
therefore make it more likely to put on weight.
The copper coil, which doesn't have any hormone in it,
can make your periods heavier.
And really important to take account
of these side effects when you are balancing out what kind
of contraception might work for you,
but if you are already trying one of these forms
of contraceptives and you find these side effects are really
impacting the quality of your life, please go
and speak to one of your GPs, your sexual health advisors,
to be able to talk about these side effects
and to be able to think about what you might want
to do next.
How do I find the best type of contraception for me?
Every person is different
and every kind of contraception is different.
So I always recommend having a think about your lifestyle,
about what kind of sexual partner or partners you have,
and what you think might work for you.
It's also a really good place to start is by talking
to friends about what their experience has been.
Then I recommend going to speak to a GP
or a sexual health advisor to be able to
talk in detail about all
of the contraceptive options out there
and how they might work for you and your lifestyle.
If you choose something that works for you to start with,
it's more likely to be effective and act in the longer term.
Where can I get contraception, and is it free?
Contraceptive services in this country are free
and they're confidential.
There are lots of options for you, so a lot
of pharmacists will be able to issue you free contraception.
You can also go to sexual health clinics
and you can find those by looking online
for your nearest one or your local GP.
It's also you are able to walk into any high street pharmacy
where you are able to purchase a number
of contraceptive options like condoms.
What is emergency contraception?
Emergency contraception is used to prevent a pregnancy
when your usual form of contraception has failed.
For example, when a condom has split
or if you've missed a pill. It's worth bearing in mind
that emergency contraception won't protect you from sexually
transmitted infections.
What are the options for emergency contraception?
If your regular form of contraception has failed
for whatever reason, then there are two options.
The first is a tablet, often known as the morning
after pill that contains a high dose of hormone.
It can be taken up to five days after unprotected sex,
but it's worth bearing in mind that the longer you leave it,
the less effective it might be.
As most people know, you can get
that from most high street pharmacies.
The other option is actually the copper coil, so
that can also be inserted up to five days
after unprotected sex
and can obviously then be in place for up to five years.
That is not available through pharmacies,
but if you go to your local sexual health centre
or your GP, then they'll be able
to advise you on the best next step.
Can you still get pregnant if you use contraception?
The short answer is yes. Unfortunately,
no contraception is a hundred percent effective.
Now, your risk of pregnancy varies between different types
of contraception, and that's why it's really important to have
that conversation with your sexual health advisor or your GP
before you start using it.
Now, your risk of getting pregnant not just varies
by the type of contraception,
but also how closely you follow the instructions for
that type of contraception.
So I'd really recommend that people are fully aware of how
to take their contraceptive safely.
Does contraception protect against STIs?
The only form of contraception
that protects against some sexually transmitted infections
are condoms, and that's
because it forms a barrier between sharing of bodily fluids
between sexual partners, things like semen,
vaginal secretions, and blood.
It's worth bearing in mind
that some other sexually transmitted infections like genital
herpes or lice are exempt from that.
Does contraception affect your fertility?
The short answer is no.
No contraception will permanently impact your fertility.
What contraception is designed to do is
to prevent pregnancy in the short term.
When you stop contraception, the amount of time
that it takes for your fertility to return
to normal can vary depending on the
contraception you choose.
So I'd always recommend that if you do want to try
to conceive sooner rather than later, that's something
that you factor in with that discussion with your GP
or sexual health nurse.
How does contraception affect my periods?
Contraception, particularly hormonal forms
of contraception, can affect when your periods are,
how long they are, how painful they are,
and also how heavy they are.
The exact impact can really vary based on
what kind of contraception you're on,
but also what your periods
and your cycles were like beforehand.
I think it's probably worth bearing in mind
that many hormonal forms
of contraception can make periods a bit lighter
or more infrequent, and actually in some cases
can stop periods altogether.
The copper coil, many people can associate with heavier
periods, but again, it can vary on a case by case basis.
So really worth speaking to your GP
or sexual health advisor.
Can hormonal contraception affect my mood?
So hormonal contraception can have an impact on mood,
and that's been shown in scientific studies,
but it really varies by person to person.
So for some people, they find an improvement in mood
and some people can find it has a negative impact.
The important thing is to be aware of your mood,
particularly when you're starting a new contraceptive,
and if you find that it's changing, please go back to speak
to your GP or sexual health advisor.
Are there any male contraceptives?
Most people will be aware that contraceptive options
for men involve condoms, which form a barrier
to sperm reaching an unfertilized egg,
and also male sterilisation,
otherwise called a vasectomy,
where the tubes carrying the sperm are sealed, closed.
Beyond that, although it's an area of research
and an interest,
there aren't any other current options available for men.
Do I have to tell anyone if I'm using contraception?
Contraceptive services are confidential.
If you are with a partner, I think it's a really good thing
to discuss your contraceptive choices with them,
but that decision is up to you.
If you are worried about disclosing whether you are on
contraception with anybody, I'd really recommend
that you speak to your sexual health advisor
or your GP about it.
If you've been using contraception for a long time, do you need to take a break?
So there's no need to take a break from
contraception for the sake of it.
You can use contraception for really long periods
of time without having any negative impact
on you and your health.
I think what's right for you is a contraception
that's effective and safe,
and in terms of choosing the right kind of contraceptive
at different times in your life.
There are some exceptions to that.
So for example, for the combined contraceptive pill,
which uses oestrogen
and progesterone, that's not advised, for example,
over the age of 35, if you are a smoker
or over the age of 50,
and that's to minimise the risk
of developing more harmful side effects like osteoporosis
or cardiovascular problems like heart attacks or strokes.
I think it's always worth speaking to your GP
or your sexual health advisor if you have any concerns about
how long you've been on contraception
or if your life has changed
and you think you might want to have a new form
of contraception.
I am using contraception now but want to stop. What's the best way to stop?
So I'd always recommend that you reflect on why you want
to finish using contraception.
Is it that you want to change
to another kind of contraception?
Is it a change in where you are in your life?
Or is it that you want to try to conceive?
Because all of those will impact what kind
of advice your GP or sexual health advisor might give you.
So I'd always recommend making an
appointment with them first.
In general, for the hormonal medications like the pill,
they can be stopped at any point in your cycle.
It might take a while for your cycles to return to normal,
so it's worth bearing that in mind.
For things like the implant, for the copper coil
or for the hormone system like the Mirena, then those need
to be removed by a health professional.
So it is definitely worth making an appointment with one
of those health professionals and then booking yourself in
to have one of those removed.
I am going through menopause - do I still need to use contraception?
So it's really worth bearing in mind
that the menopause isn't a moment in time.
It actually includes a period called the perimenopause
where you might still be having periods irregularly,
and that means that you are still fertile.
In general, you can stop contraception if you haven't had
your period for one year after the age of 50
or for two years below the age of 50.
You can stop contraception
after the age of 55 as it's extremely rare,
but not unheard of to get pregnant after that time.
I am post-menopausal - do I still need to use contraception?
After you've been through the menopause, you don't need
to use contraception to prevent a pregnancy.
However, you may still want to use forms of contraception
to prevent sexually transmitted infections.
Book a sexual health check
If you or a sexual partner have symptoms of an STI, we can help.
Even if you don't have symptoms, a discreet and confidential check can be reassuring too.
Our pay-as-you-go sexual health checks are available to everyone, with or without health insurance. There are different options to suit your needs.
If we find anything, a GP will help you with your next steps. We can help you with notifying past partners too, if you'd like.
You can also check your area for an NHS sexual health clinic.
Let any sexual partners know
It's important to keep those around you safe.
If you think you have an STI or have been given a positive STI result, it's important to let any sexual partners know.
That way they can get checked too, and you can help stop the spread of infection.
Advice on sexual health and common conditons
Vaginal dryness and the menopause
Feeling dry doesn't mean you can't have sex. There's lots of treatment options.
What is chlamydia?
Chlamydia is one of the most common STIs in the UK. Find answers to common chlamydia questions.
What is gonorrhoea?
How can you tell if you have gonorrhoea? And how is it treated? We explain more about this common STI.
What is HIV?
Our experts explain what HIV is, how you get it, symptoms of HIV and how HIV treatment works.
Can Bupa help you take control of your health?
I’m interested in health insurance for myself or my family members
I’m interested in health insurance for my business employees
I want to know more about health subscriptions
I don’t want insurance, but I’m interested in pay-as-you-go services
Legal disclaimer
This information was published by Bupa's Health Content Team and is based on reputable sources of medical evidence. It has been reviewed by appropriate medical or clinical professionals and deemed accurate on the date of review. Photos are only for illustrative purposes and do not reflect every presentation of a condition.
Any information about a treatment or procedure is generic, and does not necessarily describe that treatment or procedure as delivered by Bupa or its associated providers.
The information contained on this page and in any third party websites referred to on this page is not intended nor implied to be a substitute for professional medical advice nor is it intended to be for medical diagnosis or treatment. Third party websites are not owned or controlled by Bupa and any individual may be able to access and post messages on them. Bupa is not responsible for the content or availability of these third party websites. We do not accept advertising on this page.
