Your health expert: Dr Sam Wild, Bupa GP and Women’s Health Lead
Content editor review by Liz Woolf, November 2021
Next review due November 2024

Contraception helps to prevent pregnancy after sex. There are many different types of contraception, so you can choose one that suits your needs.

Some contraceptives work better than others. Some can protect against sexually transmitted infections (STIs).

What is contraception?

Contraception aims to prevent pregnancy when you have sex. Different types work in different ways.

There are three main types of contraception.

  • Hormonal contraceptives. These include tablets (the pill), patches, implants, injections, and vaginal rings.
  • Barrier contraceptives. These include condoms, diaphragms and caps.
  • Intrauterine devices (IUDs). These are also called coils. They are fitted inside the womb. Some types of coil release hormones slowly: these are called ‘intrauterine systems’ (IUS).

No single type of contraception suits everyone. So it’s worth finding out what’s on offer before you and your partner make a decision on what’s best.

Emergency contraception

Emergency contraception aims to stop you, or your partner, becoming pregnant after sex without contraception. There are two types of emergency contraception available in the UK:

  • a copper intrauterine device (IUD), also called a copper coil
  • levonorgestrel or ulipristal acetate single dose tablets

The copper IUD is most effective. You have it put into your womb within either:

  • five days (120 hours) of sex without contraception
  • five days of ovulating (so, by day 19 of a 28-day cycle)

Once you’ve had the coil put in, it will provide ongoing contraception.

The tablets are hormonal. They stop the ovaries releasing an egg, so won’t help if you’ve already ovulated before you had unprotected sex.

Emergency contraception should only be used in an emergency and not as regular contraception. You can get it from your GP, reproductive health clinics, sexual health clinic or young people’s clinic. You can also get free emergency contraceptive tablets from your local or online pharmacy and A&E departments.

Barrier contraception

Barrier methods include condoms, contraceptive diaphragms and caps. Barrier methods stop you getting pregnant by preventing sperm reaching an egg. They also create a barrier to female cervical secretions, and so protect against some sexually transmitted infections (STIs).

You shouldn’t use oil-based lubricants with condoms, diaphragms or caps. They can damage the latex, increasing your chance of pregnancy or a sexually transmitted infection (STI).


In the UK, there are many types and brands of male condoms. There is one brand of female condom called Femidom®. You put male condoms over the penis and female condoms into the vagina before having sex.

Check the use-by date, as condoms can perish. Use a new condom each time you have sex.

Diaphragms or caps

These dome-shaped barriers sit over a woman’s cervix. They come in different sizes, so a doctor fits them initially to make sure they properly cover your cervix. Diaphragms and caps don’t protect you against sexually transmitted infection (STIs).

Before having sex, you put sperm-killing gel (spermicide) into your cap or diaphragm. You then place it up into your vagina so that it sits over your cervix. It holds the spermicide against the cervix, providing a chemical barrier alongside the physical one.

You can put the cap or diaphragm in up to three hours before sex. You leave it in for at least six hours afterwards. After use, wash it with a mild, unscented soap, dry properly and keep somewhere cool. Check each time you use it and replace if you see holes or puckering.

Intrauterine contraception

IUD stands for intrauterine device. IUS stands for intrauterine system. They are often called ‘coils’, although they are mostly T shaped. They sit inside the womb until you have them removed and can stay in place for many years.


IUDs prevent pregnancy because they contain copper, which is toxic to eggs and sperm. They also help to stop a fertilised egg implanting.

There are many different types and brands of copper IUDs available in the UK. They can stay in place for 10 years or more, depending on the type.


An IUS is a copper-free coil. It releases a set amount of progestogen hormone (levonorgestrel) each day. The progestogen thickens the mucus in the neck of the womb, to help stop sperm getting in. It also alters the lining of the womb so that an egg is less likely to implant. You usually have an IUS for at least 3 years.

Having an IUD or IUS put in

A specially trained healthcare professional will insert your coil. You may have it checked around six weeks later.

After it’s in, you’ll have two loose threads that you can feel at the opening of your cervix. The doctor uses these to remove the coil . Check the threads regularly to make sure it’s in place. Your GP or nurse will tell you how to do this and what to do if you can’t feel them.

The coil can stay in for between 5 and 10 years, or even longer depending on the type and your age when it’s fitted. You can have it removed at any time, but this needs to be done by a trained healthcare professional.

Your partner shouldn’t be able to feel your IUS or IUD during sex. But if it’s uncomfortable for you or your partner, see your GP or nurse. They can shorten the threads.

Hormonal contraception

Hormonal contraceptives come as pills, patches, implants, injections and vaginal rings. There are also hormone-releasing coils which are covered in the IUD and IUS section above.

To prevent pregnancy, your doctor may suggest using barrier contraception for two to nine days after first starting any hormonal contraceptive. This depends on the type of contraception and when in your cycle you start using it.

Oral contraceptives (the pill)

There are two main types of contraceptive pill:

  • the combined pill contains the hormones oestrogen and progestogen
  • the progestogen-only pill contains progestogen only

There are many combined oral contraceptive pills licensed in the UK. They contain different types and amounts of progestogen and oestrogen.

The progesterone-only pill (POP) is sometimes called the ‘mini pill’. Different types contain different forms of the hormone progestogen.

Combined oral contraceptives mainly work by stopping your ovaries from releasing an egg (ovulation). They also thicken the mucus in your cervix and affect the lining of your womb (endometrium). This blocks sperm and prevents a fertilised egg implanting if you do ovulate.

Progestogen-only contraceptives work mainly by thickening cervical mucus to block sperm and by changing the womb lining so an egg won’t implant. They also make ovulation less likely. Although some women continue to ovulate, the other effects help to prevent conception.

Your nurse or GP will talk through the types of hormonal contraception with you, to help work out which one is best.

How you take the pill

Most contraceptive pills come in a calendar strip. With most combined pills, you take one pill a day for three weeks (21 days), followed by a seven-day break. Some combined brands have some dummy pills to mimic a break, so you take one pill a day for 28 days, then start a new strip. There’s no break with the progestogen-only pill. You take one pill every day.

It’s important to take your pills at the same time each day, particularly for the progestogen-only pill. Even a three-hour delay can affect how well it works. Some types of progestogen-only pill you can take up to 12 hours late. Check with your doctor how long the safe period is for your pill – if you take it later than that, you’ll need to treat it as a missed pill.

A set time also helps you to get into a good routine and hopefully avoid missing pills. If you do miss one, take it as soon as you remember and continue to take your pills daily. Contact your doctor or nurse to find out if you need to take extra precautions against pregnancy and for how long. This varies between types of pill and when you missed one.

Contraceptive patch

The contraceptive patch contains oestrogen and progestogen. The UK-licensed Evra® is beige and about 2cm square (smaller than the average post-it note). Every day that you wear it, it releases hormones into your skin which pass on into your bloodstream.

How you use a patch

You use the patch on the same day each week for three weeks. You stick one patch onto either:

  • your upper arm
  • upper torso (but not your breasts)
  • lower tummy (abdomen)
  • your bum

After three weeks, you have a break for a week.

The skin where you stick the patch must be clean, dry and healthy – so not red or broken. It must be hairless and free of lotions. Change where you stick the patch each week to prevent irritation.

Patches shouldn’t come off, even when you are in the shower, bath or swimming. But if one does, or you’re late starting a new patch, check the patient information leaflet, or speak to your pharmacist, nurse or GP for advice.


Contraceptive vaginal ring

The vaginal ring contains oestrogen and progestogen. The UK licensed NuvaRing® is flexible, see-through and measures 5cm across.

How you use a vaginal ring

The day you start using your ring, you place it high up into your vagina. It doesn’t matter exactly where it is, as long as it’s comfortable. You might need to pinch it between your thumb and forefinger. It may also help if you squat, lie down or put one leg up.

The ring stays in for three weeks. Then you remove it by hooking it out with your finger and have a break for seven days. Then you put in a new ring to start the cycle again. If you’re late starting a new ring, check the patient information leaflet or speak to your pharmacist, nurse or GP for advice.

Check regularly that the ring is still in place. It can shift if it’s not in properly, during sex or if you’re constipated.

Contraceptive injection

The contraceptive injection contains progestogen. The most commonly used type in the UK is Depo-Provera®.

How you have the injection

You have the injection just under the skin (subcutaneously) or into a muscle (intramuscularly). A nurse or doctor will give it into your upper arm, upper thigh, abdomen or bum. How often you need to have it depends on the type - it’s usually every 8 to 13 weeks. 

Contraceptive implant

The implant contains progestogen. The UK licensed Nexplanon® is a flexible plastic rod, about the size of a matchstick. It can last up to 3 years.

How you have the implant

A doctor or nurse first injects local anaesthetic on the inside of your upper arm. Then they’ll put the implant just under the skin in the same place. They use a needle so it’s similar to having an injection. They will ask you to feel the implant through your skin before you leave. It can stay in place for up to three years, but it doesn’t have to stay in that long – you can have it removed sooner if necessary.

To remove the implant, you have local anaesthetic and then the doctor makes a small cut in your skin and pulls it out. If you’re having it replaced, they’ll put a new one in the same place.


Sterilisation means having an operation that permanently prevents pregnancy. It works very well, but it is very difficult to reverse. Sterilisation doesn't protect against sexually transmitted infections (STIs).

Sterilisation can involve:

  • Cutting or interrupting a tube that carries sperm from the testicles. This operation is called a vasectomy.
  • Removing or closing the fallopian tubes. This stops eggs from meeting sperm. Doctors call this operation tubal occlusion.

Vasectomy is usually done under local anaesthetic, and is a more minor operation.

Because sterilisation is permanent, you should consider very carefully whether it is the right option. Speak to your doctor for more information.

How to decide on contraception

To decide on contraception, you need to know about side-effects or complications associated with your method and how well it works. You also need to think about how well it fits in with your life. A diaphragm may not be best for spontaneity. If you tend to forget tablets, an implant or injection may be better than a daily pill.

There’s a risk that any type of contraception won’t work. But they are much more likely to be reliable if you’re using them properly. If you are unsure about anything, ask your nurse or GP.

With some medical conditions or if you take certain tablets, hormonal contraception may not be advisable. Your doctor will talk you through your options.


Side-effects from hormonal contraception include:

  • changes in periods (although this may be a benefit as they can be lighter and less painful)
  • breast tenderness
  • weight gain (contraceptive injection)
  • acne (although some types may improve acne if you already have it)
  • discomfort or pain with insertion of contraceptive injection, implant or coil

Few side-effects are associated with non-hormonal contraceptives. Some people are allergic to latex condoms. You may also be more likely to get a urine infection if you use a diaphragm. IUDs (coils) can cause heavy periods.


The risk of complications is low overall and depends on the type of contraceptive you’re using. These include the following.

  • Increased risk of ovarian cysts with some progestogen-only contraception.
  • A small increased risk of breast cancer and cervical cancer with combined hormonal contraceptives, which returns to normal within 10 years of stopping.
  • A drop in bone density when using the contraceptive injection for over a year. This usually returns to normal after stopping and there’s no evidence of increased fracture risk.
  • Increased risk of pelvic infection (PID) when a coil is put in (this is a low risk).
  • Increased risk of ectopic pregnancy (a fertilised egg implanting outside your womb) if you become pregnant with a coil in, or on the progestogen-only pill. This is a lower risk than if you don’t use any contraception because these contraceptives work so well that you are unlikely to become pregnant.
  • Increased risk of blood clots with combined contraceptives varies depending on the type. The risk is higher with the patch and vaginal ring than the pill, although very low overall, and lower than during pregnancy.

If you’re worried or would like more information about these complications, speak to your nurse or GP.


Hormonal contraceptives can interact with other medicines, affecting how well they work. This includes some epilepsy medicines, certain antibiotics and antivirals, and the herbal product St. John’s wort. Your doctor may advise using barrier contraception while you’re taking any of these short term. If you’re on some long-term medicines, hormonal contraception may not be suitable for you or your doctor may need to alter your dose.

How to get contraception

You can get contraceptives from:

  • your GP
  • a reproductive health (family planning) clinic
  • a young person’s clinic or sexual health clinic
  • your local or online pharmacy

You can also get emergency contraception from your pharmacy or A&E.

Hormonal contraceptives and coils are generally more reliable than barrier methods. But the best one is the one that works for you. No contraceptive is 100% reliable, but they are going to be more reliable if you’re using them properly. Our section on choosing contraception has more information.

The three main types of contraception are:

  • contraception based on hormones, such as the pill, implant and injection
  • barrier methods, such as the cap or diaphragm, and the condom
  • intrauterine methods, which are put into the womb such as the coil


All these are covered in more detail above.

Statistically, hormonal contraceptives are the most effective contraception, particularly long-term ones such as the injection and implant. This is really because you can’t forget to take them, unlike the pill. Whichever type of contraception you choose, it’s important to use it properly. Ask your doctor or nurse if you have any questions or concerns.

More on this topic

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