What is contraception?
The main aim of contraception is to prevent pregnancy when you have sex. Contraception can also be used to help manage some menstrual conditions. These include heavy periods (menorrhagia) and painful periods (dysmenorrhoea).
Contraceptives work in different ways and have different benefits. It’s worth finding out what options are available because no single type of contraception will suit everyone.
If you don’t plan to become pregnant, you should use contraception until the menopause, which normally happens between the ages of 45 and 55. You can normally stop taking contraception:
- if you’re younger than 50 and haven’t had a period for two years
- if you’re aged between 50 and 55 and haven’t had a period for a year
- once you reach age 55
What are the main types of contraception?
There are three main types of contraception.
- Barrier contraceptives. These include condoms, diaphragms, and caps.
- Hormonal contraceptives. These include tablets (the pill), patches, implants, injections, and vaginal rings.
- Intrauterine contraception. These are sometimes called coils and they’re fitted inside the womb (uterus).
Condoms can also protect against sexually transmitted infections (STIs). And some intrauterine devices can be used to treat heavy or painful periods, while acting as a contraceptive.
Barrier methods prevent sperm reaching an egg. Barrier methods include condoms, diaphragms, and caps.
You put male condoms on the penis and female condoms inside the vagina before having sex. Condoms create a barrier to different secretions during sex, so they can protect against some sexually transmitted infections (STIs). Make sure to check the expiry date and use a new condom each time you have sex.
Diaphragms and caps sit over a woman’s cervix and hold sperm-killing gel (spermicide) against it. They come in different sizes, which means a doctor will need to fit one at first to make sure it covers your cervix. You can put the cap or diaphragm in up to three hours before sex, and leave it in for at least six hours afterwards.
Hormonal contraceptives come as pills, patches, implants, injections, and vaginal rings. They contain either one hormone (progestogen) or two hormones combined (progestogen and oestrogen).
Combined hormonal contraception is available as a pill, patch, or vaginal ring. Progestogen-only contraception is available as a pill, implant, or injection. The combined oral contraceptive pill is the most commonly used contraception in the UK, but it’s not suitable for everyone.
Your nurse or GP will discuss the types of hormonal contraception with you, to help work out which one is best.
Hormonal contraception can work in several ways, depending on what form of it you take. It can prevent conception by:
- stopping your ovaries releasing an egg (ovulation)
- making it harder for sperm to reach an egg (fertilisation)
- preventing a fertilised egg implanting in your womb (uterus)
The main aim of combined hormonal contraception is to stop your ovaries releasing an egg (ovulation). Progestogen-only contraception works mainly by making it harder for sperm to reach an egg, and for a fertilised egg to implant in your womb (uterus).
You’re in control of using pills, patches, and vaginal rings, which means you need to remember to take or use them. Contraceptive injections and implants are a type of long-acting reversible contraception and need to be provided by a health care professional.
Intrauterine contraception (the coil)
There are two types of intrauterine contraception: intrauterine devices (IUDs) and intrauterine systems (IUSs). They’re often called ‘coils’, although they’re usually T-shaped. These devices are placed inside your womb by a specially trained health care professional. A coil also needs to be removed by a professional.
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 5 or 10 years, depending on the type.
An IUS is a copper-free coil. It releases a set amount of progestogen hormone (levonorgestrel) each day. The progestogen helps to stop sperm reaching an egg and can make it less likely for a fertilised egg to implant. You usually have an IUS for between 3 and 6 years.
What’s the best contraceptive?
Hormonal contraceptives and coils are generally more reliable than barrier methods at preventing pregnancy. But the best one is the one that works for you. Think about how well it will fit 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.
No contraceptive is 100% reliable, but they’ll be more reliable if you’re using them properly.
What are the side-effects of contraception?
To decide on contraception, you need to know about side-effects or complications associated with your method and how well it works.
Other medicines can interact with hormonal contraceptives, affecting how well they work. This includes antiepileptic medicines, antibiotics, antivirals, and herbal remedies such as St John’s Wort. Your doctor can talk you through your options.
Side-effects from hormonal contraception include:
- changes in periods
- breast tenderness
- weight gain (progestogen-only injections)
- acne (although some types may improve acne if you already have it)
- nausea and tummy (abdominal) pain
- discomfort or pain with insertion of a coil
There is a small increased risk of breast cancer and cervical cancer with combined hormonal contraceptives. There’s also an increased risk of blood clots (venous thromboembolism) with combined hormonal contraceptives, but this 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.
Your healthcare provider will talk to you about your medical history so they can advise the best contraceptive options for you.
If you’re worried or would like more information about these complications, speak to your nurse or GP.
Where can I get contraceptives from?
You can get contraceptives from:
- your GP
- a reproductive health (family planning) clinic
- a sexual health clinic
- your local or online pharmacy
If you’ve had sex without using contraception, you can get emergency contraception from a pharmacy, GP, reproductive health clinic, or sexual health clinic. But this should only be used in an emergency, and not as regular contraception.