Contraception: which is right for me?

There are many different types of contraception available and it is important to pick the type that works best for you. Below is some information on the effectiveness, advantages and disadvantages of each type. Check out the’ Where can I page’ to find a local clinic where you can discuss choices further and get supplies.

    Effectiveness

    Male condoms are 98% effective if used according to the instructions. The most common types of condom is made of latex. A condom fits over a guy’s erect penis and catches semen on ejaculation. This prevents sperm from getting into the vagina and also stops body fluids from mixing during any kind of sexual activity, and therefore reducing the risk of Sexually Transmitted Injections (STI’s). Condoms are often lubricated (to make sex more comfortable) but spermicide/ lubricant free condoms are readily available, as are flavoured, coloured or textured varieties for some extra pleasure. Condoms made from polyurethane are a recent development. They offer the same level of protection, and provide an effective alternative if you are a latex- allergy sufferer.

    How it’s used

    1. A condom should always be unrolled onto an erect penis before sex, and preferably before any kind of sexual activity. This is because during arousal the penis may release a clear liquid (called pre-cum) which can contain semen.

    2. Always pinch the teat at the top of the condom before rolling it over the penis. This will help to be sure that you’re putting it on right (teat facing upwards) and expel any trapped air. This also reduces the risk of the condom splitting during sex.

    3. After sex, hold the base of the condom when withdrawing the penis to prevent it from slipping off. Get rid of it responsibly and if you’re up for any more action be sure to roll on another one fresh from its foil packet, never re-use

    Advantages

    • Can help to protect from Sexually Transmitted Infections (STI’s)
    • No serious side effects from using it
    • Free from health clinics
    • Nothing additional is needed, just unwrap and use

    Disadvantages

    • May slip off or split if not used correctly or the wrong shape/ size
    • Must remove penis from the vagina after ejaculation and before the penis goes soft to avoid spilling the semen
    • Need one condom for every time you have sex
    • Do not use if your have an allergy to latex.

    Further information

    Don’t use oil-based lubricants such as body oils, lotions or petroleum jelly with male condoms as they make them more likely to split. Use water-based lubricants instead. They need to be stored as instructed on the packet. Some people are sensitive to the chemicals in latex condoms. Spermicides do not need to be used with condoms, as they do not offer any added protection.

    Effectiveness

    Female condoms are 95% effective if used according to instructions. Female condoms are made from thin, soft, lubricated silicone, which lines the vagina when in place. The closed end of the condom is inserted high into the vagina and the open, outer ring lies just outside the vagina. To remove the condom after sex, the outer ring is twisted to keep the sperm inside and the condom is pulled out and should be disposed of carefully.

    Advantages

    • They only need to be used when you have sex and can also offer protection against some STI’s
    • Female condoms can be put in at any time before sex

    Disadvantages

    • Be careful as the condom can be easily damaged by sharp fingernails or jewellery
    • Care must be taken to ensure that the man’s penis goes inside the female condom and not down the side between the condom and the vagina
    • Female condoms are not widely available for free

    Further information

    Some people are sensitive to the chemicals in latex condoms. Spermicides do not need to be used with condoms, as they do not offer any added protection.

    Effectiveness

    An IUS (IntraUterine System) is usually fitted during the first seven days of your period and it provides immediate contraceptive protection. If fitted on any other day, an extra method of contraception must be used for seven days. The IUS works by:

    -          Stopping sperm reaching the egg by thickening the mucus from the cervix

    -          Stopping the egg settling in the womb

    -          Sometimes stopping the ovaries releasing an egg each month (ovulation)

    Advantages

    • Stopping sperm reaching the egg by thickening the mucus from the cervix
    • Stopping the egg settling in the womb and sometimes stopping the ovaries releasing an egg each month (ovulation)
    • It’s very effective
    • It doesn’t interfere with sex
    • It works for five years
    • Periods become shorter, lighter and less painful after three months
    • Fertility returns quickly once it’s removed
    • You don’t have to think about contraception for as long as it works, although you should still consider the risk of STI’s
    • If you change your mind, it’s easily removed

    Disadvantages

    • Most girls have irregular, light bleeding to start with, but this should settle down after three months
    • Temporary side effects can include headaches, acne and breast tenderness, which should clear up after a few months
    • Some girls may develop cysts on their ovaries. These aren’t dangerous, often have no symptoms and usually disappear without treatment
    • The IUS can be pushed out of the womb (expulsion) move or go through (perforate) the lining of the womb or cervix. This is rare when fitted by an experienced doctor or nurse. Check the threads every month to make sure it’s still in place
    • It will not protect you from STI’s

    Further information

    You’ll need a check-up four to six weeks after the IUS is inserted. Contact your doctor or nurse if you have any problems. You will be taught to feel the threads regularly too.

    Effectiveness

    The IUD (IntraUterine Device) is a small, plastic and copper device that used to be known as the coil. It’s inserted into the womb by a doctor or nurse.

    It has two short threads attached to the end which hang down a little way into the vagina so you can check it’s in place. It works for five to ten years, depending on the type used.

    The IUD is around 99% effective, depending on the type.
    The IUD works by:

    • Stopping the sperm reaching the egg
    • Stopping the egg from settling in the womb

    Advantages

    • It’s very effective
    • It doesn’t interfere with sex
    • It works as soon as it’s fitted
    • It works for three to ten years, depending on the type used
    • You don’t have to think about contraception for as long as it works
    • Fertility returns as soon as it’s removed
    • If you change your mind, it can easily be removed
    • This can be used as a emergency contraception.

    Disadvantages

    • Periods may be heavier, longer or more painful
    • It will not protect you or your partner from Sexually Transmitted Infection (STI’s)
    • There’s a small risk of infection after fitting
    • The IUD can be pushed out of the womb, move or go through the lining of the womb or cervix. This is uncommon when fitted by an experienced doctor or nurse. You can check the threads every month to make sure it’s still in place.
    • If you become pregnant using the IUD, there’s a small risk of ectopic pregnancy. This is uncommon but dangerous.

    Further information

    You’ll need a check-up four to six weeks after it’s put in. Contact your doctor or nurse if you have any problems. You will be taught how to feel the threads regularly too.

    Effectiveness

    The combined pill is also known as the Pill. There are many different types of combined pill, but all contain two hormones: oestrogen and progestogen. The Pill is more than 99% effective if taken according to instructions and if you start to take the Pill from the 1st to the 5th day of your period it provides immediate protection against pregnancy. If started on any other day, an extra method of contraception must also be used for seven days. The main way the Pill works is by stopping the ovaries releasing an egg each month (ovulation). It also stops sperm reaching the egg by thickening the mucus from the cervix and stops an egg from settling in the womb. A pill is taken every day for 21 days until the pack is finished. Then you have a seven-day break when you get a bleed. The next pack is started on the eighth day.

    What to do if you forget a pill

    It’s important to take the combined pill at a regular time every day. You should not take your pill later than 24 hours after your chosen time. If you do, you must treat this as a missed pill day. Do not stop taking your pill and take your next pill at the normal time. Missing one pill anywhere in your pack or starting your pack one day late is not a problem. Depending on which type of Pill you take, missing more than one Pill or starting the packet more than one day late could affect your contraceptive cover. If this happens seek advice. If you’re sick within two hours of taking the Pill it will not have been absorbed properly. Take another Pill as soon as you feel well enough. If you continue to feel sick, seek advice. If you have very severe diarrhoea for more than 24 hours this makes your pill less effective. Seek advice.

    Advantages

    • Doesn’t interfere with sex
    • Makes periods shorter, lighter and less painful
    • Protects against cancer of the ovary and womb
    • Protects against some pelvic infections
    • Reduces the risk of fibroids (non-cancerous tumours in the womb) and ovarian cysts
    • The effects are reversible, which means girls can become pregnant as soon as they stop taking the pill

    Disadvantages

    • Temporary side effects include headaches, weight gain, breast tenderness, mood changes, nausea and bleeding between periods
    • May increase blood pressure
    • Rare but serious side effects can include blood clots
    • There is a very small increased risk of breast cancer and cervical cancer
    • Some prescription drugs or complementary medicines may affect how the Pill works

    Further information

    Initially you’ll be given three months supply of the Pill. You don’t need a cervical smear test or internal examination to use it. Some medicines affect how well the pill works, check with your doctor, nurse or pharmacist.

    Effectiveness

    The Progestogen-Only Pill (POP) contains a hormone called progestogen. It’s different to the combined pill, which contains two hormones: oestrogen and progestogen. There are different types of POP. If taken according to instructions, the POP is 99% effective and is usually started on the first day of a period it immediately protects against pregnancy. Some girls can start taking the POP up to the fifth day of their period if they don’t have short menstrual cycles, if it’s started on any other day, an extra method of contraception must also be used for two more days. The POP works by:

    - Stopping sperm reaching the egg by thickening the mucus from the cervix

    - Stopping the egg from settling in the womb

    - Sometimes stopping the ovaries releasing an egg

    - A pill is taken every day until the pack is finished. The new pack is started immediately, without any break, which means pills are taken during your period. The pill must be taken within a 3 hour window each day to remain effective

    What to do if you forget a pill

    It’s important to take it at the same time every day, but if you forget, here’s what to do:

    1. If you’re less than three hours late. Take it as soon as you remember, then take the next one on time. You’ll still be protected against pregnancy.

    2. If you’re more than three hours late. You won’t be protected against pregnancy. Continue to take the POP as usual and use an extra method of contraception for the next two days to protect yourself from pregnancy.

    3. If you are using the POP called Cerazette, you have up to 12 hours to remember to take your pill. If you are more than 12 hours late, follow the advice above.

    4. If you vomit within two hours of taking the POP or have severe diarrhoea, you must use an extra method of contraception for the next two days and seek advice if needed.

    Advantages

    • It doesn’t interfere with sex
    • There are no serious side effects
    • Can be used if you’re a smoker over 35
    • Can be used while breastfeeding
    • Can help with pre-menstrual tension and period pain

    Disadvantages

    • Periods may be irregular, light or more frequent. This should settle down and isn’t harmful.
    • Temporary side effects can include spotty skin, headaches, tender breasts. These should settle down after a few months.
    • Some girls develop cysts on their ovaries. These aren’t dangerous, often have no symptoms and usually disappear without treatment.
    • If you become pregnant using the POP, there’s a small risk of ectopic pregnancy. This is uncommon but dangerous.
    • Some prescription and complementary medicines affect how the POP works.

    Further information

    Initially you’ll be given three months supply of the POP to see if it suits you. After that, you must go back for regular supplies. Some medicines affect how the POP works so check with your doctor, nurse or pharmacist.

    Effectivness

    The contraceptive implant is a small, flexible tube about the size of a hair grip that’s inserted under the skin in the upper arm. It slowly releases a hormone called progestogen and works for three years. The implant must be fitted by a trained doctor or nurse under local anesthetic. The tube is both flexible and unbreakable and shouldn’t be visible, but you may feel it by pressing over the area with your fingertips. It provides a long-term method of hormonal contraception. The implant is more than 99% effective and is usually put in during the first five days of your period to provide immediate contraceptive protection. If its put in place on any other day, an extra method of contraception must be used for seven days. The main way the implant works is by stopping the ovaries from releasing an egg each month (ovulation). The implant also works by stopping sperm from reaching the egg by thickening the mucus from the cervix and stops an egg from settling in the womb.

    Advantages

    • It’s highly effective
    • It doesn’t interfere with sex
    • Fertility returns quickly once it’s removed
    • It can be used by girls who are breastfeeding
    • Offers some protection against pelvic inflammatory disease
    • You don’t have to think about contraception for as long as it works
    • If you change your mind, it can be removed

    Disadvantages

    • Many girls experience irregular bleeding and changes to their periods. This should settle down after the first year, but it continues for longer in some girls
    • Some girls experience side effects including weight increase, headaches, acne, and breast tenderness and bloating
    • Some girls may develop cysts on their ovaries. These aren’t dangerous, often have no symptoms and usually disappear without treatment
    • Rarely, having an implant can cause an infection in the arm and sometimes the implant is difficult to remove

    Further information

    You’ll need a check-up three months after the implant is put in and then once a year after that. Some medicines can affect how the implant works, check with your doctor, nurse or pharmacist.

    Effectiveness

    The contraceptive injection contains a hormone called progestogen and is a long-term method of contraception. It’s injected into a muscle and the hormone is released very slowly into the body.

    A common injection is Depo-Provera which provides contraceptive protection for three months (12 weeks) and is more than 99% effective. The hormone is injected into a muscle in your bottom and it’s usually given during the first five days of a period when it provides immediate contraceptive protection. If given on any other day, an extra method of contraception must be used for seven days.

    The injection works by:

    • Stopping the ovaries releasing an egg each month.
    • Stopping sperm reaching the egg by thickening the mucus from the cervix.
    • Stopping the egg settling in the womb.

    Advantages

    • It’s highly effective
    • It doesn’t interfere with sex
    • The injection provides some protection against both cancers of the womb and pelvic inflammatory disease
    • It can be used by girls who are breastfeeding
    • You don’t have to think about contraception for as long as it works

    Disadvantages

    • The injection can cause irregular bleeding or longer periods. Some girls find their periods stop completely, while others have frequent, light bleeding. Irregular bleeding can continue for some months after stopping the injections
    • Some girls experience side effects including weight increase, headaches, acne, breast tenderness, mood swings and bloating
    • The injection cannot be removed from the body. If side effects occur, they’ll last as long as the injection does and sometimes longer
    • Your fertility and periods can take a while to get back to normal after stopping Depo-Provera

    Further information

    Contraceptive injections can be less effective if you don’t have the next one on time. Girls who use Depo-Provera have been shown to have a temporary lower bone mineral density than girls who don’t use it. It is not known if this effect increases the risk of osteoporosis and fractures in later life. Because of this girls, especially if under 19, should discuss this contraception with their GP and look at all the contraceptive options available.

    Effectiveness

    Natural family planning (NFP) helps girls recognise the fertile and infertile times of their menstrual cycles to plan or avoid a pregnancy. A girl’s fertile time (when she can get pregnant) lasts for eight to nine days in each menstrual cycle. An egg lives for up to 24 hours and is released 12 to 16 days before the next period. Sperm can live for up to seven days. This means if you have sex seven days before you ovulate, you could get pregnant. NFP teaches you to recognise and record the different natural signs or indicators of fertility each day of your menstrual cycle.

    It must be taught by a specialist teacher to be effective. If used according to teaching and instructions, it’s up to 98% effective.

    Indicators

    NFP is most effective when two or more fertility indicators are used to identify the fertile time.

    1. Temperature: your body temperature rises after ovulation. If you record your temperature every day when you wake up, you’ll know when ovulation has happened.
    2. Cervical secretions: during the menstrual cycle changes occur in the cervical mucus. These cause feelings of dryness, moistness or wetness in the vagina. When the secretions are clear and slippery, you’re at your most fertile.
    3. Other changes: the position of the cervix changes during the menstrual cycle. Some girls notice pain around ovulation, changes to their moods, skin, breasts or sexual desire.

    Effectiveness

    Sterilisation is the only permanent method of contraception and involves cutting, blocking or sealing the tubes in guys and girls that carry either the sperm or eggs. It’s more than 99% effective. Failure is uncommon, but can happen when the tubes that carry the sperm or eggs rejoin.

    Men

    Male sterilisation is called a vasectomy. Under local anaesthetic, a small cut is made in the skin of the scrotum. The tubes that carry the sperm from the testicles to the penis are then cut. The operation can take between 10 and 15 minutes. The scrotum recovers quickly. Feelings, sex drive, erections and climax remain the same as before. Sperm is re-absorbed by the body as they cannot travel along the tubes once they have been tied / cut. Although semen is still released from the glands further along the tubes where they are still intact but the semen will no longer contain sperm. Semen samples need to be taken at weeks 12 and 16 post surgery to make sure that there are no sperm left in the semen. When all the sperm are gone, the vasectomy is effective. Reversal of vasectomy is possible although this is not usually carried out on the NHS. To have the procedure carried out privately the price is approx. £5000.

    Women

    In female sterilisation the tubes that carry the egg from the ovary to the womb are cut, sealed or blocked in an operation done under general or local anaesthetic. The ovaries, cervix and womb are all left in place. Feelings, sex drive and climax remain the same as before. An egg is still released each month, but is naturally absorbed by the body. Sterilisation is effective from the first menstrual period after the operation.

    Advantages

    • Sterilisation is permanent, so you won’t have to think about contraception again
    • It doesn’t interfere with sex

    Disadvantages

    • The tubes may rejoin and fertility returns
    • Sterilisation is hard to reverse. The reversal operation is complicated, can be expensive and may not be successful
    • It takes several months for sperm to disappear from the semen, so an extra method of contraception must be used until then
    • There is no protections from STI’s

    Effectiveness

    The contraceptive patch is a small, thin, beige coloured patch (5cm x 5cm). You stick it to your skin and it releases two hormones; estrogen and progestogen. If the patch is used correctly and to the instructions it’s over 99% effective.

    The  hormones are released through the skin daily, into the bloodstream. The main way it works it to stop the ovaries from releasing an egg each month (ovulation). It also:

    - thickens the mucus from your cervix. This makes it difficult for sperm to move through it and reach an egg.
    - makes the lining of the uterus (womb) thinner so it is less likely to accept a fertilised egg.

    The patch is used on a 4 week cycle; you use the patch for 3 weeks, changing it every 7 days and then on the 4th week you do not use the patch at all. This is a patch free week and during this week you should have a bleed, like a period.

    Advantages

    • You don’t have to think about it every day- you only have to replace the patch once a week
    • It doesn’t interrupt sex and it is easy to use
    • The patch is not affected by vomiting or diarrhoea
    • Bleeding will become more regular, lighter and less painful
    • It can help with pre-menstrual symptoms
    • May reduce the risk of cancer of the ovary, uterus and colon
    • May reduce the risk of fibroids, ovarian cysts and non- cancerous breast disease

    Disadvantages

    • It can be seen
    • It may cause skin irritation in some girls
    • You may get side- effects within the first few months like headaches, nausea, breast tenderness and mood changes
    • Unexpected bleeding or spotting may happen in the first few months.
    • It doesn’t protect against STI’s

    Further information

    There can also be some serious side-effects from using the patch. If you think this might be a good option for you speak to your GP about it in more detail.

    Effectiveness

    Diaphragms and Caps are barrier methods of contraception. They fit inside the vagina and cover the cervix (entrance to the womb). Diaphragms are circular domes which come in different shapes and sizes and are normally made of soft, thin latex with a flexible rim. Cervical caps are smaller and are made of latex. To be effective they both need to be used with spermicides, this is a chemical which kills sperm.

    The effectiveness of the diaphragm and caps are dependent on how old you are, how often you have sex and on whether the instructions are followed correctly. They are 92- 96% effective when used with spermicide.

    The diaphragm or cap will be less effective if:

    • It’s damaged, for example if its torn or has holes
    • You don’t use it every time you have sex
    • It doesn’t cover your cervix
    • It isn’t the right size
    • You use it without spermicide
    • You have sex 3 hours or more after you put it in and don’t use extra spermicide
    • You remove it too soon- less than 6 hours after having sex
    • You use oil- based products such as baby lotion, bath oils or some vaginal medicines with latex diaphragms or caps

    Advantages

    • You only have to use it when you have sex
    • It has no serious health risks
    • You are in control of your contraception
    • You can put it in before you have sex. You will have to add extra spermicide if sex takes place more than three hours after putting it in.

    Disadvantages

    • Putting it in can interrupt sex
    • Some people find the spermicide messy
    • It can take time to learn how to use it
    • Cystitis can be a problem for some girls who use a diaphragm
    • Some people are sensitive to the chemicals in latex or spermicide. This may cause irritation in some girls and/ or their partner

    Effectivness

    The contraceptive vaginal ring is a flexible, transparent plastic ring. It is placed in the vagina where it releases two hormones- estrogen and progestogen. The effectiveness of the ring will depend on how old you are and how often you have sex, it also depends on whether you follow the instructions correctly.

    The ring releases a constant dose of hormones into the bloodstream through the vaginal wall. It mainly stops the ovaries from releasing an egg each month (ovulation). It also thickens the mucus on the cervix which makes it difficult for a sperm to move through it and therefore reach the egg, and it makes the lining of the uterus (womb) thinner so it is less likely to accept a fertilised egg.

    The ring is inserted and left in place for 3 weeks. After 3 weeks the ring is removed and for 7 days you have a ring-free interval; during this week you may have a bleed, like a period.

    Advantages

    • You don’t have to think about it every day- you only use one ring a month
    • It doesn’t interrupt sex
    • It is easy to insert and remove
    • The ring is not affected by vomiting or diarrhoea
    • Bleeding will usually become more regular, lighter and less painful
    • It may help with pre-menstrual symptoms
    • It may reduce the risk of cancer of the ovary, uterus and colon
    • It may reduce the risk of fibroids, ovarian cysts and non- cancerous breast disease

    Disadvantages

    • Some women may not feel comfortable inserting and removing the ring
    • You may get temporary side effects at first including increased vaginal discharge, headaches, nausea, breast tenderness and mood changes
    • May have breakthrough bleeding and spotting
    • The vaginal ring does not protect you against STI’s, so you may need to use condoms as well

    Emergency Contraception

    If you have had unprotected sex, that is, sex without using contraception or think that the contraception you have use might have failed, you can use emergency contraception. Check out the ‘Where Can I page’ to find out where you can get emergency contraception free and/ or fitted and get further advice. There are different types of emergency contraception you could be offered, these include:

    The emergency intrauterine device (IUD)

    This is a small plastic and cooper device which is fitted in your uterus up to 5 days or 120 hours after unprotected sex or within 5 days of the earliest time you could have released an egg. It takes about 15- 20 minutes to fit and it can be a little uncomfortable, but that doesn’t last long.

    The emergency contraceptive pill- Levonelle

    This is a tablet containing a hormone called progestogen. You will need to take this tablet within 3 days or 72 hours of having unprotected sex. It is more effective the sooner you take it after unprotected sex, or suspected contraceptive failure.

    The emergency contraceptive pill- EllaOne

    This is a tablet which contains ulipristal acetate. You must take this tablet within 5 days or 120 hours of having unprotected sex.

    Contact your GP or local pharmacy for extra advice or support.

    Condoms

    Effectiveness

    Male condoms are 98% effective if used according to the instructions. The most common types of condom is made of latex. A condom fits over a guy’s erect penis and catches semen on ejaculation. This prevents sperm from getting into the vagina and also stops body fluids from mixing during any kind of sexual activity, and therefore reducing the risk of Sexually Transmitted Injections (STI’s). Condoms are often lubricated (to make sex more comfortable) but spermicide/ lubricant free condoms are readily available, as are flavoured, coloured or textured varieties for some extra pleasure. Condoms made from polyurethane are a recent development. They offer the same level of protection, and provide an effective alternative if you are a latex- allergy sufferer.

    How it’s used

    1. A condom should always be unrolled onto an erect penis before sex, and preferably before any kind of sexual activity. This is because during arousal the penis may release a clear liquid (called pre-cum) which can contain semen.

    2. Always pinch the teat at the top of the condom before rolling it over the penis. This will help to be sure that you’re putting it on right (teat facing upwards) and expel any trapped air. This also reduces the risk of the condom splitting during sex.

    3. After sex, hold the base of the condom when withdrawing the penis to prevent it from slipping off. Get rid of it responsibly and if you’re up for any more action be sure to roll on another one fresh from its foil packet, never re-use

    Advantages

    • Can help to protect from Sexually Transmitted Infections (STI’s)
    • No serious side effects from using it
    • Free from health clinics
    • Nothing additional is needed, just unwrap and use

    Disadvantages

    • May slip off or split if not used correctly or the wrong shape/ size
    • Must remove penis from the vagina after ejaculation and before the penis goes soft to avoid spilling the semen
    • Need one condom for every time you have sex
    • Do not use if your have an allergy to latex.

    Further information

    Don’t use oil-based lubricants such as body oils, lotions or petroleum jelly with male condoms as they make them more likely to split. Use water-based lubricants instead. They need to be stored as instructed on the packet. Some people are sensitive to the chemicals in latex condoms. Spermicides do not need to be used with condoms, as they do not offer any added protection.

    Female condoms

    Effectiveness

    Female condoms are 95% effective if used according to instructions. Female condoms are made from thin, soft, lubricated silicone, which lines the vagina when in place. The closed end of the condom is inserted high into the vagina and the open, outer ring lies just outside the vagina. To remove the condom after sex, the outer ring is twisted to keep the sperm inside and the condom is pulled out and should be disposed of carefully.

    Advantages

    • They only need to be used when you have sex and can also offer protection against some STI’s
    • Female condoms can be put in at any time before sex

    Disadvantages

    • Be careful as the condom can be easily damaged by sharp fingernails or jewellery
    • Care must be taken to ensure that the man’s penis goes inside the female condom and not down the side between the condom and the vagina
    • Female condoms are not widely available for free

    Further information

    Some people are sensitive to the chemicals in latex condoms. Spermicides do not need to be used with condoms, as they do not offer any added protection.

    IUS (IntraUterine System)

    Effectiveness

    An IUS (IntraUterine System) is usually fitted during the first seven days of your period and it provides immediate contraceptive protection. If fitted on any other day, an extra method of contraception must be used for seven days. The IUS works by:

    -          Stopping sperm reaching the egg by thickening the mucus from the cervix

    -          Stopping the egg settling in the womb

    -          Sometimes stopping the ovaries releasing an egg each month (ovulation)

    Advantages

    • Stopping sperm reaching the egg by thickening the mucus from the cervix
    • Stopping the egg settling in the womb and sometimes stopping the ovaries releasing an egg each month (ovulation)
    • It’s very effective
    • It doesn’t interfere with sex
    • It works for five years
    • Periods become shorter, lighter and less painful after three months
    • Fertility returns quickly once it’s removed
    • You don’t have to think about contraception for as long as it works, although you should still consider the risk of STI’s
    • If you change your mind, it’s easily removed

    Disadvantages

    • Most girls have irregular, light bleeding to start with, but this should settle down after three months
    • Temporary side effects can include headaches, acne and breast tenderness, which should clear up after a few months
    • Some girls may develop cysts on their ovaries. These aren’t dangerous, often have no symptoms and usually disappear without treatment
    • The IUS can be pushed out of the womb (expulsion) move or go through (perforate) the lining of the womb or cervix. This is rare when fitted by an experienced doctor or nurse. Check the threads every month to make sure it’s still in place
    • It will not protect you from STI’s

    Further information

    You’ll need a check-up four to six weeks after the IUS is inserted. Contact your doctor or nurse if you have any problems. You will be taught to feel the threads regularly too.

    IUD (IntraUterine Device)

    Effectiveness

    The IUD (IntraUterine Device) is a small, plastic and copper device that used to be known as the coil. It’s inserted into the womb by a doctor or nurse.

    It has two short threads attached to the end which hang down a little way into the vagina so you can check it’s in place. It works for five to ten years, depending on the type used.

    The IUD is around 99% effective, depending on the type.
    The IUD works by:

    • Stopping the sperm reaching the egg
    • Stopping the egg from settling in the womb

    Advantages

    • It’s very effective
    • It doesn’t interfere with sex
    • It works as soon as it’s fitted
    • It works for three to ten years, depending on the type used
    • You don’t have to think about contraception for as long as it works
    • Fertility returns as soon as it’s removed
    • If you change your mind, it can easily be removed
    • This can be used as a emergency contraception.

    Disadvantages

    • Periods may be heavier, longer or more painful
    • It will not protect you or your partner from Sexually Transmitted Infection (STI’s)
    • There’s a small risk of infection after fitting
    • The IUD can be pushed out of the womb, move or go through the lining of the womb or cervix. This is uncommon when fitted by an experienced doctor or nurse. You can check the threads every month to make sure it’s still in place.
    • If you become pregnant using the IUD, there’s a small risk of ectopic pregnancy. This is uncommon but dangerous.

    Further information

    You’ll need a check-up four to six weeks after it’s put in. Contact your doctor or nurse if you have any problems. You will be taught how to feel the threads regularly too.

    The combined pill

    Effectiveness

    The combined pill is also known as the Pill. There are many different types of combined pill, but all contain two hormones: oestrogen and progestogen. The Pill is more than 99% effective if taken according to instructions and if you start to take the Pill from the 1st to the 5th day of your period it provides immediate protection against pregnancy. If started on any other day, an extra method of contraception must also be used for seven days. The main way the Pill works is by stopping the ovaries releasing an egg each month (ovulation). It also stops sperm reaching the egg by thickening the mucus from the cervix and stops an egg from settling in the womb. A pill is taken every day for 21 days until the pack is finished. Then you have a seven-day break when you get a bleed. The next pack is started on the eighth day.

    What to do if you forget a pill

    It’s important to take the combined pill at a regular time every day. You should not take your pill later than 24 hours after your chosen time. If you do, you must treat this as a missed pill day. Do not stop taking your pill and take your next pill at the normal time. Missing one pill anywhere in your pack or starting your pack one day late is not a problem. Depending on which type of Pill you take, missing more than one Pill or starting the packet more than one day late could affect your contraceptive cover. If this happens seek advice. If you’re sick within two hours of taking the Pill it will not have been absorbed properly. Take another Pill as soon as you feel well enough. If you continue to feel sick, seek advice. If you have very severe diarrhoea for more than 24 hours this makes your pill less effective. Seek advice.

    Advantages

    • Doesn’t interfere with sex
    • Makes periods shorter, lighter and less painful
    • Protects against cancer of the ovary and womb
    • Protects against some pelvic infections
    • Reduces the risk of fibroids (non-cancerous tumours in the womb) and ovarian cysts
    • The effects are reversible, which means girls can become pregnant as soon as they stop taking the pill

    Disadvantages

    • Temporary side effects include headaches, weight gain, breast tenderness, mood changes, nausea and bleeding between periods
    • May increase blood pressure
    • Rare but serious side effects can include blood clots
    • There is a very small increased risk of breast cancer and cervical cancer
    • Some prescription drugs or complementary medicines may affect how the Pill works

    Further information

    Initially you’ll be given three months supply of the Pill. You don’t need a cervical smear test or internal examination to use it. Some medicines affect how well the pill works, check with your doctor, nurse or pharmacist.

    Progestogen-Only Pill (POP)

    Effectiveness

    The Progestogen-Only Pill (POP) contains a hormone called progestogen. It’s different to the combined pill, which contains two hormones: oestrogen and progestogen. There are different types of POP. If taken according to instructions, the POP is 99% effective and is usually started on the first day of a period it immediately protects against pregnancy. Some girls can start taking the POP up to the fifth day of their period if they don’t have short menstrual cycles, if it’s started on any other day, an extra method of contraception must also be used for two more days. The POP works by:

    - Stopping sperm reaching the egg by thickening the mucus from the cervix

    - Stopping the egg from settling in the womb

    - Sometimes stopping the ovaries releasing an egg

    - A pill is taken every day until the pack is finished. The new pack is started immediately, without any break, which means pills are taken during your period. The pill must be taken within a 3 hour window each day to remain effective

    What to do if you forget a pill

    It’s important to take it at the same time every day, but if you forget, here’s what to do:

    1. If you’re less than three hours late. Take it as soon as you remember, then take the next one on time. You’ll still be protected against pregnancy.

    2. If you’re more than three hours late. You won’t be protected against pregnancy. Continue to take the POP as usual and use an extra method of contraception for the next two days to protect yourself from pregnancy.

    3. If you are using the POP called Cerazette, you have up to 12 hours to remember to take your pill. If you are more than 12 hours late, follow the advice above.

    4. If you vomit within two hours of taking the POP or have severe diarrhoea, you must use an extra method of contraception for the next two days and seek advice if needed.

    Advantages

    • It doesn’t interfere with sex
    • There are no serious side effects
    • Can be used if you’re a smoker over 35
    • Can be used while breastfeeding
    • Can help with pre-menstrual tension and period pain

    Disadvantages

    • Periods may be irregular, light or more frequent. This should settle down and isn’t harmful.
    • Temporary side effects can include spotty skin, headaches, tender breasts. These should settle down after a few months.
    • Some girls develop cysts on their ovaries. These aren’t dangerous, often have no symptoms and usually disappear without treatment.
    • If you become pregnant using the POP, there’s a small risk of ectopic pregnancy. This is uncommon but dangerous.
    • Some prescription and complementary medicines affect how the POP works.

    Further information

    Initially you’ll be given three months supply of the POP to see if it suits you. After that, you must go back for regular supplies. Some medicines affect how the POP works so check with your doctor, nurse or pharmacist.

    Contraceptive implant

    Effectivness

    The contraceptive implant is a small, flexible tube about the size of a hair grip that’s inserted under the skin in the upper arm. It slowly releases a hormone called progestogen and works for three years. The implant must be fitted by a trained doctor or nurse under local anesthetic. The tube is both flexible and unbreakable and shouldn’t be visible, but you may feel it by pressing over the area with your fingertips. It provides a long-term method of hormonal contraception. The implant is more than 99% effective and is usually put in during the first five days of your period to provide immediate contraceptive protection. If its put in place on any other day, an extra method of contraception must be used for seven days. The main way the implant works is by stopping the ovaries from releasing an egg each month (ovulation). The implant also works by stopping sperm from reaching the egg by thickening the mucus from the cervix and stops an egg from settling in the womb.

    Advantages

    • It’s highly effective
    • It doesn’t interfere with sex
    • Fertility returns quickly once it’s removed
    • It can be used by girls who are breastfeeding
    • Offers some protection against pelvic inflammatory disease
    • You don’t have to think about contraception for as long as it works
    • If you change your mind, it can be removed

    Disadvantages

    • Many girls experience irregular bleeding and changes to their periods. This should settle down after the first year, but it continues for longer in some girls
    • Some girls experience side effects including weight increase, headaches, acne, and breast tenderness and bloating
    • Some girls may develop cysts on their ovaries. These aren’t dangerous, often have no symptoms and usually disappear without treatment
    • Rarely, having an implant can cause an infection in the arm and sometimes the implant is difficult to remove

    Further information

    You’ll need a check-up three months after the implant is put in and then once a year after that. Some medicines can affect how the implant works, check with your doctor, nurse or pharmacist.

    Contraceptive injection

    Effectiveness

    The contraceptive injection contains a hormone called progestogen and is a long-term method of contraception. It’s injected into a muscle and the hormone is released very slowly into the body.

    A common injection is Depo-Provera which provides contraceptive protection for three months (12 weeks) and is more than 99% effective. The hormone is injected into a muscle in your bottom and it’s usually given during the first five days of a period when it provides immediate contraceptive protection. If given on any other day, an extra method of contraception must be used for seven days.

    The injection works by:

    • Stopping the ovaries releasing an egg each month.
    • Stopping sperm reaching the egg by thickening the mucus from the cervix.
    • Stopping the egg settling in the womb.

    Advantages

    • It’s highly effective
    • It doesn’t interfere with sex
    • The injection provides some protection against both cancers of the womb and pelvic inflammatory disease
    • It can be used by girls who are breastfeeding
    • You don’t have to think about contraception for as long as it works

    Disadvantages

    • The injection can cause irregular bleeding or longer periods. Some girls find their periods stop completely, while others have frequent, light bleeding. Irregular bleeding can continue for some months after stopping the injections
    • Some girls experience side effects including weight increase, headaches, acne, breast tenderness, mood swings and bloating
    • The injection cannot be removed from the body. If side effects occur, they’ll last as long as the injection does and sometimes longer
    • Your fertility and periods can take a while to get back to normal after stopping Depo-Provera

    Further information

    Contraceptive injections can be less effective if you don’t have the next one on time. Girls who use Depo-Provera have been shown to have a temporary lower bone mineral density than girls who don’t use it. It is not known if this effect increases the risk of osteoporosis and fractures in later life. Because of this girls, especially if under 19, should discuss this contraception with their GP and look at all the contraceptive options available.

    Natural family planning

    Effectiveness

    Natural family planning (NFP) helps girls recognise the fertile and infertile times of their menstrual cycles to plan or avoid a pregnancy. A girl’s fertile time (when she can get pregnant) lasts for eight to nine days in each menstrual cycle. An egg lives for up to 24 hours and is released 12 to 16 days before the next period. Sperm can live for up to seven days. This means if you have sex seven days before you ovulate, you could get pregnant. NFP teaches you to recognise and record the different natural signs or indicators of fertility each day of your menstrual cycle.

    It must be taught by a specialist teacher to be effective. If used according to teaching and instructions, it’s up to 98% effective.

    Indicators

    NFP is most effective when two or more fertility indicators are used to identify the fertile time.

    1. Temperature: your body temperature rises after ovulation. If you record your temperature every day when you wake up, you’ll know when ovulation has happened.
    2. Cervical secretions: during the menstrual cycle changes occur in the cervical mucus. These cause feelings of dryness, moistness or wetness in the vagina. When the secretions are clear and slippery, you’re at your most fertile.
    3. Other changes: the position of the cervix changes during the menstrual cycle. Some girls notice pain around ovulation, changes to their moods, skin, breasts or sexual desire.

    Sterilisation

    Effectiveness

    Sterilisation is the only permanent method of contraception and involves cutting, blocking or sealing the tubes in guys and girls that carry either the sperm or eggs. It’s more than 99% effective. Failure is uncommon, but can happen when the tubes that carry the sperm or eggs rejoin.

    Men

    Male sterilisation is called a vasectomy. Under local anaesthetic, a small cut is made in the skin of the scrotum. The tubes that carry the sperm from the testicles to the penis are then cut. The operation can take between 10 and 15 minutes. The scrotum recovers quickly. Feelings, sex drive, erections and climax remain the same as before. Sperm is re-absorbed by the body as they cannot travel along the tubes once they have been tied / cut. Although semen is still released from the glands further along the tubes where they are still intact but the semen will no longer contain sperm. Semen samples need to be taken at weeks 12 and 16 post surgery to make sure that there are no sperm left in the semen. When all the sperm are gone, the vasectomy is effective. Reversal of vasectomy is possible although this is not usually carried out on the NHS. To have the procedure carried out privately the price is approx. £5000.

    Women

    In female sterilisation the tubes that carry the egg from the ovary to the womb are cut, sealed or blocked in an operation done under general or local anaesthetic. The ovaries, cervix and womb are all left in place. Feelings, sex drive and climax remain the same as before. An egg is still released each month, but is naturally absorbed by the body. Sterilisation is effective from the first menstrual period after the operation.

    Advantages

    • Sterilisation is permanent, so you won’t have to think about contraception again
    • It doesn’t interfere with sex

    Disadvantages

    • The tubes may rejoin and fertility returns
    • Sterilisation is hard to reverse. The reversal operation is complicated, can be expensive and may not be successful
    • It takes several months for sperm to disappear from the semen, so an extra method of contraception must be used until then
    • There is no protections from STI’s