What is contraception?

Contraception aims to prevent pregnancy.

A woman can get pregnant if a man’s sperm reaches one of her eggs (ova).

Contraception tries to stop this happening by:

• keeping the egg and sperm apart
• stopping egg production
• stopping the combined sperm and egg (fertilised egg) attaching to the lining of the womb

Contraception is free for most people in the UK. Condoms can also be bought in pharmacies and supermarkets.

With 15 methods to choose from, you can find one that suits you best.

Barrier methods, such as condoms, are a form of contraception that help to protect against both sexually transmitted infections (STIs) and pregnancy.

You should use condoms to protect both your sexual health and that of your partner, no matter what other contraception you’re using to prevent pregnancy.

 

The 15 methods of contraception

Don’t be put off if the first type you use isn’t quite right: you can try another.

Read about the different methods of contraception:

• caps
• combined pill
• condoms (female)
• condoms (male)
• contraceptive implant
• contraceptive injection
• contraceptive patch
• diaphragms
• intrauterine device (IUD)
• intrauterine system (IUS)
• natural family planning
• progestogen-only pill
• vaginal ring

What is birth control (Contraception) ?

Birth control is a way for men and women to prevent pregnancy. There are many different methods of birth control. By learning more about the options, you can decide which method is right for you and your partner.

If you are sexually active and don’t want a baby, don’t wait to use birth control. An unintended pregnancy can happen any time you have unprotected sex.

What are the types of birth control (contraception) ?

The following information describes many different birth control methods. Before you choose a method, you should discuss birth control with your partner and your healthcare provider.

Birth control methods are only effective if used properly. Make sure that you understand how to correctly use the method you choose.

Abstinence

Abstinence is the only Contraception that is 100 percent effective and is also the best way to protect you against STDs. You may not be ready to have sex.

Don’t let someone pressure you into having sex if you don’t feel ready. It is an important decision with serious emotional and physical consequences.

Female sterilization – tubal ligation (surgical)

What is it? Tubal ligation is surgery to “tie the tubes” (fallopian tubes) of a woman. This causes permanent sterility by preventing transport of the egg (ovum) to the uterus. This also blocks the passage of sperm up the tube to the ovulating ovary where fertilization normally occurs.

How is it done? Tubal ligation is done in a hospital or outpatient surgical clinic while the patient is asleep (given anesthesia). One or two small incisions (cuts) are made in the abdomen at the navel, and a device similar to a small telescope on a flexible tube (called a laparoscope) is inserted.

Using instruments that are inserted contraception through the laparoscope, the fallopian tubes are burned or sealed shut. The skin incision is then stitched closed. Tubal ligation can be performed immediately after childbirth through a small incision near the navel or during a Cesarean section (C-section).

How is it available? Tubal ligation must be performed by a healthcare provider.

How effective is it? Except in rare cases, this procedure is contraception almost 100 percent effective. Depending on the technique your doctor uses, tubal ligation has about three to 17 failures in 1,000 procedures.

You should know: Female sterilization is not reversible. Sterilization does not protect against STDs, including HIV (the virus that causes AIDS). The male condom provides the best protection against most STDs.

 

Male sterilization – Vasectomy

What is it? A vasectomy is a simple, permanent sterilization procedure for men. The operation, usually done in a physician’s office, requires cutting and sealing the vas deferens, the tubes in the male reproductive system that carry sperm. A vasectomy prevents the transport of sperm out of the testes.

contraception surgery does not affect the man’s ability to achieve orgasm or ejaculate (potency). There will still be a fluid ejaculate, but there will be no sperm in this fluid. Studies have shown that vasectomy increases sexual satisfaction between couples.

How is it done? Vasectomy is usually done in the surgeon’s office while the patient is awake but pain-free (using local anesthesia). A small incision is made in the upper part of the scrotum.

The tubes (vas deferens) are tied off and cut apart. The skin incision is stitched closed. The patient is able to return home immediately. Vasectomy is a much simpler procedure than tubal ligation.

How is it available? Vasectomy must be performed by a healthcare provider.

How effective is it? Except in rare cases, this procedure is nearly 100 percent effective. Although vasectomy has a failure rate of less than 1 percent, failure, while rare, is possible.

You should know: Sterilization does not protect against STDs, including HIV (the virus that causes AIDS). The male condom provides the best protection against most STDs.

Progestin arm implant – Nexplanon®

What is it? Nexplanon® is a single rod of hormone (the size of a matchstick) that is placed directly under the skin of the upper arm by a physician. It delivers a progestin hormone (no estrogen), over a three-year period.

How can I get it? Nexplanon® is placed by a physician who is certified in this procedure.

How effective is it? Nexplanon® is almost 100 percent effective. It is the most effective form of reversible contraception, with less chance of failure than even female sterilization.

You should know: The side effects of Nexplanon® are similar to other progestin-only (no estrogen) methods. The most common side effect is irregular bleeding, though the bleeding tends to be light.

This typically improves contraception after six to 12 months, with many women having no further bleeding (which is safe). Nexplanon® will need to be removed via an office procedure after three years, but can removed at any time before that time if desired.

Intrauterine device (IUD)

What is it? An intrauterine device (IUD) is a small, flexible, T-shaped device that is placed into the uterus (womb). There two types of IUDs:

An IUD made of copper
An IUD made of plastic with very low doses of progestin (no estrogen)

The copper ParaGard T380A®, can be kept in place for 10 years. The copper stops the sperm from making it through the vagina and uterus to reach the egg, preventing fertilization.

The progestin IUDs include Mirena® (five years, highest progestin dose), Kyleena® (five years, medium dose), and Skyla® (three years, lowest progestin dose).

The progestin dose of the IUDs are so low, that they have contraception minimal absorption into the body. These IUDs work by causing the cervical mucus to become thicker so the sperm cannot reach the egg. The hormone also thins the lining of the uterus, so menstrual bleeding becomes lighter.

 

 

How is it used? Once the IUD has been inserted, the woman does not need to take any further steps to prevent pregnancy.

How is it available? After a pelvic exam, the IUD is placed into the uterus through the cervix by a trained healthcare provider.

How effective is it? The IUD is close to 100 percent effective. Progestin containing IUDs and the arm implant are the most effective contraceptive options.

You should know: Side effects are different for the different IUDs. Copper IUDs may cause more painful and heavy periods in some women. The advantage is that it can be used in women who can’t use any hormones (such as breast cancer survivors).

The side effects of progestin containing IUDs are similar to other progestin-only (no estrogen) methods. The most common side effect is irregular bleeding, though the bleeding contraception tends to be light. This typically improves after six to 12 months, with many women having no further bleeding (which is safe).

IUDs will need to be removed via a simple office procedure at the expiration time, but can removed at any time before that time if desired. In the rare chance pregnancy occurs while having an IUD, there is greater risk of ectopic pregnancy (pregnancy outside the uterus).

Combined hormonal contraception

Includes estrogen containing birth control pills, the contraceptive vaginal ring (NuvaRing®), and patch (Xulane®)

What is it? The pill, patch and ring are medications that women take to prevent pregnancy. The pill is taken daily, the vaginal ring is used once a month, and the patch is changed weekly.

How is it used? A pill is taken at the same time every day. There are several different types of pills. Some are designed to allow the woman to have a period every month and others allow the women to have period every three months or not at all. All of these methods require that a woman use it regularly. If you forget to use the contraceptive, irregular menstrual cycles are common, and you can get pregnant.

How can I get it? In most states, the pill must be ordered for you by your healthcare provider. It is obtained by prescription. In a growing number of states it is available over-the-counter without a prescription, under the supervision of a pharmacist.

How effective is it? Combined hormonal contraceptives have the potential to be 99 percent effective if used correctly. However, in the real world with typical use, nine out of 100 women will get pregnant each year on the pill because they do not use it correctly.

Some studies show that women who are overweight might be more likely to get pregnant while on the pill than normal weight women. However, the pill is much more effective than the barrier methods such as condoms, diaphragm, cervical cap, contraceptive foam, etc.

You should know: The pill can cause minor side effects in the first several months of use, including:

Breast tenderness/pain
Nausea
Headaches
Irregular menses

Typically these symptoms resolve. Estrogen containing contraceptives can increase the risk of blood clots. Estrogen containing contraceptives are not recommended for women who are over 35 years of age if they smoke, but can be used until menopause if you don’t smoke cigarettes and are in good health.

There are many health benefits to these contraceptives, including lighter, regular periods, as well as less menstrual cramping. Pill users also will notice improvement in acne, PMS, menstrual headaches, as well as a lower risk of uterine and ovarian cancer in pill users.

 

Progestin only pills (mini pills)

What is it? These are pills that contain only one hormone (progestin).

How do they work? Mini pills work by thickening the cervical mucus so the sperm cannot reach the egg. The hormone in the pills also thins the lining of the uterus, so menstrual bleeding is lightened. A pill is taken every day with no placebo (break).

How is it available? In most states, the pill must be ordered for you by your healthcare provider. It is obtained by prescription. In a growing number of states it is available over-the-counter without a prescription, under the supervision of a pharmacist.

How effective is it? With typical use, nine out of 100 women will get pregnant each year on the pill because they do not use it correctly. It is important to take it daily, at the same time each day.

Some studies show that women who are overweight might be more likely to get pregnant while on the pill than thinner women. However, the pill is much more effective than the barrier methods such as condoms, diaphragm, cervical cap, contraceptive foam, etc.

You should know: The side effects of progestin only pills are similar to other progestin-only (no estrogen) methods. The most common side effect is irregular bleeding, though the bleeding contraception tends to be light.

This typically improves after six to 12 months, with many women having no further bleeding (which is safe). The mini pill is a good alternative for women who are breastfeeding or who cannot take estrogen in the traditional pill.