Contraception
Combined
pill / Progestogen-only pill
/ Barrier methods /
Longer acting contraception (depot,
implants & coils) / Sterilisation /
Emergency contraception
How effective is
contraception?
All the methods of contraception listed below are effective. However, no
method is absolutely 100% reliable. The reliability for each method is
given in percentages. For example, the contraceptive injection is more
than 99% effective. This means that less than 1 woman in 100 will become
pregnant each year using this method of contraception.
The effectiveness of some methods depend on how you use them. You have to
use them properly, or they may lose their effect. For example, the 'pill'
is more than 99% effective if taken correctly. If it is not (for example,
if you miss a pill, etc) then it becomes less effective. Other 'user
dependent' methods are barrier methods, the progestogen only pill, and
natural family planning.
Some methods are not so 'user dependent' and need to be renewed only
infrequently or never. These methods are: the contraceptive injection,
implant, intrauterine devices, and sterilisation.
When no contraception is used, more than 80 in 100 sexually active women
become pregnant within 1 year.
What are the different methods of contraception
Choosing a method of
contraception involves a balance between.
* how effective it is
* possible risks and side-effects
* plans for future pregnancies
* personal preference
* if you have a medical condition that needs to be considered.
Combined pill
Often just called 'the pill'. It is more than 99% effective if used
properly. Contains oestrogen and progestogen. Works mainly by stopping
ovulation. It is very popular. Different brands suit different people.
* Some advantages - Very effective. Side-effects uncommon. Helps ease
painful and heavy periods. Reduces the chance of some cancers.
* Some disadvantages - Small risk of serious problems (eg thrombosis).
Some women get side-effects. Have to remember to take it. Can't be used by
women with certain medical conditions.
Progestogen only pill (POP)
Used to be called the 'mini-pill'. Contains just a progestogen hormone.
More than 99% effective if used properly. Is commonly taken if the
combined pill is not suitable. For example: breast-feeding women, smokers
over the age of 35, and some women with migraine. Works mainly by causing
a plug of mucus in the cervix that blocks sperm, and by thinning the
lining of the uterus. May also stop ovulation.
* Some advantages - Less risk of serious problems than the combined pill.
* Some disadvantages - Periods often become irregular. Some women have
side-effects. Not quite as reliable as the combined pill. May be less
effective if you weigh over 70kg (11stone).
Barrier methods
These include male condoms, female condom, diaphragms, and caps. Prevents
sperm entering the uterus. Male condoms are about 98% effective if used
properly. Other barrier methods are slightly less effective than this.
* Some advantages - No serious medical risks or side-effects. Helps
protect from sexually transmitted infections. Condoms are widely
available.
* Some disadvantages - Not quite as reliable as other methods. Needs to be
used properly every time you have sex. Male condoms occasionally split or
come off.
Contraceptive injections (eg
Depoprovera and Noristerat)
Contains a progestogen hormone which slowly releases into the body. More
than 99% effective. Works by preventing ovulation and also has similar
actions as the POP. An injection is needed every 8-12 weeks.
* Some advantages - Very effective. Don't have to remember to take pills.
* Some disadvantages - Periods may become irregular (but often lighter or
stop altogether). Some women have side-effects. Normal fertility after
stopping may be delayed by several months. Can't undo the injection, so if
side-effects occur they may persist for 8-12 weeks or slightly longer.
Contraceptive implants (eg Implanon)
An implant is a small device placed under the skin. Contains a progestogen
hormone which slowly releases into the body. Is more than 99% effective.
Works in a similar way to the contraceptive injection. Involves a small
minor operation using local anaesthetic. Each one lasts 3 years.
* Some advantages - Very effective. Don't have to remember to take pills.
* Some disadvantages - Periods may become irregular (but often lighter or
stop altogether). Some women develop side-effects but these tend to settle
after the first few months.
Intrauterine device (IUD)
A plastic and copper device is put into the uterus. Lasts 5 or more years.
It works mainly by stopping the egg and sperm from meeting. It may also
prevent the fertilised egg from attaching to the lining of the uterus. The
copper also has a spermicidal effect (kills sperm).
* Some advantages - Very effective. Don't have to remember to take pills.
* Some disadvantages - Periods may get heavier or more painful. Small risk
of serious problems.
Hormone releasing intrauterine device (eg Mirena)
Otherwise called the intrauterine system (IUS). A plastic device that
contains a progestogen hormone is put into the uterus. The progestogen is
released at a slow but constant rate. More than 99% effective. Works in a
similar way to the POP. Is also used to treat heavy periods (menorrhagia).
* Some advantages - Very effective. Don't have to remember to take pills.
Periods become light or stop altogether.
* Some disadvantages - Side-effects may occur as with other progestogen
methods such as the POP, implant and injection. However, they are much
less likely as the hormone is mainly confined to the uterus (little gets
into the bloodstream).
Natural methods
This involves fertility awareness. Effective if done correctly. Requires
commitment and regular checking of fertility indicators such as body
temperature and cervical secretions.
* Some advantages - No side-effects or medical risks.
* Some disadvantages - May not be as reliable as other methods. Fertility
awareness needs proper instruction and takes 3-6 menstrual cycles to learn
properly.
Sterilisation
Involves an operation. Is more than 99% effective. Vasectomy (male
sterilisation) stops sperm travelling from the testes. Female
sterilisation prevents the egg from travelling along the Fallopian tubes
to meet a sperm. Vasectomy is easier and more effective than female
sterilisation. Popular when family is complete.
* Some advantages - Very effective. Don't have to think further about
contraception.
* Some disadvantages - Very difficult to reverse. Female sterilisation
usually needs a general anaesthetic.
Emergency contraception
Can be used if you had sex without using contraception. Also, if you had
sex but there was a mistake with contraception. For example, a split
condom or if you missed taking your usual contraceptive pills.
* Emergency contraception pills - are usually effective if started within
72 hours of unprotected sex. Can be bought at pharmacies or prescribed by
a doctor. It works either by preventing or postponing ovulation, or by
preventing the fertilised egg from settling in the uterus (womb).
* An IUD - inserted by a doctor or nurse can be used for emergency
contraception up to 5 days after unprotected sex.
copyright PIP & EMIS
You don't need to have a lot of
sexual partners to get a sexually transmitted infection (STI). Sex just
once with someone who has an infection can be enough.
Common signs of an STI are:
* unusual discharge of liquid from vagina or penis
* pain or burning when you urinate
* itching, rashes, lumps or blisters around the genitals
* low abdominal pain
* pain or bleeding during or after sex.
However, symptoms vary and many people have no symptoms at all.
Link to NHS website answering questions about sexual infections
Most STI's can be completely cured if found early enough. However, if left
untreated they can be painful and uncomfortable or at worst cause
permanent damage to your health and your fertility.
What is important is that you
contact your general practice or a genitourinary medicine (GUM)/sexual
health clinic as soon as possible. Information and tests are free and
confidential. If you go to your general practice, you may have to pay a
prescription charge for treatment.
Local GUM Clinic opening
times, addresses, and contact number
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