Methods of Contraception
What is Contraception?
Contraception is a way to prevent pregnancy by stopping sperm from fertilising an egg. Different methods work in various ways, including preventing ovulation, blocking sperm, or altering the conditions within the body to reduce the likelihood of conception.
Contraceptive methods have been used for centuries, evolving from rudimentary techniques to highly effective modern options. Today, there are a wide range of choices that cater to different needs, including daily pills, long-term implants, and permanent surgical options.
Understanding contraception is important for sexual and reproductive health. It allows individuals to make informed decisions based on their personal circumstances. Some people use contraception to prevent pregnancy, while others use it to regulate their menstrual cycle or manage medical conditions such as endometriosis or polycystic ovary syndrome (PCOS).
Apart from preventing pregnancy, some contraceptive methods provide additional health benefits. Hormonal methods, for example, can help reduce acne, lighten periods, and lower the risk of certain cancers. Barrier methods, such as condoms, protect against sexually transmitted infections (STIs) in addition to preventing pregnancy.
Choosing the right contraceptive method depends on factors like lifestyle, medical history, and personal preferences. Some people prefer long-acting methods such as implants or intrauterine devices (IUDs), while others may opt for short-term solutions like the pill or condoms. Consulting a healthcare professional can help individuals find the most suitable method.
Difference Between Hormonal and Non-Hormonal Contraception
Contraceptive methods fall into two main categories: hormonal and non-hormonal. Understanding the difference can help in choosing the right option based on personal needs and health considerations.
Hormonal Contraception
Hormonal contraceptives contain synthetic versions of the body’s natural hormones—oestrogen and/or progestogen. These hormones prevent pregnancy by:
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Stopping ovulation (the release of an egg from the ovaries)
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Thickening cervical mucus to make it harder for sperm to reach the egg
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Thinning the lining of the womb to prevent a fertilised egg from implanting
Examples of hormonal contraceptives include:
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Combined Pill
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Progestogen-Only Pill
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Contraceptive Patch
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Vaginal Ring
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Contraceptive Implant
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Contraceptive Injection
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Hormonal IUS (Intrauterine System)
Hormonal contraception is highly effective when used correctly, but it may cause side effects such as nausea, mood changes, or irregular bleeding. It is not suitable for everyone, particularly those with certain medical conditions such as a history of blood clots, liver disease, or migraines with aura.
Non-Hormonal Contraception
Non-hormonal contraception does not use synthetic hormones. Instead, these methods prevent pregnancy through physical barriers, spermicide, or by altering the conditions in the reproductive system. They do not interfere with natural hormonal cycles.
Examples of non-hormonal contraception include:
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Condoms (male and female)
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Diaphragm
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Copper IUD (Intrauterine Device)
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Natural Family Planning
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Sterilisation (female and male)
Non-hormonal methods are ideal for those who cannot or do not wish to use hormonal contraception. Barrier methods, such as condoms, provide the added benefit of protecting against STIs. The copper IUD is a long-term method that does not involve hormones but can make periods heavier or more painful in some users.
Both types of contraception have their own benefits and drawbacks. Some people prefer the convenience of long-term hormonal methods, while others choose non-hormonal options due to personal or medical reasons. Speaking to a healthcare provider can help determine the best choice based on individual needs.
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Methods of Contraception
Contraception is an essential part of reproductive health, offering individuals the ability to control when and if they want to have children. With a wide range of methods available, it can sometimes be overwhelming to choose the right one.
From hormonal options like the pill and implant to non-hormonal methods like condoms and the copper IUD, each form of contraception works in different ways to prevent pregnancy.
Some methods also provide added benefits, such as reducing the risk of sexually transmitted infections (STIs) or easing menstrual-related issues. Understanding the various options available can help you make an informed decision based on your lifestyle, health, and personal preferences.
Below we’ve broken down each method, explaining how they work, their effectiveness, and the pros and cons to help you find the best fit for your needs.
Combined Pill
The combined pill contains two hormones: oestrogen and progestogen. It prevents pregnancy by stopping ovulation, thickening cervical mucus, and thinning the womb lining.
How to Use
Take one pill daily at the same time. Most packs contain 21 pills, followed by a seven-day break where you may have a withdrawal bleed.
Effectiveness
When taken correctly, the combined pill is over 99% effective. With typical use, the effectiveness drops to around 91% due to missed pills or incorrect usage.
Benefits
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Can regulate periods and reduce menstrual pain
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May improve acne
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Reduces risk of ovarian, womb, and bowel cancer
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Can make periods lighter and more predictable
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May help with symptoms of premenstrual syndrome (PMS)
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Offers an easy-to-use, non-invasive method of contraception
Disadvantages
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Can cause side effects like nausea, headaches, and mood changes
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Not suitable for smokers over 35 or those with certain health conditions
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Requires daily consistency for maximum effectiveness
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Does not protect against STIs
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Some users experience breakthrough bleeding, especially in the first few months
Who Can Use It
Most women can use the combined pill, but a healthcare provider will check for contraindications like high blood pressure, migraines with aura, or a history of blood clots. It may not be suitable for those with a strong family history of breast cancer.
What If You Miss a Pill
If you miss one pill, take it as soon as you remember. If you miss two or more, follow the instructions in the leaflet and use additional contraception if needed. Missing pills, especially early in a pack, increases the risk of pregnancy.
Additional Considerations
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Certain medications, such as some antibiotics and epilepsy drugs, can reduce the effectiveness of the pill
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Vomiting or severe diarrhoea can impact absorption, requiring additional contraception
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Some women may need to try different brands to find one that suits their body best
Progestogen-Only Pill
The progestogen-only pill (POP), also known as the "mini-pill," contains only the hormone progestogen. It works by thickening the cervical mucus, making it harder for sperm to reach the egg. It also thins the lining of the womb, which reduces the likelihood of implantation.
How to Use
Take one pill every day, at the same time each day. Unlike the combined pill, there is no break between packs. It’s important to take the pill on time, as its effectiveness can decrease if you are late by more than three hours.
Effectiveness
When taken correctly, the progestogen-only pill is 99% effective. With typical use, it is about 91% effective, as forgetting pills or taking them late can reduce its effectiveness.
Benefits
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Suitable for women who cannot take oestrogen
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Doesn’t affect the monthly cycle in the same way as the combined pill
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Can be used while breastfeeding
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Helps reduce period pain and bleeding for some women
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Easy to use, discreet, and portable
Disadvantages
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Must be taken at the same time every day to be effective
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May cause irregular bleeding or spot bleeding, especially in the first few months
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Can cause mood changes or headaches
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Does not protect against STIs
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Some people experience a decrease in sex drive
Who Can Use It
Most women can use the progestogen-only pill, including those who smoke or are over 35. It’s often recommended for breastfeeding women or those who have contraindications for oestrogen.
What If You Miss a Pill
If you miss a pill, take it as soon as you remember. If it’s more than 3 hours late, use backup contraception (like condoms) for the next 48 hours.
IUD (Intrauterine Device / Copper Coil)
The IUD is a small T-shaped device made of plastic and copper that is inserted into the uterus by a healthcare professional. It prevents pregnancy by releasing copper into the uterus, which is toxic to sperm and prevents fertilisation. The copper IUD also alters the lining of the womb to prevent implantation.
How to Use
A healthcare professional will insert the IUD into the womb. It is a long-term, reversible method, lasting between 5 to 10 years, depending on the type.
Effectiveness
The copper IUD is more than 99% effective. It’s one of the most reliable forms of contraception, and once inserted, you don’t need to do anything to maintain its effectiveness.
Benefits
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No hormones, so no hormonal side effects
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Can be used by women who can’t take hormonal contraception
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Lasts for several years (up to 10)
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Can be removed at any time if you decide to try for a pregnancy
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Doesn’t interfere with sexual activity
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Can be used as emergency contraception if inserted within 5 days of unprotected sex
Disadvantages
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May cause heavier, more painful periods, especially in the first few months
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Risk of infection during the first 20 days after insertion
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Small risk of the IUD being expelled
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Does not protect against STIs
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In rare cases, can cause an ectopic pregnancy if pregnancy occurs
Who Can Use It
Most women can use the copper IUD, but it may not be suitable for those with certain conditions like pelvic infections or a history of heavy periods.
Additional Considerations
You should check the IUD string regularly to ensure it hasn’t moved or fallen out. Your healthcare provider can help you with this.
IUS (Intrauterine System / Hormonal Coil)
The IUS is similar to the IUD but contains the hormone levonorgestrel, a type of progestogen. It works by thickening cervical mucus, thinning the womb lining, and sometimes preventing ovulation.
How to Use
The IUS is inserted into the uterus by a healthcare provider. It provides long-lasting contraception for 3 to 5 years, depending on the type.
Effectiveness
The IUS is more than 99% effective, offering one of the highest success rates of any contraceptive method.
Benefits
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Reduces menstrual bleeding, and can stop periods altogether for some women
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Suitable for women who cannot take oestrogen
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Long-lasting, up to 5 years
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Can be removed at any time if you decide to get pregnant
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Can help with conditions like heavy periods, endometriosis, or fibroids
Disadvantages
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May cause irregular bleeding or spotting, especially in the first few months
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Can cause hormonal side effects, such as mood changes, acne, or headaches
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Does not protect against STIs
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May cause discomfort during insertion or removal
Who Can Use It
Most women can use the IUS, including those who can’t take hormonal contraceptives like the combined pill.
Additional Considerations
As with the copper IUD, you should check the IUS string to make sure the device hasn’t moved. Insertion may cause some discomfort, but the process is generally quick and well-tolerated.
Contraceptive Implant
The contraceptive implant is a small rod about the size of a matchstick that is placed under the skin of your upper arm. It releases progestogen, which thickens cervical mucus and suppresses ovulation.
How to Use
The implant is inserted by a healthcare provider and can remain in place for 3 years. There’s no need for daily action, which makes it a convenient long-term option.
Effectiveness
The contraceptive implant is over 99% effective.
Benefits
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Lasts for 3 years
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Doesn’t require daily attention
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Can be used while breastfeeding
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Can make periods lighter or stop them altogether
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Suitable for women who can’t use oestrogen
Disadvantages
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May cause irregular bleeding or spotting in the first few months
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Possible hormonal side effects, including mood swings and headaches
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Doesn’t protect against STIs
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Requires a healthcare provider for insertion and removal
Who Can Use It
Most women can use the implant, but it may not be suitable for those with certain medical conditions, such as a history of breast cancer or unexplained vaginal bleeding.
Additional Considerations
After insertion, you may experience some discomfort or bruising at the insertion site, which typically resolves quickly.
Contraceptive Injection
The contraceptive injection contains progestogen, which prevents ovulation and thickens cervical mucus. It is given as an injection every 12 weeks.
How to Use
The injection is administered by a healthcare provider. You will need to get a new injection every 12 weeks.
Effectiveness
The injection is more than 99% effective when used on time.
Benefits
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Long-acting, only needing to be administered every 12 weeks
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Doesn’t require daily attention
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Suitable for women who can’t use oestrogen
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Can stop periods altogether for some women
Disadvantages
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May cause irregular bleeding or spotting in the first few months
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Possible side effects include weight gain, headaches, and mood changes
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Doesn’t protect against STIs
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Some people may experience a delay in fertility after stopping the injection
Who Can Use It
Most women can use the contraceptive injection, but it may not be suitable for those with certain health conditions, including osteoporosis.
Additional Considerations
Regular follow-up appointments are required to ensure you’re receiving the injection on time. If you’re late for your injection, you may need additional contraception.
Contraceptive Patch
The contraceptive patch is a small, sticky patch that releases hormones (oestrogen and progestogen) through the skin to prevent pregnancy.
How to Use
You wear the patch on your skin for a week at a time, changing it every week for three weeks, followed by one week without a patch.
Effectiveness
When used correctly, the patch is 99% effective. With typical use, it’s about 91% effective.
Benefits
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Convenient and discreet
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Does not require daily attention
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Reduces period pain and heavy bleeding
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Can improve acne and symptoms of PMS
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Can be worn on the skin for a week
Disadvantages
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Can cause skin irritation
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Some may experience side effects like headaches, nausea, or mood changes
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Does not protect against STIs
Who Can Use It
Most women can use the patch, but those with a history of blood clots or certain types of cancer should avoid it.
Additional Considerations
If the patch comes off or becomes loose, you may need to replace it with a new one to maintain effectiveness.
Vaginal Ring
The vaginal ring is a small, flexible ring that releases hormones (oestrogen and progestogen) into the body. It’s placed inside the vagina, where it works similarly to the combined pill.
How to Use
You insert the ring into your vagina, where it stays for 3 weeks. After 3 weeks, you remove it for a week, during which time you will have a withdrawal bleed.
Effectiveness
When used correctly, the vaginal ring is 99% effective.
Benefits
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Easy to use and discreet
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Doesn’t require daily attention
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Can regulate periods and reduce menstrual cramps
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Suitable for women who can’t take oral contraceptives
Disadvantages
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May cause irritation or discomfort for some users
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Does not protect against STIs
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Some users may experience side effects like headaches, nausea, or mood swings
Who Can Use It
Most women can use the vaginal ring, but those with certain health conditions should consult their healthcare provider before use.
Additional Considerations
Make sure to remove the ring on schedule to maintain its effectiveness. If the ring is accidentally removed, follow the instructions for re-insertion and use backup contraception.
Condoms
Condoms are barrier methods of contraception that physically prevent sperm from entering the vagina. Male condoms are worn over the penis, while female condoms are worn inside the vagina.
Check out our Condoms Guide to learn more.
How to Use
Male condoms are worn over the erect penis before any sexual contact. Female condoms are inserted into the vagina before intercourse.
Effectiveness
With correct use, male condoms are 98% effective. Female condoms are slightly less effective at 95%.
Benefits
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Protects against STIs
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Widely available and inexpensive
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No need for prescription
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Can be used as a backup method with other forms of contraception
Disadvantages
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Requires consistency during every sexual act
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Some people may have allergic reactions to latex
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Can reduce sensation for some users
Who Can Use It
Both men and women can use condoms. They are suitable for all and do not require a prescription.
Additional Considerations
Ensure correct use, as breakage or slippage can reduce effectiveness. If the condom breaks or slips, use emergency contraception if needed.
Female Sterilisation
Female sterilisation is a permanent method of contraception that involves surgically closing or blocking the fallopian tubes, preventing eggs from reaching the uterus.
How to Use
A healthcare provider performs the procedure, which is typically done under general anaesthesia.
Effectiveness
Female sterilisation is over 99% effective.
Benefits
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Permanent contraception
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No need for ongoing attention
Disadvantages
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Permanent; not reversible
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Requires surgery and recovery time
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Does not protect against STIs
Who Can Have It
Female sterilisation is typically recommended for women who are certain they do not want children in the future.
Vasectomy
A vasectomy is a permanent method of contraception for men, involving the cutting or blocking of the vas deferens to prevent sperm from entering the semen.
How to Use
The procedure is performed under local anaesthesia, and the man can typically return to normal activities in a few days.
Effectiveness
Vasectomy is over 99% effective.
Benefits
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Permanent solution
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Quick procedure with minimal recovery time
Disadvantages
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Permanent; not reversible
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Does not protect against STIs
Who Can Use It
Men who are sure they do not want more children.
Diaphragm
A diaphragm is a barrier method of contraception that covers the cervix, preventing sperm from entering the uterus.
How to Use
The diaphragm is inserted into the vagina before intercourse and removed afterward.
Effectiveness
With typical use, it is about 88% effective.
Benefits
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Reusable
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No hormones involved
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Can be used with spermicide for added effectiveness
Disadvantages
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Requires fitting by a healthcare provider
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Can be cumbersome to insert and remove
Emergency Pill (Morning After Pill)
The emergency pill can be taken after unprotected sex to prevent pregnancy.
How to Use
Take the pill as soon as possible, ideally within 72 hours of unprotected sex.
Effectiveness
Most effective when taken within 24 hours, but can still work within 72 hours.
Benefits
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Emergency solution after contraception failure or unprotected sex
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Available over-the-counter
Disadvantages
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Not intended for regular use
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Does not protect against STIs
Make Sure to Protect Yourself
Choosing the right contraception method is a personal decision that depends on individual preferences, health conditions, and lifestyle. Whether you're looking for a short-term solution, a long-term option, or something that helps with managing other health conditions, there is a variety of contraceptive methods to suit different needs.
One important point to remember is that condoms are the only method of contraception that provide protection against both sexually transmitted infections (STIs) and pregnancy. They are a vital tool for anyone looking to reduce the risk of STIs while preventing pregnancy.
For enhanced protection and peace of mind, it’s often recommended to combine condoms with another form of contraception, such as hormonal methods (like the pill or IUD) or non-hormonal options (such as a diaphragm or IUD). This combination can significantly increase the effectiveness of contraception, offering an added layer of security against unintended pregnancy.
Ultimately, discussing your options with a healthcare professional can help you make an informed decision that aligns with your health needs, lifestyle, and long-term goals. Regardless of the method you choose, contraception plays a crucial role in empowering individuals to take control of their reproductive health and well-being.
