What contraceptive options are available to me?

*Perfect use means using the method correctly every time. Effectiveness in practice is the level that is usually seen taking into account that the method may not be used correctly every time

Below is some information about each option:

• The combined pill – these contain the hormones oestrogen and progestogen. You take one pill every day for 21 days with a break or continuously depending on the pill. 

• Progesterone-only pills – contain only the hormone progestogen and not oestrogen. A pill is taken every day without a break

• External condom – worn on the penis. This is a barrier method of contraception and prevents the sperm from meeting the egg.

• Internal condom – placed inside the vagina and works the same way as the external condom

• Vaginal ring – the vaginal ring releases the hormones progestogen and oestrogen. It is left in for 21 days then removed for 7 days. A new ring in is then inserted for the next 21 days. 

• Diaphragm – this is inserted into the vagina before sex. It covers the cervix making it harder for a sperm to reach an egg

• Intrauterine device (IUD) – these are made of copper. This changes the cervical mucus, making it harder for the sperm to reach the egg

• Intrauterine system (IUS) – a small device which sits just inside the womb and releases the hormone progestogen to make pregnancy less likely

• Implant – a small plastic rod which is inserted under the skin of the arm and releases progestogen into the bloodstream

• Contraceptive injection – these also release progestogen into the bloodstream and last 8–13 weeks

• Contraceptive patch – a sticky patch which you put on your skin just like the stop smoking aids. These contain both the hormones progestogen and oestrogen

• The rhythm method – works by identifying fertility signals and indicating when you’re at risk of getting pregnant if you have sex. This is a very unreliable method.

• Female sterilisation – permanently prevents eggs from travelling down the fallopian tube and so stops fertilisation from being possible

• Male sterilisation (vasectomy) – works by cutting or sealing the tubes which carry the sperm

How can I narrow down my contraceptive options?

There are questions you can ask yourself to help narrow down your choices – including:

• Which contraceptives should I avoid if I am a smoker?

• Which contraceptives do not have hormones in?

• Which contraceptives might affect my other medications?

• Which methods do I have to remember for them to work well?

Which contraceptives should I avoid if I am a smoker? – smoking itself doesn’t usually prevent you from using a contraceptive method. When combined with other factors such as your age, however, some methods may not be suitable. You should avoid:

• The combined pill

• The vaginal ring

• The patch

Consider quitting smoking if you prefer the idea of using these methods. You will see improvements in other aspects of your life including your fitness and energy levels, too.

Which contraceptives do not have hormones in? – if you are not able to or don’t want to use hormonal contraception, avoid the following hormone-containing contraceptives:

• The copper coil

• Condoms

• Diaphragm

Which contraceptives might affect my other medications? – a doctor will assess you for suitable contraceptives that don’t affect your other medications. Contraceptives that could affect your other medications include:

• The combined pill

• Progestogen-only pill

• Implant

Which methods do I have to remember for them to work well? – if you’re worried about forgetting your contraception, the following might not be suitable for you:

• The combined pill

• The progestogen-only pill

How do I know which contraceptive options will suit me?

For men, there are 2 types of contraception available:

• Condoms

• Male sterilisation/vasectomy

The other 13 methods are for women – some of the things you will could consider to help you choose are:

• Which methods of contraception can make my periods lighter?

• I’m over 35 and I smoke what can I use?

• How can I protect myself from pregnancy and STIs?

• Which contraceptives are permanent?

Which methods of contraception can make my periods lighter? – the following can help with heavy periods:

• Combined Pill

• Progestogen-only pill

• Injection

• IUS

• Vaginal ring

I’m over 35 and I smoke what can I use? – you may be better suited to the following methods:

• IUS

• IUD

• Implant

• Injection

• Progestogen-only pill

How can I protect myself from pregnancy and STIs? – a condom is the only way to get protection against both STIs and getting pregnant. They can also be used together with some other methods to get STI protection and further reduce your risk of getting pregnant.

Which contraceptives are permanent? – the following methods are permanent:

Female sterilisation – female sterilisation uses surgery to permanently prevent pregnancy. Once the operation is complete, it is over 99% effective. However, it is very difficult to reverse and so you must be certain that this method is suitable for you

Male sterilisation – male sterilisation or a vasectomy is a surgical method where the tubes which carry sperm are cut or sealed. A vasectomy can also be difficult to reverse so you must be certain that this is the best method of contraception for you

It’s worth considering that many contraceptive methods are usable over a long period of time, or last for weeks at a time.

What are my options for getting/buying contraceptives?

• Simply fill out our brief questionnaire and tell us if you are already using any contraception

• Your online doctors will review your request and check to see if you can be prescribed that particular pill

• If you can, then the pill can be sent directly to your door

• If you aren’t taking a contraceptive pill already, and want to start taking one, our doctors can prescribe certain types of progesterone-only pill for you to start taking

• Our prices include your prescription and standard delivery

Where can I buy other forms of contraception? – you can buy some forms of contraception on the high street or from your local pharmacy or online. However, if you buy online make sure you are buying from a reputable company.

Male condoms come in all shapes, sizes, textures, colours and tastes. You can choose which ones you would like and buy them here. 

Getting NHS contraception – even if you’re under 16, you can get contraception from your regular GP or from the following places:

• Community contraception clinics

• Sexual health clinics

• Some young people’s services

• Some genitourinary medicine (GUM) clinics

What about emergency contraception?

There are currently two types of emergency contraception available:

• The morning after pill:

• ellaOne

• Levonelle and generic Levonelle (levonorgestrel) 

• Intrauterine device (IUD)

The table below compares the 2 types of morning after pill available:

You can buy both of these types of morning after pill using our service – to order, you will need to answer a short questionnaire about your health. One of our doctors will review your request and your answers to our questionnaire. If they feel you are suitable the morning after pill will be dispatched by our pharmacy to your address.

Neither type of morning after pill is effective if you have already ovulated. The IUD is the only form of emergency contraception which is effective after ovulation.

The IUD – this is another form of emergency contraception available. It is a small, T shaped device made of plastic and copper which is inserted into your womb by a doctor or nurse. Once the IUD is inserted, it can be left in for 5 to 10 years, depending on the type. This gives long-term contraceptive cover. However, if you prefer to have it removed, this can be done by a doctor or trained professional.

Can I use the morning after pill as a long-term contraception method? – No. The morning after pill is intended for emergency use and so you should try to avoid using it regularly. If you are struggling to remember to take your usual contraceptive pill, speak to your GP about other contraception methods available.

The morning after pill and unprotected sex are riskier than using a regular form of contraception. Unprotected sex also puts you at a high risk of an STI, so you must ensure you wear a condom every time you have sex to protect you and your partner from infection. 

The morning after pill is a more expensive option than other contraceptives and using it often will cost you more than taking the pill or using a condom. Using it on a regular basis can cause changes to your period and can affect your menstrual cycle.

Sources

A randomised controlled trial of the clinical effectiveness and the cost-effectiveness of the levonorgestrel-releasing intrauterine system in primary care against standard treatment for menorrhagia: the ECLIPSE trial (2015) Health Technology [accessed 4th August 2020]

Choosing a combined oral contraceptive pill (2015) Aust Prescr [accessed 1 April 2020]

Emergency contraception (morning after pill, IUD) (2015) NHS [accessed 4th August 2020]

Getting and using Contraception (2018) NHS [accessed 1 April 2020]

How effective is withdrawal method (pulling out)? (2018) Planned Parenthood [accessed 1 April 2020]

Safety of the progesterone-releasing vaginal ring (PVR) among lactating women: a systematic review (2016) Contraception [accessed 4 August 2020]

Safer choices: reducing ten pregnancy, HIV, and STDs (2001) Public Health Reports [accessed 1 April 2020]

Techniques for the interruption of tubal patency for female sterilisation (2015)The Cochrane Collaboration [accessed 4 August 2020]

Use of Natural Family Planning (NFP) and its effect on couple relationships and sexual satisfaction: a multi-country survey of NFP users from the US and Europe (2017) Public Health [accessed 1 April 2020]

Where do women and men in Britain obtain contraception? Findings from the third national survey of sexual attitudes and lifestyles (2018)BMJ [accessed 4 August 2020]

Which method of contraception is right for me? (2017) FPA [accessed 4 August 2020]