Which Methods of Contraception are There?

Contraceptives can work in three different ways:

• Prevent the sperm from reaching the egg (this is how condoms work, and the pill also helps to do this by thickening the mucus at the neck of the womb).
• Prevent ovulation (the release of an egg).
• Make it difficult for a fertilised egg to implant in the womb.

A fourth way of preventing conception is sterilisation. This is a type of surgery or procedure that stops you being able to get pregnant or to get someone pregnant. Sterilisation involves a small operation to block the tubes that carry the eggs in a woman (the fallopian tubes) or the sperm in a man (the vas deferens).

If you don’t want to get pregnant, you should use contraception every time you have sex. Condoms are the best way to avoid catching a sexually transmitted infection (an STI).

All currently available hormonal contraceptives are for women. There are various options of hormonal contraception.

The most common form of hormonal contraception, the pill, needs to be taken on a daily basis. Other hormonal methods of contraception offer a more long-term alternative:

• The contraceptive patch - needs to be worn for three weeks every month followed by a one week break
• Hormonal coil (IUS) - can stay in place for up to five years before you need to replace it
• Contraceptive injection - needs to be renewed every 8–12 weeks
• Contraceptive implant - needs to be replaced every three years
• The contraceptive ring - needs to be inserted into the vagina for three weeks every month, followed by a one week break

Which method of contraception suits you best depends on a number of factors, such as your age, lifestyle and general health.

There are many different types of contraceptives, all of which have advantages and disadvantages. Some are prescription-only, for example because they contain hormones which aren’t suitable for everyone. Other contraceptives, such as the condom, are available over the counter.

If you have an irregular work or sleep pattern, the contraceptive pill may not suit you. It has to be taken at around the same time every day in order to be effective. This may be difficult for you if you do not have a set routine or if you travel on a regular basis.

However, there are other contraceptives which work in a similar way as the pill, such as the contraceptive implant or the contraceptive injection.

If you have sex with changing partners you should always use a condom to stay protected from sexually transmitted diseases. This applies every time you have sex with someone who has not tested negative for STIs.

In order to find the most suitable contraceptive for you, you should read up about your options. The NHS offers a free contraception service, where you can get advice. If you want to start using a prescription-only contraceptive, you need to see a doctor, or you may be able to order certain hormonal contraceptives such as the pill using a regulated online doctor service. Hormonal contraception should only ever be prescribed after talking to a doctor or nurse who will ask you about your medical history, any medications you take and your family history as well as checking your blood pressure, height and weight to check which method is safe for you to take.

Men can use the following contraceptives:

• Condom
• Vasectomy

Women can use the following contraceptives:

• Contraceptive pill
• Female condom
• Contraceptive diaphragm
• Cervical cap
• Contraceptive implant
• Contraceptive patch
• Contraceptive ring
• Intrauterine contraception
• Contraceptive injection
• Sterilisation
• Natural family planning

Women over the age of 35 can still use most contraceptives though this will depend on whether you smoke or have given up in the last year. If you are on the pill and you are not experiencing any issues, you can continue taking it until the age of 50 for the combined pill or 55 for the minipill, provided your GP approves.If you are certain that you do not wish to have children or any more children, you can also consider sterilisation, which offers permanent protection from pregnancy. However, sterilisation is not reversible. As with women under the age of 35, it is important that you consult your GP or online doctor if you want to use a prescription-only contraceptive and that you regularly attend check-ups and smear tests.

Long acting reversible contraceptives (LARCs) are contraceptives which protect you from pregnancy for several months or even years. LARCs include the contraceptive coil and the contraceptive implant. They are very effective and their effect is reversible so they do not have a negative impact on your fertility once you stop using them.There are currently no LARCs for men. The only method of contraception for men which is effective in the long term is vasectomy, which is not reversible.

The pill is one of the most commonly used contraceptive methods. If you take it properly, it is 99% effective at preventing pregnancy. You need to remember to take it as directed for it to work. As life can sometimes get in the way of taking the pill perfectly this makes it about 91% effective with “typical use”.

There are two types of contraceptive pill: combined pills and mini-pills. Both contain synthetic versions of “sex” hormones which control your reproductive system. “Combined” pills contain a combination of two hormones, oestrogen and progesterone, whilst the “Mini-pill” only contains progesterone.

The combined pill is taken every day for 21 days, after which you usually have a maximum seven day break. During this break you will have a bleed, like a period. There are newer ways you can take the combined pill (and patch and ring) such as not having any breaks between packets. You should chat to your doctor about which way will suit you best. The main difference with the progestogen-only mini-pill is that it must be taken at the same time each day, and you take it every day, without a break. As a result, you may not have regular bleeds when you take the mini-pill. The mini-pill is suitable for some groups of people who are unable to take the combined pill. Both pills prevent you from releasing an egg each month so any bleeding experienced is usually not a true period.

Contraceptive pills do not prevent infection with an STI, so you still need to wear a condom if you are unsure whether you might be at risk. All contraceptive pills are prescription-only medications. In order to begin using an oral contraceptive, you need to see your GP or consult an online doctor.

The Superdrug Online Doctor service provides a convenient service, based on the information you supply us, for pill prescriptions with the option to pick up your pill at your local Superdrug pharmacy, or have it delivered to your home or work address.

Condoms are the most popular form of contraceptive. The condom has many advantages. It is a cheap, widely available and very effective method of contraception which also protects you from Sexually Transmitted Infections (STIs) such as HIV and chlamydia.

In order to provide reliable protection, condoms need to be the correct size and they need to be in good condition. Condoms should never be reused. Many sexual health clinics will give away some condoms for free. The most commonly used material is latex. However, you can also buy condoms made of polyurethane or lambskin for people with latex allergies. Unlike rubber condoms, lambskin condoms do not prevent infection with a sexually transmitted infection.

Always check whether the condom you are using is compatible with any lubricant you wish to use as some lubricants will erode the condom and make it more likely to break or leak.

It is also possible to buy female condoms or “Femidom”. Just like male condoms, female condoms can be bought without a prescription in pharmacies. They are 95% effective in preventing pregnancy when used as directed and can be inserted into the vagina up to eight hours before sex. Female condoms are less effective than male condoms when it comes to preventing infection with an STI. They also tend to be a bit more expensive.

The diaphragm is another type of barrier contraceptive. It works by blocking the entrance to the womb, which prevents sperm from reaching the egg. The contraceptive diaphragm needs to be treated with a spermicide each time before you use it. You can put it in place any time before having sex, but if you have put it in more than three hours before intercourse, you will need to use extra spermicide.

It should left in place for at least 6 hours after having sex (but don't leave it in place for longer than the manufacturer advises). If you take care of your diaphragm, you can use it several times.To get a contraceptive diaphragm, you need a prescription from your GP. It takes a little practice to learn how to use it correctly. Your GP will need to advise you on how to use it safely. The diaphragm will not protect you from STIs, and is about 94% effective at preventing pregnancy when used as directed.

The cervical cap or femcap is one of the less well-known contraceptives. It is similar to the diaphragm and requires the use of a spermicide to be effective. The cap is made of silicone and is inserted into the vagina.

You need to leave it in for six hours after sex, but you should take it out within 48 hours. It does not provide reliable protection from sexually transmitted infections.

A contraceptive implant is a small tube about 4cm long, that is inserted under the skin of your upper arm. It needs to be put in place by a doctor and is 99.95% effective at preventing pregnancy.

It works in the same way as the contraceptive mini-pill, by releasing the hormone progesterone continuously into the body. It provides contraceptive cover for up to three years, which makes it very convenient to use. You do not need to remember to take any pills when using the implant, but you do need to use a condom to prevent catching an STI. If you decide you would like to become pregnant or stop using the implant, your doctor will be able to remove it any time. Your natural fertility will go back to normal quite quickly after it is taken out.

Just like the implant, the contraceptive injection works by slowly releasing progesterone into the body. The injection will protect you from falling pregnant for 8–12 weeks. While the injection is very effective, unlike the implant, it cannot be removed once you have had it. This means that if you experience any side effects they might persist for several weeks until the effect naturally wears off. It may also take up to a year for fertility to return to normal after stopping the injection. As with other hormonal contraception options, you’ll still need to use barrier contraception (condoms) to protect yourself from STIs.

Another form of hormone-based contraception is the contraceptive patch. It works in the same way as a combined oral contraceptive and contains both oestrogen and progesterone. The patch needs to be worn for three weeks, then is usually followed by a one-week break.

There are two different types of coil: the copper coil (IUD) and the hormonal coil (IUS). You can discuss which is best for you with a doctor or nurse. The coil needs to be inserted by a doctor and you will require a check-up to ensure your coil is still in the right place. Intrauterine contraception is very safe and over 99% effective at preventing pregnancy.

Once inserted, a coil can be left in place for five to ten years, depending on the type of coil and your age. During this time, you don’t have to worry about contraception every day, or every time that you have sex. However, it will not protect against STIs. The coil can be removed at any time by a specially trained doctor or nurse and your fertility quickly returns to normal. The IUD can also be used as emergency contraception if you’ve had unprotected sex or if something went wrong with the contraceptive you were using. In this case, for the coil to prevent pregnancy, it needs to be inserted within five days of unprotected sex.

Some couples choose to rely on natural family planning in order to prevent pregnancy. This technique involves keeping track of your menstrual cycle and avoiding sex on fertile days (days when you could get pregnant). Body temperature, cervical mucus and the day of your cycle are all indicators of your fertility status. The problem with this method is that no woman’s cycle is perfectly regular, which means it is hard to be certain when your fertile days begin and end, and the effectiveness at preventing pregnancy can be as low as 76%. However, if used carefully, this method is on average 95% effective and removes the risk of side effects.

Different contraceptives rank differently on the Pearl index used to rate contraceptive effectiveness. According to the Pearl index, hormonal contraceptives such as the contraceptive pill, the IUS, the IUD, the contraceptive implant or the contraceptive injection are amongst the safest contraceptives in regards to preventing pregnancy, alongside sterilisation and vasectomy. However, the effectiveness of contraceptives which require you to remember taking a pill or taking action at regular intervals highly depends on your use. If you forget to take the pill or replace the patch or ring on time, your contraceptive protection will be affected.

Which method is likely to be the most effective for you depends on your situation and preference. It is also important to bear in mind that not all contraceptives protect against STIs and you should always use a condom when having sex with a partner who has not recently had a clear STI test.

The safest way to prevent pregnancy may be to use both a hormonal method of contraception or an IUD in combination with a barrier method, such as a condom. Not all methods of contraception are suitable for every woman, and therefore the information you give to your doctor or nurse should be as accurate as possible to ensure that the contraceptive methods discussed with you are safe for you to take.