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Contraceptive Advice
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Useful contraception information
Condoms
Condoms are extremely useful, as they prevent pregnancy with a success rate of 98% if used correctly, while also protecting against Sexually Transmitted Diseases (STDs) including HIV. The male condom is created from latex or polyurethane and is available at any chemist and many supermarkets.
The female condom, while far less popular than the standard ‘male’ condom, works by lining the inside of the vagina, preventing sperm from reaching the egg. This condom also protects against Sexually Transmitted Diseases. It is slightly less effective than the male condom in preventing pregnancy.
Pros
Condoms can be used to prevent pregnancy as well as STDs, and are available over-the-counter at any chemist and most supermarkets and local shops.
Cons
Condoms can be expensive, and if you are regularly sexually active and in a monogamous relationship, your contraception bill can accordingly become quite high. Reaching for a condom in the ‘heat of the moment’ can be less than sexy. However, only abolish condoms in your relationship if both you and your partner have been tested for STDs and are monogamous.
Oral Contraceptives
The Pill is one of the most effective forms of birth control, and is currently the most commonly used contraceptive in the UK and many other countries. The Pill comes in two forms – the combined oral contraceptive pill and the progestogen-only pill or ‘Mini Pill’. The difference between the two pills is that the Mini Pill does not contain oestrogen but contains progestogen – the synthetic form of the progesterone a woman’s body naturally produces. The combined pill contains both oestrogen and progestogen. While the combined pill always prevents ovulation if taken as directed, the Mini Pill works more by thickening the mucous plug in the neck of the womb, therefore preventing sperm from reaching and fertilising the egg.
Combined Oral Contraceptive Pill (The Pill)
Pros
Studies show that if taken as prescribed (every day at the same time) the Pill is about 99% effective in preventing pregnancy. Many women on the combined pill experience shorter, lighter, and less painful periods. Women who use the Pill are less likely to get ovarian or endometrial cancer, Pelvic Inflammatory Disease, and ovarian cysts. The Pill may also improve skin conditions like ‘teenage skin’.
Cons
Drawbacks of using the Pill include having to remember to take it around the same time each day, possible side effects including headache, nausea, slight weight gain, and improbably blood clots. Birth control pills have also been shown to increase one’s risk of certain cancers including cervical cancer. While rare, the Pill can also raise the woman’s blood pressure or cause blood clots. These are unlikely side effects. Women taking certain medications should not take the Pill and only your doctor, STD clinic practitioner or other healthcare professional can determine whether the Pill is compatible with the other medicines you may take.
Progestogen-only Pill (Mini Pill)
Pros
Breastfeeding women, smokers, diabetics, women with high blood pressure, and older women are advised against taking the combined oral contraceptive pill. They may, however, be able to use the Mini Pill. The Mini Pill can also safely be used by women who are advised against using oestrogen-based products. This pill may also improve pre-menstrual symptoms. Only your doctor or STD clinic practitioner can help choose the right pill for your needs.
Cons
The Mini Pill has a slightly higher failure rate than the combined pill, as it demands an even greater compliance of the woman to take the pill around the same time each day. The Mini Pill does not protect against STDs.
Contraceptive Patch
The Contraceptive Patch is just like the combined pill – but it comes in the form of a patch which remains on your skin for 3 weeks at a time (a one week break during which you will have your period follows). The patch must be changed weekly. It does not protect against STDs.
Pros
The woman only needs to remind herself about birth control on a weekly basis, as opposed to the daily compliance the Pill requires. Women who use the patch are less likely to get ovarian or endometrial cancer, Pelvic Inflammatory Disease, and ovarian cysts. The patch also decreases pre-menstrual symptoms like cramps.
Cons
The Patch is visible to the eye and in some cases irritates the skin. It is not suitable for overweight women. Possible side effects include headache, nausea, slight weight gain, and improbably blood clots. Like the Pill, the patch has been shown to increase one’s risk of certain cancers including cervical cancer. Women taking certain medications should not use the patch.
Contraceptive IUD (‘coil’)
This highly effective method of birth control comes in the form of a small plastic or copper mechanism that is placed in the womb by your doctor or STD clinic practitioner. It does not protect against Sexually Transmitted Diseases. Once fitted, IUDs can remain in place up to 10 years, yet can be removed at any time. Having the IUD inserted is a quick and easy procedure.
Pros
The IUD is exceptionally effective in preventing pregnancy, and allows for a spontaneous sex life for those in a monogamous relationship. Once the IUD is put in place the woman does not have to think about contraception on a daily basis.
Cons
The IUD, like many other forms of contraception, does not protect against STDs. After insertion, bleeding may occur, and irregular and heavy periods may persist. This form of contraception can only be fitted by a healthcare professional. There is also a very small risk of infection within the first 20 days after insertion.
Contraceptive IUS (Intrauterine System)
This form of contraception, often referred to by its trade name Mirena, is similar to the IUD yet it contains the hormone progestogen. The device, which can remain effectively in place for 5 years, has a similar action to that created by the Pill. Some women who use the IUS as their method of birth control stop ovulating while the device is in place, therefore stopping their periods altogether. The IUS is 99% effective in preventing pregnancy but does not prevent the transmission of Sexually Transmitted Diseases. Once removed, a woman can conceive without indications.
Pros
The IUS is over 99% effective in preventing pregnancy and once it’s in place the woman does not need to think about contraception on a daily basis – for up to 5 years. Many women find that their periods become much lighter or even stop completely once the Mirena is put in place.
Cons
The IUS can only be fitted by a GP, STD clinic practitioner or other healthcare professional. Some women experience side effects like acne or mood changes. There is also a very small risk of infection within the first 20 days of insertion.
Contraceptive Injection
Contraceptive injections given 12 weeks or 8 weeks apart, depending on the type of injection you choose (Depo-Provera or Norethisterat respectively) are 99% effective in preventing pregnancy. This method works similarly to the Pill in that it stops ovulation, changes the mucous plug near the womb so that sperm cannot reach the egg, and thins the lining of the womb to prevent the fertilisation of the egg.
Women who use the injection method often get irregular periods or no periods at all. The menstrual cycle will however return to normal once the injections are stopped and at least 3 months have passed since the last injection. It is important to note that it can sometimes take up to a year after stopping the injections in order for normal fertility to restore.
Pros
The Contraceptive Injection does not interfere with the effectiveness of other medicines. This form of birth control often decreases pre-menstrual symptoms and lightens the woman’s period. Studies show that the Contraceptive Injection may also decrease a woman’s risk of developing Pelvic Inflammatory Disease and cancer of the womb. The Injection doesn’t require the woman to think about contraception on a daily basis.
Cons
It can take up to a year after ‘quitting’ the injections in order for normal fertility to restore. Some women gain weight, experience irregular bleeding, or other side effects including headache, mood changes, breast tenderness, and acne. Because the Injection lasts for up to 12 weeks, side effects may not diminish within this time period.
Contraceptive Implant
The Contraceptive Implant, sometimes known as Implanon, is a small device which is inserted into the skin of the woman’s upper arm. The implant is very small and invisible to the eye. It only takes about 5 minutes for your doctor or health practitioner to insert and should cause little pain, if any. Like the Pill, the Implant works by releasing progestogen, stopping ovulation. The Contraceptive Implant remains effective for 3 years.
Pros
The Contraceptive Implant can be used by women who are advised against oestrogen-based contraceptives. The Implant is highly effective in preventing pregnancy, and has also been shown to reduce the risk of Pelvic Inflammatory Disease and cancer of the womb. Periods may also become lighter or shorter. Once implanted, the woman does not need to worry about contraception on a daily basis.
Cons
The Implant does not protect against Sexually Transmitted Diseases. It requires the woman undergo a simple procedure at her doctor’s office or STD clinic – both to insert the mechanism and to remove it. Some women develop side effects like acne, mood changes, and breast tenderness. Periods may also become irregular. The Implant is not recommended for women with certain health conditions (migraines, for example) or women who take certain medications. Visit your doctor or walk-in clinic if you are considering the Contraceptive Implant as your form of birth control.
Diaphragm and Cervical Cap
The diaphragm and cervical cap work similarly – they both cover the cervix, thereby preventing sperm from reaching the uterus. The diaphragm is a rubber-made device while the cervical cap is latex and smaller in size. Both devices require the usage of spermicide and must be kept inside the vagina for at least 6 hours after sex yet no more than 30 hours.
Pros
No serious health risks are associated with the use of diaphragms and cervical caps. When in place, the woman can have sex during her period, with no excretion of blood.
Cons
Diaphragms and Cervical Caps require the use of spermicide, which can be messy. The woman also has to think about contraception more frequently and inserting one of these devices can disrupt spontaneous sex. Such devices are not reliable in protecting the woman from STDs. The devices must also be fitted by a healthcare professional who will conduct an internal examination.
Sterilisation (Male & Female)
This method of contraception is permanent and accordingly should be well thought-out, especially if you have not had children or are under 30.
The sterilisation procedure for men – the Vasectomy – is a quick procedure in which the vas deferens are cut and tied or sealed with heat. This involves making a very small incision in the skin and the whole procedure, performed under local anaesthetic, takes about 15 minutes. It can be carried out by your GP, private doctor, or STD clinic.
The sterilisation procedure for women involves cutting and tying, or sealing or blocking the fallopian tubes. The procedure is usually done under a local anaesthetic and involves making a very small cut in the woman’s abdomen.
Pros
Sterilisation is permanent, so if you are sure you don’t want kids or more kids, it is an excellent choice.
Cons
Contrary to popular belief, sterilisation is not easily reversible. It also requires a minor surgical procedure.
Emergency Contraception
Emergency contraception is to be used when your regular form of birth control has failed (broken condom, for example) or you did not use any form of contraception. The most common Emergency Contraceptive is sometimes called the ‘Morning-After Pill’ and is a progestogen-based pill that must be taken within 72 hours of unprotected intercourse. The second type of emergency contraception is the IUD, which must be inserted within 5 days of unprotected sex, and can then be left in place for ongoing contraception. Emergency contraception is not to be used regularly, as it is not everyday contraception. It is for emergencies only. The ‘Morning-After Pill’ will not prevent pregnancy on an ongoing basis.
Pros
Emergency contraception is extremely helpful if you have failed to use birth control or are worried that your regular form of contraception has failed. The Emergency Contraceptive Pill is available over-the-counter at a pharmacy or a private walk-in clinic. If the IUD is inserted, it will prevent pregnancy on an ongoing basis.
Cons
Emergency contraception cannot prevent the woman from contracting any Sexually Transmitted Disease from her partner with which the ‘accident’ occurred. If the IUD is your chosen emergency measure, you will have to visit a healthcare professional to have it inserted professionally, and may later experience side effects like irregular bleeding
