Contraception and pregnancy

Different types of contraception

Contraceptive injection

Effectiveness:

• Over 99% effective.

How it works:

• It releases the hormone progesterone slowly into your body.
• This stops you ovulating and thickens cervical mucus to prevent sperm and egg meeting.

Advantages:

• Lasts for 12 weeks (Depo-Provera) or 8 weeks (Noristerat).
• It may protect you against cancer of the womb and pelvic inflammatory disease.
• You don't have to think about contraception for as long as the injection works.

Disadvantages:

• Your periods may become irregular or stop.
• It may take a year or more after stopping the injections for your regular periods and fertility to return.
• Some women gain weight.
• Other possible side effects include headaches, acne, mood changes and tender breasts.

Comments:

• The injection can't be removed from your body so any side-effects may continue for as long as it works and for some time afterwards.

Implant

Effectiveness:

• Over 99% effective

How it works:

• A small, flexible tube is placed under the skin in your upper arm.
• It releases the hormone progesterone into the bloodstream to stop ovulation and thickens cervical mucus to prevent sperm and egg meeting.

Advantages:

• It works for 3 years but can be taken out at any time.
• When the implant is removed your normal level of fertility will return immediately.
• You don't have to think about contraception for as long as the implant works.

Disadvantages:

• Your periods might be irregular, very long or stop for a t least the first year.
• Some women gain weight.
• Other possible side-effects include headaches, acne, mood changes and tender breasts.

Comments:

• The implant is usually put in under a local anaesthetic and you won't need stitches.  The area may be tender for a day or 2 with bruising and some swelling.
• Most women can feel the implant with their fingers but it can't be seen.
• Minor surgery necessary to take the implant out.

Intrauterine system - IUS

Effectiveness:

• Over 99% effective

How it works:

• A small plastic device which releases the hormone progesterone is put into your womb.
• It thickens cervical mucus to stop sperm meeting an egg.
• It may stop an egg settling in the womb or stop ovulation.

Advantages:

• It works for 5 years but can be taken out at any time.
• Your periods will be much lighter, shorter and usually less painful.
• You don't have to think about contraception for as long as the IUS works.

Disadvantages:

• You might experience Irregular light bleeding for the first 3 months and sometimes longer.
• There may be temporary side-effects such as head-aches, acne and tender breasts.

Comments:

• You'll usually be taught to check the IUS is in place by feeling the threads high in your vagina.
• It's very useful if you have very heavy or painful periods.

Intrauterine device (IUD)

Effectiveness:

• 98-99% effective

How it works:

• A small plastic and copper device is put into your womb.  It stops sperm meeting an egg or may stop an egg settling in the womb.

Advantages:

• It works as soon as it is put in and can stay in for 3-10 years depending on type, but can be taken out at any time.
• You don't have to think about contraception for as long as the IUD works.

Disadvantages:

• Your periods may be heavier or longer and more painful.
• It's not suitable for women at risk of getting a sexually transmitted infection.

Comments:

• If it's fitted after the age of 40 it can stay in until the menopause.
• You'll be taught to check the IUD is in place by feeling the threads high in your vagina.

Female sterilisation

Effectiveness:

• Over 99% effective

How it works:

• The fallopian tubes are cut or blocked so the egg cannot travel down them to meet sperm.

Advantages:

• It is permanent and has no known long-term side effects.
• Once the operation has worked you don't have to think about contraception.

Disadvantages:

• The fallopian tubes may rejoin so you may become fertile again.
• Contraception must be used up to the time you are sterilised and until you have had your first period after sterilisation.

Comments:

• This should not be chosen if you're in any doubt and counselling is important.
• Time in hospital varies from 1-3 days and you'll need a few days rest needed afterwards.

Male sterilisation (vasectomy)

Effectiveness:

• Over 99% effective

How it works:

• The tubes carrying the sperm are cut, so sperm are not present in the semen that is ejaculated when the man 'comes'.

Advantages:

• It is permanent and has no known long-term side effects.
• It is a minor operation which takes 10-15 minutes and can be done at a doctor's surgery or clinic.
• Once the vasectomy has worked you don't have to think about contraception.

Disadvantages:

• It usually takes a few months for all the sperm to disappear from the semen.
• You must use contraception until there are 2 negative semen tests (no sperm seen).
• The tubes may rejoin so the man is fertile again but this is not common.

Comments:

• This should not be chosen if you're in any doubt and counselling is important.
• There is likely to be bruising, swelling and some discomfort or pain for a short time after the operation.
• You'll need to rest for 24-36 hours and avoid strenuous exercise for at least a week.

Combined pill

Effectiveness:

• Over 99% effective if taken according to instructions.

How it works:

• Contains 2 hormones - oestrogen and progesterone - which stop you ovulating.

Advantages:

• It often reduces bleeding, period pains and PMT.
• It also protects you against cancer of the ovary and womb and some pelvic infections.
• It is suitable for healthy, non-smokers up to the menopause.

Disadvantages:

• It isn't suitable for all women.
• There are some rare but serious side-effects which may include blood clots (thrombosis), breast cancer and cervical cancer.
• There can also be temporary minor side-effects.
• The Combined pill is not suitable for smokers over 35.

Comments:

• It's not effective if you take your pill over 12 hours late or after vomiting or severe diarrhoea.
• Some drugs may stop the pill working.
• Pill users should not smoke.

Progesterone-only pill

Effectiveness:

• 99% effective if taken according to instructions.

How it works:

• The hormone progesterone thickens cervical mucus to prevent sperm meeting an egg or an egg settling in the womb.  In some women it prevents ovulation.

Advantages:

• It's useful for older women who smoke or who cannot use the combined pill.
• Also, it can be used when breast-feeding.

Disadvantages:

• There may be minor side-effects.
• Your periods may be irregular, with some bleeding in between, or be missed.
• It may be less effective if you weigh over 70kg (11 stone)

Comments:

• It's not effective if you take it over 3 hours late or after vomiting or severe diarrhoea.
• Some drugs may stop the pill working but antibiotics do not affect this pill.

Male condom

Effectiveness:

• 98% effective if used according to instructions.

How it works:

• Made of very thin latex (rubber) or polyurethane it is put over your erect penis and stops sperm from entering the woman's vagina.

Advantages:

• You can get them free from family planning clinics and they're sold widely.
• They may protect you both from sexually transmitted infections, including HIV.
• Men can take responsibility for contraception.
• There are a wide variety of types to choose from.

Disadvantages:

• Putting it on can interrupt sex.
• It may slip off or split if not used correctly.
• The man needs to withdraw as soon as he has 'come' and be careful not to spill any semen.

Comments:

• You must use a new condom each time and you have to put it on before the penis touches the woman's vagina.
• Make sure you use condoms with a BSI Kitemark (BS EN 600) and CE Mark on the pack and check the expiry date.
• Remember - Oil based products damage latex condoms but can be used with polyurethane condoms.

Female condom

Effectiveness:

• 95% effective if used according to instructions.

How it works:

• A soft polyurethane sheath lines your vagina and the area just outside, and stops the sperm entering the vagina.

Advantages:

• It can be put in at any time before sex and may protect you both from sexually transmitted infections including HIV.
• Oil based products can be used with female condoms.

Disadvantages:

• Putting it in can interrupt sex.
• You need to make sure the man's penis enters the condom and not between your vagina and the condom.
• It may slip and they are expensive to buy.

Comments:

• You have to use a new condom each time and follow the instructions carefully.
• Female condoms also have a CE Mark.
• They are sold widely and are free at some family planning clinics.

Diaphragm / cap with spermicide

Effectiveness:

• 92-96% effective if used according to instructions.

How it works:

• A flexible, rubber or silicone device used with spermicide is put into your vagina to cover your cervix.  It has to be specially fitted to make sure it is the right size for you.

Advantages:

• It can be put in any time before sex and may protect you against some sexually transmitted infections and cancer of the cervix.
• There are a variety of types to choose from.

Disadvantages:

• Putting it in can interrupt sex.
• You need extra spermicide if you have sex again.
• Cystitis can be a problem for some diaphragm users.

Comments:

• Fitting should be checked every 12 months and if you gain or lose more than 3kg (7lbs), or have a baby, miscarriage or abortion.
• Silicone caps come in disposable and reusable varieties.

Talk to a sexual health worker at the Youth Info Shop or Under1Roof session, a family planning clinic or your health visitor or doctor to find out more and help you decide what would be best for you.

You could also try ringing one of the numbers on our contacts page, or visiting one of the websites

Remember - condoms are the only contraceptives that protect you from STI's, HIV and AIDS.

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