Contraception: What Are My Options?
Written by Eleanor Pearson who is currently studying at the University of London Institute in Paris. Eleanor is a sexual health enthusiast and writer. As well as managing her blog, Sexclusive, she has written for Sex, Etc. since 2016. This article was originally published on Our Progress Project in August 2017.
When it comes to contraception, we think we know what’s available to us: condoms, the pill and IUDs right? But the truth is that there’s actually fifteen different types of contraception - all of which vary in popularity, in effectiveness and in how you use them. So here’s the low-down:
Typically made of latex and worn on the penis during sex, male condoms are 98% effective when used correctly every time sex occurs. They’re the only type of contraception that will protect you and your partners from STIs as well as pregnancy and should be used during vaginal, oral and anal sex whenever a penis is involved. They can also be used on sex toys in order to help better protect your body from any chemicals put on the materials.
Male condoms are sold in most supermarkets but are also free from your GP or sexual health clinic. In fact, depending on your county, if you’re between the ages of 16 and 25, you can register for the condom distribution scheme - meaning you can pick up free condoms and lube from your local libraries and youth centres.
Less commonly used in comparison to the male equivalent, female condoms are worn inside the vagina to stop sperm from reaching the egg. Much like male condoms, these will protect you and your partners from STIs and pregnancy but are a little less effective in doing so - 95%.
Female condoms are less widely available compared to male condoms and tend to be more expensive. That being said, you may still be able to get them for free from your GP, sexual health clinic or Brook Advisory Centre.
The Combined Pill:
When taken correctly by people with wombs and ovaries, the combined pill is 99% effective in preventing pregnancy (please note that the pill does NOT protect against STIs). It contains a combination of progesterone and oestrogen which act to change the thickness of the lining of the womb so as to make it harder for sperm to penetrate the egg and harder to eggs to survive.
Whilst they all act to achieve the same goal, there is some variation between the different types of combined pill:
some you take every day for 21 days in a specific order
some you take every day for 21 days in any order
some you take every day for 28 days with the last seven days being “dummy pills” - meaning they don’t contain any hormones but also don’t disrupt your daily routine.
There are, of course, some side effects that come from taking the pill but your doctor or sexual health advisor will warn you of these.
Progestogen-Only Pill (POP):
Unlike the combined pill, the POP doesn’t contain oestrogen. If taken correctly (at the same time every day) it is more than 99% effective in thickening the lining of the womb to make it harder for sperm to penetrate the egg. Some types of progestogen-only pills will also act to prevent ovulation. Again, like the combined pill, the POP doesn’t act to prevent STIs and you may experience side effects so make sure your healthcare provider fully explains the pros and cons before you make the decision.
*Editor's note* It is important to be aware that the margin of failure with contraceptive options such as the pill and condoms is high due to incorrect usage (e.g. taking the pill at the wrong time, or incorrectly putting on/in a condom) which increases your risk of unwanted pregnancy. Healthcare professionals would highly recommend an LARC method (long-acting reversible contraception) as they are highly effective, without relying on the user, which is especially suitable for young people. LARCs include the contraceptive implant, the contraceptive injection, IUDs and IUS. Read more on the FPA website.
Intrauterine Device (IUD)
Made of copper and sort of t-shaped, IUDs have to be fitted in the uterus by a healthcare provider. They act by releasing copper into the womb so as to make it inhabitable for sperm, making it 99% effective in preventing pregnancy. Whilst some have said that the process of having them fitted can be quite uncomfortable, an IUD won’t have to be replaced for another 5-10 years, meaning you don’t have to think about it too much.
Whilst they are also t-shaped like an IUD, IUS’ release progesterone to alter the lining of the womb. There are two brands available in the UK - Mirena and Jaydess and they differ in terms of how often they need to be replaced (between 3 and 5 years). However, just like the IUD, they are 99% effective and the insertion process may be uncomfortable.
The contraceptive implant is inserted into your upper arm by a healthcare professional and releases progestogen into the body. Once it has been fitted, it doesn’t need to be replaced for another three years and is 99% effective. The implant does, however, often come with side effects such as bruising when it’s first fitted and changes to your menstrual cycle.
Lasting for between 8 and 14 weeks, the injection is yet another method of contraception that acts by releasing progestogen into the bloodstream. Whilst they are up to 99% effective, they can come with side effects such as changes to your period, mood swings and headaches. In addition to this, the injection may affect your fertility for up to a year after your most recent injection wears off.
The vaginal ring is a small circular ring that is made of plastic. It is inserted into the vagina and left there for 21 days. On the 21st day, it is thrown away and you have ring-free days when you may experience menstruation. On day 28, a new ring can be put in. 99% effective, it works by releasing hormones that make it less likely that sperm will reach the egg.
Cervical Cap and Diaphragms
These are made of silicone and act to cover the cervix so as to stop sperm from reaching the egg. Caps and diaphragms are available from your healthcare provider as you’ll need to be fitted for the correct size. Used alongside spermicide, cervical caps are around 92% effective and come with no serious health risks or side effects.
This is a patch that is placed on your skin and distributes hormones into your bloodstream. These hormones work in the same way as those used in the combined pill (see above). The patch should be changed every week. It is more than 99% effective and shouldn’t be affected by swimming, bathing or sports. If it does fall off, its effectiveness and your consequent actions depend on how long it’s been off for so you’ll need to consult with your healthcare provider or the information booklet that comes with your patches.
Natural family planning
This method involves studying the changes to your body that indicate the times in your cycle in which you’re fertile and those when you’re not. These changes include body temperature and cervical secretions. It is important to note that noticing these changes must be done under the guidance of an expert or a certified app, such as Natural Cycles. When followed correctly, natural family planning can be up to 99% effective.
This is a permanent method of contraception which involves the tubes in the testicles being cut or sealed so as to prevent sperm from reaching the semen. It is thought to be up to 99% effective and means that you’re unlikely to have to think about contraception ever again. Of course, having a vasectomy does involve having to have some minor surgery which may be uncomfortable but this is something that should be discussed with your healthcare provider.
Essentially very similar to having a vasectomy, female sterilisation involves blocking the fallopian tubes to prevent the release of an egg. Again, it’s 99% effective and cannot be easily undone - although there is a chance that the surgery may reverse on its own. As with any surgery, it does come with risks and these should be addressed in a conversation with your healthcare provider.
So, these are the many different types of contraception that you have to choose from. There’s no right or wrong method - it all depends on your situation and what you feel comfortable with. However, experts do recommend using condoms (as they prevent against pregnancy as well as infections) as well as another method so as to further decrease your risk.