Remember back in school when we were forced to sit there and watch videos about the importance of safe sex? Or maybe you had a tutorial of putting a condom on a banana? We all know how important it is to stay protected during sex, and how easily it is to become pregnant. But now we’re older, it’s time to discover what works best for us in helping to prevent pregnancy and improve our lifestyle.
There are now 15 types of contraceptives available that help us to enjoy sex without the risk of getting pregnant, including: condoms, natural family planning, vasectomy and female sterilisation. However, others can contain risks to our bodies and may not even be as effective as you think.
The combined pill (the pill) is a small tablet that you swallow orally to prevent pregnancy. It is made of artificial oestrogen and progesterone hormones designed to prevent your ovaries from releasing an egg. You are instructed to take one pill at the same time each day for 21 days, and then have a seven day break for your body to ‘rest’, to have a period before continuing to absorb the hormones for another 21 days. It is advised to take the pill on the first day of your period for instant protection against pregnancy; otherwise you will need to use additional contraception for seven days before the pill takes effect. The pill is 99% effective but only if it is taken at the same time every day for 21 days. It becomes less effective if you take the pill late, or by missing two pills there is the potential your ovaries may be able to release an egg, allowing you to become pregnant. If you do miss a pill, follow the instructions on your packet to know what to do next. The pill is very sensitive to other natural bodily functions such as vomiting and diarrhoea, which can affect the hormone intake of the pill by not allowing it to be absorbed into our bloodstream. Similarly, antibiotics interrupt the pill too. The known side effects of the pill include headaches, nausea, breast tenderness and mood swings. It can also increase blood pressure and has been linked to breast cancer. However, there are still many benefits of the pill. It can make periods regular, lighter and less painful, it reduces cancer of the womb, ovaries and colon, and it reduces PMS, acne, fibroids, ovarian cysts and non-cancerous breast disease. The flexibility of the pill can also be used to prevent periods for a holiday or special occasion by taking two packets back to back. Taking more than two packets will allow the womb lining to break and spot bleeding will occur. Although there are many types of pill, there are three common types that are used: Monophasic, which is taken for 21 days and has the same level of hormones in each pill, Phasic, which is taken for 21 days and contains pills with different amounts of hormones, and Every day (ED), which is taken for 28 days and contains seven inactive pills. However, Monophasic is the most common because it is the easiest to use as the others have a specific order that may mean the chances of pregnancy are increased if you fail to follow instructions. Once off the pill it can take around two to three months for some women’s menstrual cycle to go back to normal. Doctors say women can start trying for a baby straight away but advise to wait for your periods to be regular to understand your body.
The progestogen-only pill (POP) is a tablet similar to ‘the pill’ but only contains the hormone progestogen and not oestrogen and can stop ovulation. They are designed for women of any age who can’t take contraception that uses oestrogen. It is commonly prescribed to women who smoke, with high blood pressure, blood clots or are overweight. POP should be swallowed every day at the same time with no breaks in-between. If you take the pill later than three hours, it may not be effective. As well as it being designed for women who cannot take oestrogen. It can also reduce the symptoms of premenstrual syndrome and painful periods. However, women taking POP may have irregular periods, making them lighter, more frequent or they may completely stop. This may cause concern for some women as they will never know when to expect their period, affecting their lifestyle. Some types of antibiotics are also known to affect its production making it less effective. POP has been known to be the cause of fluid-filled cysts on your ovaries which are usually not harmful and go away without treatment but some women do experience pelvic pain. It may also be linked to breast cancer, like any type of hormonal contraception. Much like the pill, once you’ve stopped taking POP you can get pregnant right away but it’s best to wait for your periods to be regular. It can take up to nine months for periods to regulate but doctors do not fear unless it has been over a year.
The contraceptive injection is another form of POP but it is injected into you through a muscle in your bottom. It is used to thicken the mucus in the cervix to prevent sperm from reaching the womb by slowly releasing the progestogen hormone. It also thins the womb making it unable to release a fertilised egg. It must be injected within the first five days of your menstrual cycle, and offers immediate protection. The injection can be 99% effective and protects against cancer of the womb and pelvic inflammatory disease. There are three different types of injection in the UK; Depo-Provera, which lasts 12 weeks, Sayana Press, which lasts 13 weeks, and Noristerat, which lasts for eight weeks. Depo-Provera is the commonly used injection form because of its many benefits, such as being unaffected by medication and ideal for people who forget to take the pill. It affects the regular flow of your period making them irregular or stops completely. This can affect women’s lifestyle choices because they may never know when to expect a period. They also have to remember when to book an appointment for the next injection after 12 weeks, ensuring they have the right date to have complete protection. The injection is also known to affect the oestrogen levels in your body and can lead to the thinning of the bones. This does not affect most women but if you or your family suffer from osteoporosis it may increase your risk, and is inadvisable to those under 18 years of age as they may not be fully developed. Once off the injection, your fertility levels should be back to normal within three to six months. However, this depends on how long you were taking the injections and how regular your periods are. Doctors advise to try for a year before worrying.
The contraceptive implant is a small, thin, flexible tube of 4cm, which is inserted under the skin of the upper arm by a doctor, which releases progestogen into the body. It lasts for three years and then gets replaced, but can easily be removed anytime by a doctor if it unsuitable for any reason. Once the implant is removed your fertility should return to normal straight away. The implant needs to be fitted during the first five days of your menstrual cycle to be instantly protected against pregnancy, otherwise you will need to wait seven days and use additional protection. The implant has some major advantages to your health by protecting against pelvic inflammatory disease and some protection against cancer of the womb. It is also known to reduce heavy and painful periods after the first year of use. Ideally, the implant is best for those who have intention of getting pregnant. However, the implant can affect the flow of your period. Based on current statistics, 20% of women will have no bleeding at all and 50% will have infrequent or prolonged periods. Other side effects include headaches, acne, nausea, mood swings and loss of sex drive. Nexplanon is the main contraceptive implant currently used in the UK. It is designed to reduce the risk of insertion errors and is visible on X-rays and CT scans
The contraceptive patch is a sticky patch that is 5x5cm and delivers oestrogen and progesterone hormones into your body. Each patch lasts for one week and is changed for three weeks with a week off. You should apply the patch anywhere on your body, expect the breasts and irritated skin, on the first day of your cycle for instant protection. It can be worn in the shower, bath or pool but if it does come off you should replace it with another one or follow the instructions. The patch is still effective if you vomit or have diarrhoea as it does not need to be absorbed by the stomach. It can help with premenstrual symptoms and make periods lighter and regular. It can also reduce the risk of ovarian, womb and bowel cancer and reduce the risk of fibroids, ovarian cysts and non-cancerous breast disease. However, it can cause skin irritation, itchiness and soreness and bleeding between periods during the first few months. Women also get mild side effects such as headaches, nausea, breast tenderness and mood changes. It can also increase your chance of blood clots if you smoke, are diabetic or have high blood pressure. Doctors are still working on the patch’s long-term results as it is one of the newest forms of contraception being introduced in early 2000s. If you forget to wear a patch for over 48 hours, your body will no longer be protected against pregnancy. However, it can take a few months for your menstrual cycle to return to normal.
IUD (intrauterine device/coil) is a small T-shaped plastic and copper device that is inserted into your womb to prevent pregnancy. Instead of releasing hormones, it releases copper which affects the fluids in the womb and fallopian tubes to stop sperm surviving. Once fitted, an IUD can last for five to ten years and removed at any time by a doctor with your fertility returning to normal instantly. An IUD can be fitted at any time during your menstrual cycle but you will need an internal examination to determine the size and position of your womb to ensure the IUD will be in the correct place. Your doctors will be able to teach you how to check if your IUD is in the correct place after insertion. It is very unlikely it will come out of place but if it does you will not be protected and should see your doctor straight away. The main advantage of using an IUD is that there are no links to cancer of the cervix of endometrial cancer. However, it can change the flow of your periods making them heavier, longer or more painful. An IUD can also cause vaginal bleeding and pain, and can cause damage to the womb, cause pelvic infections and ectopic pregnancy. Fewer than one in 1000 have made a hole in the womb or cervix when it’s put in. Once an IUD is removed your fertility should return to normal straight away, meaning any sperm that is in your womb from the past seven days can make you pregnant.
IUS (intrauterine system/hormonal coil) is a small T-shaped plastic device that is inserted into your womb. Much like an IUD, the IUS only contains progestogen and can last up to five years. It is recommended that the IUS is fitted during the first seven days of your menstrual cycle to have instant protection. You will need an examination to determine the size and position of your womb before insertion. An IUS may be useful for those with heavy periods as it can make periods lighter and shorter, and may stop completely after the first year. Your fertility will return to normal once the IUS is removed. There is also no evidence that it will make you put on weight, or increase the risk of cervical or ovarian cancer, or cancer of the uterus. However, it is common for women to experience irregular bleeding and spotting within the first six months but should decrease over time. Similarly to the IUD, the IUS can cause unharmful cysts on the ovaries and cause bleeding and pain, as well as pelvic infections and ectopic pregnancy. Similarly to the IUD, once the IUS is removed your fertility should return to normal straight away meaning you can become pregnant at any time.
Vaginal ring is a small, soft plastic ring of 4mm thick and 5.5cm in diameter, which releases oestrogen and progestogen that you place inside your vagina. It stays in for 21 days, after this time it is to be removed and thrown away; a new one replaces it after seven days. You should place the vaginal ring on the first day of your menstrual cycle to have instant protection. This can affect your lifestyle as you must remember to replace it after each period. Advantages of the vaginal ring include the reduced risk of ovarian, uterus and colon cancer, as well as fibroids, ovarian cysts and non-cancerous breast disease. It can also help with premenstrual symptoms and makes periods lighter, regular and less painful. However, there may be spotting and bleeding during the first few months and can cause side effects such as discharge, headaches, nausea and mood swings. The vaginal ring may also interact with medicines. There are also some uncommon serious side effects such as developing a blood clot or having a heart attack or stroke. Once you stop using the vaginal ring you will be unprotected from pregnancy within three hours.
The contraceptive diaphragm is a reusable form of contraception that is inserted into the vagina before sex. It is to be used with spermicide to kill sperm and left in the vagina for six hours. However, it is only 92-96% effective and you need to be fitted for the correct size by a doctor or nurse. The diaphragm can provide some protection against STIs but it is highly recommended that you use additional contraception. Although using a diaphragm means you are in control of your contraception, it means you aren’t as protected as with other contraception and you will interrupt sex to put it in. It can also cause cystitis and irritation to women and their sexual partners. This may also mean that women will worry about the diaphragm for it may be uncomfortable for them and their partners. Doctors say you should not leave a diaphragm in for more than 30 hours at which point the spermicide will wear off and you will not be protected against pregnancy.
The contraceptive cap works similarly to the diaphragm. It is a circular dome made of thin, soft silicone which is inserted into the vagina with spermicide. It should be left for at least six hours, then taken out and washed to be reused. You need to be fitted for one by a doctor or nurse to determine your size first. They are 92-96% effective but means you can control your contraception and there are no serious health risks. However, like the diaphragm it does provides some protection for STIs but ideally you should use additional contraception. It can cause bladder infections and the latex and spermicide can cause irritation for women and their partners. The cap works similarly to the diaphragm as the spermicide will have completely worn off after 30 hours and you will no longer be protected against pregnancy.
Any type of contraception has risks and symptoms. You should talk to your GP to find out what works best for you and your health before taking anything.