If it's very important for you not to get
pregnant, are you using the most effective contraception?
We'll tell you about contraceptive methods that are suitable for all ages
and help you prepare for a visit to your nurse, doctor or pharmacist to discuss
contraception and ask them questions. A few people get side effects that
usually settle after a short time, but if you do experience side effects,
discuss the options with your contraception provider.
If you want to get pregnant when you stop using your contraception,
with most methods you are fertile straight away,
but with a contraceptive injection it can take up to 12 months for fertility
to return.
The contraceptive implant is a small rod which is inserted under the skin of your
arm where it releases progestogen hormone which stops your ovulation.
Most women are satisfied with the implant,
it is our most effective form of contraception. It can stay in place for
three years and has the advantage that you don't
have to remember to take anything. Removing it is a quick, easy procedure.
It is over 99.9 per cent effective and less than one woman in ten thousand
who use the implant get pregnant in a year.
The commonest problem is irregular bleeding.
Some users find they have little or no bleeding,
but two in 10 users get frequent or prolonged bleeds.
Hormone side effects are rare as the dose of hormone is low,
but some users report headaches, spots,
sore breasts, mood changes
and loss of interest in sex. It does not cause weight gain.
A hormonal coil or IUS is one of the most effective contraceptives and can
remain in place for three to six years depending on the type. It can be used by
all women, even if you have not been pregnant before.
It's more than 99 per cent effective, only 10 to 30 women out of 10 000 with a
hormone coil get pregnant in a year. The IUS acts locally and you don't have
to remember to take anything. It's very effective for heavy painful
periods and for most users periods get a lot lighter,
for two in ten users they stop altogether.
The IUS is the contraceptive that women report being most satisfied with.
An IUS is inserted in the uterus and contains progestogen making the
uterine lining thin, it also prevents sperm from fertilizing the egg
as most of the hormone stays in the womb.
Side effects are rare, but some users report headaches,
spots, sore breasts, mood changes and loss of interest in sex.
It does not cause weight gain.
Copper coils or intrauterine devices (IUDs) can stay in place for five years
and are more than 99 per cent effective. With the copper IUD, only 80 women out of
10 000 get pregnant in one year. The copper IUD is a highly effective,
hormone-free contraceptive. You can use it even if you have not been
pregnant before and you don't have to remember to take
anything. It's also a contraceptive that women are
very satisfied with. There are no hormonal side effects,
the only drawback is that some people find their periods get a bit heavier and
longer. The copper coil is positioned in the
uterus by a doctor or nurse with special training
and the copper prevents the sperm from fertilizing eggs.
The procedure can be uncomfortable but it doesn't last long and pain relief is
available. The IUS and IUD are designed to work for
a few years, but you can get it taken out at any
time, for example if you want to get pregnant.
Having an IUD removed is quick and easy.
A contraceptive injection is 94 per cent effective,
this means approximately 600 out of 10 000 women
who use the injection get pregnant each year.
The injection is given once every three months into the muscle at the top of
your buttock. It has a high dose of progestogen which
prevents ovulation, and hormone side effects are rare,
but the commonest ones are feeling anxious,
headache and gaining weight. About 25 out of 100 users gain weight
due to the injection and the average weight gain is 11 pounds
over three years. Like all contraceptives,
the injection can cause irregular bleeding,
but after one year, around 50 out of 100 users find they don't
get any bleeding at all, and there's a version of the injection
you can give yourself so you don't need to go to the clinic
every three months.
Combined methods include contraceptive pills, patches and vaginal rings.
They contain two hormones, estrogen and progestogen,
which prevent ovulation. They are 91 per cent effective, approximately 900 out of 10,000
women who use these methods get pregnant each year.
You need to be careful to take one pill a day
or put on one contraceptive patch per week or put a ring in your vagina once a
month. The combined methods are more effective
when used without a break, however,
you can use them continuously with a four day break if you have
vaginal bleeding. After a four day break
you need to use your method for a short
time before a new break. Although you have to remember to use
them, some people like these methods as they feel in control and can choose
when to have a bleed. Combined methods make the uterine lining
a little thinner leading to less menstrual bleeding and cramps.
The commonest side effects are bleeding in between periods, feeling sick,
sore breasts and changes in mood or sex drive.
It doesn't cause weight gain. Contraception with estrogen
has an extremely rare side effect of thrombosis,
which means blood clots in the legs or lungs.
This happens in 5 to 12 in 10 000 users but is lower than the risk of a blood
clot in pregnancy.
These are pills containing only one hormone called progestogen.
They're short acting and you must be absolutely sure to take it at about the
same time every day. They're about 91 percent effective,
around 900 out of 10 000 women get pregnant per year whilst using them.
All mini pills affect the mucus in the cervix,
preventing the sperm from reaching and fertilizing the egg.
Some progestogen only pills temporarily stop your ovaries from releasing an egg
each month. Progestogen makes the uterine lining
thinner, so menstrual bleeding often lessens or
disappears completely, with reduced menstrual cramping.
These pills can be used when you can't use estrogen containing methods
due to risk factors such as a hereditary risk of thrombosis or being over 35 and
a smoker. Hormone side effects are rare
as the dose of hormone is low, but some users report headaches, spots,
sore breasts, mood changes and loss of interest in sex.
It does not cause weight gain.
There are various kinds of diaphragms and caps that prevent sperm from
reaching and fertilizing an egg. They can be as much as 88 per cent effective,
between 1200 and 2400 out of 10 000 women get pregnant each
year when using diaphragms. They should be used with a spermicide
and can be put in a couple of hours before you have sex,
so they don't interrupt sex. After sex, they must be left inserted for
at least six hours before being taken out.
Some people like them as they are under the user's control.
Condoms are around 82 percent effective, around 1800 out of 10,000 women get
pregnant during the first year of condom use.
Condoms prevent sperm from entering the uterus and fertilizing the egg and must
be used for the whole intercourse. They protect against sexually
transmitted infections and should always be used if there is a risk of infection,
even while other contraceptives are being used.
They are durable but are only to be used once and to prevent breakage,
be careful as you open the wrapping and put the condom on.
Keep condoms safe so the wrapping doesn't get damaged
and check the use before date so you always have safe and fresh condoms to
use. To help decide when choosing
contraception, it can help to ask yourself, How would you deal with a
pregnancy if it were to occur? How long am I planning to use
contraception? Do I want a baby in the next year?
Do I want my contraception to help with heavy or painful periods?
In our experience, long acting contraceptives like coils and implants
are the most effective contraceptive and studies show these methods are the
ones most women choose to continue with. Short acting contraceptives like pills
patches rings diaphragms and condoms depend entirely on you to use them
correctly for them to be effective. Whatever method
you choose, condoms must also be used when there's a
risk for sexually transmitted infections. For more information have a look at
contraceptionchoices.org or try
nhsinform.scot