MENUMENU

Choosing Contraception

There are many different contraceptive methods available, and different methods suit different people at different times of their lives. A GP or family planning clinic will help you choose the one that is best for you and your partner. Throughout the 80’s and 90’s, contraception has become increasingly talked about. Perhaps best remembered from AIDS/HIV campaigns. The 1990’s are now over, and what important lessons should we keep in the fore of our mind as we enter this new millenium?

Implant

Small soft tube(s) are placed under the skin of the innder upper arm. They steadily release progestogen hormone into the bloodstream to prevent the sperm and egg meeting. This means of contraception is over 99% effective during the 1st year of use. It is 98% effective over 5 years.

Advantages
+ Single rod works for 3 years, others work for up to 5 years
+ When the implant is taken out, a woman’s normal level of fertility will return immediately
+ You don’t have to think about contraception for as long as the implants work

Disadvantages
– Periods often become irregular for at least the first year, with some bleeding in between, or may be missed.
– May be some side effects such as headaches and breast tenderness
– Some women gain weight

The implant is put in under local anaesthetic and no stitches are needed. The area may be tender for a day or two with bruising and some swelling. Most women can feel the implant, but it can’t be seen.

Female Sterilisation

A permanent method in which the fallopian tubes are cut or blocked so the eggs cannot travel down them to meet sperm. It is over 99% effective, the failure rate is 1 in 200 depending upon the method used.

Advantages
+ It is permanent
+ Once the operation has worked, you don’t have to think about contraception

Disadvantages
– Disadvantages
– The tubes may rejoin and the woman is fertile again

This is a permanent method and should not be chosen if in any doubt. Counselling is important. The time in hospital varies from one to three days depending on the type of operation. A few days rest is needed afterwards.

Natural Family Planning

Knowing when a woman is fertile means pregnancy can be planned or avioded. Noting several fertility indicators, this method is 98% effective. This means that 2 in 100 women will get pregnant in a year. This means that less than 1 to 2 women in 100 will get pregnant in a year.

Advantages
+ No side-effects
+ No hormones are used
+ Gives a woman a greater awareness of her body

Disadvantages
– Need to avoid sex or use a condom or diaphragm at fertile times of the cycle
– To be effective, the method needs to be learned

The fertile and infertile times of the menstrual cycle are identified by noting the different fertility indicators. This shows when you can have sex without risking pregnancy.

Injection

This injection works for either 8 or 12 weeks. It cannot be removed from the body, so any unwanted effects may continue during this time. This means of contraception is over 99% effective. The injection releases the hormone progestogen very slowly into the body, stopping ovulation.

Advantages
+ May protect against cancer of the womb
+ You don’t have to think about contraception for as long as the injection works

Disadvantages
– Periods often become irregular or stop
– Regular periods and fertility may take a year or more to return after stopping the injections
– Some women gain weight

Injection administered by clinic or GP every 8 or 12 weeks.

IUD

If fitted after the age of 40, an IUD device can remain in until the menopause. It is 98% to over 99% effective depending on the type of IUD. This means that less than 1 to 2 women in 100 will get pregnant in a year.

Advantages
+ Works as soon as it is put in
+ Works for at least 5 years but can be taken out at any time
+ You don’t have to think about contraception for as long as the IUD works

Disadvantages
– Periods may be heavier or longer and more painful
– Unsuitable for women who have heavy and painful periods
– Not suitable if a woman has more than one partner or her regular partner has other partners

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

Condoms

The condom is one of the most effective all-round forms of contraception. They’re inexpensive, easy to use, widely available and could save your life! The condom is 98% effective when used according to the instructions. The condom is made of very thin polyurethane and is put over the erect penis and stops sperm from entering the womans vagina (and/or coming into contact with your partner).

Advantages
+ Free from sexual health clinics and sold widely and cheaply
+ May protect both partners from sexually transmitted infections, including HIV
+ Men can take responsibility for contraception

Disadvantages
– Putting on can interrupt sex
– May slip off or split if not used correctly
– Man needs to withdraw as soon as he has ejaculated and must be careful not to spill any semen

There are many different types of condom to choose from. Some are ribbed, flavoured or coloured, but be careful when using “novelty” condoms as these are often not up to standard. ALWAYS use condoms with the British Kite Mark for BS EN 600! This means that the condom is of an acceptable quality.

How to use a condom? This is important!

– Put the condom on when the penis is erect, before there is any contact between the penis and your partners body.
– Tear along one side of the wrapper being sure not to rip the condom. Condoms are strong, but can easily be torn by sharp fingernails or jewellery.
– Air trapped inside a condom could cause it to break. Squeeze the closed end of the condom with forefinger and thumb and place the condom over the penis. Be sure that the roll is on the outside.
– Whilst still squeezing the closed end, use your other hand to unroll the condom gently down the full length of the penis.
– Soon after ejaculation (or when you’re finished making love!) withdraw the penis whilst erect and carefully remove the condom. Be sure not to let any sperm come into contact with your partners body.
– Put the condom in a tissue and put it in the bin. Do not flush it down the toilet!

NEVER USE A CONDOM MORE THAN ONCE!
P.S. We don’t expect you to log on to the internet to check these instructions during sex – you’ll find this info in all packets of condoms!

IUS

This method can be very useful for women with very heavy, painful periods. The IUS is over 99% effective. A small, plasic device contianing progestrogen hormone is put into the womb. This stops the sperm meeting an egg or (rarely) stops an egg settling in the womb.

Advantages
+ Works as soon as you put it in
+ You don’t have to think about contraception for as long as the IUS works
+ Works for 5 years, but can be removed at any time
+ Periods will be much lighter and shorter

Disadvantages
– Irregular light bleeding is common for the first 3 months
– May be temporary side effects such as breast tenderness or acne

Fitted by clinic or GP. Women are taught to check the IUS by feeling the threads high in the vagina.

Male Sterilisation

A permanent method in which the tubes carrying the sperm are cut, so sperm are not present in the semen that is ejaculated when the man “comes”. It is over 99% effective. The failure rate is about 1 in 2000!

Advantages
+ It is permanent
+ Operation takes 10-15 minutes and can be done at a doctor’s surgery or clinic
+ Once the operation has worked, you don’t have to think about contraception

Disadvantages
– It usually takes a couple of months for all the sperm to disappear from the semen
– Contraception must be used during this time until there are two negative sperm tests
– Rarely the tubes rejoin and the man is fertile again

This is a permanent method and should not be chosen if in any doubt. Councelling is important.

Female Condom

A soft polyurethane sheath lines the vagina and stops sperm from entering. If used according to the instructions, this method is 95% effective. This means that 5 women in 100 will get pregnant in a year.

Advantages
+ Can be put in any time before sex
+ May protect both partners from STI’s including HIV
+ Oil-based products can be used with female condoms

Disadvantages
– Putting in can interrupt sex
– Need to make sure the mans penis enters the condom and not between the vagina and the condom
– May slip
– Expensive to buy

A soft polyurethane sheath lines the vagina and the area just outside and stops sperm from entering the vagina.

Combined Pill

The combined pill contains two hormones, oestrogen and progestogen – which stop a woman releasing an egg each month (ovulation). If used according to the instructions, the combined pill is 99% effective. This means that 1 woman in 100 will get pregnant in a year.

Advantages
+ Often reduces bleeding, period pain and pre-mentrual tension.
+ Protects against cancer of the ovary and womb and some pelvic infections.
+ Suitable for healthy, non-smokers up to the menopause.

Disadvantages
– May not be suitable for some women, a full medical history should be taken.
– Not suitable for smokers over 35 or women who are breast feeding.
– May cause temporary minor side-effects

The pill is taken orally as per the specific instructions supplied with it.

Diaphragm/Cap

New types of cap may be left in for up to three days. If used according to the instructions, the cap is 92-96% effective. This means that between 4 and 8 women in 100 will get pregnant in a year.

Advantages
+ Can be put in any time before sex (if more than 3 hours, more spermicide may be needed)
+ May protect against some STI’s
+ A variety of types to choose from

Disadvantages
– Putting it in can interrupt sex
– Cystitis can be a problem for some diaphragm users.

A flexible rubber/silicone device used with spermicide is put into the vagina to cover the cervix and must stay in place for at least 6 hours after sex.

Progestogen only Pill

The hormonr Progestogen, taken at the same time each day causes changes making it difficult for sperm to enter the womb or for the womb to accept a fertilised egg. In some women, it prevents ovulation. If used according to the instructions, the combined pill is 99% effective. This means that 1 woman in 100 will get pregnant in a year.

Advantages
+ Useful for older women who smoke and women who cannot use the combined pill.
+ Can be used when breast feeding.

Disadvantages
– Periods may be irregular, with some bleeding in between or missed periods.
– May be less effective in women who weigh over 70kg (11 stone)
– May cause temporary minor side-effects

The pill is taken orally as per the specific instructions supplied with it.

Emergency Contraception

If you have had sex without using contraception or think your method might have failed, there are two emergency methods you can use.

EMERGENCY PILLS
Emergency Pills must be started up to 3 days (72 hours) after sex. They are most effective if started within 24 hours of sex.

AN IUD
An IUD must be fitted up to 5 days after sex. If you cannot visit a doctor or clinic, then a GUM/Sexual Health Clinic or Hospital may be able to help you.