The Different Contraception Methods

This article has been medically approved by Pharmacist Sumaiya Patel - GPhC Reg No: 2215078

When looking at what method of contraception best suits your lifestyle, you may have a lot of questions. In our article below, we’ll look at the different contraception methods in more detail.

What are the different methods?

There are 12 methods of contraception:

• caps or diaphragms
• combined pill
• condoms
• contraceptive implant
• contraceptive injection
• contraceptive patch
• female condoms
• IUD (intrauterine device or coil)
• IUS (intrauterine system or hormonal coil)
• natural family planning (fertility awareness)
• progestogen-only pill
• vaginal ring

There are also 2 permanent methods of contraception:

• female sterilisation (tubes tied)
• male sterilisation (vasectomy)

For this article, we’ll only be looking at non-permanent contraception.

Contraceptive diaphragm or cap

The contraceptive cap or diaphragm is a circular dome made from thin, soft silicone. It is inserted into the vagina before sex to cover the cervix and block sperm from entering the uterus. It needs to be used with a gel that kills sperm (spermicide). You only have to use a diaphragm or cap when you have sex, but it must be left in for at least 6 hours after sex.

A diaphragm or cap does not protect you from sexually transmitted infections (STIs).

When used correctly with spermicide, a diaphragm or cap is 92-96% effective at preventing pregnancy.

You're likely to be able to use a diaphragm or cap, but it may not be suitable for you if you:

• have an unusually shaped or positioned cervix, or if you cannot reach your cervix
• have vaginal muscles that cannot hold a diaphragm in place (possibly as a result of giving birth)
• have a sensitivity or an allergy to latex or the chemicals in spermicide
• have ever had toxic shock syndrome
• have repeated urinary tract infections
• currently have a vaginal infection (wait until your infection clears before using a diaphragm or cap)
• have a high risk of getting an STI – for example, if you have multiple sexual partners

Combined pill

The combined pill, often just called ‘the pill’, contains artificial versions of female hormones oestrogen and progesterone. These are produced naturally in the ovaries. It prevents pregnancy in 3 ways: it prevents the ovaries from releasing an egg each month; it thickens the mucus at the cervix, making it harder for sperm to enter the uterus; and it thins the lining of the uterus, meaning it’s less likely that a fertilised egg will implant and begin to grow.

There are 3 main types of combined pill:

Monophasic 21-day pills – this is the most common type. Each pill has the same amount of hormone in it. One pill is taken each day for 21 days and then no pills are taken for the next 7 days.

Phasic 21-day pills – Phasic pills contain 2 or 3 sections of different coloured pill in a pack, which contain different amounts of hormones. These pills need to be taken in the right order. One pill is taken each day for 21 days and then no pills are taken for the next 7 days.

Every day pills – Every day pills contain 2 different types of pills, 2 active pills and 7 inactive (dummy) pills. These pills need to be taken in the right order. One pill is taken each day for 28 days with no break between packs.

The combined pill does not protect you from sexually transmitted infections (STIs).

When taken correctly, the pill is over 99% effective at preventing pregnancy.

The pill may not be right for you if you:

• are pregnant
• smoke and are 35 or older
• stopped smoking less than a year ago and are 35 or older
• are very overweight
• take certain medicines

The pill may also not be right for you if you have (or have had):

• blood clots in a vein, for example in your leg or lungs
• stroke or any other disease that narrows the arteries
• anyone in your close family having a blood clot under the age of 45
• a heart abnormality or heart disease, including high blood pressure
• severe migraines, especially with aura (warning symptoms)
• breast cancer
• disease of the gallbladder or liver
• diabetes with complications or diabetes for the past 20 years

Condoms

Condoms are the only type of contraception that both prevent pregnancy and protect against STIs. Condoms are made from very thin latex (rubber), polyisoprene or polyurethane and are designed to stop semen.

There are 2 types of condoms: external condoms, worn on the penis and internal condoms, worn inside the vagina.

When used correctly every time you have sex, external condoms are 98% effective. Internal condoms are 95% effective.

Most people can safely use condoms, but they may not be suitable if:

• you are allergic to latex (polyurethane or polyisoprene condoms are less likely to cause an allergic reaction)
• you have difficulty keeping an erection, as this may create leakage or let the condom slip off

Contraceptive implant

The contraceptive implant is a small, flexible plastic rod that is placed under the skin in your upper arm. It then releases the hormone progestogen into your blood stream to prevent pregnancy for 3 years. It prevents pregnancy in 3 ways: it prevents the ovaries from releasing an egg each month; it thickens the mucus at the cervix, making it harder for sperm to enter the uterus; and it thins the lining of the uterus, meaning it’s less likely that a fertilised egg will implant and begin to grow.

The implant does not protect you from sexually transmitted infections (STIs).

The implant is more than 99% effective.

Most women can be fitted with the contraceptive implant. It may not be suitable if you:

• think you might be pregnant
• don't want your periods to change
• take other medicines that may affect the implant
• have unexplained bleeding in between periods or after sex
• have arterial disease or a history of heart disease or stroke
• have liver disease
• have breast cancer or have had it in the past
• have a medical condition that may affect which contraception you can use – speak to your GP or practice nurse, or visit your nearest sexual health clinic to discuss further

Contraceptive Injection

The contraceptive injection releases the hormone progestogen into your bloodstream to prevent pregnancy. It prevents pregnancy in 3 ways: it prevents the ovaries from releasing an egg each month; it thickens the mucus at the cervix, making it harder for sperm to enter the uterus; and it thins the lining of the uterus, meaning it’s less likely that a fertilised egg will implant and begin to grow.

There are 3 main types of contraceptive injection: Depo-Provera, Sayana Press or Noristerat. Depo-Provera is most commonly given in the UK and lasts for 13 weeks. Occasionally, Noristerat may be given, which lasts for 8 weeks. Sayana Press also lasts for 13 weeks, but it's a newer type of injection so is not available at all clinics or GP surgeries. You usually have the Depo-Provera and Noristerat injections in your bottom, but you can have them in your upper arm. You can have the Sayana Press injection in your tummy (abdomen) or thigh and would normally learn to do this yourself.

The contraceptive injection does not protect you from sexually transmitted infections (STIs).

When used correctly, the contraceptive injection is more than 99% effective.

Most women can have a contraceptive injection, but it may not be suitable if you:

• think you might be pregnant
• do not want your periods to change
• want to have a baby in the next year
• have unexplained bleeding in between periods or after sex
• have arterial disease or a history of heart disease or stroke
• have liver disease
• have breast cancer or have had it in the past
• are at risk of osteoporosis

Contraceptive patch

The contraceptive patch is a small, sticky patch that slowly releases hormones in your body to prevent pregnancy. It works in the same way that a nicotine patch does. The patch contains the same hormones as the combined pill, oestrogen, and progestogen. It prevents pregnancy in 3 ways: it prevents the ovaries from releasing an egg each month; it thickens the mucus at the cervix, making it harder for sperm to enter the uterus; and it thins the lining of the uterus, meaning it’s less likely that a fertilised egg will implant and begin to grow.

The contraceptive patch does not protect you from sexually transmitted infections (STIs).

When used correctly, the contraceptive patch is more than 99% effective.

The contraceptive patch isn't suitable for everyone, so if you're thinking of using it, a GP or nurse will need to ask about you and your family's medical history. Tell them about any illnesses or operations you've had, or medicines you're taking. You may not be able to use the patch if:

• you're pregnant or think you may be pregnant
• you're breastfeeding a baby less than 6 weeks old
• you smoke and are 35 or over
• you're 35 or over and stopped smoking less than a year ago
• you're very overweight
• you're taking certain medicines, such as St John's Wort, or medicines used to treat epilepsy, tuberculosis (TB) or HIV

You may also not be able to use the patch if you have or have had:

• blood clots in a vein or artery (or an immediate family member had a blood clot before they were 45)
• a heart problem
• high blood pressure
• some blood conditions that increase your chance of getting a blood clot, such as lupus (systemic lupus erythematosus)
• breast cancer
• migraine with aura (warning signs)
• disease of the liver or gallbladder

Intrauterine device (IUD)

An IUD is a small, T-shaped device made from plastic and copper. It is placed into the uterus where it prevents pregnancy for between 5 and 10 years. It’s sometimes known as the coil or copper coil. It is a non-hormonal for of contraception because, unlike the IUS, it releases copper instead of progestogen. The copper alters the cervical mucus, which makes it more difficult for sperm to reach an egg and survive. It can also stop a fertilised egg from being able to implant itself.

The copper IUD does not protect you from sexually transmitted infections (STIs).

When inserted correctly, IUDs are more than 99% effective.

A GP or nurse will ask about your medical history to check if an IUD is suitable for you. The IUD may not be suitable if you:

• think you might be pregnant
• have an untreated STI or a pelvic infection
• have problems with your uterus or cervix
• have unexplained bleeding between periods or after sex

Intrauterine system (IUS)

An IUS is a small, T-shaped device made from plastic. It sits in the uterus where it releases progestogen to prevent pregnancy for 3 to 5 years, depending on the brand. It prevents pregnancy in 2 ways: it thickens the mucus at the cervix, making it harder for sperm to enter the uterus; and it thins the lining of the uterus, meaning it’s less likely that a fertilised egg will implant and begin to grow. For some people it can also prevent the release of an egg each month, but most people will continue to ovulate.

The IUS does not protect you from sexually transmitted infections (STIs).

When inserted correctly, the IUS is more than 99% effective.

A GP or nurse will ask about your medical history to check if an IUS is suitable contraception for you. The IUS may not be suitable if you have:

• breast cancer, or have had it in the past 5 years
• cervical cancer or uterus cancer
• liver disease
• unexplained bleeding between periods or after sex
• arterial disease or a history of serious heart disease or stroke
• an untreated sexually transmitted infection (STI) or pelvic infection
• problems with your uterus or cervix

Fertility awareness

Fertility awareness is a method of contraception where a woman monitors different fertility cycles during her cycle to work out her ‘fertile days’. There are 3 different fertility signals you can monitor and record for fertility awareness. These are:

• the length of your menstrual cycle
• daily readings of your body temperature
• changes to your cervical mucus

Fertility awareness does not protect you from sexually transmitted infections (STIs).

When followed consistently and correctly, fertility awareness can be up to 99% effective.

Most women can use fertility awareness. However, certain situations can affect fertility signs and you might want to consider a different method if:

• there could be a health risk to the baby if you got pregnant
• you're having irregular periods
• you have a short or long-term condition affecting your fertility signs, such as a sexually transmitted infection (STI) or pelvic inflammatory disease
• you're taking a medication that disrupts production of cervical mucus (ask your GP or a pharmacist if you're not sure)
• you've recently stopped taking hormonal contraception
• you've recently had a miscarriage or abortion
• you've recently given birth and are breastfeeding
• you regularly travel through different time zones
• you have a vaginal infection such as thrush or an STI, or you're at increased risk of getting an STI
• you're not able to take your temperature in the recommended way
• you're a heavy drinker

Progestogen-only pill

The progestogen-only pill (also known as POP) prevents pregnancy by thickening the mucus in the cervix to stop sperm reaching an egg. The desogestrel progestogen-only pill can also stop ovulation. There are 2 different types of progestogen-only pill:

• 3-hour progestogen-only pill (traditional progestogen-only pill) – must be taken within 3 hours of the same time each day
• 12-hour progestogen-only pill (desogestrel progestogen-only pill) – must be taken within 12 hours of the same time each day

There are 28 pills in a pack of progestogen-only pills. You need to take 1 pill every day within either 3 or 12 hours of the same time each day, depending on which type you're taking. There's no break between packs of pills – when you finish a pack, you start the next one the next day.

The POP does not protect you from sexually transmitted infections (STIs).

If taken correctly, POP is more than 99% effective.

You should be able to use the progestogen-only pill, but you may not be able to if you:

• think you might be pregnant
• do not want your periods to change
• take other medicines that may affect the pill
• have unexplained bleeding in between periods or after sex
• have developed arterial disease or heart disease or have had a stroke
• have liver disease
• have breast cancer or have had it in the past
• have severe cirrhosis or liver tumours

Vaginal ring

The vaginal ring is a small, soft, plastic ring that is placed inside the vagina. Here, it releases a continuous dose of oestrogen and progestogen to prevent pregnancy. It prevents pregnancy in 3 ways: it prevents the ovaries from releasing an egg each month; it thickens the mucus at the cervix, making it harder for sperm to enter the uterus; and it thins the lining of the uterus, meaning it’s less likely that a fertilised egg will implant and begin to grow.

The vaginal ring does not protect you from sexually transmitted infections (STIs).

If used correctly, the vaginal ring is more than 99% effective.

Some women can't use the vaginal ring. It may not be suitable if you:

• have had a blood clot in a vein or artery
• have had heart or circulatory problems, including high blood pressure
• are 35 or older and smoke, or stopped smoking in the past year
• have migraine with aura (warning symptoms)
• have had breast cancer in the past 5 years
• have diabetes with complications
• are overweight
• take medicines that may interact with the ring
• can't hold the ring in your vagina