Here at Perky we want you to have fun while also being protected.
If you are sexually active then at some point or another you would have had to use contraception or at least think about it. Finding the right protection for you can be a bit of a pain but there are 15 methods to choose from to help ward off unwanted crotch goblins. Whether they’re hormonal, non-hormonal, long-acting, irreversible or emergency, these are all free on the NHS if you live in the UK.
So without further ado... here is a list of the pros and cons of different types of contraceptives.
Non-hormonal contraception
Condoms form a barrier that stop sperm meeting an egg. They are the only contraceptive that protects you from STIs including HIV. External condoms (AKA male condoms) are one of the most popular— I mean who hasn’t awkwardly practiced putting one on a banana, eh?—but internal condoms (AKA female condoms) are also a choice, even if they are the less popular one.
With perfect use, male condoms are 98% effective, however with typical use they’re only 82% effective. This means if 5 of your friends are using condoms 1 of them will be pregnant within a year
With perfect use, female condoms are 95% effective, but with typical use, they’re 79% effective — meaning 21 in 100 women will get pregnant in a year using internal condoms.
Pros
Male condoms are widely available, can be bought in supermarkets, pharmacies and vending machines within public toilets and are fairly cheap
Both forms of condom (male and female) are free in sexual health clinics and family planning clinics. You can even ask your local GP.
You only need to use them while having sex
They protect against STI’s as well as Pregnancies!
Cons
They can slip off and break, oil based lube can cause them to become porous (have tiny holes in them) making them ineffective.
female condoms aren't as widely available as male condoms and can be a bit more expensive too
they don't protect you from getting genital wart (eww!) which are caused by HPV
The IUD, or as its more commonly known, the coil is a small plastic and copper device that sits inside the uterus and has 2 strings that stick out of the cervix. How it works is it releases small amounts of copper that alter the cervical mucus, making it difficult for sperm to survive and can also stop a fertilised egg from implanting in the uterus.
This method is known as LARC (long acting reversible contraception) and can also be called fit and forget. it is 99% effective and although its one of the safest and most effective of contraceptions it is also the most misunderstood.
Pros
It can last unto 5 - 10 years (depending on the brand)
It takes less than 15 minutes to insert and cane done at any point in your cycle (but only if you aren't already pregnant)
Can be removed at any point by a nurse or doctor without disrupting your fertility.
It's not affected by other medication.
it is also safe to use while breast feeding.
Cons
Having the IUD inserted can be uncomfortable and sometimes painful. It has to be done by a trained specialist nurse.
Some spotting is common in the first couple months, and can cause periods to be longer and heavier in the first 6 months.
There is a 1 in 20 chance that your body will expel the IUD in the first 3 months
There is a very small chance that the IUD will dislodge and puncture the uterus. *this is extremely uncommon and is typically due to inexperienced clinicians inserting it incorrectly or abnormal anatomy*
Diaphragms are dome-shaped cups made of thin, soft latex or silicone and have a flexible rim. Cervical caps are slightly smaller and made of silicone. both of these act as a barrier. These aren't very popular and are seen as and old fashioned method.
They’re inserted in the vagina and sit at the base of your cervix, preventing sperm from entering the uterus and fertilising an egg. they are around 71-81% effective.
Pros
Only need to be used when you have sex.
They can be worn for up to 6 hours after sex.
they have 0 serious risks or side effects
Cons
Caps and diaphragms should be used with spermicide, which can disrupt your vaginal microbiome. (vaginal microbiome affects everything from your ability to fight off infections, to your likelihood of getting pregnant, miscarrying, and even of developing certain cancers)
You will need to see a doctor or nurse the first time you use one to make sure it fits correctly, as their shape and size can vary.
If you lose weight (more than 7lbs) or have a baby, you might have to fitted with a new cap or diaphragm.
It can take time to learn how to use it properly.
Some women develop cystitis when they use a diaphragm or cap
Even though like condoms they act as a barrier, they don’t protect you from STIs.
Can also be known as “natural family planning", fertility awareness methods (FAM) means you track your cycle to find out when you’re ovulating so you can either plan or avoid a pregnancy. It means you would have to keep daily records, but can be relatively effective (76%) 24 in 100 women will get pregnant in a year when using FAM.
In order for this to work you need to record your basal body temperature (BBT) at the same time every morning before getting out of bed, and before drinking or eating anything.
Pros
This method has no physical or mental side effects
It doesn’t require relying on synthetic hormones or any devices.
It’s accepted by all faiths and cultures.
It can help you understand your cycle better.
Cons
It can take a while to get the hang of it.
It is not suitable for people with irregular periods.
Having to keep daily records is hard if you aren't used to it.
Illness, alcohol, stress, travel and certain medications can throw off your basal body temperature and make anything recorded wrong.
During your fertile days you need to avoid having sex, or use a barrier contraception to prevent pregnancy.
Hormonal contraception
Usually referred to as "the pill," it is the most common form of contraception and also the most contentious. Its made of 2 synthetic versions of progestogen and oestrogen, the female hormones which the body produces naturally.
How it works is it prevents ovulation meaning your ovaries don't release an egg. It thickens your cervical mucus too, making it harder for sperm to reach the egg, and thins the uterine lining, preventing a fertilised egg from implanting. it is 99% effective.
there are 2 types of the combined oral contraceptive pill:
Monophasic pills and phasic pills
Monophasic pills are the most commonly used, and they contain the same dose of hormones. You usually take them every day for 21 days, then have a break for 7 days before starting a new pack. There is no reason why you can’t take this type of pill back to back. The 7 day break is mostly intended to allow women to have a withdrawal bleed. During the break, the drop in hormones triggers the lining of the uterus to shed, but since you don’t ovulate on the pill, it’s not the same as your period. There’s no health benefit to having a withdrawal bleed every month, and it’s not medically necessary.
Phasic pills contain 2 or 3 sections of pills that contain different amounts of hormones, and it’s really important that you take them in the right order.
Skipping the 7 day break doesn't cause you any harm it just means you won't bleed, however skipping it several times in a row can cause spotting as the lining of the uterus does have a use by date meaning your body will reset and basically its hasta la vista womb lining. How heavy they are depends on your body and the brand of pill you are taking.
Pros
It can make your periods lighter, more regular and even less painful
It can help reduce PMS symptoms.
Some brands of the pill can help with cystic acne.
Research has shown it reduces the risk of ovarian, uterine and colorectal cancer.
It doesn’t affect your fertility (yay!)
A common misconception is that the pill can cause weight gain. This is not true.
It helps with problems related with polycystic ovarian syndrome.
Cons
Side effects include: headaches, nausea, mood changes, and breast tenderness.
There is an increased risk of breast and cervical cancer
although not definitively proven, there could be a link between the pill and depression there has been overwhelming anecdotal proof of this. More research has to be done.
It increases your risk of deep vein thrombosis however, this is very rare.
Missing a pill, vomiting or severe diarrhoea after taking the pill can make it less effective.
It may not be suitable if you’re a smoker and are over 35 years old, have a family history of breast cancer, have cardiac problems or are very overweight.
Medications to treat HIV, epilepsy and TB, as well as St. John’s Wort can make the pill less effective.
known as the mini pill works by thickening your cervical mucus, which is what prevents sperm from reaching an egg. It also thins the uterine lining, so it’s less likely for a fertilised egg to implant. This is 91% effective. Some brands of the mini pill also prevent ovulation which means no periods. the mini pill also taken every day at the same time, but, unlike the combined oral contraceptive pill, there is no 7 day break.
Pros
It doesn’t contain oestrogen, so it’s useful for women who cannot take oestrogen (such as breastfeeding women).
It’s safe for smokers over 35.
It can help with PMS symptoms and painful or heavy periods.
Cons
You need to take the pill within 3 hours of your usual time every day.
It may cause temporary side-effects in the first few months, such as headaches, breast tenderness, weight change and spots.
Periods can become irregular or stop altogether. Spotting in between periods is also common.
Missing a pill, vomiting or severe diarrhoea after taking the pill can make it less effective.
Medications to treat HIV, epilepsy and TB, as well as St. John’s Wort can make the pill less effective.
An IUS is a small T-shaped plastic device that’s inserted into your uterus and releases progestogen and has 2 strings that stick out of your cervix. It’s 99% effective, and comes in different sizes which release different amounts of progestogen. similar to an IUD, it is a LARC method. The IUS thickens your cervical mucus, making it harder for sperm to reach the egg, and thins the uterine lining, preventing a fertilised egg from implanting. Two brands are available in the UK: Mirena, which lasts 5 years, and Jaydess, which lasts 3 years.
Pros
Once inserted, it lasts 3-5 years depending on the brand.
It makes your periods lighter and less painful, and may make them stop altogether.
It doesn’t contain oestrogen.
It’s good for women who can’t remember to take the pill every day.
It takes less than 15 minutes to insert and can be done at any point of the menstrual cycle, provided that there is no chance of you being pregnant.
It works as soon as it’s inserted, and can be removed at any point by a nurse or doctor without disrupting your fertility.
It isn’t affected by any other medicines.
Cons
You may experience spotting during the first few months.
When it's being inserted it can be uncomfortable or painful, and has to be done by a specially trained nurse or doctor.
There is a 1 in 20 chance that your body will expel the IUS in the first 3 months.
There is a very small chance that the IUD will dislodge and perforate your uterus. This is extremely uncommon and is typically due to an inexperienced clinician not inserting it properly.
some research has suggested that the Mirena coil may make you more prone to chronic stress.
The implant is a small plastic rod, about 4 cm in length, that is inserted under the skin of the upper arm. It contains the progestogen, which stops ovulation and thickens the cervical mucus, preventing sperm from reaching an egg. The contraceptive implant is a LARC method that lasts 3 years and is 99% effective.
Pros
It doesn’t contain oestrogen, so it’s useful for women who cannot take oestrogen.
Having it put in is quick and only requires local anaesthetic.
Cons
It can cause bruising at the insertion site, swelling and tenderness in your arm. Infections are very rare, but can happen.
Removing the implant can be painful or tricky.
It may cause temporary side-effects for the first few months, such as headaches, breast tenderness, weight change and spots.
In the first year your period may become irregular, lighter or heavier. It can also stop altogether.
Medications to treat HIV, epilepsy and TB, as well as St John’s Wort can make the implant less effective.
The contraceptive injection is an injectable form of progestogen, which prevents ovulation. It’s a LARC method and works for either 8, 12 or 13 weeks, depending on the type. The types of injection available in the UK are Savana Press, DepoProvera and Noristerat. It is 94% effective.
Pros
Periods can become lighter or stop altogether.
Can help with PMS symptoms
It can't be affected by other medications
it doesn't contain oestrogen
The Sayana Press injection can be self-administered without the presence of a nurse or doctor.
It’s good idea for women who won’t remember to take the pill every day but don’t want an IUD/IUS.
Cons
Women have experienced weight gain with the injection.
Breakthrough bleeding and occasional spotting is common.
The DepoProvera and Noristerat injections need to administered in-clinic by a doctor or nurse. Noristerat has to be administered every 8 weeks, but is not commonly used in the UK.
side effects include: headaches, mood swings and breast tenderness. If side effects occur, they will last for 12 weeks until the injection leaves your system.
It can take a while for your fertility to return to normal once you stop taking the injections. (some have suggested it can stop fertility altogether)
It can reduce bone mineral density causing your bones to thin. This usually recovers once you stop taking the injections.
The patch is a slightly lesser-known form of contraception. It’s a small square (5 cm x 5 cm) plastic patch that sticks to the skin just like a plaster and releases oestrogen and progestogen. how it works is by preventing ovulation. It also thickens your cervical mucus, making it harder for sperm to reach the egg, and thins the uterine lining, preventing a fertilised egg from implanting. Its 91% effective and has to be applied weekly for 3 weeks in a row, followed by a 7 day break. Just as with the pill
Pros
It is not affected by vomiting and diarrhoea unlike the pill.
It can make periods lighter, more regular and less painful.
It can help with PMS symptoms.
It can help with cystic acne.
Research has found that it reduces the risk of ovarian, uterine and colorectal cancer.
It doesn’t affect your fertility once you stop using it.
It does not cause weight gain.
It helps the problems associated with polycystic ovarian syndrome.
Cons
It can react when applied to your skin.
It can fall off without you noticing.
Side-effects include headaches, nausea, mood changes, and breast tenderness are common.
it might not be suitable if you smoke and if you are over 35 years old, have a family history of breast cancer, have cardiac problems.
It can increase your risk of breast and cervical cancer.
It can increase your risk of deep vein thrombosis
Medications to treat HIV, epilepsy and TB, as well as St John’s Wort can make the patch less effective.
The contraceptive ring, also known as the NuvaRing, is a flexible plastic ring that is placed inside the vagina and releases oestrogen and progestogen. It’s 91% effective. It prevents ovulation. It also thickens your cervical mucus, making it harder for sperm to reach the egg, and thins the uterine lining, preventing a fertilised egg from implanting. It is inserted and worn for 3 weeks, followed by a 7 day break.
Pros
You don’t have to think about it every day.
It’s easy to put in and take out and you can do it yourself.
It can make periods lighter, more regular and less painful.
It can help with PMS symptoms
Reduces the risk of ovarian, uterine and colorectal cancer.
It doesn’t affect your fertility if you stop using it.
It helps the problems associated with polycystic ovarian syndrome.
Cons
It can fall out during intercourse or strenuous bowel movements (very rarely happens)
Side-effects include: headaches, nausea, mood changes, and breast tenderness.
It can increase your risk of breast and cervical cancer.
It increases your risk of deep vein thrombosis (very rare)
Its not be suitable if you’re a smoker and are over 35 years old, have a family history of breast cancer, have cardiac problems, or are very overweight
Permanent Contraception
Sterilisation is a permanent form of contraception, and can be both male and female. Male sterilisation known as a vasectomy involves cutting or sealing the vas deferens, which stops sperm travelling from the testicles to the penis. Although vasectomy is technically reversible, the procedure is complicated and dramatically reduces the chances of pregnancy.
Female sterilisation is commonly referred to as “getting your tubes tied”, and involves cutting or blocking the fallopian tubes, which stops an egg travelling from the ovary to the uterus. You will still ovulate and have regular periods, the egg is simply absorbed by your body rather than being shed. Unlike vasectomies, tubal occlusion is NOT reversible.
Pros
Once you’ve had the procedure, you never have to take contraception ever again. It’s the best option for people who don’t want children.
Vasectomy doesn’t require a surgical procedure, and only requires local anaesthetic.
Only about 1 in 2000 vasectomies fail.
People who have had their tubes tied can still conceive through IVF, where an egg is extracted and fertilised in vitro, then reintroduced in the uterus. It’s complicated and costly, but possible.
Cons
Getting your tubes tied requires an invasive surgery
Failure rates for getting your tubes tied are slightly higher compared to vasectomy, and about 1 in 200 fail.
You need to take contraception for 12 weeks following a vasectomy, until semen tests can confirm that the sterilisation was successful.
you still need to condoms to protect against STIs.
Emergency Contraception
Emergency contraception should only be used if you’ve had unprotected sex, or your usual method of contraception has failed. It is not a routine method of contraception, and although it is very effective, it is not as effective as taking regular methods of contraception.
Emergency contraception comes in three forms:
emergency IUD and two types of “morning after pills.”
*Emergency contraception can be taken up to 3 to 5 days after having unprotected sex*
Emergency IUD
The IUD is the most effective form of emergency contraception, and less than 1% of women who have the emergency IUD fitted get pregnant. It can be fitted up to 5 days after having sex, and doesn’t rely on hormones. The copper present in the IUD is toxic to an egg, and prevents it from implanting. The emergency IUD is the only form of emergency contraception that works even after ovulation.
Ulipristal acetate pill
Sold under the name ellaOne, this is a pill containing ulipristal acetate (UPA). UPA stops progesterone from functioning normally, either delaying or stopping ovulation. It can be taken up to 5 days after sex, however, the sooner you take it the more effective it is.
If you feel sick 3 hours after taking ellaOne, you may need to take another dose or have an emergency IUD fitted. Most women can take ellaOne, but if you used hormonal contraception the week before taking ellaOne, it may make it less effective.
Levonorgestrel pill
Sold under the name Levonelle, this emergency contraceptive pill contains levonorgestrel, a synthetic version of progesterone that prevents ovulation. It needs to be taken within 3 days of unprotected sex.
If you feel sick 2 hours after taking Levonelle, you may need to take another dose or have an emergency IUD fitted. Levonelle doesn’t interfere with your usual method of contraception. Most women can take Levonelle, but if you’re taking certain medications or have a BMI higher than 26, you may need a higher dose of levonorgestrel.
*There are no serious side effects attached to ellaOne and Levonelle, but some women may experience headaches or nausea shortly after taking the pill.*
Key points
Contraception comes in non-hormonal, hormonal, emergency and permanent forms. These methods are: condoms (external and internal), caps and diaphragms, IUD, FAM, combined pill, progesterone-only pill, IUS, implant, patch, injection, vaginal ring, sterilisation (male and female), and the morning after pill (ulipristal acetate pill and levonorgestrel pill).
Non-hormonal forms of contraception work by preventing sperm from reaching an egg, or by inhibiting implantation.
Hormonal forms of contraception work by preventing ovulation, thickening cervical mucus, or making the endometrium inhospitable.
The efficacy of a contraceptive methods highly depends on how accurately it's used.
Whether or not a contraceptive method is right for you depends on your age, health, medical history, weight and lifestyle.
No method of contraception is 100% risk or side-effect free. Finding the right type for you is a matter of weighing the pros and cons.
If you have questions about anything ask your local GP family planning centre or even the welfare officer at school/college. They are there to help and
not to judge.
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