Contraception

There are many different kinds of contraception available which means that there will be at least one method that will suit you. The most reliable are the LARC methods (long acting reversible contraception), such as Depo Provera, Implanon, IUDs and IUCDs.

Even if you are under 16, you have the right to confidential contraceptive advice and treatment without parental advice. Although the law says you should be 16 or older to have sex, you can get contraception legally if you are under 16, as long as your doctor or nurse are satisfied that you know what you are doing and understand any potential side effects. They will help you decide which method of contraception will suit you best.

You can get advice and contraception from your GP, family planning, young persons clinic (such as Brook), Boots in Birmingham, BRASH or sexual health clinic (like the Calthorpe).

It is important to remember that condoms are the only methods of contraception that can help protect against sexually transmitted infection as well as pregnancy.

Contraception injection (Depo Provera)
Implant (Implanon)
IUD (Intrauterine device)
IUS (Intrauterine system) - Mirena
Male condom
Female condom
Combined Pill
Progesterone-only Pill
Contraceptive vaginal ring
Diaphragm (the cap)
Female sterilisation
Male sterilisaton (vasectomy)
Emergency contraception

Contraception injection (Depo Provera)

This releases the hormone, progesterone, which stops ovulation (egg release), thickens cervical mucus to prevent sperm reaching the egg and thins the lining of the womb to prevent a fertilised egg from implanting. It is 99% effective.

Advantages:

Lasts for 12 weeks
You don't have to think about contraception while the injection lasts
It does not interfere with sex

Disadvantages:

Periods can become irregular or stop
Periods and fertility can take a while to return to normal after stopping the injection
Might make you feel hungrier so you put on weight
You can't ‘remove' the injection so, if you suffer from side effects, you will have to wait until the side effects stop
It does not protect against STIs
Can cause thinning of the bones with long-term use

Implant (Implanon)

This is a small soft tube, about the size of a matchstick or hair grip, which is placed under the skin of the upper arm by a doctor or nurse, using a local anaesthetic (no stitches are needed). It releases a constant flow of the progesterone which prevents ovulation (egg release), thickens cervical mucus and thins the lining of the womb. It is more than 99% effective.

Advantages:

It can stay in place for up to 3 years but can be taken out sooner
You don't have to think about contraception while the implant is in place
It does not interfere with sex
It can be used while breastfeeding
Fertility returns to normal when it is removed
Periods can be less painful

Disadvantages:

Periods can stop, be irregular or last longer
During the first year, it is common to have irregular bleeding
Can cause greasy skin
Some medicines may stop the implant from working
It does not protect against STIs
Might make you feel hungrier so you put on weight

IUD (Intrauterine device)

Also known as the coil, this small plastic or copper device is placed inside the vagina by a doctor or nurse. It makes the womb lining hostile to sperm; copper kills off sperm and prevents an egg from implanting in the womb.

Advantages:

It works as soon as it is put in if fitted day 1-5 of your cycle; it can be fitted up to day 19 of your cycle as emergency contraception
It can stay in place for 5-10 years, depending on the type, but can be taken out at any time
You don't have to think about contraception while it is place
Fertility returns to normal when it is removed
If fitted after 40, it can stay in place until the menopause

Disadvantages:

Periods may be heavier or longer and may be more painful
There is a slight chance of an infection during the first 20 days after insertion
It does not prevent STIs

IUS (Intrauterine system) - Mirena

This is a small T-shaped plastic device similar to the coil. The difference is that an IUS such as the Mirena slowly releases the hormone progestogen into the body. This stops ovulation (egg release), thickens cervical mucus to prevent sperm reaching an egg and thins the lining of the womb to prevent a fertilised egg from implanting. It is placed inside the vagina by a doctor or nurse and can stay in place for up to 5 years. It is over 99% effective.

Advantages:

It works for 5 years but can be taken out sooner
Periods are usually lighter, shorter and can be less painful
You don't have to think about contraception while it is in place
Fertility returns to normal when it is removed
If fitted after 45 it can stay in place until the menopause

Disadvantages:

Irregular bleeding or spotting can occur during the first 6 months
Periods can stop altogether (although some women see this as an advantage)
There is a slight chance of an infection during the first 20 days after insertion
It does not protect against STIs

Male condom

Can be made of latex (rubber) or polyurethane (plastic). They are placed over an erect penis to prevent sperm from entering the vagina.

If the condom splits, you should use emergency contraception as soon as possible (see below). When used correctly, the condom is 98% effective at preventing pregnancy.

Advantages:

Condoms are widely available and are free from contraception, sexual health, young people's and GUM clinics
They can protect both partners from sexually transmitted infections (STIs) including HIV
There are no medical side effects
Available in different shapes and sizes

Disadvantages:

Putting one on interrupts sex
If put on incorrectly, it can slip off or allow sperm into the vagina
The man needs to withdraw straight after ejaculation and before the penis goes soft, making sure not to spill any semen
Avoid oil-based lubricants, such as Vaseline and baby oil, because they can cause breakages

Female condom

Designed to line the vagina, the female condom is also known as Femidom in the UK. It is 95% effective in preventing pregnancy when used correctly.

Advantages:

It also protects both partners against sexually transmitted infections (STIs)
There are no medical side effects

Disadvantages:

Putting it on interrupts sex
You must make sure the man's penis enters the condom and not go between the vagina and the condom
It's not as widely available as the male condom

Combined Pill

The pill is 99% effective in preventing pregnancy when used correctly. It contains oestrogen and progesterone which stops ovulation (release of egg), thickens the cervical mucus to prevent sperm from reaching an egg and thins the lining of the womb to prevent a fertilised egg from implanting. In the UK, you will be given a pack containing 21 pills which you take every day for 3 weeks (some other countries use packs with more than 21 tablets). At the end of the 3 weeks, you have a break for 7 days during which time you have your period. After the 7 day break, you start your next pack of 21 pills.

Advantages:

It gives you regular periods, with less cramping
It can reduce premenstrual symptoms
Can be used by healthy non-smokers up to the menopause
It can reduce acne
When you stop using it, your fertility returns to normal
Protects against ovarian cancer, cancer of the womb and colon cancer
Protects against PID (pelvic inflammatory disease)

Disadvantages:

Not suitable for very overweight women or smokers over 35 years old
Side effects can be headaches, nausea, breast tenderness and mood changes
You must take it the same time every day; missing a pill can make it less effective
Diarrhoea, sickness, antibiotics and certain anti-epilepsy drugs can make the pill less effective
DVT (deep vein thrombosis) or clotting is believed to be slightly more common in women who are taking the combined pill, especially if they have a family history of DVT, are smokers or suffer with migraines
It does not protect against STIs

Progesterone-only Pill

Also known as the mini Pill, it is 99% effective in preventing pregnancy when used correctly. Progesterone thickens cervical mucus which prevents sperm reaching an egg and thins the lining of the womb which stops a fertilised egg from implanting.

Advantages:

It can be used by women who can't use oestrogen
Women who smoke and are over 35 can use it
Diabetics can use it
It can be used if you are breastfeeding
It has fewer health risks than the combined pill

Disadvantages:

Periods may stop or become irregular, light or more infrequent
You might experience headaches
You need to take it at the same time every day, even when you have your period
It does not protect against STIs

Contraceptive vaginal ring

This is a small, flexible plastic ring which is put into the vagina. It releases oestrogen and progesterone which stops ovulation and thickens the lining of the womb which prevents sperm from reaching an egg. It is 99% effective if used according to instructions. You insert and remove it yourself. It must be used for 3 weeks out of 4; during the week you take it out, you will have your period.

Advantages:

It can make your bleeds regular, lighter and less painful
You don't have to think about contraception every day
When you stop using it, your fertility returns to normal

Disadvantages:

It's not suitable for very overweight women or smokers over 35
Side effects can be increased vaginal discharge, headaches, breast tenderness and mood changes
Some medicines can make it less effective
Breakthrough bleeding and spotting can occur in the first few months of use
It does not protect against STIs

Diaphragm (the cap)

A round flexible dome made of latex (rubber) or silicon that is used with spermicidal cream. It is placed over the neck of the womb and stops sperm from entering. It is 92-96% effective (latex type) if used correctly.

Advantages:

It can be put in place any time before sex
You only need to use it when you have sex
There are no serious health risks

Disadvantages:

Putting it in can interrupt sex
Extra spermicide will be needed if you have sex again
It must stay in for 6 hours after sex
You will need to replace it if you gain or lose more than 7lbs (3kgs), have a baby, miscarry or an abortion

Up to 95% effective if taken within 24 hours
Up to 85% effective if taken within 25-48 hours
Up to 58% effective if taken between 49-72 hours

You can get the morning after pill from this Clinic, a family planning clinic, your GP or a pharmacy.

You can also have an IUCD fitted for emergency contraception (this is much more reliable)

Up to day 19 of a 28 day cycle
Up to 5 days after unprotected sex

No form of contraception is perfect. If you suspect you may be pregnant, take a pregancy test as soon as possible (from the first day of a missed period or, if you don't know when your next period is due, 21 days after unprotected sex). If you do a pregnancy test any earlier, the pregnancy hormone (hCG) may be too low to show up on a test and you could get a negative result.

Calthorpe Clinic, 4 Arthur Road, Edgbaston, Birmingham B15 2UL