Contraception

Your guide to contraception

There are many different methods of contraception available that are outlined in detail below. Contraception is important to prevent unwanted pregnancies, and should be used until the menopause. Choosing a method of contraception that is right for you is a very important decision.

 

1) Combined Oral Contraceptive Pill (COCP)

The combined pill contains two hormones (oestrogen and progestogen) that are similar to the natural hormones women produce in their ovaries. If the pill is taken according to instructions it is over 99% effective. There are a wide variety of pills available, but generally you take the pill for 21 days then have 7 days when you have a pill free week. During this pill free week, you will have a withdrawal bleed like a period.

What are the advantages of the pill?

  • Does not interrupt sex
  • Your periods usually become regular, lighter and less painful
  • It can reduce premenstrual symptoms
  • Reduces the risk of cancer of the ovary, uterus and colon
  • Reduces acne in some women
  • Reduces the risk of fibroids, ovarian cysts and non-cancerous breast disease

What are the disadvantages of the pill?

  • There are several side affects including headaches, nausea, breast tenderness and mood changes
  • May increase blood pressure
  • Does not protect you against sexually transmitted infections
  • You often experience break-through bleeding or spotting
  • Cannot be used in breast-feeding women and some women with certain health problems
  • Increases the risk of blood clots (venous thrombosis), heart disease and stroke
  • Small increase in the risk of being diagnosed with breast cancer
  • Small increase in the risk of developing cervical cancer with longer use of the COCP

 

2) Progestogen-Only Pill (Mini-Pill or POP)

The Progestogen-only pill (POP) contains a progestogen hormone that is similar to the natural progesterone women produce in their ovaries. Progestogen-only pills are different to combined pills because they do not contain any oestrogen. This pill needs to be taken the same time every day, and unlike the COCP there is no break with this pill.

What are the advantages of the POP?

  • Does not interrupt sex
  • Your periods usually become regular, lighter and less painful
  • It can be used if you are breast-feeding
  • It can be taken by women who are unable to take oestrogens.
  • You are able to use it at any age regardless if you smoke
  • It can reduce pre-menstrual symptoms

What are the disadvantages of the POP?

  • Your periods may become irregular or more frequent while you are taking the POP
  • Does not protect you against sexually transmitted infections
  • You have to remember to take the pill at the same time every day with no break
  • Common temporary side effects include acne, breast tenderness, weight change and headaches

 

 3) Contraceptive injection (also known as Depot or Depo-Provera)

The contraceptive injection contains a progestogen hormone that is similar to the natural progesterone that women produce in their ovaries, and is given in your buttock. Depo-Provera protects you from pregnancy for 12 weeks and is over 99% effective.

What are the advantages of a contraceptive injection?

  • It lasts for 3 months and does not interrupt sex
  • It can be used when breast-feeding
  • It is not affected by other medications
  • Reduces heavy painful periods and it can help with premenstrual symptoms for some women
  • It can be used by women who are unable to use contraception containing the hormone oestrogen.

What are the disadvantages of a contraceptive injection?

  • Irregular bleeding is common, and may continue for some months after you stop the injection
  • Weight gain is a common side affect of the depot
  • Delay of up to a year before the return of your periods and fertility after stopping the depot
  • Risk of infection at the site of the injection
  • May affect your bones by causing thinning of your bones. 

 

4) Emergency Contraception

If you have had unprotected sex without using contraception, or think that your contraception might have failed, you can use emergency contraception. There are two different types of emergency contraception:

Emergency contraceptive pill called Levonelle (also known as the morning after pill)

- This pill can be taken up to 72 hours after sex

- It is more effective the sooner that the pill is taken after sex

Emergency intra-uterine device (IUD)

- This can be inserted up to 5 days after sex

- It can remain in the womb to provide long-term contraception if desired

Emergency contraception can be very effective especially if you have an IUD fitted or if the emergency contraceptive pill is taken soon after sex. You should see your GP, Practice Nurse or Pharmacist as soon as possible if you are worried about unprotected sex. Please contact us urgently if you require this.

 

5) Intra-uterine System (IUS or Mirena Coil)

The IUS is a small, soft, flexible plastic system that is placed in the womb to prevent pregnancy. It can be used up to 5 years.

What are the advantages of using an IUS?

  • You do not have to remember to take a pill every day
  • It lasts for up to five years and does not interfere with sex
  • It can be used when breast-feeding
  • Period pain is usually less, and the IUS is a recommended treatment for heavy painful periods
  • It can be used by some women who are unable to use contraception containing oestrogen
  • If you wish to conceive in the future, your fertility returns to normal after the removal of the IUS.

What are the disadvantages of using a contraceptive implant?

  • Often causes changes to the pattern of your periods, and some patients have irregular bleeding
  • Perforation of the womb, bleeding and infection may rarely occur at the time of insertion
  • Expulsion of the coil from the womb can occur, often in the first month after insertion
  • Pelvic or abdominal pain
  • Headache
  • Breast tenderness
  • Skin changes (acne)
  • It does not protect against STI's, so you also need to use condom.

 

*If you wish to have an IUS inserted or removed, you should book an appointment with us

 

6) Intra-uterine Device (IUD or Copper Coil)

An IUD is a small plastic and copper device with threads on the end that is put into your womb (also called uterus). The thin threads hang through the opening at the entrance of your uterus called your cervix into the top of your vagina. An IUD can stay in for 5-10 years, depending on the type. If you are aged 40 or older when the IUD is fitted, it can be left in until the menopause.

What are the advantages of using an IUD?

  • It is effective as soon as it is inserted
  • It works for 5-10 years depending on the type of coil
  • It does not affect sex
  • It can be used if you are breast-feeding
  • Your fertility returns to normal as soon as the IUD is taken out
  • It can be used as a form of emergency contraception

What are the disadvantages of an IUD?

  • Periods can sometimes become heavier, longer or more painful with the coil
  • It does not protect you from sexually transmitted infection, so you need to use condoms
  • Perforation (puncture of the wall of the womb) may rarely occur at the time of insertion
  • Rarely infection and bleeding at the time of insertion can occur
  • Expulsion of the coil from the womb can occur, often in the first month after insertion
  • If you do become pregnant while you are using an IUD there is a small increased risk of you having an ectopic pregnancy (fetus growing outside of the womb)

*If you wish to have an IUD inserted or removed, you should book an appointment with us 

 

7) Contraceptive Implant (Nexplanon)

Nexplanon is a small flexible single rod that is inserted just under the skin on the inside of your upper arm. It is the size of a matchstick, and releases a low daily dose of a hormone called etonogestrel for up to 3 years. It is a very effective (over 99%) contraceptive that does not affect your fertility. If you wish to conceive in the future, your fertility returns as soon as the implant is removed.

What are the advantages of using a contraceptive implant?

  • You do not have to remember to take a pill every day
  • It lasts for three years and does not interfere with sex
  • It can be used when breast-feeding
  • Period pain is usually less
  • It can be used by some women who are unable to use contraception containing oestrogen

What are the disadvantages of using a contraceptive implant?

  • Often causes changes to the pattern of your periods, and some patients have irregular bleeding
  • Periods can sometimes be heavier and last longer with the implant
  • It does not protect against sexually transmitted infections (STI's) so you also need to use condoms

 

If you wish to have Nexplanon inserted or removed, you should book an appointment with Family Planning on 01522 539145. Nexplanon is best fitted during the first five days of your period. Please note that you will need to book an appointment for counselling about the procedure before your Nexplanon can be inserted.