contraception

CONTRACEPTIVE CHOICES
There are a wide range of contraceptive choices which you can choose. The table on this page allows you to compare 12 methods, their effectiveness, and how they work

MALE CONDOM How effective is it? If used according to instructions it is 98% effective. This means that 2 women in 100 will get pregnant in a year If it is not used according to instructions then the chance of pregnancy is higher How it works Made of very thin latex (rubber) or polyurethane it is put over the erect penis and stops sperm from entering the woman's vagina Advantages Free from family planning clinics and also sold widely May protect both partners from sexually transmitted infections, including HIV Men can take responsibility for contraception Disadvantages Putting it on can interrupt sex. ' May slip off or split if not used correctly Man needs to withdraw as soon as he has ejaculated and be careful not to spill any semen Comments Use a new condom each time Must be put on before the penis touches the woman's vagina Use a condom with a BSI Kitemark (BS EN 600) and CE Mark on the pack and check the expiry date. Oil based products should not be used with latex condoms as they damage them, but can be used with polyurethane condoms

FEMALE CONDOM How effective is it? If used according to instructions it is 95% effective. This means that 5 women in 100 will get pregnant in a year. If it is not used according to instructions then the chance of pregnancy is higher How it works A soft polyurethane sheath lines the vagina and the area just outside, and stops sperm from entering the vagina Advantages Can be put in any time before sex May protect both partners from sexually transmitted infections, including HIV Oil based products can be used with female condoms Disadvantages Putting it in can interrupt sex Need to make sure the man's penis enters the condom and not between the vagina and the condom. May slip Expensive to buy Comments Use a new condom each time and follow the instructions carefully Female condoms have a CE mark Sold widely and is free at some family planning clinics

DIAPHRAGM/CAP WITH SPERMICIDE How effective is it? If used according to instructions it is 92% to 96% effective. This means that between 4 and 8 women in 100 will get pregnant in a year If it is not used according to instructions then the chance of pregnancy is higher How it works A flexible rubber/silicone device used with spermicide, is put into the vagina to cover the cervix and must stay in for at least six hours after sex. Must be specially fitted to make sure it is the right size Advantages Can be put in any time before sex (if more than three hours before, extra spermicide is needed). May protect against some sexually transmitted infections and cancer of the cervix Are a variety of types to choose from Disadvantages Putting it in can interrupt sex. Extra spermicide is needed if you have sex again Cystitis can be a problem for some diaphragm users Changing to a slightly smaller or different type of diaphragm or cap may help Comments Fitting should be checked every 12 months and if you gain or lose more than 3kg (7lbs), or have a baby miscarriage or abortion Silicone caps may be left in for longer than rubber

NATURAL FAMILY PLANNING How effective is it? Using several fertility indicators is 98% effective. This means that 2 women in 100 will get pregnant in a year If it is not used according to instructions then the chance of pregnancy is higher How it works 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 Advantages No side-effects. No hormones are used Gives a woman a greater awareness of her body Knowing when the woman is fertile means pregnancy can be planned or avoided 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 from a trained NFP teacher Comments There are different natural methods to use Persona is a small handheld computerised monitor with urine test sticks, which measure hormonal changes. Persona predicts the fertile and infertile times of the menstrual cycle. It is claimed to be 94% effective

COMBINED PILL How effective is it? If taken according to instructions it is over 99% effective. This means that less than I woman in 100 will get pregnant in a year If it is not taken according to instructions then the chance of pregnancy is higher How it works Contains two hormones - oestrogen and progestogen - which stop a woman releasing an egg each month (ovulation) Advantages Often reduces bleeding, period pain and pre-menstrual tension Protects against cancer of the ovary and womb and some pelvic infections Suitable for healthy non-smokers up to the menopause Disadvantages Not suitable for all women Rare but serious side-effects may include blood clots (thrombosis), breast cancer and cervical cancer Can be temporary minor side-effects Not suitable for smokers over 35 Comments Not effective if taken over 2 hours late or after vomiting or severe diarrhoea, when an extra method should also be used. Some drugs may stop the pill working - a doctor nurse or pharmacist can advise Pill users should not smoke

PROGESTOGEN-ONLY PILL How effective is it? If taken according to instructions it is 99% effective. This means that I woman in 100 will get pregnant in a year If it is not taken according to instructions then the chance of pregnancy is higher How it works The hormone 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 Advantages Useful for older women who smoke and who cannot use the combined pill Can be used when breast-feeding Disadvantages May be temporary minor side-effects Periods may be irregular with some bleeding in between, or be missed May be less effective in women who weigh over 70kg (11 stone) Comments Not effective if taken over three hours late or after vomiting or severe diarrhoea, when an extra method should also be used Some drugs may stop the pill working - a doctor nurse or pharmacist can advise

FEMALE STERILISATION How effective is it? It is over 99% effective. The lifetime failure rate is about 1 in 200, depending on the method used. How it works A permanent method in which the fallopian tubes are cut or blocked so the eggs cannot travel down them to meet sperm Advantages It is permanent. Once the operation has worked, you don't have to think about contraception Disadvantages The fallopian tubes may rejoin and the woman is fertile again Contraception must be used up to the time you are sterilised and until you have had your first period after sterilisation Comments This is a permanent method and should not be chosen if in any doubt Counselling is important Time in hospital varies from one to three days depending on the type of operation A few days rest needed afterwards

MALE STERILISATION (VASECTOMY) How effective is it? It is over 99% effective. The lifetime failure rate is 1 in 2,000 How it works 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' Advantages It is permanent Minor operation takes 10-15 minutes and can be done at a doctor's surgery or clinic. Once the vasectomy has worked, you don't have to think about contraception Disadvantages It usually takes a few months for all the sperm to disappear from the semen Contraception must be used during this time until there are two negative semen tests (no sperm seen) Rarely the tubes rejoin and the man is fertile again Comments This is a permanent method and should not be chosen if in any doubt Counselling is important Likely to be bruising, swelling and some discomfort or pain for a short time after the operation Rest for 24-36 hours and avoid strenuous exercise for at least a week

CONTRACEPTIVE INJECTION How effective is it? It is over 99% effective. This means that less than I woman in 100 will get pregnant in a year How it works An injection releases the hormone progestogen very slowly into the body This stops a woman from releasing an egg (ovulation) and thickens cervical mucus to prevent sperm meeting an egg Advantages An injection lasts for 12 weeks (Depo-Provera) or 8 weeks (Noristerat) May protect against cancer of the womb Some protection from pelvic inflammatory disease 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 Other possible side-effects include headaches, acne, tender breasts, mood swings and bloating Comments The injection works for either 12 or 8 weeks. It cannot be removed from the body so any side-effects may continue during this time and for some time afterwards

IMPLANT How effective is it? It is over 99% effective. This means that less than I woman in 100 will get pregnant in a year How it works Small flexible tube(s) are placed under the skin of the inner upper arm. They steadily release a progestogen hormone into the bloodstream to stop ovulation and prevent the sperm and egg meeting Advantages Single tube works for three years, others work for up to five 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 implant works Disadvantages Periods are often irregular for at least the first year; with some bleeding in between, or may be missed Some women gain weight May be temporary side-effects such as headaches, mood changes and breast tenderness Comments Implant is usually put in under a 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 beneath the skin. but it can't be seen Removal is sometimes difficult

INTRAUTERINE DEVICE (IUD) How effective is it? It is 98% to over 99% effective depending on the type of IUD, This means that less than I to 2 women in 100 will get pregnant in a year How it works 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 Advantages Works as soon as it is put in Can stay in 3 to 10 years depending on type, 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 already have heavy and painful periods Not suitable for women at risk of getting a sexually transmitted infection Comments If fitted after the age of 40 can stay in until the menopause Women are taught to check the IUD is in place by feeling the threads high in their vagina

INTRAUTERINE SYSTEM (IUS) How effective is it? It is over 99% effective. This means that less than 1 woman in 100 will get pregnant in a year How it works A small plastic device which releases the hormone progestogen is put into the womb. It stops sperm meeting an egg or stops an egg settling in the womb Advantages Works as soon as it is put in Works for five years but can be taken out at any time Periods will be much lighter and shorter You don't have to think about contraception for as long as the IUS works Disadvantages Irregular light bleeding is common for the first three months or so May be temporary side-effects such as breast tenderness and acne Comments Women are taught to check the IUS is in place by feeling the threads high in their vagina It can be useful for women with very heavy painful periods

Source: Family Planning Association

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