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Contraception

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  A strip of tablets on a red background.

 

What is contraception?

Contraception or birth control is an artificial method or device used to prevent a woman from getting pregnant. A woman can become pregnant if a man’s sperm reaches one of her eggs, contraception keeps the sperm and the eggs apart or stops egg production to prevent pregnancy from happening.  In the UK there are currently 15 methods of contraception to choose between and is free.

Unplanned pregnancies are very common and there may be many reasons you do not want a baby, such as age, you have just had a baby and want to wait before having another, you feel your family is complete and don’t want anymore babies or you have just had an abortion.

What types of contraception are available?

Contraception types are broken down into five groups these are as follows:

Hormonal birth control – these methods interfere with a woman’s hormones to prevent ovulation occurring. These methods include birth control pills, patches and injections. The different types available are as follows:

  • Progestogen only pill – as the title suggests this contains just the one hormone progestogen. For more detailed information on this click here.
  • Combined oral contraceptive pill – this pill combines the 2 female hormones progestogen and oestrogen. For more detailed information on this click here.
  • Contraceptive patch – this contains the same hormones as the combined pill but is in patch form. The patch is stuck on the skin so that the two hormones are continuously released to the body. The advantage of the patch is that you do not have to remember to take a pill every day. Your periods should become lighter and unlike the pill if you have sickness or diarrhoea the patch is still effective. The disadvantages of the patch are that some women experience skin irritation and despite the discreet design some women are conscious that it can be seen. The patch can also come off and then its not as effective. The patch also has the same risk of blood clots as the pill.
  • Contraceptive vaginal ring – like the patch and the pill the ring also contains both hormones. The ring is a flexible see through ring just over 5cm in diameter. The ring sits in your vagina for 3 weeks then you have 1 week without. After the week you put a new ring into your vagina. The ring is effective and easy to use and again means you do not have to remember to take a pill each day. Like the patch if you have sickness or diarrhoea the ring is still effective. The disadvantages of the ring are that some women and their partners say they can feel it during sexual intercourse. It may also cause irritation to your vagina causing soreness or discharge. The risks of blood clots are the same as that of the pill.
  • Contraceptive injection – these are not commonly used in the UK it is an injection containing a hormone similar to progesterone that stops you ovulating. The injection lasts for about 2-3 months. The disadvantage is that once you have had the injection you cannot reverse it so you have to be certain it is what you want.
  • Contraceptive implant – a small flexible rod is inserted under the skin of the upper arm. This is a long acting form of contraception that releaes progesterone steadily into the bloodstream. The implant lasts for 3 years though it can be removed and fertility will return to normal as soon as it is removed. The implant can’t be seen in the arm but you will be able to feel it.

Barrier methods – these methods work by preventing the sperm from entering the uterus and reaching the egg. These methods include condoms (female and male), diaphragm and cervical cap. The advantages of barrier methods is they do not have any serious medical risks or side effects and they provide protection from sexually transmitted diseases. However, they are not always as effective as other methods and need to be used properly every time you have sex. Male condoms are made of thin latex and are put over the penis to prevent sperm entering the vagina. The disadvantages are some people can be allergic to latex and condoms can tear or come off and they can make sex less spontaneous.

The female condom fits inside the vagina to prevent sperm from entering. The female condom is not widely available and can be pushed inside the vagina, like a male condom it can tear if not used correctly.

A diaphragm or contraceptive cap is a soft dome made of latex or silicone that is inserted into the vagina to cover the cervix. It can be put in  any time before sex and then removed at least 6 hours afterwards but shouldn’t be left in for more than 30 hours. You will need to use a spermicide with it to kill sperm. It can take some women awhile to learn how to use it correctly.

Intrauterine devices (IUD)-  commonly called the coil, these are hormone free devices that are inserted into the uterus where they can stay implanted for 1-10 years. An IUD prevents the fertilised egg from implanting in the uterus and alters the cervical mucus. When an IUD is removed fertility will return to normal. An IUD can make periods heavier.

Sterilisation – this should be considered a permanent option and is usually the method used when you feel your family is complete or you are certain you never want children. In men a procedure called a vasectomy is carried out. A vasectomy is when the tubes that carry sperm into semen are cut, sealed or tied. In a woman a minor operation is carried out to cut or seal the fallopian tubes.

Natural methods – this involves the practise of fertility awareness, you track your monthly cycle and so know the times when to avoid sexual intercourse. This method is cheap and helps you become aware of your body, so helping you when you do decide to have a baby. The disadvantages are it takes very careful planning and you have to be prepared to avoid sexual intercourse at certain times every month or use barrier methods during this period. This method is not as reliable and as many as 25 women in 100 can become pregnant during this method. If your cycles are irregular this method is very unreliable.

What type of contraception is right for me?

With 15 choices available you will be able to find one that suits you best and during different stages of your life the method you choose may change. The method you choose is a personal decision and can depend on you health, sexual activity, family history and if you want children in the future.

It is important to remember that you will always need to use condoms to avoid contracting sexually transmitted diseases (STD’s). Condoms are the only form of contraception that are effective in preventing sexually transmitted diseases. Unfortunately no form of contraception offers 100% reliability. However, when used correctly failure rates are very low. The reliability of each method is given as a percentage, for example 99%, this means that out of  100 women 1 will become pregnant each year.

Where can I get contraception from?

In the UK contraception services are free and confidential. If you are aged under 16 then it is not legal to have sex however, the service is still available but there are strict guidelines the healthcare professionals have to follow. They will not tell your parents or carer though they will encourage you to tell your parents. The doctor or nurse will need to ensure you fully understand the information you have been given. If they believe you are at risk of abuse then they might tell someone however, this is usually discussed with you first.

Contraception is available from the following places:

  • Doctors surgery
  • Contraception clinics
  • GUM (Genitourinary medicine) clinics – These clinics also
  • Sexual health clinics
  • Young peoples services
  • Online pharmacy’s – You will need to answer a few questions online and this method is not free. The advantage is no doctors appointment is required and its quick and easy.

Most of these clinics will also offer information, guidance and sexual health tests and treatment if necessary. To find your nearest clinic click here to visit the NHS wesbite.

What are the risks for the different forms of contraception?

Most types of contraception have risks or side effects. Knowing all the risks might help you make a decision on the right form of contraception for you. Hormonal methods can cause changes in your monthly cycle and changes in your hormones. Other side effects can include weight gain, acne or headaches. Sterilisation can carry risks such as those associated with any form of surgery.