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A Guide to Contraception

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LSU CASH’s Workshop Coordinator and volunteer writer, Megan McKone, gives a guide of all of the different types of contraception available.

Contraception in the UK is free for those that want it. Contraception is the use of methods to deliberately prevent pregnancy. Contraceptives can be hormonal or not and come in a variety of shapes and sizes, not all types of contraception will work for you and that is okay, there will be a suitable contraception for you; what may suit your friend may not suit you and that is okay – you can try different methods of contraception to decide which you prefer, one size does not fit all. Not all people choose to use contraception and that is their decision but if you do want to learn about different types of contraception to help you make an informed decision or if you are just curious then this guide is for you! Small disclaimer: I am not a medical professional so please consult a doctor when deciding which contraceptive methods, you may want to try. 

It is important to note that not all those who take contraception take it to prevent pregnancy, contraception can improve regularity and can ease some symptoms such as acne or pain. You and your partner should be on the same page about contraception, if you consent to sex with contraception and you or your partner deliberately remove, lie about, or take away their contraception without both party’s knowledge and consent then the sex is no longer consensual. For example, an individual may consent to sex with a condom, the condom-wearer removing their condom without informing the other party makes the sex non-consensual. 

Generally, contraception prevents pregnancy, not STIs. Only condoms can protect against STIs. Condoms are 98% effective against pregnancy so for every 100 people 2 of them will become pregnant in one year. For this reason, you may want to use other methods of contraception such as the pill in addition to using a condom to prevent pregnancy. 

Sterilisation, whether that be female or male sterilisation, is the only permanent method of contraception. The rest of the contraceptives in this guide will prevent pregnancy only while the contraceptive is being used. 

Not everyone wants hormonal contraception, so I have included in brackets whether the contraceptive method is hormonal to assist you in your contraceptive journey. 

The Pill (Hormonal)

There are two main types of pill – the combined pill and the progesterone-only pill. The pill is often associated with side effects such as mood swings and changes in acne, however, after a few months, these side effects generally lessen. To learn more about the pill please see my guide to the pill via CASH x Label. 

Condoms (Non-Hormonal)

Condoms are traditionally worn by those with a penis, but female condoms do exist. Condoms protect against STIs as well as pregnancy, if the condom is used correctly. Using the wrong sized condom, multiple condoms at once or an oil-based lube with a latex condom can cause the condom to break. To learn more about condoms, some condom myths, what to do if they break etc, please see my guide to protection under CASH x Label or via this link. Do not try to use male and female condoms at the same time. 

Contraceptive Implant (Hormonal)

The contraceptive implant is one of the most common non-pill contraceptives, it is a small flexible rod that is inserted into the upper arm by a nurse or doctor. The implant releases progesterone into the bloodstream, it is effective for three years before it must be removed. Once inserted you will be able to feel the implant in your upper arm. The contraceptive is more than 99% effective and one of the main benefits of it is that once the implant is in you do not need to consider contraception for the next three years, again only condoms can protect against STIs so be mindful if you do decide to have unprotected sex. Oestrogen is not always suitable for everyone, so the implant is a good alternative for people who do not get on with oestrogen. It is possible to remove the implant early if there are too many uncomfortable side effects or if you would like to get pregnant. There may be some bruising and/or swelling at the insert site after it is first put in and when it is taken out. The contraceptive implant can stop periods (only while using the implant and perhaps shortly after as your body returns to what is normal for you), this could be a good thing for some, but others may not want their periods to completely disappear. Amenorrhea (the stopping of periods) is a common side effect; the implant can often be effective for those with heavy periods as the implant often lightens periods. However, for some women, their periods may even become heavier, longer, or more irregular as your body adjusts. The implant can be inserted at any point in the menstrual cycle, if it is inserted within the first five days of the cycle then protection against pregnancy is immediate. If the implant is inserted at any other point in the menstrual cycle, then additional protection such as condoms is needed for seven days. One of the main advantages of the implant is that it does not interrupt sex, some methods of contraception may be felt during sex, and nor do you have to remember to take contraception every day as you would the pill. 

When should I consult my doctor if I think there is something wrong?

If you cannot feel your implant, become pregnant, notice any pain or changes to the skin where the implant sits or if you feel as if the shape of the implant has altered then it is important to consult a doctor. 

Contraceptive Injection (Hormonal)

This method of contraception involved injecting progesterone into the bloodstream, there are different types of injections, but this method of contraception usually lasts about 13 weeks. This means that repeat injections are necessary otherwise the contraceptive will no longer be effective. There are some possible side effects associated with the injections such as headaches, weight gain and mood swings, additionally periods may become irregular, they could become lighter, heavier, shorter or stop completely. Unlike most of the other contraceptives, it can take a year before fertility is restored to normal so those who may want to have a baby shortly after coming off contraception may wish to consider an alternative method. As with the implant, the injection is immediately effective at preventing pregnancy if the injection is administered within the first five days, but if administered at any other point during the menstrual cycle then additional protection is required for seven days. The injection should not be administered for more than two years as some injections affect oestrogen levels which could potentially lead to the damaging of bone. 

Contraceptive Patch (Hormonal)

The contraceptive patch is exactly what it sounds like, it is a small patch that is stuck to the skin and hormones are released into the body to prevent pregnancy. If used effectively then the patch is more than 99% effective in preventing pregnancy. Each patch lasts one week, so every week the patch is changed for three weeks, the fourth week of the cycle does not require a patch. The contraceptive patch is still effective even during sickness and diarrhoea, it can be worn in the shower, bathing, swimming, and playing sports. The patch is not removed unless it is being replaced, taken off for the fourth week of the cycle or being removed for pregnancy purposes. The patch can be helpful for those who experience heavy or painful periods; however, the patch could cause side effects such as raised blood pressure or headaches. Some studies suggest that the patch can protect against ovarian, womb and bowel cancer. The patch can be placed anywhere on the body but areas that are sore or irritated should be avoided. The patch should not be stuck to your breasts. You can always change the position of the patch between patches. 

What if my patch comes off? 

The patch is incredibly sticky and is designed to stay on the body even in showers, baths, and saunas etc but if the patch does come off for less than 48 hours, the old patch can be stuck back on if it is still sticky. If it is not sticky, then a new patch can be put on but continue to change your patch on your normal patch day. If the patch came off after six days or less into the cycle, then additional protection such as condoms are required. If the patch comes off and it has been longer than 48 hours put on a new patch and start a new cycle, this will alter your normal patch day. You should use additional contraception for the following seven days. If you have had sex during this period, you may need emergency contraception. 

IUD (intrauterine device) (Non-Hormonal)

The IUD is one of the longest effecting contraceptives, it can last between five and ten years. You may hear the IUD being called the copper coil. The IUD is small, it has a tube made from plastic and has T shape, the copper device is inside this tube. The IUD is inserted into the womb by a medical professional. The IUD is more than 99% effective, it can be inserted at any point in the menstrual cycle if you are not pregnant. The coil must be taken out by a doctor or nurse, but it can be taken out at any time before it becomes ineffective. In the first six months, periods may be heavier and more painful, there may also be spotting or bleeding between periods. The IUD could move but this risk is small, the doctor/nurse will guide you on how to know if the IUD is still in place. The IUD releases copper into the womb, copper alters the cervical mucus like how progesterone does, the copper can prevent a fertilised egg from being able to implant itself on the uterus. Inserting the IUD can be painful but local anaesthetics are often provided, when fitted for an IUD you may also be tested for STIs. The IUD has two small threads which hang into the vagina, you should be able to feel these and this is how you check the IUD is in place, however, a partner may be able to feel these threads during sex. 

IUS (intrauterine system) (Hormonal)

The IUS is like the IUD, it is also a T shaped device made from plastic, that is inserted into the womb by a doctor or nurse, unlike the IUD, the IUS is hormonal. The IUS releases progesterone into the uterus thus preventing pregnancy. The IUS is not suitable for those who experience migraines. Unlike the IUD the device does not protect against pregnancy immediately, so additional contraception is needed for the following seven days unless the IUS is inserted during the first seven days of the menstrual cycle. A new cycle begins as a period arrives. The IUS is sometimes referred to as the Mirena coil. The coil also has two threads which hang down into the vagina. The IUS is effective for three to five years. The IUS may also cause some side effects such as headaches, acne, and changes in mood. Although it is uncommon the womb may reject the IUS, but the doctor/nurse will provide guidance on how to check if the IUS is still in place.

Vaginal Ring (Hormonal)

Vaginal rings are small rings of flexible plastic that are inserted into the vagina, they release oestrogen and progesterone into the bloodstream. The ring is inserted into the vagina and left for 21 days, it is then removed for 7 days and then a new ring is inserted. The ring is immediately effective if inserted on the first day of the cycle however on any other day of the cycle additional protection is needed for seven days. When the ring is used properly it is more than 99% effective and does not require you to think about contraception every day like you would with the pill. The ring is not affected by illness as with the pill. The ring can help to ease period pain and can lighten the bleeding. You can still have sex with the ring in the vagina, however, you or your partner may feel it during sex. If the ring comes out on its own, it can be washed with warm water and reinserted if the ring has not been out for more than three hours. If the ring has been out for more than three hours in the first or second week, rinse the ring and reinsert it, but use additional protection for seven days. If it has been out for more than three hours in the third week either put a new ring in or do not put another ring in and have a seven-day break. Inserting the ring is easy, with clean hands you would just squeeze the ring between your finger and thumb and insert the tip into the vagina. The ring cannot get lost in the vagina. To remove the ring, you would just hook your finger around it and pull the ring out, again using clean hands. A waste bag is provided, the ring should not be flushed down the toilet. 

Caps or Diaphragms (Non-Hormonal)

Diaphragms or caps are domes of thin silicone, the diaphragm is inserted into the vagina before sex, it must cover the cervix so it can prevent sperm from getting into the uterus to fertilise the egg. The cap or diaphragm may interrupt sex as sex has to be halted to fit the cap. Spermicide is a chemical substance that destroys sperm, it is used in conjunction with the cup or diaphragm. When they are both used, they are between 92 and 96% effective in stopping pregnancy. After sex, the cup must be left in for at least six hours. Using a diaphragm or cup could lead to a bladder infection, cups are also fitted to size so weight loss or gain of 3kg, having a baby, abortion or miscarriage will mean a new cup has to be fitted. Spermicide could also cause irritation, whether that be to you or your partner. Using the cup or diaphragm is a learning process. Spermicide needs to reapplied if the cup has been inside you for more than three hours or if you have had sex and are planning to do so again. Diaphragms or cups should not be used while experiencing a period. The diaphragm may not be effective if the cup is not the correct size, it is used without spermicide, it is removed too soon, or is damaged usually by oil-based products.

Fertility Awareness (Non-Hormonal)

Fertility awareness does not involve taking contraception but rather the individual would track and record fertility signals to work out when they will be likely to become pregnant, to prevent pregnancy they may choose to avoid sex during this period. There are many apps such as Clue which can help women track their cycles and symptoms. Fertility awareness is very effective when done correctly, it can be up to 99% effective but if natural planning is not carefully followed then individuals will be more likely to become pregnant. As there is no hormonal component involved there are no side effects, planning can begin immediately. However, this method involves regularly taking your temperature and recording/tracking the fluids coming from the cervix. Effective planning can usually begin after 6 menstrual cycles have been recorded. Fertility signals are not always accurate though and could be affected by stress or illness, it is important to keep this in mind. Those who wish to have sex when they are in the stage where they are most likely to become pregnant may wish to use condoms to prevent pregnancy. Fertility awareness can also help those wishing to become pregnant to become pregnant. 

There we have it! A comprehensive – but definitely not exhaustive – guide to contraception. 

For more information, please visit the NHS website. Another good source of information can also be found via the YouTube channel Hannah Witton, whose channel is based around sex education, she also has a book and Instagram account called the hormone diaries which discusses different methods of contraception and real people’s experiences with them. 

 

Consent and Sexual Health Association Socials:

Email: w&dcashcoordinator@lsu.co.uk

Instagram: @lsucash

Twitter: @lsucash

Facebook: @lsuconsent&sexualhealthcoordinator

 

Featured header image designed by Christos Alamaniotis.

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