Contraception

The perfect contraceptive to suit everyone does not exist - if it did it would be 100% effective and easily reversible; easy to use; have no side effects or health risks; able to prevent the spread of sexually transmitted infections; not disrupt sex and not involve the need to consult a professional to obtain it!!!!

Although the above is not available there are methods or combinations of methods that come very close. Contraception has been around for hundreds of years and new improved methods are being developed all the time:

  • The oral contraceptive pill is a popular choice for most women and is available in two forms: Combined oral contraceptive pill – Over 99% effective when taken correctly, provides the benefit of cycle control and relief of some problems associated with menstruation. With careful assessment and monitoring it is safe for the majority of women to use and serious problems linked to this pill are rare. Progestogen only contraceptive pill – 99% effective when taken correctly, beneficial for women who may not be able to take combined oral contraception i.e. due to health factors or breastfeeding women. It is safe for the majority of women to use and serious problems linked to this pill are extremely rare. However the oral contraceptive pill offers no protection against sexually transmitted infections.
  • Depo Provera is a hormonal injection that is given every twelve weeks and over 99% effective. Whilst having the benefit of being long lasting and reducing some premenstrual symptoms, this method can cause some undesirable changes to bleeding patterns.
  • Implanon is a small flexible implant that is put just under the skin in the arm and lasts for three years; it is over 99% effective. Whilst being long lasting and easily reversible, this method can cause some undesirable changes to bleeding patterns.
  • Intrauterine contraceptive devices (IUCD), these are often referred to as coils, and are small devices that are inserted into the uterus. These methods are over 99% effective. There are two types of IUCD: An intrauterine device(IUD) consisting of plastic and copper which can stay in place for 5 – 10 years depending on the type inserted, this method may cause periods to be slightly longer and more uncomfortable. An intrauterine system (IUS) is a small plastic device which slowly releases the hormone progestogen and lasts for up to 5 years. Periods usually become lighter, shorter and less painful however this method can cause some undesirable changes to bleeding patterns. A health professional is involved in making a medical assessment to ensure these methods are suitable. These methods offer no protection against sexually transmitted infections.
  • Sterilisation is a permanent, highly effective method. It can be carried out on men under local anaesthetic at the surgery / clinic - this is called a vasectomy. Women need to be admitted to hospital and may have to stay overnight. These methods offer no protection against sexually transmitted infections.
  • Natural methods are when women monitor and record certain signs of the fertile time in their cycle and avoid intercourse to prevent a pregnancy. This is a complex method and couples need expert help to use it successfully and at least 3 – 6 months to learn effectively. Again no protection against sexually transmitted infections.
  • Devices (caps and diaphragms) can be placed by the user to cover the cervix and prevent sperm from going into the uterus. This method is 92-96% effective if used correctly. It is used in conjunction with special creams, foams or pessaries that contain spermicides; whilst there are no serious health risks associated with this method, it can take some time to use effectively, interrupt sex and be a little messy.
  • Condoms – Use of condoms is the best way to reduce the risk of sexually transmitted infections as well as being 98% effective in preventing pregnancy. The most popular are male condoms. There are also female condoms. Condoms come in all sorts of shapes and sizes and most men can find one that is comfortable.

Ideally a combination of condom use in conjunction with another method, will bring us nearer to the ideal contraceptive – highly effective in preventing pregnancy and reducing the transmission of sexually transmitted infections!!!

If you do have unprotected sex there are two methods of emergency contraception that will drastically reduce the risk of pregnancy:

Levonelle – commonly referred to as the ‘morning after pill’ available from all community contraceptive clinics, young peoples clinics. Also available from your own GP and many chemists will provide this free of charge. Very safe to take and very effective if taken soon after sex (ideally within 24 hours but can be taken up to 72 hours). Some accident and emergency departments may issue it too but you should only attend there if you are really unable to attend elsewhere.

If you choose you can opt to have an emergency IUD (copper coil) fitted, this is the most effective form of emergency contraception. It can be fitted outside the limit of 72hours but you will need to visit a contraceptive clinic or your GP to discuss this.

For further information about services in your locality see the services section.