Lifestyle

Better Living - Contraception

Introduction

When it comes to contraception it is important to choose a method that is right for you. This is most likely to change as you go through life. There are many effective methods of contraception to choose from. Your GP or Family Planning Clinic will help you to choose the right method, taking into account your age, whether you have had children, whether you smoke, any current illnesses and any medications you take.
There are a lot of myths around about contraception however we feel it is better to be for armed with the facts. These are the facts: A woman can still get pregnant:

if it is the first time she has sex
if she does not have an orgasm
if a man pulls out of her vagina before he comes
if she has sex when she has a period
if she is not fully breastfeeding
if she douches (squirts water into the vagina). This can be harmful to women
whatever position the couple has sex in

The pill

Description

The contraceptive pill or oral contraception is a common form of contraception for women. There are two main types:

The combined pill

Description

This is the most common type. It contains two hormones - oestrogen and progestogen - which prevent an egg from being released from a woman's ovary each month. The combined pill can reduce pre-menstrual syndrome (PMS) and period pain. There is evidence that it also offers some protection against cancer of the uterus and ovaries. You don't need to worry about any devices or spermicides and using the pill does not interfere with the spontaneity of sex.

Considerations

A full medical history is essential as this pill is not suitable for women who have certain conditions such as high blood pressure, circulatory disease or diabetes. Women over 35 who smoke or are very overweight would be advised to choose another method of contraception. There are several different types of pill so if one does not suit you then another might. The combined pill is not reliable if taken over 12 hours late or if you have vomiting and diarrhoea, when extra protection is required. Some drugs like antibiotics can also affect its reliability. Some women experience side effects such as nausea, headaches and weight gain. The pill offers no protection against sexually transmitted diseases/HIV/AIDS.

Availability

By prescription only from your GP, family planning clinic.

Effectiveness

99% if taken correctly.

Progesteron-only pill (Mini pill)

Description

Unlike the combined pill, this only contains the hormone progestogen. It works by thickening the cervical mucus, which acts as a barrier to stop sperm entering the womb. It also makes the lining of the womb thinner, to prevent it accepting a fertilised egg. This type of pill is good for women who are breast-feeding, older women, smokers and others who cannot use the combined pill. It can also help with pre-menstrual syndrome (PMS) and painful periods.

Considerations

It must be taken at the same time each day or at most within three hours of that time. It will not work if taken over three hours late or if you have vomiting and diarrhoea, in these cases extra protection is needed. It can cause irregular bleeding and periods may stop altogether while you are taking it. The pill offers no protection against sexually transmitted infections/HIV/AIDS.

Availability

By prescription only from your GP, family planning clinic.

Effectiveness

98% if taken correctly.

Female sterilisation

Description

Female sterilisation is the most popular form of contraception in the world. It is a safe, effective method of birth control for women who have completed their families or for those who do not wish to have children. Sterilisation works by sealing the fallopian tubes that carry eggs from the ovaries to the womb. Eggs are prevented from meeting sperm, so pregnancy cannot occur.

Considerations

It is a permanent method, so you should only use it if you either do not want children or have all the children they want. If you have any doubts you should choose a different method. Female sterilisation offers no protection against sexually transmitted infections/HIV/AIDS.

Availability

Some family planning clinics perform female sterilisations.

Effectiveness

Over 99%.

Vasectomy

Description

Vasectomy (male sterilisation) is the only permanent method of contraception for men - a safe, simple and effective solution recommended by family planning practitioners world-wide. Nearly one in five men of reproductive age in the UK has had a vasectomy. It is a minor surgical procedure to seal the tubes that carry sperm. This stops sperm getting into the ejaculated fluid. There are many fears and myths surrounding vasectomy but we can dispel two of those straight away:

it might hurt a bit
if it affects your sex life, it will be for the better!

Considerations

It is a permanent method, so you should only choose this method if you either do not want children or you have all the children you want. If you have any doubts about this, then vasectomy is not for you. Vasectomy offers no protection against sexually transmitted infections/HIV/AIDS.

Availability

Some GP's and family planning clinics perform vasectomies.

Effectiveness

Over 99%.

The Male condom

Description

This is a thin latex or plastic sheath placed over a man's erect penis during sex to trap sperm at the point of ejaculation. It must be put on the penis as soon as it becomes erect and before any contact takes place with the vagina. Men should withdraw as soon as they have ejaculated and take care not to spill any semen. Condoms must be used with care as they can slip off or split. They should never be used with oil-based products such as petroleum jelly or baby oil as these will damage the rubber.

Advantages

Easily available; offers protection against sexually transmitted infections including HIV/AIDS.

Considerations

Can reduce spontaneity.

Availability

Pharmacies, supermarkets, vending machines. Free from family planning clinics.

Effectiveness

94%-98% depending on correct use. Only use condoms with the BSI or CE kitemark on the packet. Also check use by dates.

Female condom - (Femidom)

Description

This is a thin polyurethane sheath placed inside the vagina (also covering the cervix and the area outside) to stop sperm from entering. It can be put in at any time before sex and is actually stronger than the male condom. You need to be sure that the penis enters the condom and is not inserted between the condom and the vaginal wall.

Advantages

Offers protection against sexually transmitted infections, including HIV/AIDS.

Considerations

Can reduce spontaneity.

Availability

Pharmacies. Free from family planning clinics.

Effectiveness

95% if used correctly.

Diaphragm/cap

Description

The diaphragm or cap is a dome of rubber, which is fitted by the woman over her cervix before sex. It acts as a barrier to stop sperm getting through to the uterus. It should be used with a spermicidal cream, jelly or pessaries that contain a chemical that kills sperm. A doctor or nurse will need to fit a diaphragm initially to check what size you need and to teach you how to use it. Like condoms, you only use it when you are sexually active. It may protect against cancer of the cervix. The diaphragm must stay in place for six hours after sex. More spermicide must be inserted if you have sex again within six hours.

Considerations

Offers no protection against sexually transmitted infections and HIV/AIDS. Spermicides may cause irritation or an allergic reaction.

Availability

GPs, family planning clinics.

Effectiveness

92%-96% if used correctly.

Contraceptive injections

Description

This is an injection of hormones that provides a longer-acting alternative to the pill. It works by slowly releasing the hormone progestogen into the body to stop ovulation. Each injection lasts for 8-12 weeks. Injections may reduce heavy or painful periods and may give some protection against cancer of the uterus.

Considerations

Periods can become irregular or stop altogether. It can take over a year for fertility to return to normal after stopping contraceptive injections, so if you are planning to start a family in the near future, it may not be suitable. It is important to remember to attend your appointments on time every 8-12 weeks; otherwise contraceptive cover can stop. Injections do not offer protection against sexually transmitted infections or HIV/AIDS.

Availability

GP, family planning clinics.

Effectiveness

99%.

Contraceptive implants

Description

This is a small stick containing the hormone progestogen, which is inserted under the skin in the arm. The hormone is slowly released into the body, preventing eggs from being released, and sperm from reaching an egg or an egg settling in the womb. Implants are a good method for women who want a long-term contraceptive, as each implant lasts for three years.

Considerations

Periods can become irregular or stop altogether. Implants do not offer protection against sexually transmitted infections or HIV/AIDS.

Availability

GP, family planning clinics.

Effectiveness

99%.

Emergency contraception

This is contraception that can be used after unprotected sex - whether you haven't used any contraception at all or whether your normal contraception has failed (a split condom, missed pill etc).
It shouldn't be seen as a regular method of contraception - it is much better to use a reliable method every time you have sex and to be aware of the other risks carried by unprotected sex, such as sexually transmitted infections and HIV/AIDS.

There are two methods of emergency contraception:

Up to three days - emergency contraceptive pill

Description

Also known (incorrectly) as the 'morning after pill', it must be taken within 72 hours of unprotected sex. Women must take two pills: one as soon as possible after unprotected sex, the second 12 hours after the first. The pills work by stopping an egg from being released, stopping the sperm from reaching an egg, or preventing a fertilised egg from settling in your womb. New types of emergency contraceptive pill should not cause nausea like previous types. However, if you do vomit within two hours of taking the first pill, you should take the second immediately and contact your doctor or pharmacy for another pill. Some women also experience a change in their menstrual pattern or some irregular bleeding or spotting.

Availability

Free from GPs, family planning clinics, around £20 from some pharmacies.

Effectiveness

95% within 24 hours after unprotected sex, 85% within 25-48 hours.

Up to five days: intrauterine device (IUD) (Coil)

Description

If you have left it too late for the emergency contraceptive pill then you can still have an IUD, also known as a Coil, fitted up to five days after unprotected sex, to prevent pregnancy occurring.
The IUD works by stopping an egg from being fertilised or implanted in your womb and can be left in as a form of regular contraception or removed after a normal period.

Availability

Free from GPs and family planning clinics

Effectiveness

98%-99%.

Summary

There are many different contraceptive choices available to both men and women today. Several factors could affect the contraception you decide to use, the status of your relationship, health, whether or not you smoke, or even if you want to start a family soon. It is worthwhile remembering that some of the methods we've mentioned may stop a pregnancy but will however offer no protection against sexually transmitted diseases. Do spend some time thinking about the options available to you, discuss it with your partner if you have one, and probably most important - make your sexual experience a happy and safe one!

Additional Information

The following websites offer essential reading on contraception and sexual health in general, if you have any queries that we haven't addressed here, they are worth a look. If you prefer to speak to someone face to face, you can go to your GP or pop along to your local Family Planning clinic.