Despite the fact that we tend to teach young people that sex is about reproduction the main reason humans actually have sex is for pleasure. For most people sex for reproduction purposes will be something they do on a number of limited occasions throughout their life and for some people it will be something they never ever do. Clearly the key to worry free pleasurable sex is reducing the risks such as contracting sexually transmitted infections and/or pregnancy and that is where good contraception comes in.
Your contraception needs will change throughout your life, someone in their late teens or twenties will probably have different needs to someone in their 30’s or 40’s. The type of relationship(s) that someone is in and where they are in terms of having children will be just two of the big factors that will affect the type of contraception that they might choose.
So let’s talk about some of the different types of contraception
Both caps and diaphragms are inserted into the vagina, along with spermicide, prior to sex. They work by covering the cervix and creating a barrier so that sperm can’t get into the womb. When used correctly they are 92 – 96% effective. The upside of a cap or diaphragm is that they only need to be inserted when you want to have sex and there are no serious health risks or side affects associated with them but clearly one of the major downsides is that they are not conducive to spontaneous sex. They can also take a bit of time to learn how to insert them and they don’t give any protection against contracting STI’s.
Male condoms are worn over the penis and create a barrier preventing the sperm from reaching the womb. When used correctly they are 98% effective and they are the ONLY form of contraception that also protects against STI’s.
Female condoms work in the same way as male condoms in that they create a barrier preventing sperm from reaching the womb but instead of being worn over the penis it is inserted inside the vagina. When used correctly they are 95% effective and can help prevent the transmission of many STI’s including HIV.
There are two types of contraceptive pill, the Combined Pill and the Progestogen only Pill. They work in slightly different ways but both use hormones to disrupt the female reproduction cycle in some way. If taken regularly they are both 99% effective in preventing pregnancy. The pill is a very convenient method of contraception but there are some medical reasons why some women just can’t use it and there are also some side effects to both types that should be considered.
The implant is a small flexible tube that is inserted by a doctor or nurse underneath the skin in the upper arm and releases a small amount of progestogen which inhibits the body from releasing an egg from the ovary(s). Unlike the pill it is not reliant on the person remembering to take it and so once inserted has a 99% effective rate. It lasts for 3 years but like all hormone based methods it plus and minus’ that need to be considered.
In the UK there are different types of contraceptive injection available and depending on which one you have they last somewhere between 8 and 13 weeks. Like many of the other hormone methods they use progestogen and are 99% effective. However they also share many of the side effects of those methods too and you have to go back every 8 – 13 weeks to have another shot.
The patch is a bit like a nicotine patch that sticks to you and releases the hormones directly into your body through your skin. Each patch lasts for a week, you then replace it with another one for 3 weeks in a row and then you take one week off. The patch is very easy to use but does rely on you remembering when to change it. It is 99% effective when used correctly.
The Vaginal ring is a small, soft, plastic ring that you insert into your vagina and leave there for 21 days. You then remove it and throw it in the bin. 7 days later you insert a new ring. It works by releasing small doses of a combined hormone mix and if used correctly is 99% effective.
The intrauterine system is a small plastic device that is inserted into your uterus by a medical professional. It releases a small dose of hormone directly into your womb and is 99% effective. It stays in place for 3 to 5 years depending on which one you have. It is an increasingly popular form of long term contraception for women.
Like the IUS the Intrauterine device is a small plastic and copper device that is inserted into your uterus by a medical professional. Unlike the IUS it does not release hormones but a small dose of copper which changes the make-up of the fluid which inhibits the survival of the sperm and also stops the egg from implanting. There are various different types of IUD available and depending on which one you pick they last between 5 and 10 years.
Natural Family Planning
This is also known as fertility awareness and involves monitoring various factors to determine when your most fertile time of the month is so that you can avoid sexual intercourse during that period. If done correctly it can be 99% effective but due to the imprecise nature of it and the chances for human error the effect rate is probably more like 75%. Clearly, the up side is there are no side effects to this system but the down side is that it is quite labour intensive and can 3 – 6 months to begin to develop a pattern that you rely on.
This involves a surgical procedure that seals or blocks the fallopian tubes therefore preventing eggs from reaching the womb and being fertilised. It is 99% effective and you will never need to worry about contraception again however it does involved having surgery that always comes with a risk and it should also be viewed as permanent and so you need to be absolutely sure that it is the right decision for you.
Male Sterilisation involves a small procedure that is done under a local anaesthetic where the tube that carries sperm from the testicles to the penis is cut, blocked or sealed. The whole thing takes about 15 minutes and is 99% effective. It is a much easier and less invasive procedure than female sterilisation. For someone who has finished having their family or does not ever want one, it is an ideal long term solution.
How do I pick?
Clearly, that is the key question and the answer is that you should really go and get advice from a professional. What you decide to use will very much depend not just on your current need for contraception but also your age, health, family history and where you are in regards to having or not children. All of the options come with advantages and disadvantages which need to be considered and not all the options will suit everyone so getting good professional advice is the key to helping you decide what it best for you.
If you are in the UK then your nearest GP should be able to help you. When you make an appointment tell them what it is for as they often have dedicated clinics or specific doctors that deal with contraception. There is also a comprehensive guide to all these types of contraception on the NHS website.
However, there are also other organisations you can turn to for help and advice such as
and in the USA