There are a number of different types of contraceptives which allow you to enjoy sex whilst reducing the risk of getting pregnant, however not all will protect you from the risk of contracting sexually transmitted infections.
You can differentiate between the different types based on how they work: Barrier methods (e.g. condoms or a cervical cap), hormonal methods (e.g the pill), intrauterine devices (IUD) and emergency contraception.
Hormonal Contraceptive Methods
- The Pill
The pill is one of the most commonly used forms of contraception and there are different types, which contain artificial versions of female hormones oestrogen and/or progesterone. The pill may also be prescribed if you have heavy or painful periods, sever PMS or Endometriosis.
The usual way to take the pill is to take one every day for 21 days and then stop for seven days before commencing again. During the time when you’re not taking the pill, you’ll have a period-type bleed.
The pill, like all hormonal contraceptives, does not protect from sexually transmitted infections.
- The Implant
This is another form of contraception that offers long term protection and lasts up to three years on average.
The contraceptive implant contains progestin (progesterone), which is released into the body at a steady, slow pace for three years, producing the same effects as the pill.
The implant is inserted in the arm by a healthcare specialist and must be removed after three years. Since the risk of human mistake is ruled out, the implant has a much higher effectiveness rate than the pill – around 99.99%.
- The Contraceptive Patch
The contraceptive patch is exactly the same thing as the contraceptive pill but in the form of a patch. It provides the same effective protection against pregnancy and has similar side effects (positive and negative). It does not protect from STIs.
You wear the patch for three weeks, take it off for one week – allowing for your menstrual cycle – and then start with a new patch. The patch is a good option as once applied, you don’t need to remember to ‘take it’ for another 4 weeks.
There is however a risk of skin irritation, and a (rare) chance of the patch accidentally coming off.
- Contraceptive Injection
One shot of hormones lasts in the body for 8 to 12 weeks (3 months) and has the same effect as the pill.
Injectable contraceptives are about 99% effective, with pregnancy occurring mostly with women who forgot to renew their contraceptive shot in time (i.e. past weeks 11 to 12). Obviously, once the shot is given it cannot be reversed, so you are effectively infertile for the next three months.
Just like the contraceptive pill, contraceptive injections do not protect from STIs.
- The Vaginal Ring
The vaginal contraceptive ring is a small, transparent plastic ring that is inserted in the vagina and kept for three weeks. It is then removed during menstruation and replaced with a new one.
The ring contains the same hormones as the contraceptive pill (progesterone and oestrogen), therefore providing the same kind of effective protection and side effects. You’ll need a doctor’s prescription to buy the ring.
Just like other hormonal contraceptives, the vaginal ring does not protect from STIs.
Barrier Contraceptive Methods:
- The Male Condom
The male condom is one of the most common contraceptive method. It is easy to use, affordable and offers the best protection against STIs (e.g. gonorrhoea, chlamydia, HIV)
- The Female Condom
Just like the male condom, the female condom is one of the few types of contraceptives that you can buy without a prescription. It offers 95% effective protection for pregnancy, as well as some protection against STIs. Female condoms can be inserted up to eight hours before sex.
- The Diaphragm
The Diaphragm is another barrier contraceptive and is placed inside the vagina in order to prevent the sperm from getting into the uterus. However, this type of contraceptive doesn’t protect against STIs.
Unlike the Male and Female Condom, you need a prescription to get a Diaphragm as a doctor needs to show you how to use one. The Diaphragm needs to be coated with spermicide each time before sex and inserted at least 6 hours before sex.
- The Cervical Cap – Femcap
It’s a small device made of soft latex rubber that fits over your cervix and is held in place by suction so that sperm cannot enter the uterus.
Cervical caps come in different sizes and must be fitted by a clinician. It must be left in place for at least 6 hours after the last act of intercourse but no longer than a total of 24 hours. It’s worth noting that the effectiveness of this method ranges from 84% to 91% for women who have not had children, and 68% to 74% for those who have.
Sterilisation can be done for both men and women. Sterilisation for men is called a vasectomy and sterilisation for women is called a tubal ligation.
For women, sterilisation is performed by cutting, clamping or tying the tubes leading from the ovaries to the uterus. These tubes are known as the fallopian tubes. It is a surgical procedure usually performed in a hospital, using a general anaesthetic.
Tubal ligation is 99.5% effective immediately. However, it is important to note that, this contraceptive method is permanent.
Also, it does not offer protection from sexually transmitted infections.
Spermicides contain the sperm-killing chemical nonoxynol-9 and work by setting up a chemical block at the entrance to the uterus. Here, sperm are trapped by the foam or gel barrier and destroyed by the chemical.
Vaginal spermicides used alone are about 78% effective, however they may cause irritation to the vagina or penis and contribute to yeast and urinary tract infections.
- The Sponge
The sponge is a small, round-shaped foam (polyurethane) placed deep inside the vagina. It contains spermicide so that sperm does not get past the foam. You should leave the sponge inside the vagina for at least six hours after sex, but remove it within 24 hours following sexual intercourse (to lessen the risk of toxic shock).
The Intrauterine Device (IUD)
- Hormonal or Copper IUD
Hormonal and copper IUDs are both long-term solutions, meaning that you can keep them inside the vagina for up to five or ten years respectively.
Note that IUDs can be a form of emergency contraception if the device is inserted within 5 days after unprotected sex, however they provide no protection against STIs.
- Morning after pill
Emergency contraceptives exist to stop you getting pregnant if you have had unprotected sex.
This method is for one-off occasions and is not recommended for daily use. It is particularly useful if a condom broke or if you missed one of your contraceptive pills.
It is worth noting that there is no such thing as a contraceptive method that offers 100% protection against pregnancy or STIs. As such it is incredibly important to look at effectiveness rates for all the different methods and take these into account.
On average, hormonal contraceptive methods (e.g. the pill) are over 95% effective or more, and the condom is about 99% effective, although other barrier methods such as the diaphragm offer a protection rate between 80% to 95%.
Facts and Myths about contraceptive methods:
- Using a condom is the only way to prevent STDs
Yes: As mentioned above, Condoms, both male and female block the exchange of bodily fluids, meaning they are the most effective way of preventing the spread of STDs such as Genital herpes, Chlamydia, Gonorrhoea, and HIV.
It is worth noting however that some of diseases, like herpes, HPV, and syphilis, can also spread with skin to skin contact with infected areas, including parts of the genitalia not covered by the condom.
- Hormonal contraceptive makes periods longer and more painful
Yes and No: Properly selected hormonal contraceptive (pills, patches, injections, vaginal rings, intrauterine devices with hormonal components) can have a beneficial effect on the menstrual flow. However, if not carefully selected they can also have negative side effects such as depression, weight gain, migraines and so on.
- You can get pregnant at any day of your cycle after unprotected sex
Yes: You can only get pregnant during the ovulation period. However, this time varies from different women and well as from cycle to cycle. There can be a number of things impacting when a woman ovulates (sickness, stress, travelling, lifestyle changes and even for no apparent reasons)
- Spotting may happen in the first months of using any hormonal contraceptive methods and this does not indicate a problem
Yes: when you start using any form of contraceptive, your body needs to get used to a new dose of hormones. This can cause vaginal discharge, which doesn’t indicate pathology. The absence of any discharge is also perfectly normal.
- You need anaesthesia for intrauterine device insertion
Yes and No: Can be done with or without anaesthesia. And is inserted during menstruation when the cervix is slightly open. The procedure takes several minutes. The pain threshold varies for each woman Some find the procedure unpleasant and others don’t.
- Birth control pill makes you gain weight
Yes and No: This is subjective to the individual. Not all women experience this side effect, but some do. As a rule, hormonal contraceptive options should be carefully selected by a doctor. If you are experiencing weight gain of other side effect, you should contact your doctor.
Male Contraceptive Methods
Male forms of birth control are still in the research phase. However the most promising forms are a pill, a gel and a nonsurgical vasectomy, with a new gel entering the trial stage.
The transparent gel is applied to the upper arm and shoulder area every day and is absorbed through the skin, eventually reaching the pituitary gland and blocking the production of sperm. The effects of the gel are reversible with discontinued use, however, they have been shown to cause side effects of acne and weight gain in a small portion of men.
You can read more about this new trial here.
For more information on contraceptive methods and which one is best for you, contact your GP.