Types of contraception
Contraceptives are essential if you want to avoid pregnancy, but they can also help improve your health and wellbeing. In fact, many women use contraceptives for other reasons besides preventing pregnancy. For example the combined pill can alleviate endometriosis symptoms, and the intrauterine device can provide 5-10 years of contraception for oestrogen-sensitive women.
Here's a list of currently available contraception in the UK:
- Containing oestrogen and progesterone
- The Combined Pill
- Vaginal Ring
- Contraceptive Patch
- Containing progesterone only
- Mini pill
- Contraceptive Implant
- Contraceptive Injection
- Intrauterine Device (IUD)
- Intrauterine System (IUS)
- Morning After Pill
- Barrier methods
- Male condoms
- Female condoms
- Other methods
- Fertility Apps
If you're looking for a contraceptive that can help with a specific problem here's a handy guide to choosing the best.
Best contraceptive to prevent STIs
The only way to prevent an STI is to use a barrier method such as a condom every time you have sex. Male and female condoms help prevent bodily fluid exchange and make it less likely you will pass on or develop an infection.
Condoms are low cost and available in supermarkets and pharmacies. Male condoms are 98% effective when used correctly and female condoms, which can be harder to find, are 95% effective.
Sexually transmitted infections are very common. In 2015 the total number of new STI diagnoses in England rose to 434,456.
STIs are passed between partners who have shared sexual encounters that exchange fluids or skin-on-skin contact.
Even if you are taking a hormonal form of contraception you should use a condom to avoid sexually transmitted infections.
If you think you may already have an infection, it's worth making an appointment at your sexual health clinic for a free screening. Some STIs can cause problems such as infertility, so it's advised to get checked for the sake of your health.
Best low maintenance contraceptive
Some contraceptives require more thought than others, so if you are forgetful or have a busy life you might want to think about a longer lasting option.
The range of combined pills and mini pills need to be taken every day at the same time. If you are late or miss a tablet you are at risk of pregnancy and will need to use barrier contraception until the pill is back in your system.
Longer lasting methods of contraception more than 99% effective are available to help keep your contraception on track.
- Weekly: The contraceptive patch Evra releases oestrogen and progesterone hormones through your skin. It's like a sticking plaster you apply to your arms, leg or buttocks each week for three weeks followed by a seven day break.
- Monthly: The vaginal ring Nuvaring is a soft circle of plastic that's placed inside the vagina each month to deliver oestrogen and progesterone. It's used for three weeks followed by a seven day break.
- Quarterly: The contraceptive injection releases progesterone that prevents pregnancy for 12-13 weeks. A doctor will inject the contraceptive into a thigh or buttock.
- Three years plus: The contraceptive implant lasts up to three years. A doctor or specialist nurse will fit it under the skin of your arm where it releases progesterone.
- Five years plus: Intrauterine implants – IUDs and IUS can last from five to 10 years. A doctor needs to fit the small 't'-shaped device into your womb. The IUD contains copper and the IUS contains progesterone to prevent pregnancy.
If you want a contraceptive purely for the purpose of avoiding pregnancy keep condoms handy and use one every time you have sex.
Best contraceptive for smokers
The best contraceptive options for smokers over the age of 35 are barrier methods and progesterone only contraceptives.
Smokers have a higher risk of blood clots so combined hormonal contraceptives that contain oestrogen such as the combined pill, vaginal ring or contraceptive patch are not recommended.
Mini pills are also known as POP pills and need to be taken every day. They contain progesterone to thicken the lining of the womb and prevent pregnancy when taken correctly. Newer generation mini pills with desogestrel contain a higher dose of progesterone which can stop monthly periods and reduce PMS in some women too.
Other good contraceptive options for smokers include the implant, the injection, an IUD or IUS, condoms, a cap or a diaphragm.
Best contraceptive for new mums
It's possible to become pregnant a few weeks after giving birth even before you've had your first period, so sorting contraception out as soon as possible is a good idea.
You can use barrier methods such as condoms after birth, but if you have a cap or diaphragm you will need a new fitting to ensure it covers your cervix correctly.
If you prefer hormonal birth control, you can take the mini pill straight after giving birth as it doesn't contain oestrogen or affect breastfeeding. It's simple to take but the downside is you may forget to take it with the strain of a new baby.
Breastfeeding mums should avoid hormonal contraception that contains oestrogen as they are at a higher risk of blood clots naturally and it can interfere with the milk supply.
If you are not breastfeeding and you have no blood clot risks then you can take the combined pill, vaginal ring or contraceptive patch three weeks after giving birth.
Other good options for new mums are the oestrogen-free contraceptive implant or an IUD/IUS. Intrauterine devices can be fitted 48 hours after giving birth or four weeks post delivery.
Best contraceptive for acne
Combined hormonal contraceptives can help reduce acne because oestrogen in the combined pill, the patch, and the vaginal ring help balance hormones and regulate the production of sebum.
Acne is caused by an excess of oil otherwise known as sebum, which is produced by our skin. Androgen hormones that increase around the time of puberty cause excess sebum, but adult acne can become a problem at any time. Androgens cause sebaceous glands to produce more sebum than necessary that can lead to pimples, spots, black heads and acne on your face, chest and back.
It can take a while for hormones to begin regulating sebum, but some women find it very effective.
Best contraceptive for weight loss
Women looking at hormonal contraceptives may be concerned about weight gain. There has been negative press about contraception leading to excess weight, but few of the rumours are true.
When women begin hormonal birth control they may experience some fluid retention which adds pounds to the scales, however this is temporary and usually corrects itself. Modern methods of hormonal birth control mean that amounts of oestrogen are lower than in the past so an increase in appetite is unlikely.
No research has concluded that contraception causes weight loss or weight gain, but if you are concerned try barrier methods such as condoms, diaphragms and caps which don't contain hormones.
As oestrogen was previously blamed for weight gain you might want to avoid the combined pill, patch or ring and opt for the progesterone-only mini pill or an IUD. However, there is no medical evidence that combined contraceptives cause weight gain if you eat a sensible balanced diet and take regular exercise.
Best emergency contraceptive after sex
If you've had unprotected sex, a condom spilt, or you forgot a pill then emergency contraception can be taken up to 5 days afterwards to prevent a pregnancy.
There are two types of morning after pill that can prevent pregnancy.
EllaOne should be taken within 120 hours of sex and Levonelle within 72 hours. Both pills work by delaying ovulation so the sooner you can take one of these pills the less likely you are to become pregnant.
Another option is an IUD that can be inserted 5 days after sex to avoid pregnancy. Intrauterine devices have the highest rate of contraception after sex, but it can be difficult to have one fitted within the time frame.
Morning after pills and IUDs cannot prevent an STI, so it best to have a check up at your local clinic too.
Best Contraceptive For Endometriosis
Hormonal contraception is one of the best ways to manage endometriosis. Combined contraceptives such as the vaginal ring, the patch and the combined pill can help manage endometriosis by suppressing periods which leads to a thinner womb lining, and if taken without a break it can prevent periods completely. If the womb-lining does not build up, then cells won't build up in the wrong place either.
Endometriosis is a condition where the cells that create the monthly womb lining also build up in other parts of the body. When the womb lining sheds, and creates a period, these cells break down too, but there is nowhere for the blood to go. Instead it builds up causing inflammation and scar tissue.
Endometriosis can lead to heavy periods, period pain, bladder and bowel problems, and infertility. It's a debilitating condition that affects around 1.5 million women in the UK.
The combined pill can be taken for 3 months without a break or longer under the recommendation of your doctor. The ring and patch can be used this way too.
The mini pill is also one of the best ways to help endometriosis and is a better choice for women who are oestrogen sensitive. Progesterone suppresses endometriosis deposits which help prevent inflammation and scarring. Higher dose progesterone mini pills containing desogestrel can also prevent periods in some women.
You could consider the intrauterine system too as it is also progesterone based.
Best Contraceptive for PMS
Combined contraceptives can help manage PMS by regulating hormones that create unwanted symptoms.
The best choices are the combined pill, the contraceptive patch and the vaginal ring as these contain oestrogen to help lessen period symptoms and often prevent periods from occurring.
Premenstrual Stress (PMS) is a collection of symptoms brought on by the hormonal changes of ovulation and menstruation. PMS encompasses a wide range of adverse symptoms that include nausea, fatigue, dizziness, headaches, and emotional swings.
Progesterone based contraception can help prevent PMS too. The mini pill, the implant and the IUS can all lessen the severity of PMS by regulating hormones to a lesser extent, and in some cases prevent ovulation.
Best contraceptive for oestrogen sensitive women
Contraceptives that contain oestrogen are not suitable for some women. These include women who've had breast cancer, migraines, blood-clots, are over 35 and smoke, are overweight, or take medications that have a contraindication with oestrogen.
The best hormonal contraceptives for women who cannot take oestrogen are the mini pill, the implant or an IUS. Hormone-free options include an IUD, condoms, caps and diaphragms.
Because hormonal contraception is highly effective in a range of situations such as managing endometriosis, acne and PMS, hormonal contraceptives have been developed without oestrogen. These are progesterone-only contraceptives.
Progesterone based mini pills work by thickening the lining of the cervix so sperm cannot enter, and thins the womb-lining so an egg can't implant and grow.
Progesterone contraceptives work as effectively as combined contraceptives, but don't always have the period-management benefits they provide.
If you have no health risks then choosing contraception that offers extra benefits in terms of hormone or time management can make a real difference to your health.
If you are unable to take certain contraceptives then there are other options to choose from. Going without contraception when you need it is unnecessary and detrimental to your health.
If you are unsure what to do next, or have more questions, consult a doctor or family planning clinic that can help you make an informed decision.