Types of contraception

Barrier methods of contraception

Barrier methods of contraception refers to contraceptives that physically prevent semen from coming into contact with the other person. They’re extremely popular as they are simple to use, highly effective and very accessible.

Types of barrier contraceptives

There are two main types of barrier contraception.

Condoms are small sheath-shaped devices that are worn either externally (for men) or internally (for women). Most condoms are made from latex, but there does exist synthetic latex condoms for those who are allergic to latex. They are also the only contraceptive that protects you from getting sexually transmitted infections (STIs).

An alternative to condoms is the contraceptive diaphragm or cervical cap. It is a small silicone dome that is inserted into the vagina with a spermicide (a gel that kills sperm) and fits over your cervix. It must be left in for at least 6 hours after intercourse.

They are easy to use and are also some of the most accessible forms of contraception, as they can either be bought over the counter at a pharmacy or are available for free at most GP surgeries, family planning and sexual health clinics.

Overview of barrier methods

• Easy to use
• Condoms protect you from STIs*
• Highly effective when used correctly
• Very accessible and often free
• Available for men and women
• Generally low risk of side effects

*Diaphragms or caps do not.

Hormonal contraception

Another popular method of contraception are hormonal contraceptives. They work by affecting the levels of progesterone and/or oestrogen in the body. This is because these hormones govern your menstrual cycle and trigger processes that prepare the body for pregnancy, but if these hormones are altered, this prevents conception.

Types of hormonal birth control

Combined hormonal contraception (CHC) contains both a synthetic oestrogen and synthetic progesterone. Others just contain a synthetic progesterone. Progesterone-only methods target the cervical mucus and uterus lining. CHC also prevents ovulation, the process in which the ovary releases an egg.

“28% of women in the UK used the combined pill as their main contraception”

One of the most popular methods of CHC in the UK and Europe is “the pill”, which is the combined contraceptive pill. In 2018, 28% of women in the UK used the combined pill as their main form of contraception. However, the combined oral contraceptive pill is by no means the only hormonal option available. Other hormonal contraceptives include:

• mini-pill (progestogen-only-pill or POP)
• vaginal ring (NuvaRing)
• contraceptive patch (Evra)
• contraceptive injection (Depo-Provera or Sayana Press)

Some hormonal contraceptives are long-lasting, and are known as LARC (long-acting reversible contraceptives). They can last for 3 - 5 years, but can be removed at any time. Examples include:

• intrauterine system (IUS or hormonal IUD)
• contraceptive implant

Because of how they work, they can also have several other benefits besides preventing pregnancy, such as reducing premenstrual syndrome symptoms (PMS), making your periods more regular, lighter and can also reduce acne.

Overview of hormonal methods

• Easy to use
• Many options available - there is something for everyone
• Over 90% effective when used correctly
• Options for women who can’t use oestrogen
• Some can reduce PMS symptoms and acne*
• Some help your periods become lighter, less painful and more regular*

*Depending on your hormonal contraceptive.

The intrauterine device (IUD)

The intrauterine device (IUD), sometimes known as the copper coil, is another LARC. It is 99% effective, long-lasting and has been steadily rising in popularity throughout the years.

How does the IUD work?

The copper IUD is a small t-shaped device that is inserted into the uterus. While it is very similar to the IUS, it does not release any hormones.

It releases copper into the womb which alters the cervical mucus which makes it more difficult for sperm to reach the egg. It also prevents a fertilised egg from being able to implant itself in the uterus.

It has to be inserted by a healthcare professional but once it's in, it can be left in for 5 - 10 years. All you have to do is check it is in place after each period. It can also be used as a form of emergency contraception because it starts working immediately.

Overview of the IUD

• Low maintenance
• 99% effective
• Lasts up to 5 - 10 years
• Can be used as emergency contraception
• Low risk of side effects
• Can be removed at any time

Permanent contraception methods

There are permanent methods when it comes to contraception. For both men and women, the different methods are colloquially known as having your “tubes tied”. They are over 99% effective, don’t affect sex nor your hormone levels.

Whilst the procedures can technically be reversed, it’s very difficult and not available on the NHS. Therefore, they should be considered permanent when deciding to have one. Your doctor will also want you to think seriously about the decision and consider other long-lasting methods. It is also more likely to be offered in older adults who have had children.

What is female sterilisation?

Female sterilisation is a minor procedure to permanently prevent pregnancy. It involves the fallopian tubes being blocked, a procedure known as tubal occlusion or tubal ligation. This involves either using clips, rings or by cutting and tying the tubes. It’s a minor operation, and most women can go home the same day.

What is a vasectomy?

A vasectomy is a form of male sterilisation and, like tubal occlusion, requires a minor procedure. It involves either cutting or sealing the epididymis, the tube that carries the sperm from the testicles. This means that the man’s semen, when he ejaculates, will not contain any sperm.

Overview of sterilisation

• Permanent
• 99% effective
• Can be used by men and women
• Simple, one-off procedure
• Low risk of side effects
• Doesn’t interrupt sex

Natural ways to prevent pregnancy

Many women opt to naturally prevent pregnancy by monitoring their fertility signals throughout their menstrual cycle to predict when they’re most likely to become pregnant. This method is known as natural family planning or fertility awareness.

Women who have just had a baby can also use methods to prevent pregnancy through breastfeeding, which is known as LAM.

What is natural family planning?

Natural family planning is a way of monitoring when you’re most fertile by monitoring your menstrual cycle. There are 3 main signals that you look for:

• menstrual cycle length - predict when ovulation happens
• body temperature - there is a small rise in temperature after ovulation
• cervical mucus changes - levels rise to prepare for ovulation

If done consistently and correctly, it can be over 99% effective. However, it’s important you consult a fertility awareness teacher to get it right.

What is the lactational amenorrhoea method (LAM)?

Towards the end of pregnancy, your body is producing a hormone called prolactin, which stimulates the production of breastmilk. However, its other job is also to prevent ovulation. This means that every time you breastfeed your baby, and your body produces prolactin, ovulation is suppressed.

However, this method is only reliable if you breastfeed regularly and have not started your periods yet. Also some women may ovulate before their first period, so even if you haven’t had a period there is still a chance you could be pregnant. This method will also be less effective the older your baby gets, so it’s not a permanent solution.

Overview of fertility awareness

• Natural method
• 98-99% effective when done correctly
• No side effects
• No medicines involved
• Helps you become more attuned to your body
• Involves your partner in the process

Emergency contraception

The final type of contraception on this list is the back-up option, that you should use only when your usual type of contraception fails (e.g you miss a pill or a condom breaks).

More commonly known as the morning after pill, emergency contraception is designed to prevent ovulation after unprotected sex. There are two main pills. Levonelle can be taken up to 3 days after intercourse whilst ellaOne can be taken up to 5 days after.

The IUD can also be used as emergency contraception, if inserted up to 5 days after sex or up to 5 days after the earliest time you could have ovulated.

It is very effective, easy to access but you shouldn’t have to use it regularly. If you find you’re using your emergency contraception often or you don’t use any contraception, perhaps consider using a different kind of contraception.

Overview of emergency contraception

• A back-up option when you need it
• 99% effective when used correctly
• Can be used up to 3 - 5 days after unprotected sex
• Easily accessible

Which method of contraception suits me?

There are so many options that are all highly effective. There may have been some options on this list that you weren’t even aware of. That can make it difficult to choose.

You should consider a few elements when choosing your contraception:

• How effective is the method?
• How will it be incorporated into your daily routine?
• Do you have a busy lifestyle? Will you be able to take it regularly?
• Are you comfortable with something being inserted into your vagina?
• Are you worried about side effects (e.g weight gain or period changes)?
• Can you use hormonal contraceptives?

It’s important you research each type and see how it could work for you. If you’re not sure or you have another condition, consult your doctor and discuss your options.