Choosing contraception can feel confusing because there are many different types. The good news is that there is no “one best method” for everyone. The right choice depends on your health, periods, lifestyle, future pregnancy plans, and whether you also need protection from sexually transmitted infections, also called STIs.
Contraception helps prevent pregnancy. Some methods use hormones, some do not, some last for years, and some are used only when you have sex. Condoms are the main contraceptive method that also helps protect against STIs. Most other methods prevent pregnancy but do not protect against infections, so condoms may still be needed.
- Long-acting methods: “fit and forget” contraception
These are useful for people who do not want to remember a pill every day.
Copper coil — IUD
The copper coil, also called an IUD, is a small T-shaped device placed inside the womb by a trained doctor or nurse. It does not contain hormones. It works as soon as it is inserted and can last for 5 or 10 years, depending on the type. It is over 99% effective and can also be used as emergency contraception. Fertility returns straight away after it is removed.
Hormonal coil — IUS
The hormonal coil, also called an IUS, is also placed inside the womb. It slowly releases progestogen. It is over 99% effective and can last for 3 to 8 years, depending on the type. It often makes periods lighter, shorter and less painful, and it can be used to treat heavy periods.
Contraceptive implant
The implant is a small plastic rod placed under the skin of the upper arm. It releases progestogen and works for 5 years. It is over 99% effective if replaced on time. Fertility usually returns quickly after it is removed. ([nhs.uk]
Contraceptive injection
The injection contains progestogen and is given every 8 to 13 weeks, depending on the type. It is more than 99% effective when used correctly, but it is less effective if injections are late. One important point is that fertility may take up to 1 year to return after stopping the injection.
- Short-acting hormonal methods
These methods work well but need regular use.
Combined pill
The combined pill contains oestrogen and progestogen. It mainly works by stopping the ovaries from releasing an egg each month. It is over 99% effective when taken correctly all the time, but less effective if pills are missed. It may also help with acne, heavy or painful periods, PMS and endometriosis.
Progestogen-only pill
The progestogen-only pill, sometimes called the mini pill, contains progestogen only. It is over 99% effective when taken correctly, but missing pills makes it less effective. It may help with painful or heavy periods and endometriosis.
Contraceptive patch
The patch is a small sticky patch worn on the skin. It releases oestrogen and progestogen. Each patch is worn for 7 days, then replaced. It is 99% effective if used correctly all the time. Fertility usually returns within around 1 to 3 months after stopping.
Vaginal ring
The vaginal ring is a soft plastic ring placed inside the vagina for 3 weeks. It releases oestrogen and progestogen. It is 99% effective if used correctly all the time. Fertility usually returns within around 1 to 3 months after stopping.
- Barrier methods
Barrier methods work by stopping sperm from reaching an egg.
External condoms
External condoms are worn on the penis before vaginal, anal or oral sex. They help prevent pregnancy and reduce the risk of STIs. They are up to 98% effective if used correctly every time, but around 82% effective with typical use. A new condom should be used every time, and oil-based lubricants should not be used with latex condoms.
Internal condoms
Internal condoms are placed inside the vagina or anus before sex. They help prevent pregnancy and reduce STI risk. They can be inserted up to 8 hours before sex. They are up to 95% effective with correct use, but around 79% effective with typical use. Do not use an internal condom and external condom together, as this can make them split.
Diaphragm or cap
A diaphragm or cap is placed inside the vagina before sex and covers the cervix, which is the entrance to the womb. It must be used with spermicide. When used correctly, diaphragms and caps are estimated to be 92% to 96% effective, but they do not protect against STIs.
- Permanent contraception
These methods are for people who are sure they do not want future pregnancies.
Female sterilisation
Female sterilisation is a permanent method where the fallopian tubes are blocked or cut so sperm cannot meet an egg. It is more than 99% effective. It does not affect hormones, so periods continue. Reversal is not usually available on the NHS.
Vasectomy
A vasectomy, also called male sterilisation, is a permanent procedure that stops sperm from being ejaculated during sex. It is usually done under local anaesthetic and takes around 30 minutes. Reversal may be possible, but it does not always work and is not usually available on the NHS. A vasectomy does not protect against STIs.
- Natural family planning
Natural family planning involves tracking the menstrual cycle to work out the most fertile days and avoiding sex or using condoms on those days. The NHS also describes lactational amenorrhoea, which uses exclusive breastfeeding after birth to delay ovulation. Fertility awareness methods can be 91% to 99% effective with correct use, but only about 76% effective if not followed exactly. The withdrawal method is not recommended as an effective way to avoid pregnancy.
- Emergency contraception
Emergency contraception can be used after sex if no contraception was used or if contraception failed, for example if a condom split. The emergency contraceptive pill should be taken within 3 or 5 days after sex, depending on the type, and it works best the sooner it is taken. Emergency contraceptive pills are available from many sexual health clinics, GP surgeries and pharmacies.
Which contraception is best?
The best method is the one that is safe for you and fits your life. For example:
A long-acting method such as the coil, implant or injection may suit someone who does not want to remember contraception every day. The pill, patch or ring may suit someone who prefers a method they can start and stop themselves, though they need regular use. Condoms are important if STI protection is needed. Permanent methods should only be chosen when someone is sure they do not want future pregnancies.
When to speak to a doctor, nurse or pharmacist
Speak to a healthcare professional if you are unsure which method is safe for you, if you have medical conditions, take regular medication, have very heavy or painful periods, have had side effects from contraception before, or need emergency contraception.
Contraception is personal. You should be supported to choose a method that matches your body, your relationships and your future plans.
Remember, ALWAYS consult with your GP and/or your gynecologist for your specific treatment options. Every woman is different!