World Contraception Day: All the different types of contraception available, from the pill to the implant
This week, it was reported that one in three women do not know how to access contraception, as the coronavirus pandemic has prevented them from accessing contraceptive products as they usually would.
Frontline service providers warned that an increasing number of women were becoming pregnant because they were struggling to access contraception, with leading UK abortion provider Marie Stopes stating that people in need of contraception have been “disgracefully neglected” over the past several months.
Contraception providers have also warned that women are currently being faced with a “postcode lottery” of contraceptive services, due to investment being given to services.
There are several forms of contraception that can be used to prevent pregnancy and reduce a person’s likelihood of catching or spreading sexually transmitted infections. Here is everything you need to know.
Non-hormonal
Condoms
One of the most effective forms of contraception is condoms, sexual health and HIV charity Terrence Higgins Trust states, “as they provide a barrier that stops sperm, viruses and bacteria getting from one person to another”.
Condoms are the only form of contraception that both prevent pregnancies and protect against sexually transmitted diseases.
There are two kinds of condoms – external condoms, otherwise known as “male” condoms, which are worn over an erect penis; and internal condoms, otherwise known as “female” condoms or Femidoms, which are placed inside the vagina.
According to the NHS, external condoms, which are made from thin latex, polyisoprene or polyurethane, are 98 per cent effective when used correctly during sex.
Internal condoms, on the other hand, are 95 per cent effective at preventing pregnancy and sexually transmitted diseases when used correctly, the health service states.
The NHS stresses that once an external or internal condom has been used once, it should not be used again. They should also not be used past their use-by dates.
“Always use condoms that have the BSI kite mark and the CE mark on the packet. This means they've been tested to high safety standards,” the health service says.
Condoms can be sourced for free from health establishments including sexual health clinics, contraception clinics and some GP surgeries. They can also be bought at pharmacies, supermarkets, from vending machines in some public toilets and online.
Diaphragm/cervical cap
A diaphragm or a cervical cap is a silicone object that is placed in the vagina before sex, covering the cervix.
The placement of the diaphragm or cervical cap creates a barrier so that sperm is unable to reach the egg in the uterus, the NHS outlines.
“Diaphragms and caps are always used with spermicide, a chemical gel or foam that kills sperm,” the Terrence Higgins Trust states.
“You can put your diaphragm or cap in, with spermicide up to three hours before you have sex. It must be left in place for at least six hours after sex.”
When using a diaphragm or cervical cap, there is a small risk of developing cystitis, inflammation of the bladder that is typically caused by a bladder infection, the NHS states. However, the Terrence Higgins Trust adds that this is a “very rare” occurrence.
In the event of a person developing cystitis following use of a diaphragm or cap, the NHS advises speaking to a medical professional, who may advise that you use a smaller size.
Diaphragms or cervical caps are available for free on the NHS.
Non-hormonal coil
There are two types of coil that can be used as a form of contraception by being placed in the womb.
The IUD (intra-uterine device), is a non-hormonal device that is T-shaped and made of plastic and copper.
The IUD releases copper into the uterus, which “makes it more difficult for sperm to reach an egg and survive”, the Terrence Higgins Trust states, while also preventing fertilised eggs from implanting in the uterus.
The IUD is 99 per cent effective at preventing pregnancy and can be left in place for between five to 10 years, the charity states.
It is available for free through the NHS with a prescription.
Hormonal
Hormonal pills
There are two forms of hormonal contraceptive pills that can be taken to prevent pregnancy.
These are: the combined hormonal contraception pill, otherwise known as the pill; and the progestogen-only pill, otherwise known as the mini pill.
The combined pill “contains a combination of two hormones similar to those produced naturally by the body; progestogen and oestrogen”, states sexual health charity Brook.
“The combined pill works to prevent the sperm reaching the egg and fertilising it,” the charity states.
“It prevents pregnancy by interrupting this process in three ways: It stops eggs being released from the ovaries (ovulation); it makes it harder for the sperm to reach the egg; it makes the uterus (or womb) lining thinner so a fertilised egg cannot implant.”
Brook states that if the combined pill is taken correctly, which would usually be once a day for 21 days with a seven day break, then it is 99 per cent effective. It is available for free from contraceptive clinics and from GP surgeries.
The progestogen-only pill, on the other hand, only contains the hormone progestogen, as the name suggests, and is also available for free from contraceptive clinics and GP surgeries.
The progestogen pill prevents pregnancy by “thickening the mucus from your cervix, making it difficult for sperm to move through and reach an egg”, and it sometimes “stops your ovaries releasing an egg”, if it also contains the hormone desogestrel, Brook outlines.
Taking hormonal pills can result in certain side effects, such as headaches, tenderness of the breasts, nausea and mood swings, the charity states.
Brook notes that when a person takes the progestogen-only pill, they may experience irregular periods, adding that neither the pill or mini-pill protects against sexually transmitted infections, as they are not a barrier form of contraception.
Contraceptive patch
The contraceptive patch is another hormonal form of contraception, which releases hormones into the bloodstream through a patch that is applied on dry, clean skin.
According to the NHS, the contraceptive patch is more than 99 per cent effective at preventing pregnancy when used in the right way.
“Each patch lasts for one week,” the NHS says. “You change the patch every week for three weeks, then have a week off without a patch.”
The contraceptive patch, which Love Island viewers said they spotted contestant Rebecca Gormley wearing during the winter season of the show, releases the same hormones into the bloodstream as the combined pill – oestrogen and progestogen.
The form of contraception is free to access through the NHS. According to the health service, when you first request a contraceptive patch supply, you will first be given enough to last for three months.
“If there are no problems, you can be prescribed the patch for six months to a year,” the NHS adds.
Contraceptive vaginal ring
The contraceptive vaginal ring, which measures at approximately 5.5cm in diameter and 4mm in thickness, is a soft, pliable plastic ring that is placed inside the vagina, sexual health charity Brook explains.
In a similar manner to the combined pill and contraceptive patch, the ring releases the hormones oestrogen and progestogen into the bloodstream, which in turn prevents ovulation, which is when the egg is released, in addition to “thickening the mucus around the cervix, which makes it harder for sperm to get through”.
The release of the hormones also thins to the lining of the womb, “so that a fertilised egg cannot implant”.
The contraceptive vaginal ring is free to access through the NHS and from contraceptive clinics.
Hormonal coil
The hormonal coil, or IUS (intra-uterine system) releases the hormone progestogen.
The IUS are 99 per cent effective at preventing pregnancy, the Terrence Higgins Trust outlines, and can be left in place for between five to seven years respectively.
The IUS is both available for free through the NHS with a prescription.
Contraceptive injection
The contraceptive injection is a form of contraception that can last for around eight to 13 weeks, depending on the type of injection that is used.
According to the NHS, the Depo-Provera injection is the most widely used in the UK, and lasts for 13 weeks.
The injection releases the hormone progestogen into the bloodstream and can be used at any time during the menstrual cycle, as long as the person being injected is not pregnant.
The contraceptive injection can result in certain side effects, the NHS warns, including irregular periods or periods stopping completely.
It can also cause headaches, acne and mood swings among other side effects, the health service says.
“There can be a delay of up to one year before your periods return to normal and you can become pregnant,” the NHS adds.
The contraceptive injection is available for free from HP surgeries, contraceptive clinics and sexual health clinics.
Contraceptive implant
The contraceptive implant is a small rod made of plastic that is placed under the skin in the upper arm by a doctor or a nurse.
Once in place, the implant releases the hormone progestogen into the bloodstream, which prevents pregnancy by stopping the egg from being fertilised by the sperm, Brook explains.
It does this by “stopping ovulation, thickening the mucus around the cervix, which makes it harder for sperm to get through” and by “making the lining of the womb thinner so that a fertilised egg is less likely to implant”, the charity states.
According to Brook, the implant is 99 per cent effective at preventing pregnancy, although the charity stresses that it does not protect against sexually transmitted infections.
It can cause side effects such as headaches, nausea and mood swings, and can cause those who use it to experience irregular periods or none at all, although “this usually settles down after a year”.
The implant is available for free at GP surgeries and at contraceptive clinics.
Emergency contraception
If a woman has had sex without contraception or if the form of contraception she has used hasn’t worked, then emergency contraception can be used to prevent pregnancy.
There are two types of pill that can be taken as emergency contraception: Levonelle and ellaOne.
Levonelle can be taken up to 72 hours after having unprotected sex, while ellaOne can be taken up to 120 hours after having unprotected sex, the Terrence Higgins Trust says.
If someone takes Levonelle between 49 and 72 hours after having unprotected sex, it is 58 per cent effective at preventing pregnancy, the charity states. However, if taken within 24 hours, it is 95 per cent effective.
EllaOne, on the other hand, is said to be 98 per cent effective at preventing pregnancy.
Another form of emergency contraception is the copper IUD, which is 99 per cent effective if fitted up to 120 hours after unprotected sex. It may also prevent pregnancy if fitted after the 120-hour period, the Terrence Higgins Trust says.
“It needs to be fitted by a specially trained nurse or doctor. They will need to ask some questions first to decide whether it’s safe to use this method of emergency contraception,” the charity outlines.
“The IUD is suitable for women taking HIV treatment as it doesn’t contain any hormones.”
Read more
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