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The gal-dem guide to contraception

31 Oct 2018

Contraception can seem like a minefield. Although most women use it to stop unplanned pregnancies, some of our first encounters will be for entirely different reasons – such as for polycystic ovarian syndrome, regulating our cycle, reducing endometriosis symptoms, or stopping periods as part of transitioning. Whatever your reason for seeking more information about contraception, I’ve got you covered.

Barrier Methods

The Male condom – Old Faithful

98% BUT that’s with perfect use. It’s usually 82% because you know, well, condom accidents.

  • Thin latex or non-latex put over an ERECT penis (sounds obvious but sadly it isn’t always and it leads to unnecessary accidents).
  • Stops the swimming sperm getting up into the vagina.
The Femidom – The Rarely Used

95% effective if user perfect. Typical use is 79%. Made of a thinner plastic than the male condom, the Femidom sits inside the vagina and the opening sits just outside. Stops sperm entering the vagina.

The good?

    • Protects you against some sexually transmitted infections.
    • Few side effects although, some people need latex free variety.
    • No hormones.
    • No spermicide.

The bad?

  • They split, they slip and sometimes they kill the vibe.
  • Need to withdraw prior to the penis becoming soft or they can be spillage.

Long-Acting Reversible Contraception – LARCs

Contraception Injection – The Depo

99% effective with perfect use. Typical use 94%. Releases progesterone hormone which thins the womb lining, thickens your cervical mucus & stops ovulation.

The good?

  • In the UK, we mainly give Depo-Provera which lasts 13 weeks. However, a home self-injectable version – Sayana Press is available in some clinics.
  • Up to 80% of women don’t have any periods on the Depo. Bye to heavy, painful bleeding.

The bad?

  • Women can gain significant amounts of weight.
  • Periods may become erratic in some women.
  • It can take up to a year for your fertility to go back to normal after your last injection.
  • Failure due to women not attending for their three-monthly appointment.
The Implant – Mini but Mighty

99% Effective. Typical use is (gasp) 99% effective ‘cos well, you can’t forget to take it! A 4mm flexi rod that goes under the skin on the upper arm. Takes about 10 minutes, you are given a local anaesthetic before and bandage after (and if you’re lucky maybe a chocolate bar). You can feel it but nobody can see it. Progesterone hormone stops ovulation, thickens your cervical mucus and thins the lining of the womb.

The good?

  • Works for three years (yay!) but you can take it out sooner.
  • No pills to remember.
  • Fertility returns right after it’s removed.

The bad?

  • 1/3 have irregular bleeding. 1/3 have no periods. 1/3 have normal periods. You have to wait for a few months to see how it will be.
  • You need to have it fitted by a trained nurse or doctor.  
The Intrauterine System (IUS) – The Hormonal Coils

99% effective. Mini, T-shaped plastic device that is placed inside the womb with thin cotton threads that hand into the vagina. Works for three, four or five years depending on which device you have fitted. Jaydess has the lowest dose of progesterone. Thins the womb lining and thickens cervical mucus so sperm can’t get into the womb.

The good?

  • All of them give lighter, shorter bleeds. How light depends on the amount of progesterone and your body’s own response. Some women have no periods at all. This is most likely with the highest hormone dose – Mirena coil.

The bad?

    • Irregular bleeding or spotting more common with the lower dose coils.
    • Requires a pelvic examination and with some conditions, e.g fibroids may struggle to have one fitted.
    • Can get an infection after the coil is fitted.
    • Some people say their partners can feel their threads – it’s not painful and at least you’ll know it’s in place.
    • Risk of ectopic pregnancy if the method fails.
The Intrauterine Device (IUD) – The ‘No Hormone’ Copper Coil

99% effective. Typical use is (gasp) 99% effective ‘cos again, you can’t forget to take it! A small plastic, T-shaped device with copper on the body +/- on the arms. Copper is toxic to sperm and stops a fertilised egg implanting in the womb. Works for five or 10 years.

The good?

  • Hormone free.
  • Also can be used as an emergency contraception up 120 hours after UPSI or up to day 19 of a regular cycle (whichever is latest).

The bad?

  • Periods can be heavier, longer and more painful
  • Requires a pelvic examination and with some conditions, such as fibroids, people may struggle to have one fitted whilst awake.  
  • Can get an infection after the coil is fitted.
  • Some people say their partners can feel their threads (however, it’s not painful and at least you’ll know it’s in place).
  • Risk of ectopic pregnancy if the method fails.

Short-Acting Contraception

Combined Oral Contraceptive pill – COC (same hormone also available as a patch or vaginal ring!)

Over 99% effective if used correctly. Typical use 91%. Remember to take or change your patch or pill. Oestrogen and progestogen hormone work to stop ovulation, thicken your cervical mucus and prevent sperm reaching an egg and thin the lining of the womb.

The good?

  • You are in control and decide when to take your pill every day.
  • Usually regulates your periods and can also be used in conditions like polycystic ovary syndrome to regulate bleeding.
  • Can tricycle your pill pack to stop you getting a period.

The bad?

  • Some medical conditions such as migraines with visual problems, being overweight or being a smoker over 35 years may make the COC unsuitable.
  • Side effects include increased risk of blood clots, breast and cervical cancer.
  • Some women may experience headaches, nausea, mood changes and breast tenderness.
  • Pills are easily missed or vomiting may make it ineffective.
Progestogen-only-pill – POP

Over 99% effective. Typical use is 91% effective. Progestogen hormone only which thickens cervical mucus and can stop ovulation.

The good?

  • None of the side effects or risks associated with estrogen.
  • May help with premenstrual syndrome (PMS) symptoms.
  • Periods can be lighter or stop altogether.

The bad?

  • Need to take it at the same time every day.
  • Periods may be irregular or get frequent spotting.
  • Side effects include breast tenderness, acne, weight gain and headaches.
  • Can get ovarian cysts – usually not harmful.
  • Pills are easily missed especially as with the most common type in UK you only have 12-hour window to take your pill (some only have a three-hour window).

This is a shortened version of the guide excluding user comments and some methods. For the full guide please click here.

For further information on up to date contraception please visit the Family Planning Association website:

Follow @DecoloniseContr for more Contraception Information. Thanks to Dr Katie Bogg.

*Names have been changed to maintain people’s confidentiality.