Most people figure out their contraception once and never really revisit it. You find something that works well enough, and you stick with it. But well enough is not the same as right for you, and your body, your lifestyle, and your plans change over time.
What suits you at twenty might not suit you at thirty. What works for your friend might not work for you. So if you’ve questioned something about your contraception, or you have simply never looked into your options in depth, this is a good place to start.
What Is Contraception?
Contraception refers to methods used to prevent pregnancy. Some contraceptives also help manage other health concerns, including heavy or painful periods, hormonal symptoms, acne, and cycle irregularity.
Some methods contain hormones. Others are hormone-free. They work in different ways, including preventing ovulation, thickening cervical mucus, stopping sperm from reaching an egg, or changing conditions in the uterus so pregnancy is less likely. Some methods are short-term, and others are designed to last several years.
Things to Think About Before Choosing
Before deciding on a contraceptive method, it helps to think through a few things:
- How important is effectiveness to you, and how much of a role do you want to play in managing it day to day?
- Do you prefer a hormonal or hormone-free option?
- Are you likely to want to become pregnant in the near future?
- Do you have any relevant medical history, including migraines, cardiovascular conditions, or previous clotting issues?
- Do you also need protection against sexually transmitted infections?
There is no universally correct answer. The aim is to find a clinically appropriate option that suits your lifestyle and feels manageable to use consistently.
The Contraceptive Pill
The contraceptive pill comes in two main forms: the combined oral contraceptive pill, which contains both oestrogen and progestogen, and the progestogen-only pill, also known as the mini pill.
How It Works
The combined pill primarily prevents ovulation. It also thickens cervical mucus and alters the uterine lining. The progestogen-only pill works mainly by thickening cervical mucus and, in some people, by suppressing ovulation.
Benefits
- Can improve painful or heavy periods
- May help with acne or hormonally driven symptoms
- Does not interrupt sex
- Fertility typically returns promptly after stopping
Things to Be Aware Of
- Needs to be taken consistently and at a similar time each day, particularly the progestogen-only pill
- Certain medications, including some antibiotics and anticonvulsants, can reduce its effectiveness
- The combined pill is not suitable for people with a history of blood clots, certain migraines with aura, or uncontrolled high blood pressure
- Side effects can include headaches, nausea, breast tenderness, or mood changes, which vary from person to person and often subside within the first few months.
Long-Acting Reversible Contraception (LARC)
LARC methods are among the most effective forms of contraception available. Because they work continuously without requiring daily action, they are not affected by user error in the same way as the pill or condoms. This category includes contraceptive implants, hormonal IUDs, and the copper IUD.
The Contraceptive Implant (Jadelle)
The Jadelle implant consists of two small flexible rods inserted under the skin of the upper arm. It releases a low dose of progestogen that prevents ovulation and thickens cervical mucus, and it is effective for up to five years. It can be removed at any time if you choose.
At GP and Me, Jadelle insertion and removal are carried out in the clinic under local anaesthetic. The procedure is partially funded, making it a low-cost option for many patients.
Benefits
- Highly effective and low maintenance
- No daily reminders required
- Fertility returns quickly after removal
Things to Be Aware Of
- Irregular or unpredictable bleeding is common, particularly in the first few months
- Some people experience hormonal side effects, including headaches or mood changes
- A trained clinician is required for both insertion and removal
Hormonal IUD
A hormonal IUD is a small T-shaped device inserted into the uterus that releases a very low dose of progestogen locally. GP and Me offer Mirena and Jaydess, both of which are partially funded.
To make insertion more comfortable, we offer a local anaesthetic cervical block. Insertion is carried out in a calm, supportive environment in our purpose-built procedure room with relaxing music, and removal is usually quick and straightforward.
Benefits
- Highly effective and long-lasting (three to eight years, depending on the device)
- Can significantly reduce or eliminate periods
- Requires no daily attention - “fit and forget”
Things to Be Aware Of
- Insertion can be uncomfortable and may cause cramping
- Some people experience irregular spotting in the first few months before bleeding settles or stops
- A clinician is needed for both insertion and removal
Copper IUD
The copper IUD is a hormone-free device inserted into the uterus. Copper ions slow sperm down and reduce the chance of fertilisation. It can also be used as emergency contraception if inserted within five days of unprotected sex.
Benefits
- Hormone-free and highly effective
- Long-lasting (five to ten years)
- Immediately reversible upon removal
Things to Be Aware Of
- Periods may become heavier or more painful, particularly in the first few months after insertion
- A clinician is required for both insertion and removal
The Contraceptive Injection (Depo-Provera)
Depo-Provera is a progestogen injection given every 12 weeks.
Benefits
- Effective and discreet
- Requires no daily action
- Can reduce or stop heavy or painful periods
Things to Be Aware Of
- Irregular bleeding or spotting is common, and periods may stop altogether for some people
- Because the hormone is released gradually over 12 weeks, it cannot be removed from the body once given
- Fertility can take longer to return after stopping than with other methods, sometimes up to 12 months or more
- Regular clinic visits are required for each injection
Condoms
Condoms are the only contraceptive method that also reduces the risk of sexually transmitted infections. Your GP or nurse practitioner can provide prescriptions for funded condoms.
Benefits
- Provide STI protection alongside pregnancy prevention
- No hormones and no prescription required
- No ongoing commitment
Things to Be Aware Of
- Must be used correctly and consistently to be effective
- With typical use, they are less effective at preventing pregnancy than long-acting methods
- Many people use condoms alongside another contraceptive method for both pregnancy and STI protection
Emergency Contraception
Emergency contraception is used after unprotected sex, contraceptive failure, or a missed pill. It is not intended as a regular method of contraception. Options include:
- The emergency contraceptive pill (levonorgestrel), which is most effective when taken as soon as possible after unprotected sex - ideally within the first 24 hours. However, it can generally prevent pregnancy if taken up to 72 hours (3 days) after unprotected sex.
- Copper IUD insertion, which is the most effective form of emergency contraception, can be used up to five days after unprotected sex.
If you need emergency contraception, contact your GP or pharmacist promptly.
Fertility Awareness Methods
For some people, fertility awareness is the right fit, whether for personal, cultural, or medical reasons. These methods involve identifying fertile days in the menstrual cycle by tracking basal body temperature, cervical mucus changes, and cycle length.
They require careful and consistent daily tracking and a thorough understanding of the menstrual cycle. With perfect use, they can be reasonably effective, but with typical use, failure rates are higher than with hormonal or long-acting methods. They do not protect against STIs.
Permanent Contraception
Permanent contraception includes vasectomy and tubal ligation. These are surgical procedures intended for people who are certain they do not want future pregnancies. Reversal is sometimes possible but cannot be guaranteed, so a thorough conversation with your GP beforehand is important.
Side Effects and Finding the Right Fit
Side effects vary between individuals and between methods. Some people find that a particular method improves their menstrual symptoms, skin, or overall well-being. Others may experience bleeding changes or headaches.
If a method does not suit you, there are other options to explore, and it sometimes takes a couple of attempts to find the right fit. That is a normal part of the process.
Contraception and STI Protection
Most contraceptive methods prevent pregnancy but do not protect against sexually transmitted infections. Condoms remain the most reliable way to reduce STI transmission risk. Regular sexual health checks are an important part of overall sexual health, regardless of which contraceptive method you use.
Talking to Us About Contraception
A contraception appointment is a clinical conversation, not a judgement. Your GP or nurse practitioner will ask about your medical history, current medications, blood pressure, smoking status, migraines, menstrual symptoms, and future pregnancy plans. This helps us make sure that whatever we recommend is both safe and right for you.
GP and Me provides care for all bodies and genders, and we respect every person's right to make informed decisions about their own health. To discuss your options or book an appointment, get in touch with us.
