There are many different contraceptive methods available, and different methods suit people at different times of their lives. The guide below shows most of the available methods, explains how they work, how effective they are and the main advantages and disadvantages. You can ask your GP, practise nurse or family planning clinic for more information on any method you are interested in.

The figures quoted in this guide for how well each method works are based on extensive independent research. Most contraceptives need to be prescribed. If your general practise of family planning clinic does not provide all the methods they should be able to tell you of the nearest general practise or family planning clinic that does. If you would prefer not to see your own GP or practise nurse about contraception you can go to another general practise for contraception. Many sexual health clinics offer contraception.

You can buy male or female condom s and spermicides without going to a doctor or clinic. For most women spermicide on their own are not recommended as a reliable contraceptive. You can also buy diaphragms and caps at a pharmacy, if you know your size.

Research about the risk of breast cancer, cervical cancer and hormonal contraception is complex and contradictory. Current research suggests that all users of hormonal contraception appear to have a small increase in the risk of being diagnosed with breast cancer compared to non-users of hormonal contraception. Further research is ongoing. All risks or benefits should be discussed with your doctor or nurse.

How effective any contraception is depends on how carefully and consistently you use the method.

If 100 sexually active women don’t use any contraception, 80 to 90 of then will become pregnant in a year.

• No user failure: do not depend on you remembering to take or use contraception. These are long acting methods.
• User failure: methods you have to use and think about regularly or each time you have sex. For these methods to be effective you must use them according to the instructions given.

Some facts about avoiding pregnancy

There are a lot of myths about how to avid pregnancy. These are the facts:

A woman can still get pregnant:

• If it is the first time she has sex
• If she does not have an orgasm
• If a man pulls out of her vagina before he comes (ejaculates)
• If she has sex when she has a period
• If she is not fully breastfeeding
• If she douches (squirts fluid into the vagina). This can be very harmful to women
• Whatever position the couple have sex in

Contraception and breastfeeding

Breastfeeding can act as a very effective contraception when you are fully breastfeeding a baby under six months. This means that you must:

• Be breastfeeding at regular intervals, day and night
• Be giving your baby no other food or drink, so no breastfeeds are missed
• Have no periods
  
  
  

Methods with no user failure

Effectiveness: Over 99% effective. Less than 1 woman in 100 will get pregnant in a year.

How it works: Releases hormone progestogen slowly into the body. This stops ovulation, thickens cervical mucus to prevent sperm meeting an egg and thins the lining of the womb to prevent an egg implanting.

• Lasts for 12 weeks (Depo-Provera) or 8 weeks (Noristerat).
• May protect against cancer of the womb and offers some protection from pelvic inflammatory disease.
• You don’t have to think about contraception for as long as the injection works.

• Periods may stop, be irregular of longer.
• Periods and fertility may take time to return after stopping the injections.
• Some women gain weight.
• Other possible side-effects include headaches, spotty skin, mood changes and breast tenderness.

• The injection cannot be removed from the body so any side-effects may continue as long as it works and for some time afterwards.
• Not affected by other medicines.

Effectiveness: Over 99% effective. Less than 1 woman in 100 will get pregnant in a year.

How it works: Flexible tube put under the skin of the arm. Releases the hormone progestogen. It stops ovulation, thickens cervical mucus to prevent sperm meeting and egg and thins the lining of the womb to prevent an egg implanting.

• Works for three years but can be taken out at any time.
• You don’t have to think about contraception for as long as the implant works.
• When the implant is removed your normal level of fertility will return.

• Periods are irregular, much longer or stop for at least the first year.
• Some women gain weight.
• Other possible side-effects include headaches, spotty skin, mood changes and breast tenderness.

• Put in using a local anaesthetic and no stitches are needed. Tenderness, bruising and some swelling may occur.
• You may feel the implant with your fingers, but it can’t be seen.
• Some medicines may stop the implant from working.

Intrauterine system (IUS)

Effectiveness: Over 99% effective. Less than 1 woman in 100 will get pregnant in a year.

How it works: A small plastic device which releases the hormone progestogen is put into the womb. This thickens cervical mucus to prevent sperm meeting and egg and thins the lining of the womb to prevent an egg implanting and may stop ovulation.

• Works for five years but can be taken out at any time.
• Periods will be much lighter, shorter and usually less painful.
• You don’t have to think about contraception for as long as the IUS is in place.
• When the IUS is removed your normal level of fertility will return.

• Irregular light bleeding between periods is common for the first three months and sometimes longer.
• May be temporary side-effects such as headaches, spotty skin, mood changes and breast tenderness.
• Very small chance of getting an infection during the first three weeks after insertion.

• Women are taught to check the IUS is in place by feeling threads high in their vagina.
• Very useful for women with very heavy and/or painful periods.
• A check for an existing infection is usually advised before an IUS is put in.

Intrauterine devise (IUD)

Effectiveness: Around 99% effective. Less than 1 to 2 women in 100 will get pregnant in a year.

How it works: A small plastic and copper device is put into the womb. It stops sperm meeting an egg or may stop an egg implanting in the womb.

Advantages:

• Works as soon as it is put in.
• Can stay in 3 to 10 years depending on type, but can be taken out at any time.
• You don’t have to theink about contraception for as long as the IUD is in place.
• When the IUD is removed your normal level of fertility will return.

• May not be suitable for women at risk of getting a sexually transmitted infection.
• Periods may be heavier or longer and more painful.
• Very small chance of getting an infection during the first three weeks after insertion.
• A small increased risk of ectopic pregnancy if the IUD fails.

• If fitted after the age of 40 it can stay in until the menopause
• Women are taught to check the IUD is in place by feeling threads high in their vagina.
• A check for an existing infection is usually advised before an IUD is put in.

Effectiveness: Female sterilisation – lifetime failure rate is 1 in 200 (one in two hundred).

Male sterilisation (also known as vasectomy) – lifetime failure is 1 in 2000 (one in two thousand).

 How it works: the fallopian tubes in women or the tubes carrying the sperm (vas deferens) in men are cut or blocked to prevent sperm reaching an egg. Female sterilisation usually involves a general anaesthetic. 

 Advantages:

• Vasectomy is a simple and quick operation.
• Sterilisation is permanent with no long or short-term serious side-effects.
• Once operation has worked you don’t have to think about contraception.

• After vasectomy it takes a few months for sperm to disappear from the tubes.
• Contraception muct be used until a semen test shows that no sperm can be seen.
• A small risk of ectopic pregnancy if female sterilisation fails.

• Should not be chosen if in any doubt and counselling is important.
• You may experience discomfort or some pain for a short time after sterilisation. It is important to rest and avoid strenuous activity for a while after the procedure.
   

Contraceptive patch

 Effectiveness: Over 99% effective if used according to instructions. Less that 1 woman in 100 will get pregnant in a year.

How it works: A small patch stuck on the skin, releases two hormones, oestrogen and progestogen. It stops ovulation, thickens cervical mucus to prevent  sperm meeting an egg ad thins the lining of the womb to prevent an egg implanting.

Advantages:

• Easy to use.
• Can help to reduce bleeding and period pain.
• May protect against cancer of the ovary and womb.
• Can be used by healthy non-smokers up to the menopause.
• When you stop using the patch your normal level of fertility will return.

• Not suitable for smokers over 35 and some other women.
• Very low risk but serious side-effects ,ay include blood clots (thrombosis), breast cancer and cervical cancer.
• Can be temporary side-effects
• Possible skin reaction where the patch is stuck on the skin.

• May be seen.
• New patch has to be used each week for three weeks out of four.
• Some medicines can make it less effective.
• Less effective in women who weigh over 90kg or over.
• Not affected by diarrhoea or vomiting.

Combined pill 

Effectiveness: Over 99% effective if used according to instructions. Less that 1 woman in 100 will get pregnant in a year.

 How it works: Contains two hormones, oestrogen and progestogen. It stops ovulation, thickens cervical mucus to prevent sperm meeting an egg ad thins the lining of the womb to prevent an egg implanting 

Advantages:

• Often reduces bleeding, period pain and pre-menstrual tension.
• Protects against cancer of the ovary  and womb and some pelvic infections.
• Suitable for healthy non-smokers up to the menopause.
• When you stop using the combined pill your normal level of fertility will return.

• Not suitable for smokers over 35 and some other women.
• Very low risk but serious side-effects may include blood clots (thrombosis), breast cancer and cervical cancer.
• Can be temporary side-effects

• May not be as effective if taken late or after vomiting or severe diarrhoea.
• Some medicines can make it less effective.
• Pill users increase their risk of heart disease if the smoke.

Effectiveness: Over 99% effective if used according to instructions. Less that 1 woman in 100 will get pregnant in a year.

How it works: Contains the hormone progestogen which thickens cervical mucus to prevent sperm meeting an egg ad thins the lining of the womb to prevent an egg implanting. In some women is stops ovulation.

Advantages:

• Few serious side-effects.
• Can be used by women who cannot use oestrogen.
• Can be used by women over 35 who smoke.
• When you stop using the pill your normal level of fertility will return.

• May be temporary minor side-effects.
• Periods may be irregular, with some bleeding in between, or be missed.
• A small increased risk of ectopic pregnancy if it fails.
• May be less effective in women who weigh over 70kg.

• It needs to be taken at the same time each day.
• Not effective if take over three hours late or after vomiting or severe diarrhoea.
• Some medicines may make it less effective but most antibiotics do not affect POPs.

How it works: Made of very thin latex (rubber) or polyurethane (plastic) it is put over the erect penis and stops sperm from entering the woman’s vagina.

• Widely available and a variety of types to choose from.
• May protect both partners from sexually transmitted infections, including HIV.
• Men can take responsibility for contraception.
• No major side-effects.

• Putting it on can interrupt sex.
• May slip off or split if not used correctly.
• Man needs to withdraw as soon as he has ejaculated and be careful not to spill any semen.

• Free from family planning and sexual health clinics.
• Must be put on before the penis touches the woman’s genital area.
• Spermicide is not needed.
• Oil based products such as body lotions damage latex condoms, but can be used with polyurethane condoms.
  
  

How it works: A soft polyurethane sheath lines the vagina and the area just outside, and stops sperm from entering the vagina.

Advantages:

• Can be put in any time before sex.
• May protect both partners from sexually transmitted infections, including HIV.
• Oil based products can be used with female condoms.
• No major side-effects.

• Putting it in can interrupt sex.
• Need to make sure the man’s penis enters the condom and not between the vagina and the condom.
• May get pushed too far into the vagina.
• Expensive to buy.

• Use a new condom each time and follow the instructions carefully
• Sold widely and is free at some family planning and sexual health clinics.

 Effectiveness: Latex types are 92% and 96% effective if used correctly. Between 4 and 8 women in 100 will get pregnant in a year. Silicone caps are less effective.

 How it works: A flexible latex (rubber) or silicone device used with spermicide, is put into the vagina to cover the cervix. This stops sperm from entering the womb and meeting an egg.

Advantages:

• Can be put in any time before sex.
• May protect against some sexually transmitted infections and cancer to the cervix.
• A variety of types to choose from.
• No major side-effects.

• Putting it in can interrupt sex.
• With some types, extra spermicide is needed if you have sex again.
• Cystitis can be a problem for some diaphragm users.
• Can take time to learn how to use correctly.

• Correct size needs to be known and fitting should be checked every 12 months and if you gain or loose more than 3kg or have a baby, miscarriage or abortion.
• Silicone caps come in disposable and reusable types.
   

Natural family planning

Effectiveness: using several fertility indicators is 98% effective if instructions and teaching are followed. 2 women in 100 will get pregnant in a year.

Advantages:

• No side-effects.
• No hormones are used.
• Gives a woman a greater awareness of her body.
• Can also be used to plan a pregnancy.

• Need to avoid sex or use a condom at fertile times of the cycle.
• The method needs to be learned from a trained natural family planning teacher and takes time to learn.

Comments:

• Persona is a small handheld computerised monitor with urine sticks, which measure hormonal changes. Persona predicts the fertile and infertile times of the menstrual cycle. It is claimed to be 94% effective.

This guide is taken from a leaflet “Your guide to contraception” by Sexual Health Direct which is run by fpa (UK), with (minor) modifications where necessary. This guide is for information purpose only. For an Islamic stance to personal situations, please seek guidance. Here are a few Islamic verdicts related to contraception and birth control.

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