Learning All About Birth Control: More Than Just the Pill

For anyone whose knowledge of birth control starts and ends with your textbook Microgynon pill, we’re here to help demystify the different types of contraception available and figure out what option could be a good fit for you.

Keep scrolling for an overview of the different types of birth control from the copper coil to caps and handy low-maintenance patches, so when you sit down for a chat with your GP or practice nurse, you’ll be all clued up on all the pregnancy prevention possibilities.

The Implant

The contraceptive implant (Nexplanon) is a thin flexible rod about the same size of a matchstick and is placed under the skin in the upper arm. It releases the hormone progestogen which thickens the mucus on your cervix to prevent sperm reaching the egg and inhibits ovulation, thus preventing you from getting pregnant.

For anyone who doesn’t want the responsibility or the hassle of remembering to take a pill every day, the implant can last for three years before it needs to be replaced (but can be removed anytime) and is more than 99% effective. It’s a great reliable form of birth control and especially convenient for anyone who can’t use oestrogen-based contraception.

It works soon after it is put in, for some people it’s straight away depending on where you are in your cycle but most medical advice suggests it can take seven days before it’s reliable, so always use alternative methods of contraception in the interim.

Some side effects associated with the implant, as with most forms of contraception, can include irregular periods or absence of menstruation (amenorrhea), headaches, decreased sex drive, mood swings and weight gain.

The Contraceptive Pill

The combined pill – often just referred to as the pill – contains synthetic versions of the hormones oestrogen and progesterone, which are produced naturally in the ovaries.

The most commonly prescribed pill is the monophasic or single-phase type. This pill comes in either 21-day or 28-day packs. People taking the 21-day formulation would have 21 days of active hormones followed by seven days without pills. Those on the 28-day pack take active hormones for 21 days and a placebo pill with inactive ingredients for seven days. In both cases, the seven-day break is when menstruation occurs. Microgynon and Yasmin are examples of this type of pill.

Multi-phasic pills provide different strengths of hormones and are designed to be taken at specific times throughout the course of each pill pack.

The mini pill is a progestin-only pill taken every day without a seven-day break. It is a good option for anyone who is breast-feeding or can’t use oestrogen-based contraception for health / other reasons.

When taken correctly at the same time every day and with food, the pill is over 99% effective however, if you miss a pill, vomit or have diarrhoea you are not protected and could get pregnant.

IUD (Intrauterine Device) / Copper Coil

An IUD, also known as the coil, is a small T-shaped copper device inserted through your cervix into the uterus. It works by producing an inflammatory reaction to interfere with the sperm, preventing pregnancy.

It’s hormone-free so there are none of the common side effects you can experience on the pill, it works immediately and can last for five – ten years so for longevity and convenience purposes, this is a great set-it-and-forget-it form of birth control.

Having an IUD fitted can be slightly uncomfortable for some people but and you can discuss having a local anaesthetic beforehand and you can stop at any point during the procedure.

Your partner should not be able to feel the device during sex. If they can, you should make an appointment with your GP straight away.

IUS (Intrauterine System)

Like the IUD, the IUS is a flexible T-shaped plastic device inserted into your womb. It releases the hormone progesterone to thicken the mucus in the neck of the womb therefore preventing sperm from reaching the egg to fertilise it. It also makes the lining of the womb thinner, so a fertilised egg is less likely to implant itself. It can last three to five years depending on the brand.

If it’s fitted within the first seven days of your cycle, you’ll be protected immediately. If it’s fitted at any other time, use additional contraception such as condoms for a week afterwards.

It’s common to feel period-like cramping afterwards but pain relief can ease any discomfort.

Check your IUS is in place regularly during the first month and after each period. If you cannot feel the threads or think it may have moved, you will not be protected against pregnancy. See a GP straight away and use additional contraception.

The IUS can also be used to manage severe period symptoms, endometriosis and chronic pelvic pain.

Vaginal Ring

The NuvaRing is a small flexible ring placed on the inside of your vagina. It releases a continuous dose of oestrogen and progestogen to prevent pregnancy. One of the benefits of the vaginal ring is, unlike the pill, it still works regardless of sickness or diarrhoea. You wear the ring for 21 days then take it out for a seven-day interval, during which you’re still protected against pregnancy. After the seven days, put a new ring in (you can set a reminder on your phone so you don’t forget you’re due a new ring).

You’re fine to use tampons and have sex with the ring in – you may be able to feel the ring during sex but this is nothing to worry about.

The Contraceptive Injection (Depo-Provera)

The injection releases progestogen into your bloodstream to prevent ovulation. Depo-Provera is the most common type given in the UK and lasts for 13 weeks. Noristerat may also be given, which lasts for eight weeks.

As with some other methods of birth control, if you have it during the first five days of your cycle, you’re protected against pregnancy immediately. On any other day of your cycle, you’ll need to use additional contraception for seven days such as condoms.

It’s a particularly suitable option for anyone who cannot use oestrogen-based birth control, or who struggles to remember to take the pill every day / change their patch weekly, for example. It can also help relieve some pre-menstrual symptoms for menstruators.

Birth Control Patch (Evra)

The small patch, called Evra in the UK, releases oestrogen and progestogen through the skin into your bloodstream to prevent pregnancy. Each patch lasts one week – you’ll wear a new patch every week for three weeks and then have a patch-free week on your fourth week. During your patch break, you may experience period-like withdrawal bleeding, although this isn’t always the case.

Like the vaginal ring, you don’t need to think about it every day, you can wear it swimming, in the shower or while playing sports and it’s still effective if you have diarrhoea and sickness. The only downside is its visibility but if you can deal with that, it’s a pretty good all-rounder.

Contraceptive Diaphragm / Cervical Cap

The contraceptive diaphragm or cap is a barrier method of contraception that’s used in conjunction with Spermicide – a gel used to kill sperm.

Unlike the vaginal ring, the soft silicone dome fits inside the vagina and covers the cervix, preventing sperm from reaching the uterus to fertilise an egg.

It’s not the most popular or effective form of contraception (92-96%) as it relies on the wearer positioning it correctly, it interrupts sex and it can take time to learn how to use it but one advantage is you only have to wear it during sex. However, you do have to keep it in for six hours after the last time you had sex.

If you have sex three hours after putting it in, you will need to add extra Spermicide.

Condoms

Condoms are the only form of contraception that protects against sexually transmitted infection (STIs) and pregnancy. External condoms are a barrier method of contraception made from a thin latex rubber and worn on an erect penis to prevent pregnancy. They’re readily available and come in a variety of shapes and sizes.

If you’re using latex condoms, it’s important that you don’t use oil-based lubricant as this can damage the condom and make it more likely to split.

Condoms for people with vaginas are less common and not as effective (95%) as external condoms. This form of contraception is worn inside the vagina to stop sperm meeting an egg.

The most common types of condom include:

• Latex condoms
• Textured condoms
• Flavoured condoms
• Lubricated condoms
• Latex-free condoms

Sympto-Thermal Method / Fertility Awareness Method

The Sympto-Thermal Method (STM) is a natural fertility awareness-based method. It requires the person with a vagina to observe and record their cervical fluid secretions, basal body temperature and other biological signs to identify most fertile days in their cycle. Couples can use this method to both achieve and avoid pregnancy, by abstaining from sex on the days when you’re most fertile or using alternative contraception.

One advantage of STM is that it is a completely natural, hormone-free, side-effect free fertility awareness method and enables a person to better understand their body and menstrual cycle. According to Natural Cycles, it is 93% effective with typical use, however it remains one of the least effective forms of pregnancy prevention due to the margin for human error. If you have irregular cycles, it’s probably not the most suitable or reliable form of birth control for you.

For more guidance on choosing contraception that’s right for you, consult your GP and the NHS website here.