Contraception allows you to choose when and if you want to have a baby. Some forms of contraception also provide protection against sexually transmitted infections (STIs). Making the right contraception choice is an important aspect of sexual health – and

There are several types of contraception, which work in different ways. Before recommending a contraceptive, your GP will assess your age, medical history, and sexual lifestyle. No contraceptive is 100% reliable, and some have possible side effects. It is therefore important to consider these factors when deciding what sort of protection to use.

Myths

There are a lot myths around about contraception and how a woman can get pregnant. These are the facts. A woman can still get pregnant:

  • If a man pulls out of her vagina before he 'comes'
  • If she has sex when she has a period
  • If she is breastfeeding
  • If it is the first time she has sex
  • If she does not have an orgasm
  • If she douches (squirts water or other liquid into the vagina). This can be harmful to women
  • In whatever position the couple has sex
Types of Contraception

Here is some brief information on some forms of contraception and also some useful link where you can find further information.

Condoms – male and female

How it works: The male condom is put carefully over the man’s fully erect penis. The female condom is fitted so that it lines the vagina.

Effectiveness: Male condom - 98%. Female - 95%. Rate freefalls if used badly.

Advantages: Both protect from STIs and pregnancy. Male condom widely available in pharmacies and shops. No side effects. The female condom can be put on any time before sex and taken off any time afterwards.

Disadvantages: Must be used very carefully to ensure no tearing or slipping off. Cost. Interrupts sex. Alcohol and drugs can seriously hinder careful fitting.

Tips: Never use oil-based lubricants such as Vaseline with either. Get best size for partner. Fit carefully – be wary of long nails and jewellery and when opening packet. Hold rim of male condom as you pull out after sex.

Top tip: Condoms and another method will give you the greatest safety from STIs AND unplanned pregnancy.

Combined oral contraception – the pill

How it works: One pill taken every day for 21 days. Releases two hormones, oestrogen and progesterone, into your system. After 3 weeks are up, there is 7-day break where you have your period. Available by prescription only.

Effectiveness: 99% rate of success when used correctly.
Advantages: Does not interrupt sex. Lighter periods. PMS possibly reduced. Possible reduced incidence of ovarian cancer.

Disadvantages: Not for those with high blood pressure, heavy smokers, any smokers over 35. Possible increased risk of cervical cancer. Possible side effects: weight gain, minor headaches, bleeding, breast tenderness. Doesn’t protect from STIs.

Tips: If you miss a Pill, vomit or have diarrhoea soon after taking Pill, use other contraception for 7 days after regular taking of Pill has begun again.

Top tip: Do not automatically discount the Pill if you experience some side effects. Talk to a doctor. There are 18 other brands of the Pill out there, which vary in the combination of hormones released. One of these might be the answer for you.

Mini pill

How it works: Progesterone only pill. Available by prescription only. Taken every day, no break.

Effectiveness: Very careful use: 96-99%

Advantages: Those who can’t take combined Pill can often take this. Does not interrupt sex. Lighter (or even no) periods.

Disadvantages: Must take within 3 hours of normal time every day. Doesn’t protect from STIs. Antibiotics, vomiting and diarrhoea can interfere with effectiveness. Sometimes irregular bleeding or missed periods. Possibility of cysts developing on ovaries – not dangerous but can be painful.

Tips: Same as with combined pill

The implant

How it works: Small plastic rod put in the inner part of your upper arm. Releases progesterone. Inserted by a specially trained doctor. It works for up to three years. The rod can be felt under the skin but not seen.

Effectiveness: Studies have yet to record a pregnancy.

Advantages: Doesn’t interrupt sex. Don’t need to remember pills. Helps painful periods. After removal fertility returns to normal very quickly. Lasts for three years.

Disadvantages: Can be removed earlier but intended to be a long-term method. Some medical problems might make it unsuitable. Irregular bleeding in first year is common. Possible side effects: headaches, acne, weight gain, breast tenderness and bloating. Some medicines might make it less effective. Doesn’t protect against STIs.

Tips: If there are any problems between check ups with the implant, go to your doctor.

Contraception by injection (aka Depo-Provera)

How it works: Releases similar type hormone to mini pill very slowly into the body and each injection, given by doctor, lasts for up to twelve weeks.

Effectiveness: About 99%

Advantages: Suitable for those who can’t take other hormonal contraception. Don’t need to remember pills. Long lasting. Doesn’t interrupt sex.

Disadvantages: Side effects similar to other hormonal contraceptives. Periods can take a while to come back after stopping the injections. Possible delay of normal fertility for up to a year after injections stop. Doesn’t protect from STIs.

Contraceptive patch

How it works: This is a small patch that works like a very low dose of the oral combined pill. You change the patch every 7 days until the 3rd week when you take a 7 day break. Can be worn on any part of your body that is clean, dry and not hairy. The patch is very sticky; it should not come off during swimming, bathing or exercise.

Effectiveness: When used correctly, 99%.

Advantages: Don’t have to remember pills every day. Doesn’t interrupt sex. Not affected by vomiting or diarrhoea.

Disadvantages: Women who cannot take combined pill also cannot take this. Women over a certain weight (approximately 14 stone) might find a reduced effect. Doesn’t protect from STIs. Some prescriptive and complimentary drugs can affect it. May cause skin irritation in some. Prescription needed.

Tips: If the patch falls off, replace it immediately if it’s still sticky or with a new one. If patch has been off for more than 24 hours another form of contraception will have to be used for 7 days. Like the combined pill, the seven-day break should not be extended so as not to break contraceptive cover. Dispose of patch carefully – put it in pouch provided.

Vaginal ring – NuvaRing

How it works: Plastic, flexible ring that the woman puts in her vagina for 3 weeks at a time. It acts like a very low dose combined pill. There is a 7 day break and then a new ring is inserted. Prescription for ring needed from doctor.

Effectiveness: 99% if used correctly.

Advantages: Don’t need to remember pills. Doesn’t interrupt sex. Vomiting and diarrhoea don’t affect it.

Disadvantages: Effectiveness reduced if not used very carefully. Women who cannot take oral combined pill may not be able to take this. Possible side effects similar to oral combined pill. More expensive than oral combined pill. May sometimes be felt by partner during sex. Doesn’t protect against STIs. Antibiotics affect it.

Tips: If the ring falls out, wash it and reinsert it. If out for more than 3 hours, replace it and use another method of contraception for 7 days. Don’t leave unopened package in very high temperatures or in direct sunlight.

Diaphragm or Cap

How it works: Vaginal diaphragms and cervical caps work in a similar way; they just fit over a different part inside the woman’s vagina. Spermicide is also used with both before sex to kill any sperm. Diaphragm/cap must be left in for at least six hours after sex.

Effectiveness: 98% if used carefully

Advantages: Can be placed before sex so no interruption. May protect against STIs. Works as soon as it is in place. Don’t need to remember pills. May be suitable for people who can’t take hormonal contraception. You can use the one cap or diaphragm over and over again.

Disadvantages: Needs to be measured to your size. Weight gain, weight loss, having a baby, miscarriage or abortion can affect its fit and therefore its effectiveness.

Tips: There are quite detailed instructions about how to use your diaphragm/cap and how to take care of it. Pay close attention and ask as many questions as you need to.

Intrauterine System (IUS)

How it works: This is a small plastic T-shaped device with sleeves, which is inserted into the womb and releases the hormone progesterone. Fitted and removed by a specially trained doctor. Effective for up to 5 years, although it can be removed at any time.

Effectiveness: Rate: 1-2/1000

Advantages: Doesn’t interrupt sex. Don’t need to remember pills. Can be particularly suitable for older woman, women who have children and those who can’t take the combined Pill. Lighter, shorter periods.

Disadvantages: Doesn't protect against STIs. Sometimes device can fall out. Other contraception is advisable until first six week check-up. Not suitable for all women. Risk of ectopic pregnancy if you do get pregnant while using this (foetus grows outside womb). This is rare but serious.

Tips: Make sure you attend your check ups (once a year after the first 6 week check-up).

IUCD Intrauterine Contraceptive Device

How it works: Plastic device with thin copper wire, which works similar to the IUS but without the release of hormone.

Effectiveness: About 98%. This can be increased if you use spermicide along with it.

Advantages: Essentially the same as the IUS but suitable for those who cannot take hormones.

Disadvantages: Similar to the IUS. Possibility of heavier periods, especially during 1st year. Possibility of infection to womb or fallopian tubes, especially in younger women who may have new sexual partners or more than one partner. Possibility of device falling out of place.

Natural methods

How it works: This is using the woman's natural menstrual or period cycle to see when is a safe time to have sex. You avoid sex or use a different method of contraception in the unsafe or fertile times. You usually keep track of your cycle by monitoring or charting the different changes in your body over the month. You might use Persona, a system bought from your pharmacy.

Effectiveness: This can vary greatly, depending on how well it is used. It helps if a woman's cycle is regular but vigilance and good observation will increase effectiveness.

Advantages: Doesn't interrupt sex. Always good to be observant of your body. Suitable for women at all stages.

Disadvantages: Doesn't protect against STIs. Need really good instruction and vigilance. Buying Persona every month can be expensive. Even simple changes in a woman's life (such as going on holiday) can possibly throw her cycle off its usual course for a bit.

Tips: Consider back ups for times when you are not sure if it is safe. Consult a doctor about how best to use the natural methods.

Note: If you are being prescribed medicine always tell your doctor if you are on hormonal contraceptive and he/she will tell you if it effects your protection.

Emergency contraception

What is it and when should I use it? Two types: emergency pill and Copper IUD. The pill should be taken up to 72 hours after unprotected sex. IUD: 5 days after. To protect against immediate unplanned pregnancy. Does not protect you from an STI.

How does it work? The pill is like a special dose of combined pill. Take both at same time, not 12 hours apart like before. Copper IUD is like IUD mentioned above and will be fitted by a doctor and removed later. Most women can take either one of them but always talk to your doctor first. Very few risks associated with either of them.

Effectiveness: Pill: within 24 hours of having unprotected sex, the rate is over 90%. 72 hours after - 50%. The IUD is 98% effective. Can also provide ongoing contraceptive cover, if you do not remove it.

What else do I need to know? You should talk to your doctor if you usually take hormonal contraception. He/she will advise you how to carry on with that. You should go back to your doctor if there is any problem such as your periods are more than seven days late, you vomited within two hours of taking the emergency pill, you are worried you caught an STI etc.

Where can I get it? The emergency pill is likely to be supplied by most GPs and many family planning clinics.

Emergency contraception is never going to be as effective as regular contraception.

For further information:

Think Contraception

Irish Family Planning Association

Family Planning Association (North)

Well Woman Clinic

Just Carry One