To avoid pregnancy it is important to choose a contraceptive method that suits your needs.
Using your chosen method of contraception in the right way increases your chances of avoiding or preventing a pregnancy. For example, using the oral contraceptive pill the right way gives you a 99 per cent chance of avoiding pregnancy.
If you have had unprotected sex because you forgot to use contraception or there was a mishap such as the condom broke, you can prevent pregnancy by taking emergency contraception – often called the ‘morning after pill’.
This form of emergency contraception is more effective if taken as soon as possible after unprotected sex. It can work up to four days after sex but is not very effective after this time.
There are many different types of contraception including:
- the oral contraceptive pill
- NuvaTM ring (hormone vaginal ring)
- implanon rod
- intrauterine device (IUD) – copper and progestogen releasing ‘Mirena’
- diaphragm and cervical cap
- condom (male and female)
- the natural family planning method
You can buy the morning after pill from a chemist without a prescription from your doctor.
Barrier methods prevent sperm from reaching the egg. They include:
1. Male condoms
Condoms can protect against STIs as well as pregnancy.
Male and female condoms are the only types of contraception that protect against sexually transmitted infections (STIs).
When used correctly, male condoms are more than 80 percent effective against pregnancy, according to the Centers for Disease Control and Prevention (CDC).
To use a male condom correctly:
- Choose the correct size.
- Place the condom on the head of the erect penis. If uncircumcised, pull the foreskin back first.
- Pinch the tip of the condom to remove any air.
- Unroll the condom down the penis, being careful not to tear it.
- After intercourse, hold the base of the condom in place before pulling out of the vagina.
- Remove the condom and dispose of it. Never reuse a condom.
Most male condoms are made of latex, but other types are available for those with a latex allergy. If using a lubricant, check that it is compatible with the kind of condom being used. For example, latex condoms can only be used with water-based lube.
Condoms are available over-the-counter (OTC), without a prescription, from supermarkets, drugstores, or online. Latex-free condoms are also available to buy online.
2. Female condoms
Female condoms are also available without a prescription. They can be used instead of a male condom, but should never be used with one.
According to the CDC, female condoms are about 79 percent effective for contraception.
Many drugstores now sell female condoms, but if local stores do not stock them, they are available online.
A diaphragm is a barrier method of contraception that a person places inside the vagina. It is important to apply spermicide to the diaphragm before each use.
When used with spermicide, the CDC estimate that the diaphragm is close to 90 percent effective.
A person must insert the diaphragm a few hours before intercourse, leave it in place for 6 hours after sex, and remove it after 24 hours. Diaphragms do not protect against STIs.
4. Cervical cap
A cervical cap (sold as FemCap in the United States) is a soft silicone cup that is placed deep inside the vagina. It covers the cervix to stop sperm from reaching an egg.
This effectiveness of the cervical cap varies according to sources, but Planned Parenthood estimate that its effectiveness ranges from about 70 to 85 percent. It does not protect against STIs.
Cervical caps are available in drugstores and online.
The contraceptive sponge is a method of birth control that a person can buy without a prescription. Made of polyurethane foam and containing spermicide, the sponge is placed deep inside the vagina to block entry to the uterus.
Used alone, the sponge is 76 to 88 percent effective, but using it with a condom further reduces the risk of pregnancy and STIs.
Contraceptive sponges are available to buy online.
Spermicide is a chemical that inactivates sperm. It is available to buy without a prescription and is used with forms of barrier contraception, such as condoms, but not with the sponge.
If used alone, spermicide should be inserted close to the cervix at least 10 minutes before sex. It remains effective for 60 minutes and is approximately 71 percent effective.
Spermicide gels can be found at drugstores or purchased online. Talk to a doctor about the most effective ways to use spermicide as a contraceptive.
Hormonal forms of birth control prevent conception by stopping ovulation, which is the release of an egg from the ovaries. This type of contraception does not protect against STIs.
Most hormonal contraceptives are only available with a prescription from a doctor and, except for emergency contraception, it is not usually available online.
7. Contraceptive pills
Birth control pills are one of the most commonly used methods of contraception in the U.S.
There are various brands of pill available, and according to the National Health Service (NHS)in the UK, they are over 99 percent effective if taken as prescribed.
However, with typical use, they are approximately 95 percent effective.
There are two forms of the pill:
- The combined pill, which contains estrogen and progestin: These should be taken daily, as per the instructions. The pill pack often contains some pills that are free of hormones. When taking these pills, a person will have a monthly period.
- The mini-pill, which contains only progestin: A person must take this pill at the same time every day without a break. Someone taking the mini-pill will not necessarily have a scheduled period.
According to the NHS, the contraceptive patch is 99 percent effective when used correctly. With typical use, it is closer to 90 percent effective.
A person can place a contraceptive patch on the:
- upper arm
A person must wear each patch for 3 weeks, before removing it for 1 week to allow for a menstrual period. There is a small risk of skin irritation.
The contraceptive shot (Depo-Provera) is usually given by a doctor every 12 weeks. According to the CDC, when used correctly, and assuming that a person gets their shot on time, it is over 90 percent effective at preventing pregnancy.
According to Planned Pregnancy, it may take up to 10 months, or sometimes longer, for fertility to return to normal after a person stops getting the contraceptive shot.
10. Vaginal ring
According to the NHS, the birth control ring known as the NuvaRing is over 99 percent effective when used correctly, but is typically less than 95 percent effective due to human error.
This small, plastic ring is placed in the vagina for 3 weeks. It releases hormones into the body to prevent pregnancy.
The ring must be removed for 7 days to allow for a menstrual period before a inserting a new ring.
Intrauterine devices and implants
Intrauterine devices (IUDs) and implants are long-term contraceptive devices. The NHS state that they are over 99 percent effective at preventing pregnancy because there is little room for human error. However, they do not protect against STIs.
An IUD is a small device that a doctor inserts into the uterus. There are two types of IUDs:
- Hormonal: Once fitted, an IUD lasts for at least 5 years before it needs replacing. IUD’s do not completely stop ovulation but act as contraception by thickening the cervical mucus to prevent sperm entering the uterus, as well other hormonal changes. Brand names include Mirena, Kyleena, Liletta, and Skyla.
- Copper-based: Sold as ParaGard, this hormone-free IUD is covered in copper wire, which destroys sperm trying to enter the uterus. One IUD can prevent pregnancy for approximately 10 years.
Adverse reactions include spotting between periods, irregular periods, and menstrual cramps.
Implants are another form of hormonal birth control. A nurse or doctor inserts a matchstick-sized rod into a person’s arm to protect against pregnancy.
Implants work by releasing the hormone progestin into the body, which prevents ovulation. The CDC estimate that implants are also greater than 99 percent effective for contraception.
Implants must be replaced about every 3 years.
13. Natural family planning
The natural method of contraception involves tracking the menstrual cycle and avoiding sex when a person is in the fertile phase of the menstrual cycle.
An individual’s “fertile window” lasts for around 6 to 9 days per month and coincides with ovulation, which is the release of the egg.
Several methods are possible for natural family planning.
Many people use the following signals to work out whether they are ovulating or are in their fertile window:
- measuring basal body temperature
- taking note of the quality and quantity of the cervical mucus
- logging the start and end times of their cycle details over several months
Each person’s fertile window is different, so a person should pay attention to their body’s signals. According to the CDC, natural family planning methods are about 76 percent effective when followed accurately.
14. Emergency contraception
In the case of unprotected sex or failed birth control, such as a broken condom or a failure to take the contraceptive pill, it is possible to use emergency contraception to reduce the risk of pregnancy.
Emergency contraception should not be used in place of regular birth control methods.
There are two forms of emergency contraception:
- Emergency contraceptive pill: People must take a hormonal pill within 3 days of intercourse. The sooner a person takes it, the more effective it is, so a person should take it as soon as possible after having sex. The pill usually contains the chemical levonorgestrel. These pills are available from a doctor or a drugstore.
- Copper IUD: The ParaGard IUD can be inserted up to 5 days after sex to prevent pregnancy. According to Planned Pregnancy, it is more than 99.9 percent effective when used in this timeframe.
Both women and men can undergo procedures to reduce their fertility permanently. The NHS state that these procedures are typically over 99 percent effective at preventing pregnancy, but they do not protect against STIs.
Men can get a vasectomy, which involves snipping the tubes that carry sperm. It is a minor procedure that does not require hospitalization. A vasectomy reversal is possible in some cases. However, fertility after reversal is not always fully restored.
Women can have a sterilization procedure known as tubal ligation. It involves clamping or sealing the fallopian tubes. The effects are usually permanent. In rare cases, tubes can reconnect and result in pregnancy.