Family Planning and Contraceptives

Male condom
The male condom is made of very thin latex rubber. You use a condom once and then throw it away. It should be fitted over the man’s erect penis before it touches your vagina or genital area. This stops sperm from reaching the egg.

	Advantages		Disadvantages		Effectiveness
	It is straightforward to use. It can protect you against some sexually transmitted infections (STIs). You only need to use one when you have sex.		Sex has to be interrupted to put the condom on. The condom can be split, or can slip off if it is not put on carefully. Some people can develop an allergy to latex rubber or to the spermicide in the lubricant.		If you use them carefully and consistently, male condoms are highly effective in preventing both pregnancy and STIs, including HIV. Their general effectiveness ranges from about 85% - 98% (Family Planning Association).

Female condom
The female condom is made of very thin polyurethane. You use a female condom once and then throw it away. You put it into your vagina to form a lining before you start having sex. This stops sperm from reaching the egg.

	Advantages		Disadvantages		Effectiveness
	It is straightforward to use. It can protect you against some sexually transmitted infections. You only need to use one when you have sex.		Female condoms not as widely available as male condoms, and can be expensive. They’re not as effective as male condoms. A female condom can move around when you are having sex, so it’s important to make sure your partner’s penis stays inside it.		The female condom can be up to 95% effective if you use it according to the instructions (Family Planning Association).

Diaphragm and cap
A diaphragm is a dome of thin rubber. A cap is very similar, but smaller. Diaphragms and caps must be used with a spermicide (a gel or cream that kills sperm). You put the diaphragm or cap inside your vagina to cover your cervix (the entrance to your womb). This stops sperm from reaching the egg.

	Advantages		Disadvantages		Effectiveness
	They are straightforward to use You only need to use one when you have sex. You can put your diaphragm or cap in at any time before sex, when it is convenient.		Putting a cap or diaphragm in can interrupt spontaneous sex. The spermicide can be messy and may cause irritation for you or your partner. Caps and diaphragms need to be fitted by a healthcare professional to make sure they are the right size.		Diaphragms and caps are 92%-96% effective if you use them according to the instructions (Family Planning Association).

Intrauterine devices (IUD)
Intrauterine devices (IUDs) are small plastic and copper devices of varying shapes and sizes that are put in the womb (uterus). IUDs prevent fertilisation by an effect both on sperm and eggs. They also make the womb lining unreceptive to a fertilised egg.

	Advantages		Disadvantages		Effectiveness
	Once you have had an IUD fitted, you don’t have to think about contraception for as long as it is in place, which can be anything from 3 to 12 years. The IUD doesn’t interfere with sex.		IUDs can cause your periods to be heavier, longer and more painful than normal. Immediately after you have an IUD fitted, there is a chance that you may get an infection. IUDs can come out of your womb, so you have to be taught how to check if your IUD is still in place. IUDs are not suitable for everyone. It doesn’t protect you from sexually transmitted infections.		IUDs are 98-99% effective (Family Planning Association).

Intrauterine system (IUS)
The intrauterine system (IUS) is a ‘T’ shaped device that is put in your womb and slowly releases progestogen. This makes the womb lining very thin and unreceptive to a fertilised egg, and affects your cervical mucus to make it very hard for sperm to get through.

	Advantages		Disadvantages		Effectiveness
	Once you have had an IUS fitted, you don’t have to think about contraception for as long as it is in place, which can be up to 5 years. The IUS doesn’t interfere with sex. Within 3 to 6 months of using an IUS, most women find that their periods become lighter and less painful.		An IUS can cause irregular bleeding for the first few months after it is fitted. The IUS can come out of your womb, so you have to be taught how to check that the IUS is still in place. It can cause side effects such as breast tenderness, headaches and acne for the first three months or so after the IUS is fitted. The IUS is not suitable for everyone. It doesn’t protect you from sexually transmitted infections.		The IUS is more than 99% effective (Family Planning Association).

The combined pill
The combined pill (often just called ‘the pill’) contains two synthetic versions of hormones that women have naturally in their bodies: estrogen and progestogen (the man-made form of the hormone progesterone). The pill keeps your hormones steady so you don’t ovulate. It also affects your cervical mucus (makes it harder for sperm to get through it) and stops the lining of your womb from thickening and preparing itself to host a fertilised egg. Most types of combined pill are taken once a day for 21 days and then you have a seven-day break. During this break, you’ll have a bleed, but this is not the same as a period, it’s actually a ‘withdrawal bleed’ – your body’s response to the hormones being stopped.
Click here if you’d like to know more about the role these hormones play in your menstrual cycle.

	Advantages		Disadvantages		Effectiveness
	The pill doesn’t interrupt sex at all. Most women find that the withdrawal bleed is much lighter and shorter than a ‘real’ period, and have fewer PMT symptoms. The withdrawal bleed is very regular and predictable, because you know when you stop taking the pills for your break.		The pill can have side effects including mood swings, weight changes, breast tenderness, headaches and nausea. In rare cases, the pill can cause serious side effects, such as blood clots (thrombosis). If you are over 35, if you smoke or are breastfeeding, you may not be able to take the combined pill. It doesn’t protect you against sexually transmitted infections.		The combined pill is over 99% effective if you use it according to the instructions (Family Planning Association).

The mini pill
The mini pill is also called the progestogen-only pill. Progestogen is the man-made form of progesterone. The mini pill affects your cervical mucus (makes it harder for sperm to get through it) and stops the lining of your womb from thickening and preparing itself to host a fertilised egg. In some cases it also stops ovulation. You take a mini pill each day for 28 or 35 days (depending on the brand) and then immediately start the next pack.

	Advantages		Disadvantages		Effectiveness
	The pill doesn’t interrupt sex at all. It can also reduce PMT symptoms.		The mini-pill can have side effects including acne and breast tenderness. Your periods may stop altogether or be irregular, light, or more frequent while you are taking the mini pill. It doesn’t protect you against sexually transmitted infections. The mini-pill should be taken at same time of each day, everyday, otherwise its effectiveness is reduced		The mini pill is 99% effective if you use it according to the instructions (Family Planning Association).

Calendar Rhythm Method
The calendar rhythm method is a natural contraception method that involves learning about your fertility and working out when you are fertile and infertile each cycle, so you can avoid sex during the fertile phase of your cycle. It requires that you track your cycle for a few months to identify when you ovulate and therefore should avoid having sex. The method is based on the following facts:

• sperm can survive in your uterus for several days and you can therefore get pregnant if you have sex on the days leading up to ovulation.
• the female egg is fertile for about 24 hours following its release from your ovary.
• you cannot get pregnant between the 2 days after ovulation and your next period.

	Advantages		Disadvantages		Effectiveness
	It has no side effects. You can use this method to plan or avoid pregnancy.		It can take up to 6 cycles to build an accurate picture of your cycle. You and your partner need to be committed to the method It doesn’t protect you from sexually transmitted infections.		Can be up to 98% effective (Family Planning Association) if taught well and instructions are followed closely.

Contraceptive injections and implants (small plastic tubes implanted in the inner side of your upper arm) are long-term hormonal contraceptives. Injections and implants release progestogen into your body to prevent (or inhibit) ovulation. They also make the womb lining unreceptive to a fertilised egg, and affect your cervical mucus to make it very hard for sperm to get through.

	Advantages		Disadvantages		Effectiveness
	You don’t need to remember to do anything regularly for these methods other than repeating them They don’t interfere with sex		Most women who have injections or implants find that their periods change or become irregular. Other side effects include mood swings, weight changes, headaches, bloating, acne and breast tenderness. Implants can be difficult to remove. Once you have had a contraceptive injection, its effects cannot be reversed until the injection ‘runs out’, which can be up to 12 weeks. They don’t protect you from sexually transmitted infections.		Contraceptive injections and implants are over 99% effective (Family Planning Association).

Sterilisation is a surgical procedure that is usually permanent, so it’s only appropriate if you’re absolutely sure you don’t want more children or any at all.

Male sterilisation (vasectomy)
A vasectomy is a minor operation that stops sperm travelling from the testicles (where sperm is made) to the penis. You can rely on it when a doctor has given the all clear after two sperm tests.

	Advantages		Disadvantages		Effectiveness
	A vasectomy doesn’t interfere with sex and has no effect on sex drive or the pleasure felt at orgasm.		A vasectomy can’t easily be reversed. It doesn’t protect you against sexually transmitted infections.		Around 1 in 2000 vasectomies fail (Family Planning Association).

Female sterilisation (tubal occlusion)
Tubal occlusion is an operation that stops the egg from travelling down the fallopian tubes. It is effective from the time of the period after the operation.

	Advantages		Disadvantages		Effectiveness
	Female sterilisation doesn’t interfere with sex and has no effect on sex drive or the pleasure felt at orgasm.		You will need to be admitted to hospital for the operation and you will usually need a general anaesthetic. A tuba occlusion can’t easily be reversed. It doesn’t protect you against sexually transmitted infections.		Around 1 in 200 female sterilisations fail (Family Planning Association).