Contraception: the methods, how to choose and what to ask your doctor
There is no single "best" method of contraception – the choice depends on what matters to you: how reliable the method is, how often you have to think about it, what side effects it may have and how it affects your periods. According to the NHS, the implant, the hormonal coil and the copper coil are over 99% effective in real-life use, whereas the pill, the patch and the ring are around 91%, because they depend on regular use. Only condoms also protect against sexually transmitted infections.
- The NHS describes 15 methods – from daily pills to a coil that lasts 5 or 10 years.
- With real-life (not perfect) use, the implant, the IUS and the IUD are over 99% effective, the combined pill – around 91%, condoms – around 82%.
- Only condoms protect against sexually transmitted infections, including HIV.
- Hormonal methods may cause side effects, which usually settle within around 3 months.
- The hormonal coil (IUS) is named by the NHS as the most effective for easing heavy periods.
What are the methods of contraception?
According to the NHS, there are far more options than "the pill or a condom". The methods are grouped by whether they contain hormones and how long they last.
- Combined hormonal (progestogen + oestrogen): the combined pill, the contraceptive patch, the vaginal ring.
- Progestogen-only: the mini-pill, the hormonal coil (IUS), the implant under the skin of the arm, the contraceptive injection.
- Hormone-free: the copper coil (IUD), condoms, internal (female) condoms, the diaphragm or cap, natural family planning (tracking your cycle).
- Permanent: female sterilisation and vasectomy.
- Emergency contraception: the "morning-after pill" (up to 3 or 5 days after sex, depending on the type) and the copper coil.
How effective is each method?
The NHS distinguishes between "perfect use" (the method is used correctly every time) and "typical use" – real life, with a missed pill, a slipped condom or a forgotten ring. The difference is telling:
- Implant, hormonal coil (IUS) and copper coil (IUD): over 99% with both perfect and typical use.
- Injection: over 99% with perfect use, 94% with typical use.
- Combined pill, mini-pill, patch, ring: over 99% with perfect use, around 91% with typical use.
- Condoms: 98% with perfect use, 82% with typical use. Internal condoms: 95% / 79%.
- Natural family planning: 91–99% with perfect use, 76% with typical use.
The takeaway is simple: the methods where you do not have to remember anything keep their effectiveness in real life too.
How often do you have to think about contraception?
According to the NHS, this is one of the key questions when choosing. Condoms, the diaphragm and the cap are used every time you have sex. The pill is taken every day, the patch is changed every week, and the ring – every 3 weeks.
The other methods are fitted or given by a doctor or nurse, and then you do not think about them: the injection lasts 8 to 13 weeks depending on the type, the implant – 5 years, the hormonal coil – 3 or 6 years, and the copper coil – 5 or 10 years. For the methods you use yourself, an initial consultation with a doctor, nurse or pharmacist is still needed.
What side effects and risks does hormonal contraception have?
The NHS lists commonly reported complaints: headaches, nausea, mood changes, weight gain, sore breasts and acne. An important detail – according to the NHS, there is not enough evidence that hormonal contraception itself causes them, and if they do appear, they usually settle within around 3 months. If they bother you, contact your doctor or clinic – a different method may suit you better.
Hormonal contraception may increase the risk of blood clots and breast cancer. The NHS points out that this risk is very low, but it means that some hormonal methods are not suitable for every woman – which is why a consultation is essential.
How does contraception affect your periods?
For some women this is the deciding factor. According to the NHS, the combined pill, the hormonal coil, the implant and the injection can make periods less painful. For heavy bleeding, the combined pill, the IUS, the mini-pill, the implant and the injection help, with the hormonal coil named as the most effective option for this problem.
The opposite applies to the copper coil – it can make your periods heavier and more painful, although this usually improves within a few months. If it does not improve, the coil can be removed.
What should you ask your doctor and when should you seek help?
The NHS stresses that the choice "depends on what is important to you". Prepare your answers and questions on the four topics the NHS recommends you think about:
- How effective is the method in real-life use, and will I manage to use it correctly?
- How is it used and how often – do I want something I do not have to think about every day?
- What are the side effects and risks for me personally – hormonal or non-hormonal?
- How will my periods change?
See a doctor, nurse or sexual health clinic if:
- the side effects bother you and do not settle;
- the copper coil makes your periods heavier and more painful and this does not improve;
- you have questions about the risk of blood clots or breast cancer with a hormonal method;
- you are not sure whether a given method is suitable for your health condition.
Frequently asked questions
Which method also protects against sexually transmitted infections?
According to the NHS, only condoms protect against sexually transmitted infections, including HIV. All the other methods protect only against pregnancy.
What is emergency contraception and how long do I have?
The NHS describes two options: the "morning-after pill", which is taken up to 3 or 5 days after sex depending on the type, and the copper coil, which can also serve as emergency contraception.
Will I get side effects from the pill?
It is not certain – the NHS states that there is not enough evidence that hormonal contraception causes the commonly reported complaints. If they do appear, they usually settle within around 3 months.
Sources
- NHS – How well contraception works at preventing pregnancy – last reviewed by the NHS: 31 January 2024
- NHS – How contraception is used – last reviewed by the NHS: 31 January 2024
- NHS – Side effects and risks of hormonal contraception – last reviewed by the NHS: 31 January 2024
Informational article retold in our own words from the sources listed. It does not replace a consultation with a doctor; in an emergency call 112. If you spot an inaccuracy, write to [email protected].