Contraception prevents pregnancy and is sometimes called ‘birth control’. Condoms provide contraception and also help reduce the spread of sexually transmissible infections (STIs).
When choosing your contraception method, you should consider advantages and disadvantages of the different methods in terms of:
your personal preferences and lifestyle
possible side effects
the potential for contraception failure for each method, and possible unintended pregnancy
accessibility and ease of use of the methods
cost (immediate and long term)
protection against STIs.
Deciding on the type of contraception
There are many things to consider when deciding what’s best for you. A healthcare provider can provide more information and advice.
Condoms and other barrier or short term hormonal methods rely on the user having them ready and on using them perfectly which is not always possible. For some pros and cons on these and other methods have a look at the 9 types of contraception you can use to prevent pregnancy.
Other contraceptive options that are more like a set and forget system last for a few months or years (e.g. injection, implant, IUD). These long acting reversible contraceptives (LARCS) are less user dependent. Explore how effective various methods are for preventing unintended pregnancy.
A condom is a latex or polyurethane sheath worn on the penis. Internal condoms are also available, which are worn in the vagina. They act as a physical barrier, preventing bodily fluids from passing between people during sex.
When applied and used correctly, condoms help protect against pregnancy and STIs. They are the only form of contraception that offers some protection from STIs, however they can’t always protect from infections that can be spread through skin-to-skin contact such as herpes, genital warts, or syphilis.
If a condom breaks or comes off during sexual activity, they won’t work to protect from pregnancy and it’s likely that you and your partner have been exposed to each other’s bodily fluids. It’s important both partners are aware the condom has broken or come off, and are tested for STIs. Emergency contraception, or the ‘morning after pill’ is available if unintended pregnancy is a concern.
Condoms are widely available from supermarkets, pharmacies, sexual health clinics, family planning clinics and community-based sexual health organisations. Use condoms from reputable brands and check the use-by date.
Before using a condom, check that it has not passed its expiry date. As you open the packet, do so carefully so you do not damage or make a tear in the condom.
When the penis is erect, pinch the air out of the tip of the condom and roll it down over the penis.
Water-based lubricants should be used on the outside of the condom to make the experience more pleasurable and to reduce the risk of the condom tearing.
Never use oil-based lubricants such as massage oil or Vaseline as they can weaken the condom.
After ejaculation, hold onto the base of the condom as the penis is pulled out so it does not stay behind.
Tie a knot in the condom and put it in the bin. Avoid putting it down the toilet as this can cause a blockage in the plumbing.
Remember to always use a new condom each time you have sex, or change from having one type of sex to another.
A contraceptive implant is a small, flexible rod inserted under the skin in the upper arm that prevents pregnancy. It does not protect against STIs.
The implant works by continuously releasing a low, steady dose of a form of the hormone progesterone, which stops ovulation and thickens the mucus at the entrance to the uterus (womb), making it difficult for sperm to enter.
A prescription is required for the implant, and it needs to be replaced after 3 years. The rod can only be inserted and removed by a doctor or nurse, in a minor procedure using local anaesthetic.
The intrauterine contraceptive device (IUD) is a highly effective method of contraception that lasts for 5 years or more. An IUD is a small device placed inside the uterus to prevent pregnancy. There are 2 types of IUD—the hormonal IUD and the copper IUD.
Both types require a prescription and must be fitted by a doctor or nurse. IUDs do not protect against STIs.
The hormonal IUD is made of plastic and works by slowly releasing a progestogen hormone called levonorgestrel. The hormone thickens the mucus at the entrance to the uterus, preventing sperm from entering. It also thins the lining of the uterus, making it hard for a fertilised egg to take hold. Hormonal IUDs can last up to 5 years.
The copper IUD is made of copper and plastic. It does not release a hormone but constantly releases a small amount of copper which affects the way sperm move and survive. It can also change the lining of the uterus, preventing a fertilised egg from being able to attach and develop. A copper IUD can also be an option for non-hormonal emergency contraception if it is inserted within 5 days of unprotected sex. Some types of copper IUDs can last for up to 10 years.
The combined oral contraceptive pill, often called ‘the pill’, contains oestrogen and progesterone to protect against pregnancy. It does not protect against STIs. The pill works by preventing the release of eggs from the ovaries. It also thickens the mucus at the entrance to the uterus, making it difficult for sperm to enter.
To effectively protect against pregnancy, the pill needs to be taken daily, at around the same time every day. If not taken regularly, even just missing 1 dose, the pill might not work. The level of protection can be reduced if you’re experiencing vomiting or diarrhoea. Some medicines may also stop the pill from working, so ask your GP or pharmacist if you’re unsure. If any of these situations apply, consider using another form of contraception.
The progesterone only or ‘mini pill’ may not affect ovulation and prevents pregnancy by thickening mucus to prevent sperm from getting past the entrance to the uterus. Only one type/brand of POP prevents ovulation. The other types are less effective if missed by more than 3 hours.
Both pills are only available through prescription from a medical professional. Visit your GP or find a local doctor or family planning clinic to discuss what option will work best for you.
A plastic ring is placed in the vagina for 3 weeks and slowly releases a lower dose of the same hormones as the combined oral contraceptive pill. After 3 weeks the ring is removed for a week and a new one put back in place. It does not protect against STIs.
A diaphragm is a small, soft dome of silicon placed inside the vagina to prevent sperm entering the uterus. It forms a physical barrier, is inserted before sex and needs to stay in place for at least 6 hours after sex. It can then be taken out, cleaned, and is ready for use again. It does not protect against STIs.
Emergency contraception pill
The emergency contraception pill, also known as the morning after pill, is used to reduce the chance of pregnancy after unprotected sex, which may include condom breakage, missed contraceptive pills, or non-consensual sex. It does not protect against STIs and will not cause an abortion.
The emergency contraception pill works by delaying or stopping the ovary releasing an egg. It may also stop sperm from reaching an egg already released. The emergency contraception pill works best if taken within 1 to 3 days (the earlier the better) but can still have some effect for up to 5 days.
The emergency contraception pill is available without prescription from a pharmacy, GP, sexual health clinic or family planning clinic.
The emergency contraception pill or the ‘morning-after pill’ can be used to reduce the chance of pregnancy after unprotected sex.
This might occur after condom breakage, missed contraceptive pills, if no contraception was used, a dislodged diaphragm, or non-consensual sex.
The pill contains high levels of the hormone progestogen that is absorbed into the blood. These hormones act on the pituitary gland at the base of the brain to stop or delay ovulation.
They can also cause a temporary change to the lining of the uterus to prevent a fertilised egg from being implanted.
Emergency contraception is most effective when taken within 24 hours of having unprotected sex but some can be taken up to 96 hours after.
It is usually given as a single tablet and is available over the counter at pharmacies without a prescription.
It also available from your GP, sexual health clinic or reproductive health service.
After taking emergency contraception, it is recommended to have another appointment with a GP, sexual health clinic or reproductive health service for a follow up pregnancy test, to discuss possibly testing for STIs, and longer term contraception options.
Sterilisation requires surgery and is considered permanent. It is suitable for people who are absolutely sure they do not want any pregnancies in the future. Sterilisation does not protect against STIs.
If you’re considering your options for contraception, it’s a good idea to visit your doctor, a sexual health service or a family planning clinic. They can discuss options with you based on your health and lifestyle: