Contraceptive vaginal ring

Effectiveness

Over 99 per cent effective if used according to instructions. Less than one woman in 100 will get pregnant in a year.

How it works

A small, flexible, plastic ring put into the vagina releases estrogen and progestogen. This stops ovulation, thickens cervical mucus to prevent sperm reaching an egg, and thins the lining of the uterus to prevent a fertilised egg implanting.

Advantages

• You don’t have to think about it every day.
• It is not affected if you vomit or have diarrhoea.
• Can make bleeds regular, lighter and less painful.
• May protect against cancer of the ovary, colon and uterus.
• When you stop using it your fertility will return to normal.

Disadvantages

• Not suitable for very overweight women or smokers over 35 years.
• Very low risk but serious side-effects may include blood clots, breast and cervical cancer.
• Can be temporary side effects including increased vaginal discharge and vaginal infections, headaches, nausea, breast tenderness and mood changes.

Comments

• Women must be comfortable with inserting and removing it.
• Ring must be used for three weeks out of four.
• Some medicines can make it less effective.
• Breakthrough bleeding and spotting may occur in the first few months.
• Find out more about the contraceptive vaginal ring.

Contraceptive patch

Effectiveness

Over 99 per cent effective if used according to instructions. Less than one woman in 100 will get pregnant in a year.

How it works

A small patch stuck on the skin releases two hormones, estrogen and progestogen. This stops ovulation, thickens cervical mucus to prevent sperm reaching an egg, and thins the lining of the uterus to prevent a fertilised egg implanting.

Advantages

You don't have to think about it everyday.

It is not affected if you vomit or have diarrhoea.

Can make bleeds lighter and less painful.

May protect against cancer of the ovary,colon and uterus.

When you stop using the patch your fertility will return to normal.

Disadvantages

Not suitable for very overweight women or smokers over 35 years.

Very low risk but serious side-effects may include blood clots, breast and cervical cancer.

Can be temporary minor side-effects such as headaches, nausea, mood changes and breast tenderness.

Possible skin reaction.

Comments

May be seen.

New patch has to be used each week for three weeks out of four.

Some medicines can make it less effective.

Breakthrough bleeding and spotting is comon in the first few months.

Find out more about the contraceptive patch.

Combined pill

Effectiveness

Over 99 per cent effective it taken according to instructions.
Less than one woman in 100 will get pregnant in a year.

How it works

Contains two hormones – estrogen and progestogen. It stops ovulation, thickens cervical mucus to prevent sperm reaching an egg and thins the lining of the uterus to prevent a fertilised egg implanting.

Advantages

Often reduces bleeding, period pain and premenstrual symptoms.

Protects against cancer of the ovary, uterus and colon and some pelvic infections.

Suitable for healthy non-smokers up to the menopause.

When you stop using the combined pill your fertility will return to normal.

Disadvantages

Not suitable for very overweight women or smokers over 35 years old.

Very low risk but serious side-effects may include blood clots, breast cancer and cervical cancer.

Can be temporary side-effects such as headaches, nausea, mood changes and breast tenderness.

Comments

Missing pills, vomiting or severe long-lasting diarrhoea can make it less effective.

Some medicines can make it less effective.

Breakthrough bleeding and spotting is common in the first few months.

Find out more about the combined pill.

Progestogen-only pill

Effectiveness

Over 99 per cent effective if taken according to instructions. Less than one woman in 100 will get pregnant in a year.

How it works

Contains the hormone progestogen, which thickens cervical mucus to prevent sperm reaching an egg and thins the lining of the uterus to prevent a fertilised egg implanting. In some cycles it stops ovulation.

Advantages

No serious side-effects.

Can be used by women who cannot use estrogen.

Can be used by women who smoke and are over 35.

You can use it if you are breastfeeding.

Disadvantages

Periods may stop, or be irregular, light, or more frequent.

May be temporary side-effects such as acne, weight change and headaches.

A small increased risk of ectopic pregnancy if it fails.

May get ovarian cysts.

Comments

It needs to be taken at the same time each day.

Not effective if taken over three hours late (12 hours for Cerazette) or after vomiting or severe, long lasting diarrhoea.

Some medicines may make it less effective but most common antibiotics do not affect POPs.

Find out more about the progestogen-only pill.

Male condom

Effectiveness

98 per cent effective if used according to instructions. Two women in 100 will get pregnant in a year.

How it works

Made of very thin latex (rubber) or polyurethane (plastic) it is put over the erect penis and stops sperm from entering the vagina.

Advantages

Free from contraception, sexual health and GUM clinics, young people's services, some general practices and sold widely.

Can help protect both partners from some sexually transmitted infections, including HIV.

No medical side-effects.

Additional spermicide is not needed or recommended.

Disadvantages

Putting it on can interrupt sex.

May slip off or split if not used correctly, or is the wrong size or shape.

Man needs to withdraw as soon as he has ejaculated and before the penis goes soft, being careful not to spill any semen.

Comments

Oil based products damage latex condoms, but can be used with polyurethane condoms.

Available in different shapes and sizes.

Must be put on before the penis touches the woman’s genital area.

Advised to use extra lubricant when using condoms for anal sex.

Find out more about male condoms.

Female condom

Effectiveness

95 per cent effective if used according to instructions. Five women in 100 will get pregnant in a year.

How it works

A soft, thin polyurethane sheath loosely lines the vagina and covers the area just outside, and stops sperm from entering the vagina.

Advantages

Can be put in any time before sex

Can help protect both partners from some sexually transmitted infections, including HIV.

Oil based products can be used with female condoms.

No medical side-effects.

Additional spermicide is not needed or recommended.

Disadvantages

Putting it in can interrupt sex.

Need to make sure the man’s penis enters the condom and not between the vagina and the condom.

May get pushed into the vagina.

Not as widely available as the male condom.

Comments

Use a new condom each time and follow the instructions carefully.

Sold in some pharmacies and is free at some contraception clinics and young people's services, general practices and GUM clinics.

Find out more about female condoms.

Diaphragm/cap with spermicide

Effectiveness

Latex types are 92–96 per cent effective if used correctly.
Between four and eight women in 100 will get pregnant in a year.
Silicone caps are less effective.

How it works

A flexible latex or silicone device, used with spermicide, is put into the vagina to cover the cervix. This stops sperm from entering
the uterus and meeting an egg.

Advantages

Can be put in any time before sex.

You only have to use it when you have sex.

No serious health risks.

Disadvantage

Putting it in can interrupt sex.

Extra spermicide is needed if you have sex again.

Some people can be sensitive to spermicide.

Cystitis can be a problem for some diaphragm users.

Can take time to learn how to use correctly.

Comments

Correct size needs to be known and you need to replace it if you gain or lose more than 3kg (7lbs), have a baby, miscarriage or abortion.

There is a variety of different types to choose from.

Find out more about diaphragms/cap with spermicide.

Natural family planning

Effectiveness

If used according to teaching and instructions, up to 99 per cent effective. Up to one woman in 100 will get pregnant in a year.

How it works

The fertile and infertile times of the menstrual cycle are identified by noting the different fertility indicators. This shows when you can have sex without risking pregnancy.

Advantages

No physical side-effects

No chemicals or physical products are used.

Gives a woman a greater awareness of her body.

Can also be used to plan a pregnancy.

Disadvantages

Need to avoid sex or use a condom at fertile times of the cycle.

It takes 3–6 menstrual cycles to learn effectively. You have to keep daily records.

Comments

Persona is a small handheld computerised monitor with urine test sticks, which measure hormonal changes. Persona predicts the fertile and infertile times of the menstrual cycle. It used correctly it can be 94 per cent effective.

Find out more about natural family planning.

Back to Your guide to contraception.