Contraceptive methods with no user failure

These methods of contraception do not depend on you remembering to take or use them. This makes them very effective.

The contraceptive injection, implant, IUS and IUD are also known as methods of long-acting reversible contraception (LARC).

Contraceptive implant

Intrauterine system (IUS)

Intrauterine device (IUD)

Contraceptive injection

Sterilisation: fallopian tubes (tubal occlusion)

Sterilisation: vas deferens (vasectomy)

Contraceptive implant

Effectiveness

  • Over 99% effective once fitted.
  • Fewer than 1 in 100 implant users will get pregnant in a year.

How it works

Small flexible rod put under the skin of the upper arm. Releases the hormone progestogen, which stops ovulation, thickens cervical mucus to prevent sperm reaching an egg, and thins the lining of the uterus (womb) to prevent a fertilised egg implanting. 

Advantages

  • Works for 3 years but can be taken out sooner.
  • You don’t have to think about contraception for as long as the implant is in place.
  • When the implant is removed your periods and fertility will return to normal.

Disadvantages

  • Periods may stop, be irregular or last longer.
  • It requires a small procedure to fit and remove it.

Comments

  • Put in using a local anaesthetic and no stitches are needed.
  • Tenderness, bruising and some swelling may occur.
  • You should be able to feel the implant with your fingers, but it can’t be seen.
  • Some medicines may stop the implant from working.

Find out more about the contraceptive implant.

Intrauterine system (IUS)

Effectiveness

Over 99% effective once fitted. Fewer than 1 in 100 IUS users will get pregnant in a year.

How it works

A small T-shaped plastic device, which slowly releases the hormone progestogen, is put into the uterus (womb). It thins the lining of the uterus to prevent a fertilised egg implanting and thickens the cervical mucus which makes it difficult for sperm to meet an egg.

Advantages

  • Works for 3–5 years depending on type, but can be taken out sooner.
  • You don’t have to think about contraception for as long as the IUS is in place.
  • With the Mirena IUS, periods usually become lighter, shorter and sometimes less painful.
  • When the IUS is removed you fertility will return to normal.

Disadvantages

  • Irregular bleeding or spotting is common in the first 6 months.
  • Very small chance of getting an infection during the first 20 days after insertion.
  • Some people get ovarian cysts.
  • Insertion can be uncomfortable.

Comments

  • You’re taught to check the IUS is in place.
  • Periods may stop altogether.
  • A check for any existing infection may be advised before an IUS is put in.
  • Not affected by other medicines.
  • If fitted after 45, the Mirena IUS can stay in place until the menopause.

Find out more about the IUS.

Intrauterine device (IUD)

Effectiveness

Over 99% effective once fitted. Fewer than 1 in 100 IUD users will get pregnant in a year

How it works

A small plastic and copper device is put into the uterus (womb). It stops sperm reaching an egg, and may also stop a fertilised egg implanting in the uterus.

Advantages

  • Works as soon as it’s put in.
  • Works for 5–10 years depending on type, but can be taken out sooner.
  • You don’t have to think about contraception for as long as the IUD is in place.
  • When the IUD is removed your fertility will return to normal.

Disadvantages

  • May not be suitable if you’re at riskof getting a sexually transmitted infection.
  • Periods may be heavier or longerand more painful.
  • Very small chance of getting aninfection during the first 20 days after insertion.
  • Insertion can be uncomfortable.

Comments

  • You’re taught to check the IUD is in place.
  • A check for any existing infection may be advised before an IUD is put in.
  • Not affected by other medicines.
  • If fitted after 40 it can stay in place until the menopause.

Find out more about the IUD.

Contraceptive injection

Effectiveness

  • With perfect use, over 99% effective; fewer than 1 in 100 injection users will get pregnant in a year.
  • With typical use, around 94% effective; around 6 in 100 injection users will get pregnant in a year.

How it works

Releases the hormone progestogen which stops ovulation, thickens cervical mucus to prevent sperm reaching an egg, and thins the lining of the uterus (womb) to prevent a fertilised egg implanting.

Advantages

  • Lasts for 13 weeks (DepoProvera and Sayana Press) or 8 weeks (Noristerat).
  • You don’t have to think about contraception for as long as the injection lasts.
  • May reduce heavy, painful periods for some people.

Disadvantages

  • Periods may stop, be irregular or last longer.
  • Periods and fertility may take time to return after stopping the injection.
  • Some people gain weight.

Comments

  • The injection can’t be removed from the body so any side effects may continue for as long as it works and for some time afterwards.
  • Not affected by other medicines, diarrhoea or vomiting.

Find out more about contraceptive injections.

Sterilisation: fallopian tubes (tubal occlusion)

Effectiveness

The overall failure rate is about 1 in 200 or 1 in 500, depending on which method is used.

This is a permanent method, suitable for people who are sure they never want children or don’t want more children.

How it works

The fallopian tubes are cut, sealed or blocked either by an operation or with a procedure called hysteroscopic sterilisation. This stops the egg and sperm meeting. 

Advantages

  • It can’t easily be reversed. Hysteroscopic sterilisation can’t be reversed at all.
  • Once the sterilisation has worked, you don’t have to think about contraception.
  • Periods are unaffected.

Disadvantages

  • You’ll need other contraception until the sterilisation is effective.
  • All operations carry some risk, but risk of serious complications is low.
  • There’s a small increased risk of ectopic pregnancy if the sterilisation fails.
  • You may need a general or local anaesthetic.

Comments

  • Shouldn’t be chosen if in any doubt, and counselling is important.
  • You may experience discomfort or some pain for a short time after sterilisation. It’s important to rest and avoid strenuous activity for a while after the procedure.

Find out more about sterilisation.

Sterilisation: vas deferens (vasectomy)

Effectiveness

About 1 in 2,000 vasectomies fail.

This is a permanent method, suitable for people who are sure they never want children or don’t want more children.

How it works

The tubes (vas deferens) that carry sperm from the testicles to the penis are cut, sealed or tied. 

Advantages

  • It can’t easily be reversed.
  • Once the sterilisation has worked, you don’t have to think about contraception.
  • Usually performed under a local anaesthetic. 

Disadvantages

  • Contraception must be used until a semen test shows that no sperm are left. This can take at least 8 weeks.
  • Some people may experience ongoing testicle pain but this isn’t common. Treatment for this is often unsuccessful.

Comments

  • Shouldn’t be chosen if in any doubt, and counselling is important.
  • You may experience discomfort orsome pain for a short time aftersterilisation. It’s important to restand avoid strenuous activity for a while after the procedure.

Find out more about sterilisation.

 

INFORMATION LAST UPDATED MAY 2017. NEXT UPDATE DUE 2020.