Contraceptive methods with no user failure

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

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

Contraceptive injection

Implant

Intrauterine system (IUS)

Intrauterine device (IUD)

Female sterilisation (tubal occlusion)

Male sterilisation (vasectomy)

Contraceptive injection

Effectiveness

Over 99 per cent effective.
Less than four women in 1,000 will get pregnant over two years.

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 12 weeks (Depo-Provera), eight weeks (Noristerat) or 13 weeks (Sayana Press).

You can use it if you are breastfeeding.

You don’t have to think about contraception for as long as the injection lasts.

Disadvantages

Periods may stop, be irregular or last longer.

Periods and fertility may take time to return after stopping the injection.

Some women gain weight.

Comments

The injection cannot 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.

Implant

Effectiveness

Over 99 per cent effective.
Less than one woman in 1,000 will get pregnant over three years.

How it works

Small flexible rod put under the skin of the upper arm. Releases the hormone 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

Works for three 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 fertility will return will return to normal.

Disadvantages

Periods may stop, be irregular or last longer.

Acne may occur, or worsen.

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 per cent effective.
Less than one woman in 100 will get pregnant over five years.

How it works

A small T-shaped plastic device, which slowly releases the hormone progestogen, is put into the uterus.

It thins the lining of the uterus to prevent a fertilised egg implanting and thickens cervical mucus which makes it difficult for sperm to meet an egg.

Advantages

Works for five years but can be taken out sooner.

Periods usually become lighter, shorter and sometimes less painful.

You don’t have to think about contraception for as long as the IUS is in place.

When the IUS is removed your fertility will return to normal.

Disadvantages

Irregular bleeding or spotting is common in the first six months.

Periods may stop altogether.

Very small chance of getting an infection during the first 20 days after insertion.

May get ovarian cysts.

Insertion can be uncomfortable.

Comments

If fitted after 45 it can stay in place until the menopause.

Women are taught to check the IUS is in place.

Can be useful for women with very heavy and/or painful periods.

A check for any existing infection is usually advised before an IUS is put in.

Not affected by other medicines.

Find out more about the IUS.

Intrauterine device (IUD)

Effectiveness

Over 99 per cent effective.
Less than two woman in 100 will get pregnant over five years.

How it works

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

Advantages

Works as soon as it is put in.

Can stay in 5–10 years depending on type, but can be taken out at any time.

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 for women at risk of getting a sexually transmitted infection.

Periods may be heavier or longer and more painful.

Very small chance of getting an infection during the first 20 days after insertion.

Insertion can be uncomfortable.

Comments

If fitted after 40 it can stay in place until the menopause.

Women are taught to check the IUD is in place.

A check for any existing infection is usually advised before an IUD is put in.

Not affected by other medicines.

Find out more about the IUD.

Female sterilisation (tubal occlusion)

Effectiveness

The overall failure rate is about one in 200. This is a permanent method, suitable for people who are sure they never want children or do not want more children.

How it works

The fallopian tubes are cut, sealed or blocked by an operation. This stops the egg and sperm meeting.

Advantages

It cannot easily be reversed.

Once the operation has worked you don't have to think about contraception.

Periods are unaffected.

Disadvantages

All operations carry some risk, but the risk of serious complications is low.

There is a small increased risk of ectopic pregnancy if female sterilisation fails.

You will need a general or local anaesthetic.

Comments

Should not be chosen if in any doubt, and counselling is important.

You may experience discomfort or some pain for a short time after sterilisation. It is important to rest and avoid strenuous activity for a while after the procedure.

Find out more about female and male sterilisation.

Male sterilisation (vasectomy)

Effectiveness

About one in 2,000 male sterilisations fail. This is a permanent method, suitable for people who are sure they never want children or do not 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 cannot easily be reversed.

Once the operation 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 eight weeks.

Some men may experience ongoing testicle pain but this is not common. Treatment for this is often unsuccessful.

Comments

Should not be chosen if in any doubt, and counselling is important.

You may experience discomfort or some pain for a short time after sterilisation. It is important to rest and avoid strenuous activity for a while after the procedure.

Find out more about female and male sterilisation.