Contraceptive methods with user failure

These are methods you have to use and think about regularly or each time you have sex. They must be used according to instructions.

Contraceptive vaginal ring

Contraceptive patch

Combined pill

Progestogen-only pill

Male condom

Female condom

Diaphragm/cap with spermicide

Natural family planning

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. 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

You don’t have to think about it every day.

It is not affected if you vomit or have diarrhoea.

Can make periods regular, lighter and less painful.

It is easy to insert and remove.

Disadvantages

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

Low risk of serious side-effects such as blood clots, breast and cervical cancer.

Can be temporary side-effects including increased vaginal discharge, headaches, nausea, breast tenderness and mood changes.

Comments

Women must be comfortable with inserting and removing it.

Ring is 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. 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

You don't have to think about it every day.

It is not affected if you vomit or have diarrhoea.

Periods will usually become more regular, lighter and less painful.

It improves acne for some women.

Disadvantages

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

Low risk of serious side-effects such as blood clots, breast and cervical cancer.

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

Possible skin irritation.

Comments

May be seen.

New patch is 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

Usually makes periods regular, lighter and less painful.

Reduces risk of cancer of the ovary, uterus and colon.

Suitable for healthy non-smokers up to the age of 50.

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.

Low risk of serious side-effects such as 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. In some cycles it stops ovulation.

Advantages

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, breast tenderness, weight change and headaches.

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 POPs containing desogestrel) or after vomiting or severe, long lasting diarrhoea.

Some medicines may make it less effective.

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

Can help protect from sexually transmitted infections.

No serious side-effects.

Additional spermicide is not needed or recommended.

Disadvantages

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

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

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

Available in different shapes and sizes.

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

Made of soft, thin polyurethane, which 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.

Oil-based products can be used with female condoms.

No serious side-effects.

Additional spermicide is not needed or recommended.

Disadvantages

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 male condoms.

Comments

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

Sold online and in some pharmacies and free from some contraception and sexual health clinics and young people's services, and some general practices and GUM clinics.

Find out more about female condoms.

Diaphragm/cap with spermicide

Effectiveness

Diaphragms and caps are 92–96 per cent effective when used with spermicide.
Between four and eight women in 100 will get pregnant in a year.

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

Extra spermicide is needed if you have sex again.

Some people can be sensitive to spermicide.

Can take time to learn how to use correctly.

Comments

You need to use the correct size.

You may need a different size after you have had a baby, miscarriage or abortion.

Needs to be left in for six hours after sex.

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. If used correctly it can be 94 per cent effective.

Find out more about natural family planning.