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

Condoms (male/external)

Condoms (female/internal)

Diaphragm/cap with spermicide

Natural family planning

Contraceptive vaginal ring

Effectiveness

Over 99% effective if always used according to instructions (perfect use); fewer than 1 in 100 ring users will get pregnant in a year.

With typical use, around 91% effective; around 9 in 100 ring users will get pregnant in a year.

How it works

A small, flexible plastic ring is 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’s not affected if you vomit or have diarrhoea.
  • It usually makes periods regular, lighter and less painful.
  • It’s easy to insert and remove.
  • It improves acne for some women.

Disadvantages

  • Not suitable if you’re very overweight or a smoker aged over 35.
  • A low risk of serious side effects such as blood clots, breast and cervical cancer.
  • Can be temporary side effects such as increased vaginal discharge, headaches, nausea, mood changes and breast tenderness.

Comments

  • You must be comfortable with inserting and removing it.
  • Ring is used for 3 weeks out of 4.
  • 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% effective if always used according to instructions (perfect use); fewer than 1 in 100 patch users will get pregnant in a year.

With typical use, around 91% effective; around 9 in 100 patch users 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’s not affected if you vomit or have diarrhoea.
  • It usually makes periods regular, lighter and less painful.
  • It improves acne for some women.

Disadvantages

  • Not suitable if you’re very overweight or a smoker aged over 35.
  • A 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 3 weeks out of 4.
  • Some medicines can make it less effective.
  • Breakthrough bleeding and spotting is common in the first few months.

Find out more about the contraceptive patch.

Combined pill

Effectiveness

Over 99% effective if always taken according to instructions (perfect use); fewer than 1 in 100 pill users will get pregnant in a year.

With typical use, around 91% effective; around 9 in 100 pill users will get pregnant in a year

How it works

Contains 2 hormones – estrogen and progestogen. It 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

  • It 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 if you’re very overweight or a smoker aged over 35.
  • A low risk of some 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.

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% effective if always taken according to instructions (perfect use); fewer than 1 in 100 pill users will get pregnant in a year.

With typical use, around 91% effective; around 9 in 100 pill users 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 (releasing an egg).

Advantages

  • Can be used if you can’t use estrogen.
  • Can be used if you smoke and are aged over 35.
  • May help with premenstrual symptoms and painful periods.

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

  • Must be taken at the same time each day.
  • Not effective if taken over 3 hours late (12 hours for pills with desogestrel) or after vomiting or severe, long-lasting diarrhoea.
  • Some medicines may make it less effective.

Find out more about the progestogen-only pill.

Condoms (male/external)

Effectiveness

98% effective if always used according to instructions (perfect use); 2 in 100 women will get pregnant in a year.

With typical use, around 82% effective; around 18 in 100 women will get pregnant in a year

How it works

Made of very thin latex (rubber), polyurethane (plastic), or polyisoprene (synthetic latex). It’s 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

  • May slip off or split if not used correctly or is the wrong size or shape.
  • The penis needs to be withdrawn from the vagina straight after ejaculation before the penis goes soft, being careful not to spill any semen.

Find out more about male/external condoms.

Condoms (female/internal)

Effectiveness

95% effective if always used according to instructions (perfect use); 5 in 100 women will get pregnant in a year.

With typical use, around 79% effective; around 21 in 100 women will get pregnant in a year

How it works

Made of soft thin polyurethane which loosely lines the vagina. It covers the area just outside, and stops sperm from entering the vagina.

Advantages

  • Can be put in any time before sex.
  • Can help protect from sexually transmitted infections.
  • Oil-based products can be used with internal condoms.
  • No serious side effects.
  • Additional spermicide is not needed or recommended.

Disadvantages

  • Need to make sure the penis enters the condom and doesn’t go between the vagina and the condom.
  • May get pushed into the vagina.
  • Not as widely available as external condoms.

Comments

  • Use a new condom each time and follow the instructions carefully.
  • Sold online and in some pharmacies and free from contraception and sexual health clinics and young people’s services, and some general practices and GUM clinics.

Find out more about female/internal condoms.

Diaphragm/cap with spermicide

Effectiveness

Diaphragms and caps are 92–96% effective when used with spermicide, according to instructions (perfect use); between 4 and 8 in 100 diaphragm or cap users will get pregnant in a year. With typical use, around 71-88% effective; between 12 and 29 in 100 users 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 (neck of the womb). This stops sperm from entering the uterus (womb) and meeting an egg. 

Advantages

  • Can be put in up to 3 hours before sex, or earlier as long as you then add more spermicide before having sex.
  • You only have to use it when you have sex.
  • No serious side effects.

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’ve had a baby, miscarriage or abortion, or if you gain or lose more than 3kg (7lb) in weight.
  • Needs to be left in for 6 hours after sex.

Find out more about diaphragms/cap with spermicide.

Natural family planning

Effectiveness

Up to 99% effective if used according to teaching and instructions (perfect use); up to 1 in 100 users will get pregnant in a year.

With typical use, around 76% effective; around 24 in 100 users 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.
  • Gives you a greater awareness of your body and menstrual cycle.
  • 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 monitor with urine test sticks to measure hormonal changes. It predicts your fertile days. If used correctly it can be 94% effective.
  • There are many different fertility apps available. It’s not yet known how effective these are.

Find out more about natural family planning.

 

INFORMATION LAST UPDATED MAY 2017. NEXT UPDATE DUE 2020.