Contraception Methods

Study Notes

Contraception means prevention of pregnancy, and it's essential to choose a method that best meets individual needs and circumstances.
Considerations when choosing contraception include:
- Effectiveness in pregnancy prevention
- Health issues that may limit certain choices
- Ease of use
- Benefits other than contraception
- Cost and availability
- Reversibility
- Protection against STIs

Hormonal IUD (Mirena) is a small, T-shaped device that is fitted inside the uterus and releases a low dose of progestogen hormone.
Hormonal IUDs are 99.8% effective and may stop or make periods lighter.
Copper IUD (Cu-IUD) is a small device made from plastic and copper that is fitted inside the uterus and has no hormones.
Copper IUDs are 99.2% effective and may make periods heavier.
IUDs need to be replaced every 5-10 years, depending on the type, and can be removed easily at any time.

Contraceptive implant (Implanon NXT) is inserted directly under the skin, on the inner arm, and releases a low dose of progestogen hormone into the bloodstream.
Implants are 99.9% effective and work by preventing ovulation.
Implants can be used by most women, even those with significant health issues, and can be removed at any time.
Devices need to be replaced every 3 years.

Contraceptive injections (Depot medroxyprogesterone acetate, or DMPA) are given every 12 weeks and prevent ovulation.
DMPA is 94-99.8% effective and may cause a delay in return to usual fertility.
Periods may stop while using DMPA.

Barrier methods include condoms and the diaphragm.
Condoms are the only method that offers protection against both unintended pregnancy and STIs.
Male condoms are 82-98% effective and female condoms are 79-95% effective.
Diaphragms are 88-94% effective.

Contraceptive vaginal ring (NuvaRing) is a soft plastic ring that slowly releases low doses of two hormones, oestrogen and progestogen.
The ring is self-inserted and remains in the vagina for 3 weeks, then removed and replaced with a new one.
The ring is 91-99.7% effective.
Combined oral contraceptive pill (the Pill) is an oral contraceptive taken daily, containing oestrogen and progestogen.
The Pill is 91-99.7% effective and may help with acne or heavy periods.
Progestogen-only contraceptive pill (mini pill) is an oral contraceptive taken daily, containing a low dose of progestogen.
The mini pill is 91-99.7% effective and can be used by most women, even those with significant health issues.

Lactational amenorrhoea method (LAM) is the use of breastfeeding as a contraceptive method, reducing the probability of ovulation.
LAM is 98% effective when all 3 criteria are met: menstrual periods have not returned, gave birth less than 6 months ago, and fully breastfeeding.
Fertility awareness-based methods (FABMs) include any method based on the identification of the fertile phase of the menstrual cycle to indicate when sexual intercourse should be avoided to prevent pregnancy.
FABMs are 75-99.6% effective and require specific education from experts.
Withdrawal is where the man takes his penis out of the woman's vagina before he ejaculates, but it's not a reliable form of contraception and is 78-97% effective.

Emergency contraception (EC) can reduce the risk of unintended pregnancy after unprotected sex.
There are two types of EC: the emergency contraception pill (ECP) and the Cu-IUD.
The ECP can be taken up to 5 days after unprotected sex, but it's most effective if taken in the first 24 hours.
The Cu-IUD can also be used as EC, preventing about 99% of expected pregnancies when inserted within 5 days after unprotected sex.

Permanent contraception (sterilisation) for men or women involves a small operation and is 99.5% effective.
Female sterilisation (tubal ligation) involves blocking the Fallopian tubes to stop the passage of the ovum.
Male sterilisation (vasectomy) involves an operation on the vas deferens to prevent sperm from joining the ejaculate fluid.