What is contraception?

Contraception is the use of various methods to prevent pregnancy. Pregnancy happens when a man's sperm meets a woman's egg and fertilisation (also known as conception) occurs. Contraceptives stop this from happening, either by preventing the sperm from meeting with the egg, or by making conditions in the body unsuitable for fertilisation to occur.

Birth control is a more general term that describes a wide range of practices to prevent pregnancy, such as contraception, sterilization, or the total avoidance of sex.

What different types of contraception are there?

There are three main types of contraceptives available: barrier methods, hormonal methods and spermicides.

Barrier methods physically stop sperm from entering a woman's uterus and fertilising her egg. Barrier methods include condoms (which are available for both men and women), the diaphragm, the cap and the intrauterine device (IUD or 'coil').

Hormonal methods change the level of hormones in a woman's body, making conception very difficult. Hormonal methods come in the form of pills, patches, implants, rings, injections or the intrauterine system (IUS).

Spermicides are designed to kill sperm in the vagina. Spermicides come in the form of foams, gels or pessaries which can be either inserted straight into the vagina, used on a condom, or contained in a special sponge that covers the cervix.

What is the best method of contraception to use?

If you are considering having sex with someone, it is important that you think about sexually transmitted infections (STIs) as well as pregnancy. If you don't know your partner's sexual history (or you are unsure about your own), condoms are the best method to use as they protect against both pregnancy and STIs.

If you are going to be having sex on a regular basis with your partner, it might also be advisable to think about using another form of contraception, just to be extra sure that you are protected. This could be a hormonal method, or you could try a spermicide, (although it is important to note that spermicides used on their own or with a sponge are not a very effective method of contraception). The IUD or IUS is another good option, although it is not always suitable for everyone (especially younger women) and will need to be fitted by a trained practitioner.

Visiting your doctor or health adviser before you have sex is always a good idea, as it will enable you to choose the type of contraception that is best suited to you. It is important to find a reliable and safe method that both you AND your partner feel comfortable with.

What is the best method of contraception for women living with HIV?

Women living with HIV who are not taking antiretroviral drugs can use most types of contraception. Generally, condoms are the best method as they protect against pregnancy, and are also very effective at preventing HIV being passed on to a partner during sex.

Antiretroviral drugs affect most hormonal contraceptives, meaning that women who are taking HIV treatment will not get the same level of protection against pregnancy from the contraceptive pill, implant, vaginal ring, skin patch, and also emergency contraception (the ‘morning after’ pill). However, the Intrauterine System (IUD), also known as the Mirena® coil, and contraceptive injections are not affected. Condoms, which are a barrier method of contraception are also unaffected by antiretroviral drugs.

It is important to talk about your HIV status to your doctor or pharmacist when discussing or seeking contraception.

Where can you get the pill?

As a general rule, you can't just walk into a chemist or pharmacy and buy a packet of pills over the counter. You need a prescription to obtain the contraceptive pill. This is because there are several different versions of the contraceptive pill and it is important for a woman to get the version that suits her best. You don't have to go and see your own doctor to get the prescription; you could see the healthcare advisor at your local young person's or family planning clinic. Once you have your prescription you can get your pills from your pharmacist or clinic.

How long do you need to take the pill before it becomes effective?

The length of time it takes for the birth control pill to become completely effective as a sole contraceptive varies depending on the type of pill you use and when you start the packet of pills. You will usually need to use an alternative form of contraception (such as a condom) for at least seven days after starting, but your healthcare provider should be able to tell you exactly when the particular version of the pill you have been prescribed becomes fully effective against pregnancy. It will normally also say on the advice leaflet that comes with your pills.

It is also worth remembering that taking other medications such as antibiotics can reduce the effectiveness of the contraceptive pill, and your doctor may recommend that you use an additional form of protection during this time. Similarly, stomach upsets such as sickness and diarrhoea can affect the absorption of the pill, so again, using an additional method such as a condom can help make sure pregnancy doesn't occur.

Using condoms as well as the birth control pill can protect both you and your partner from STIs as well as providing extra protection against pregnancy.

Does the pill have any side effects?

Some women experience side effects as a result of using the contraceptive pill. However, these side effects can vary from woman to woman. The most common ones are mood swings, weight gain, breast tenderness, nausea and headaches. Serious side effects are rare.

When you visit your health care provider to obtain a prescription for the contraceptive pill they should ask you a few questions about your medical history. This helps them to make sure they prescribe the type of pill that is best suited to you and hopefully reduce the possibility of any adverse side effects.

If you do experience any problems, it is worth going back to see your healthcare provider as they may be able to change your pill for a different one.

If a girl has missed a pill what are the risks of pregnancy?

If a woman forgets to take a pill the risks of pregnancy will depend on the type of pill she is on. Progestrogen-only (or 'mini') pills that have to be taken at the same time every day are more likely to fail if one is missed. However, even the combined progestogen and oestrogen pill can allow pregnancy to occur if you forget to take it for a day or more. If you have missed a pill and are unsure what to do, you should talk to your doctor or healthcare provider to check. It may be necessary to use an additional form of contraception such as a condom for a while.

What is emergency contraception, how does it work and where can you get it?

There are two types of emergency contraception. Both are very effective in preventing pregnancy, but it is important for a woman to visit her healthcare provider or clinic as soon as possible after having sex to obtain them.

The emergency contraceptive or 'morning after' pill is an oral contraceptive pill that can be obtained on prescription from your doctor or local sexual health clinic. There are a few different types of morning after pill available, but most modern forms consist of a single tablet that is swallowed with water. For this method to work, it must be taken within 3 days (72 hours) of having unprotected sex, although the sooner the pill is taken, the more effective it is likely to be.

The IUD (intrauterine device) can also be used as an emergency method of contraception. The IUD must be fitted within five days of having sex for it to be effective, although this may not be a method that is suitable for everyone, and not all doctors are trained to fit them.

Is there a male contraceptive pill?

At the moment there is no birth control pill for men to take. Some companies are trying to develop a pill for men but it is still in the research and testing phase.

How long does it take for the Depo-Provera contraceptive injection to become effective against pregnancy?

Depo-Provera is an injectable contraceptive. If the injection is given within the first five days of a girl's period it becomes effective immediately. If it is given after this, an additional method of contraception such as a condom should be used for 7 days. The injection needs to be repeated every 12 weeks.

What are side effects of the injectable hormonal contraceptive?

The side effects of any form of contraception can vary from woman to woman. When you visit your healthcare provider or clinic to arrange contraception they should ask you a few questions about your medical history. This helps them to make sure they prescribe the method of contraception that is best suited to you and hopefully reduce the possibility of any adverse side effects. Serious side effects are rare, but you may experience side effects such as disturbance in your usual monthly cycle, mood changes, possible weight gain and fluid retention.

Also, it is important to remember that injectable hormonal contraceptives cannot be stopped or changed as quickly as some other methods.

Is there a shot that men can have?

No, an injectable hormonal contraceptive for men has not yet been developed.

What is an IUD or Mirena® coil?

IUD stands for intrauterine device. It is also known as a Mirena® coil. It is inserted into the uterus to prevent pregnancy. It also contains a slow release hormone called progestin which thins the lining of the uterus and thickens the mucus of the cervix to further decrease the risk of pregnancy (a Mirena® coil is over 99% effective if fitted properly). It is also a better option for women who suffer from heavy periods, as it can make them lighter or even stop them altogether. However it can have similar side effects to the contraceptive pill.

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