I’m a pharmacist – here’s my guide to the best contraception and why the ‘pulling out method’ does NOT work
WHEN it comes to contraception, a lot of us might just assume our choices are limited to either condoms or the Pill.
But there’s actually a whole host of different choices out there.
Deciding which contraception is right for you is very much based on personal preference.
Claire Nevinson, Superintendent Pharmacist at says that factors to consider include your personal circumstances and lifestyle, personal preference and factors such as age, whether you smoke, your medical and family history and any regular medicines you're taking.
Claire said: “Common types of contraception include the combined pill, the contraceptive implant, injection or patch and the intrauterine system or hormonal coil.
“There are also other methods of contraception to consider including female sterilisation, which is permanent.”
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Claire warns: “It’s important to remember that these types of contraception to prevent pregnancy don’t provide protection against sexually transmitted infections (STIs), so you may need to consider additional protection, such as condoms.”
Unsure what’s best for you? Claire recommends booking an appointment with your GP or local sexual health clinic who can offer you further advice.
Whether you’re choosing contraception for yourself, or perhaps you want to be armed with info to advise a friend or family member on their choices, this is the 101 on contraception…
Combined pill AKA, The Pill
“This is an oral contraceptive pill, which contains artificial versions of the female hormones oestrogen and progesterone, which are produced naturally in the ovaries.
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“When taken correctly, the Pill is over 99 per cent effective at preventing pregnancy,” says Claire.
A big plus to the pill is that it doesn’t interrupt sex.
Plus, Claire adds that the Pill “usually makes your periods regular, lighter and less painful and it can reduce symptoms of premenstrual syndrome”.
“However, some women may experience temporary side effects at first, such as headaches, nausea, breast tenderness and mood swings and breakthrough bleeding and spotting is common in the first few months of using the Pill.
“It can increase your blood pressure so it’s important to attend any pill review appointments where your blood pressure will be checked.”
Typically, one pill is taken at the same time every day for 21 days.
Then, during the seven-day break, a bleed will occur. Some pills allow for no breaks.
Of course, remembering to take the Pill every day is another pitfall as it can be easy to forget, especially initially.
Progestogen-only pill
“This is another type of oral contraceptive pill, but it only contains progestogen, the artificial version of the female hormone progesterone.
“This is also more than 99 per cent effective if taken correctly,” says Claire.
“It needs to be taken every day and at the same time each day.
“It’s sometimes taken by those who are unable to use contraception that contains oestrogen but want to choose a tablet option.”
Claire adds that for some people, periods may stop or become lighter, irregular or more frequent when taking the progestogen-only pill.
“Some people experience side effects such as spotty skin and breast tenderness, but these generally clear up within a few months.”
Contraceptive implant
The contraceptive implant is a small flexible plastic rod that's placed under the skin in your upper arm by a doctor or nurse.
It releases progestogen into your bloodstream and is more than 99 per cent effective.
Claire says: “It helps prevent pregnancy for three years and it doesn't interrupt sex.
“It can also be a good option for those who can't use contraception containing oestrogen, such as the pill.
“You may experience temporary side effects during the first few months, like headaches, nausea, breast tenderness and mood swings and you'll also need a small procedure to have it fitted and removed. After removal, natural fertility usually returns quickly.”
Contraceptive injection
The injection lasts for eight to 13 weeks, depending on the injection used.
Although you need to ensure regular GP visits to keep the injection topped up, it does mean that you don’t need to remember to take something daily, as you would with the Pill.
“The contraceptive injection releases the hormone progestogen into your bloodstream to prevent pregnancy. It’s more than 99 per cent effective,” says Claire.
“It is a good option for those who can't use contraception containing oestrogen and it's not affected by other medicines.
“However, your periods may change and become irregular, heavier, shorter, lighter or stop altogether, and this can carry on for some months after you stop the injections.”
If you decide to stop your injections, Claire warns that there can be a delay of up to one year before your periods return to normal and natural fertility returns.
So do factor this in if you’re hoping to conceive further down the line.
Contraceptive patch
“The contraceptive patch is a small sticky patch that releases hormones into your body through your skin to prevent pregnancy.
“Each patch lasts for a week. You change the patch every week for three weeks, then have a week off without a patch,” explains Claire.
“It's more than 99 per cent effective, very easy to use and unlike the combined oral contraceptive pill, you don't have to think about it every day, as you only have to remember to change it once a week.
“However, it may be visible and can cause skin irritation, itching and soreness.
“Some medicines can make the patch less effective, so if you are unsure, always ask your GP for advice or visit your local sexual health clinic.”
IUS (intrauterine system or hormonal coil)
“The intrauterine system or hormonal coil is a small, t-shaped plastic device that's put into your womb by a doctor or nurse and releases the hormone progesterone to stop you getting pregnant,” says Claire.
She adds that once inserted, it works for five years or three years, depending on the brand, and it’s one of the most effective forms of contraception available in the UK.
“Also, your periods can become lighter, shorter and less painful and may stop completely after the first year of use.
“Some people can experience headaches, acne and breast tenderness after having the IUS fitted, but these usually settle with time.
“You will also need a small procedure to have it fitted and removed.”
Non-hormonal contraception choices
There are other options, says Claire: “Non-hormonal contraceptives include the intrauterine device or coil, caps or diaphragms or the use of condoms.
“Some women might choose these options as there are no hormonal side effects, such as acne, headaches or breast tenderness and there are usually no serious associated health risks or side effects.”
Plus, the use of condoms will also protect against sexually transmitted infections.
Menopausal?
“Women who may be looking to control symptoms of the perimenopause and menopause using Hormone Replacement Therapy (HRT) must be aware that this does not act as a contraceptive,” warns Claire.
“For women in their 40s, no method of contraception needs to be avoided due to age alone.
“Once a woman reaches 50, combined hormonal contraception is not recommended for safety reasons.
“The progesterone-only pill or another method of contraception may be considered if suitable.”
Why the ‘pull out’ method might not be wise…
Trying to avoid pregnancy? Then the ‘pull out’ method should be avoided.
“There is a risk of becoming pregnant using the withdrawal method or pulling out and because sperm can live in precum, which is fluid that comes out of the penis before ejaculation, any penis to vagina contact is risky,” explains Claire.
“NHS data suggests that 84 out of 100 couples having sex two to three times a week will become pregnant within one year if they do not use a method of contraception.”
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Claire does add that the chances of pregnancy do vary throughout your menstrual cycle, which lasts from the first day of your period until the day before your next period starts.
“You can get pregnant after you ovulate, but if you've had sex in the five days before ovulation it's also possible to get pregnant because sperm can live inside a woman's body for up to five days and fertilise the egg when it's released.”