Sex is made pleasurable with the intention of encouraging pregnancy. Many people will have the desire to have sex at a time when they do not wish to conceive. They wish to control conception (contraception) to try and avoid pregnancy. For many the alternative (unwanted pregnancy, termination of pregnancy) is unacceptable. If you wish to use contraception you should seek the advice of your GP or a Family Planning Clinic. They will help you choose the one that is best for you and your partner. Outlined below is a brief summary of the main methods of contraception currently available.
There are only certain days in the monthly cycle when a woman is fertile. If she can be made aware of these days, she can avoid sexual intercourse during these days and dramatically reduce the chances of falling pregnant. Coitus interruptus, where the penis is removed before ejaculation has a very high pregnancy rate, as many sperm are released in the secretions before ejaculation.
If a combination of looking for signs of ovulation (or using a kit to predict ovulation e.g. Persona) and monitoring temperature is used properly it can be up to 98% effective. This means that 2 women in 100 will get pregnant in a year. If it is not used according to instructions then the chance of pregnancy is higher. If you want to use natural methods you should contact a specially trained teacher or get a teaching video.
No hormones are used, removing the possibility of side effects. It allows a woman a greater awareness of her body.
Need to avoid sex or use a condom or diaphragm at fertile times of the cycle. To be effective, the method must be used very carefully.
The most commonly known barrier method is the Male condom (sheath, rubber, jonny). The rubber sheath is placed over the penis before there is any contact with the woman. It is kept on the penis until ejaculation has occurred and the penis has been withdrawn from the vagina. The Diaphragm or cap is a flexible rubber dome which is placed in the vagina, after putting on spermicide. It must be placed over the cervix and stay in for at least 6 hours after sex. It needs to be specially fitted to make sure it is the right size.
- Male condom
- Diaphram or cap with spermicide
Barrier methods are between 92% to 98% effective. This means that between 2 and 8 women in 100 will get pregnant in a year. If it is not used according to instructions then the chance of pregnancy is higher.
Condoms and caps can be put on before sex, particularly if the diaphragm is used. They can prevent some sexually transmitted infections and may reduce the risk of cervical cancer.
Putting it in can interrupt sex and many men and women do not enjoy the feel of a condom during sex. Some people are sensitive to spermicide and less commonly latex rubber.
Intrauterine contraceptive devices (aka the coil, the spiral) are inserted in the womb (uterus). They are plastic, with a copper coil or a hormone wrapped around the plastic. They prevent implantation of the embryo, so preventing pregnancy.
- Intrauterine system (IUS)
They are very effective. It is 98% to over 99% effective depending on the type of IUD. This means that less than 1 to 2 women in 100 will get pregnant in a year. The intrauterine system (IUS), which uses progestogen, is more than 99% effective.
It is working as soon as it is inserted. Modern IUDs can last for 5 years or more before they need to be changed. If fitted after the age of 40 can stay in until the menopause.
Periods may be heavier or longer and more painful (periods are usually lighter with the progestogen IUS). The copper IUD may be unsuitable for women who already have heavy and painful periods.
The ‘pill’ contains oestrogen and progestogen. They fool the body into not producing an egg (an ovulation). The pills are taken for 21 days. There is a bleed a few days after withdrawing the tablets for a 7 day break.
If taken according to instructions it is over 99% effective. This means that less than 1 woman in 100 will get pregnant in a year. If not taken according to instructions then the chance of pregnancy is higher.
Usually reduces bleeding and pain by 50% (the pill is often given to young women for this reason). It can also reduce pre-menstrual tension, as well as protecting against cancer of the ovary and womb and some pelvic infections. It is suitable for healthy non-smokers up to the menopause.
It may not be suitable for some women. A full medical history should be taken before considering starting. It can affect appetite and if not watched can result in some increase in weight. It is not suitable for smokers over 35 or for women who are breastfeeding.
Sterilisation should only be considered if the family is complete, as it is often irreversible. Female sterilisation is typically performed using a laparoscope. A clip is placed across each fallopian tube (Click here to view the fallopian tube), thereby blocking the egg and sperm meeting. It has a failure rate of about 1 in 500 (for every 500 sterilisations, 1 woman will get pregnant). Male sterilisation involves a small operation where the tube (vas deferens) that brings sperm from the testicles to the prostate is cut and blocked off. The failure rate is about 1 in 1000. It is important to seek advice from your doctor if contemplating sterilisation.