Contraception.
There are many types of contraception you should be aware of.
- Combined Contraceptive Pill
- Long Acting Reversible Contraception (LARC)
- Emergency Contraception
- Other Contraception
Combined Contraceptive Pill
The Combined Contraceptive Pill is often just called 'The Pill'. There are lots of different types and you might have to try one or two before you find the right one for you.
- Contains two types of hormone called oestrogen and progestogen
- 27 different types of combined pill available
- designed to stop you getting pregnant
- might reduce spotty skin, or help with painful or irregular periods
- stops ovulation, which means a woman will not release an egg to be fertilized
- thickens the mucus around the cervix, which makes it harder for sperm to get through makes the lining of the womb thinner so that a fertilised egg would not be able to implant.
- take one pill every day for 21 days. Then have a 7-day break There is protection against pregnancy during this week.
- expect a bleed at some point during the 7 day break. This is not a proper period - it is called a 'withdrawal bleed' and it can start at any point during the 7-day break (e.g. on day 4 or 5). This bleeding is caused by you not taking hormones in the 7- day break.
- start the combined pill up to and including the 5th day of your period
- If the pill is started at any other time in your menstrual cycle, it will take 7 days before it starts to work. So you'll need to use condoms for the first 7 days.
- Does not interrupt sex
- Can help reduce spotty skin on face and body
- Bleeding may be lighter and period pain or Pre-Menstrual Syndrome (PMS) or Pre-Menstrual Tension (PMT) is less likely.
No pill will protect you against sexually transmitted infections, though, so you might want to use condoms too especially if in a new relationship.
- Take one pill every day for 21 days, until you finish one pack.
- Then have a 7-day break. ( you don't take any pills or take placebo (dummy) pills for 7 days). You will be protected against pregnancy during this week.
- Probably get a bleed at some point during the 7 day break. This is not a proper period - it is called a 'withdrawal bleed' and it can start at any point during the 7-day break (e.g. on day 4 or 5). This bleeding is caused by you not taking hormones in the 7- day break.
- Use condoms for the first 7 days.
This pill is over 99% effective if it is taken properly. The following situations make the pill less effective:
- Taking it more than 24 hours late
- Vomiting within two hours of taking it
- Very severe diarrhoea for more than 24 hours
Use of some prescription medicines including some antibiotics, medicines used to treat epilepsy, HIV and TB and the complementary medicine St John's Wort
There are some people that should not take the combined pill for instance certain types of migraine or a personal or family history of blood clots in the leg or lungs or breast cancer.
The combined pill is not suitable for all women. A doctor or nurse will ask you questions about your own and your family's medical history, weigh you and take your blood pressure, just to check it will be suitable for you. If it is, they will probably prescribe you about 3 month's worth of pills to take home, and explain how to take them correctly.
Some things will stop the pill from working effectively for instance vomiting, diarrhoea, antibiotics and forgetting it for more than 12 hours
Progesterone Only Pill (often called the 'mini-pill')
- one type of hormone called progestogen.
- probably the commonest used is Cerazette.
- packet of small tablets which you have to take at the same time every day
- there is no break between packs
No pill will protect you against sexually transmitted infections, though, so you might want to use condoms too especially if in a new relationship.
If you start taking the POP pill on the first day of your period, you will be protected against pregnancy straight away. If you start taking the pill at any other time in your menstrual cycle, it will take 2 days before it starts to work. So you'll need to use condoms for the first 2 days.
- Can be taken by some women who cannot use the combined pill
- Can be used when breastfeeding
Things to watch out for with POP:
- Your periods may become irregular. They may happen more often, less often, be lighter or stop altogether.
- Some things will stop the pill from working effectively for instance vomiting, diarrhoea, antibiotics and forgetting it for more than 3 hours (12 hours in the case of Cerazette)
Emergency Contraception
-
can be used to help prevent an unwanted pregnancy up to five days after sex.
-
can be used if a contraceptive method fails, for instance a condom splits or a pill is forgotten or taken late, or if no contraception is used
Three forms of emergency contraception:
-
emergency contraceptive pill (EC pill, Levonelle) - can be taken up to 3 days after unprotected sex to prevent pregnancy.
-
new emergency contraceptive pill called ellaOne which can be taken up to 5 days after unprotected sex to help prevent pregnancy. ellaOne is only available with a prescription, and it's not always easy to get hold of..
-
emergency intrauterine device (IUD)- can be fitted up to 5 days after unprotected sex to prevent pregnancy.
The emergency contraceptive pills Levonelle and ellaOne as well as the or emergency IUD do not prevent you from getting sexually transmitted infections (STIs). If you have had unprotected sex, you should think about having an STI test. You can find out how here.
Try and get it as soon as is possible
-
emergency contraceptive pill is more effective the sooner you take it
-
if taken within 24 hours of unprotected sex, it is 95% effective at preventing pregnancy.
-
if taken between 25-48 hours after unprotected sex it is 85% effective
-
if taken between 49-72 hours after unprotected sex it is 58% effective at preventing pregnancy.
You can get the emergency contraceptive pill, for free, at any of the following places:
Teenage drop-in centre 3-6 Wedneday
Box satellite clinic 5-7pm Mondays
HYPE satellite clinic 2.30-4.30 on Monday
-
Young people's services
-
Family planning clinics
-
GPs
-
NHS walk-in centres
-
Most sexual health/GUM clinics
-
Some accident and emergency departments
-
Some pharmacies
All these services are free to all, including under 16s.
If you're over 16, you can also buy the EC pill from most pharmacies. It costs around £25.
Emergency intra-uterine device (IUD)
-
sometimes called the 'coil'.
-
a small "T" shaped piece of plastic and copper that is inserted into the vagina, through the cervix and into the uterus. I
-
can be fitted as an emergency contraceptive up to 5 days after unprotected sex. +fitted by a specially trained doctor or nurse so you should check with a service to see if they fit IUDs before going.
The emergency IUD is almost 100% effective at whatever stage you fit it within the 5 days.
The IUD can be fitted at :the Teenage Drop-in centre but not the satellite clinics
-
Family planning clinics
-
Some GPs
Long Acting Reversible Contraception (LARC)
LARC methods don't rely on you remembering to take them, but they do need a professional (like a doctor or a nurse) to give them to you. They are very effective.
There are 4 kinds of LARC:
Implant - Nexplanon
- small, flexible rod which is put under the skin in your upper arm.
- protects against pregnancy for three years
- suitable for most women
- progestogen which it releases slowly.
- stops ovulation (the release of an egg) and thickens the mucus around the cervix,
- about the size of a match stick
- doctor or nurse will give you a local anaesthetic injection, to numb this part of your arm
- takes a few minutes,
- no stitches.
If the implant is put in during the first five days of your period, it protects you against pregnancy straight away. If it's put in on any other day of your cycle you will not be protected against pregnancy for the first seven days, so you'll need to use another method of contraception, (like condoms) for the first seven days.
- Does not interrupt sex
- Works for up to three years
- Fertility returns immediately implant is removed.
- Does not protect against sexually transmitted infections (STIs)
- Periods may be irregular or stop altogether.
The implant is 99% effective. This means that 1 in 100 women who use implants will get pregnant each year.
Intra-Uterine Device (Coil)
- IUD is a small, T-shaped piece of copper or plastic which is fitted into the uterus. I
- Can prevent pregnancy for between 5 and 10 years, depending on the device and is very effective.
- IUD is suitable for most women
- A trained doctor or nurse will fit your IUD, which will be put into your uterus, through your vagina. It usually takes about 15-20 minutes and it can be uncomfortable or painful for some women
Once the IUD is fitted, you will need to go back for a check up three to six weeks later.
You will be protected from pregnancy as soon as your IUD is fitted.
- Does not interrupt sex
- Works immediately
- Works for between 5-10 years depending on the type of IUD fitted.
- It can be easily removed by a doctor or nurse.
- Does not protect against sexually transmitted infections (STIs)
- Periods may be heavier, more painful or last longer
- If it fails, there is a risk that a pregnancy will develop in the fallopian tube (known as an ectopic pregnancy).
It is 98-99% effective depending on the type of IUD. This means that between 1 and 2 women in every 100 women who use an IUD will get pregnant each year.
Intra-Uterine System (Mirena Coil)
- IUS is a small piece of T-shaped plastic which is fitted into the uterus. It can prevent pregnancy for up to 5 years and is more than 99% effective.
The IUS is a little bit like the IUD (or the 'coil'), except the IUS has hormones in it.
- Works by stopping sperm meeting an egg or may stop an egg implanting in the womb.
- Suitable for most women.
The IUS is put into the uterus through the vagina. It can only be fitted by a trained doctor or nurse. It usually takes about 15-20 minutes and may hurt a bit, although this shouldn't last for long.
Once the IUS is fitted, you will need to go back for a check up three to six weeks later.
- It does not interrupt sex
- Once you have had it fitted, it prevents pregnancy for five years
- Your periods may be lighter
- It's not affected by other medicines
- Your fertility will return to normal after the IUS has been removed.
- It does not protect against sexually transmitted infections (STIs)
- It can cause irregular bleeding at first
- It can cause temporary side effects such as skin problems or breast tenderness.
The IUS is more than 99% effective. This means that fewer than 1 in every 100 women who use an IUS will get pregnant each year.
Injection (Depo-Provera)
- Contains only progestogen
- Stops ovulation (release of an egg) and thickens the mucus around the cervix, injected into a muscle,usually the bottom.
- Suitable for most women
- If given during the first five days of your period protection against pregnancy immediately.
- Does not interrupt sex
- Do not have to remember to take a pill
- Not affected by vomiting or diarrhoea, or certain medication.
- Does not protect against sexually transmitted infections (STIs)
- Periods may be irregular or stop
- Can take a year or more after stopping the injection for regular periods to return.
Injectable contraception is 99% effective. This means that 1 in every 100 women who use the injection will get pregnant each year?
Follow-up injections must be given on time. If you miss just one injection, you are at risk of pregnancy.
Other Contraception
In our experience hardly ever used by young people – please ask if you wish to know further information
Hormonal
- Vaginal ring
- Patch
Barrier methods
- Cap
- Diaphram
Less effective in under 25 year olds
Sterilisation
A permanent method rarely used in young people
Natural Family Planning
A method that involves getting to know your cycle and learning when to avoid having vaginal sex – less reliable in young people as often the cycle is not predicatable