We talk to our resident Doctor, Dr. Hanx on different topics, relatable to all of you HANX guys and girls. No nonsense, educational posts on things that matter. This month, we are talking contraception.

Contraception: The deliberate use of artificial methods or techniques to prevent pregnancy as a consequence of sexual intercourse. We are lucky to live in an advanced age that allows family planning. We are beings that can have sex for pleasure, not just for procreation, but with this comes responsibility. Contraception comes in many shapes and sizes… quite literally, and in the UK we have over 15 different options available to us. Definitely not the time to cover in a GP appointment, that is for sure!

Every one of us has different bodies, different hormones, different relationships, and ultimately different contraceptive choices. With a tremendous amount of information out there, it can sometimes feel like a minefield. And, what’s more, much of our information comes from our friends or other relatable personal experiences.In as simple terms as possible, this month Dr HANX is breaking down the contraceptives, the choices, the pros, the cons and the myths. Get yourself a cuppa and get ready some quick fire contraceptive facts…

When Preventing Pregnancy the main things you need to consider when choosing your contraception are:

• How effective is it?
• How often you have to use/ replace it?
• Do you need protection against sexually transmitted infections?
• Is it affected by your medications or other medical conditions (including being overweight and smoking)?
• Do you mind if you periods change?
• Do you have side effects from hormonal treatments?
• Do you want to become pregnant in the near future?

Please remember, these methods are for contraceptive-only. If you want to make sure you are protected from sexually transmitted infections every time you have sex, remember to use a condom.

Methods that rely on you

1. Combined contraceptive pill

99% effective if used correctly; taken every day for three weeks then a week break (where the user has a ‘withdrawal bleed’), the pills contain oestrogen and progestogen to prevent pregnancy.

Yay: It can help make periods lighter and less painful; has been to show a reduction in the risk of cancer of the ovary, uterus, and colon; fertility returns as soon as you stop taking the pills.

Boo: Can give hormonal side effects; not suitable if you’re overweight, a smoker or over 35 years old; can cause irregular bleeding/ spotting; some medications and illnesses can make it less effective; has shown to have a low risk of some risk of serious side effects such as blood clots, breast and cervical cancer; you need to remember to take the pill every day; no protection of STIs.

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2. Progesterone only contraceptive pill

99% effective if used correctly; these pills are taken every day, containing the hormone progestogen only.

Yay: It can help make periods lighter and less painful; you can take them if you’re overweight, a smoker, over 35 years old or cannot take oestrogen.

Boo: Can give hormonal side effects; can cause irregular bleeding/ spotting; some medications can make it less effective; can cause ovarian cysts; you need to remember to take the pill every day.

3. Male condoms

98% effective if used correctly; made of very thin latex, polyurethane (plastic), or polyisoprene (synthetic latex), condoms create a barrier to prevent pregnancy (and STIs).

Yay: Protect against sexually transmitted infections; no serious side effects.

Boo: Relies on the users.

4. Female condoms

95% effective if used correctly; this thin polyurethane sits loosely in the vagina to act as a barrier to prevent pregnancy.

Yay: Can protect against some sexually transmitted infections; no serious side effects.

Boo: Relies on the users.

5. Caps/ diaphragms

92% effective when used with spermicide and used correctly; this flexible latex or silicone device is placed into the vagina, covering the neck of the womb and thus causing a barrier to prevent pregnancy.

Yay: You only need to use it during sex, 6 hours after and up to three hours before; no serious side effects.

Boo: Relies on the users; can take time to learn how to use them correctly; extra spermicide is needed if you have sex again; some people can be sensitive to spermicide; needs to be left in 6 hours after sex; no protection of STIs.

6. Contraceptive vaginal ring

99% effective if used correctly; this is a small plastic ring that is placed into the vagina, releasing oestrogen and progestogen to prevent pregnancy. It is left in place for 3 weeks every month.

Yay: It can help make periods lighter and less painful; you don’t have to think about it once it is in for 3 weeks.

Boo: Can give hormonal side effects; not suitable if you’re overweight, a smoker or over 35 years old; can cause irregular bleeding/ spotting; no protection of STIs.

7. Contraceptive patch

99% effective if used correctly; the small patch is stuck onto the skin, releases oestrogen and progestogen to prevent pregnancy. It is left in place for 3 weeks every month.

Yay: It can help make periods lighter and less painful; you don’t have to think about it once it is in for 3 weeks.

Boo: Can give hormonal side effects; not suitable if you’re overweight, a smoker or over 35 years old; can cause irregular bleeding/ spotting, possible skin irritation; no protection of STIs.

8. Natural family planning

Although on paper this can be up to 99% effective, typical use means natural methods are around 76% effective. The user identifies fertile times of their menstrual cycle by using fertility indicators (such as temperature, cervical mucus and bleeding), and thus identifies when you can have sex without risk of pregnancy. There are many different fertility apps now available but it is not yet known how effective these are.

Yay: Can also be used to plan a pregnancy; no serious side effects.

Boo: Relies on the users; need to avoid sex or use other protection during fertile stages; takes about 6 months to learn effectively; you must keep daily records; no protection of STIs.

Methods that don’t rely on you

9. Contraceptive Implant

99% effective once fitted; this small rod is placed just under the skin of the upper arm and releases progestogen to prevent pregnancy.

Yay: Lasts for up to 3 years; no serious side effects; fertility returns to normal once removed.

Boo: Can cause irregular bleeding/ spotting; requires a small procedure to fit; can have side effects from fitting such as bruising and scarring; can be affected by medications; can have hormonal side effects; no protection of STIs.

10. Contraceptive Injection

99% effective if given regularly; the progestogen hormone injection prevents pregnancy.

Yay: Lasts for up to 13 weeks each injection; may reduce heavy painful periods.

Boo: Can cause irregular bleeding or spotting; fertility may take time to return to normal after stopping the injection; can cause weight gain; can cause hormonal side effects; no protection of STIs.

11. Intrauterine System (IUS)

99% effective once fitted; this small device sits in the womb and releases progestogen to prevent pregnancy.

Yay: Lasts 3-5 years; can decrease heavy or painful periods; fertility returns to normal once removed.

Boo: Chance of infection during fitting; can cause ovarian cysts; insertion can be uncomfortable; can stop periods or cause irregular bleeding; can have hormonal side effects; no protection of STIs.

12. Intrauterine Device (IUD)

99% effective once fitted; this small plastic and copper device is placed into the womb preventing pregnancy.

Yay: Effective immediately when fitted; lasts 5-10 years; fertility returns once removed; no hormonal side effects.

Boo: Chance of infection during fitting; can cause heavier and more painful bleeding; insertion can be uncomfortable; no protection of STIs.

Permanent

13. Female sterilisation

99% effective; there are a few different options including clipping, blocking or cutting the fallopian tubes to prevent pregnancy.

Yay: It cannot be easily reversed; periods are unaffected; no hormonal side effects.

Boo: It cannot be easily reversed; operation carries risks; small risk of ectopic pregnancy; no protection of STIs.

14. Male sterilisation

99% effective, about 1 in 2,000 vasectomies fail; this method cuts, seals or ties to the vas deferens (the tubes that carry semen the testicles to the penis) to prevent pregnancy.

Yay: It cannot be easily reversed; no effect on the female; the surgical risks are low for the male.
Boo: It cannot be easily reversed; operation carries small risks; can cause testicle pain; no protection of STIs.

Phew. A brief overview, but there is a lot more information out there… If you’re interested in learning more, wanting to know about the mechanism of action for these options, check out Family Planning Association and the NHS for starters!

With a huge backlash against taking synthetic hormones, women are turning toward non-hormonal forms of contraception more and more. Barrier methods, including male condoms (oh, HI HANX) and female condoms, have the added benefit of protecting against STIs. However, there has been recent discussion surrounding natural family planning/ fertility awareness methods to prevent pregnancies.

At HANX we are all for apps that empower women and having something that tracks our cycle and fertility are a fantastic way to know your body. However, in terms of reliability and effectiveness, these apps have little real data to show how successful they are in preventing pregnancies.

As a medical blog, we are here to give real information and support, but nothing beats seeing a professional in person. If you need more advice, please visit your local sexual health clinic, family doctor or gynaecologist.