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Contraception: Which type is best for me?

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Feet sticking out the end of the bed under a duvet

Many men are using the wrong-sized condoms, which means they're more likely to split or slip off, according to new research.

If they do slip or split, you've got more chance of getting pregnant by accident or catching a sexually transmitted infection. And, wearing a badly-fitted condom can actually reduce the pleasure of sex too!


You can buy condoms in all shapes and sizes - so make sure that your man is wearing the right one.

This is just the latest contraception story - it's in the news all the time, with new types of contraception being developed (soon there could even be a contraceptive pill for men) and studies into who is using contraception the least (apparently it's women in their 30s, 40s and 50s!).

And only a few months ago, the National Institute for Clinical Excellence (NICE) recommended that more women should be offered long-term contraception (such as the injection or the implant) to cut the number of unwanted pregnancies.

We know that contraception is a big issue for you - a recent poll on goodtoknow showed that 1 in 5 of you aren't using any - and that doesn't include anyone trying to get pregnant! There are so many methods of contraception to choose from nowadays and it can leave you feeling a bit confused. To find out more information about other types of contraception, visit the Family Planning Association's website.

There are two types of pill: the combined one, which contains the
hormones oestrogen and progestogen, and the progestogen-only pill.

A recent study, carried out by the Royal College of GPs, found that the
pill is not associated with any increased risk of death (as this was
believed by some experts in the past).

Jo Burgin from Marie Stopes international said: 'Since the
contraceptive pill is the most popular method of contraception in the
UK, we are very pleased that research concluding that it is not
associated with increased long-term risk of death has been published.
'

Combined Pill

Also known as: the 'ordinary pill'
How does it work?
The hormones in it stop you from releasing an egg each month so it can't
be fertilised. It also makes your cervix (the opening at the neck of
the womb) thicker so it's harder for sperm to get through, and makes
your womb lining thinner so it can't support any fertilised eggs.
How do you take it?
You take one tablet every day for 21 days. Then you have a seven-day
break before you start a new pack. If you like the routine of taking it
every day and don't want a break, there's a 28-day version, but the
pills you take in the last seven days are inactive.
How effective is it?
If taken properly, it's 99.8% effective. Although sickness, diarrhoea and taking antibiotics
can all make it less effective or stop it from working completely. If
you're worried, use condoms as well. Using condoms will also protect you
from sexually transmitted infections.
What are the good points about it?
It can stop period pain, and make periods shorter and lighter. It can also be used to help with acne. This is why some teenagers are prescribed the Pill, even if they're not having sex yet.
What are the bad points about it?
Some side effects include headaches, nausea, weight gain, tender breasts
and occasionally some small spots of blood, between periods. These
effects usually go away after the first few packs but if they don't,
speak to your doctor because there are 22 different brands of combined
pill. It also doesn't protect you from sexually transmitted infections.
You need to use condoms during sex for this. Taking the pill does give
you a slight increased risk of blood clots, but you'll need to pass a
health check before it is prescribed to make sure you're not at high
risk of this.

Progestogen-only Pill

Also known as: 'POP' or the 'mini-pill'
How does it work?
It thickens the cervix so it's harder for sperm to get through, it makes
the womb lining thinner and some of them, such as Cerazette, stop you
ovulating (or producing an egg).
How do you take it?
You take one tablet every day for 28 days. You don't have a break with
the mini-pill and it's important you take it at the same time every day.
Taking it even three hours late can increase the chance of getting
pregnant. Use condoms to be on the safe side if this happens. Condoms
can protect you against sexually transmitted infections too.
How effective is it?
It's not as effective as the combined pill but is 90-99% safe. Being
overweight can make it less effective too. Speak to your doctor if
you're worried.
What are the good points about it?
It gives you fewer problems than the combined pill and is especially good for breastfeeding mums (the combined pill can stop milk being produced), women who can't take oestrogen, women at risk of heart disease or strokes and heavy smokers.
What are the bad points about it?
Some side effects include irregular periods, or your periods could stop completely, spots, nausea and headaches. If you've had an ectopic pregnancy, breast cancer or abnormally high cholesterol
your doctor might not give it to you. As with the combined pill, the
progestogen-only pill does give you a slight increased risk of blood
clots, but you'll need to pass a health check before it is prescribed to
make sure you're not at high risk of this.

Both male and female condoms are available. They're really easy to
get from shops and pharmacies and you can also get them for free from
your local family planning clinic.

Male condoms

A recent study showed that many men are using condoms that don't fit
properly - and this means their more likely to split and slip off, as
well as making men more likely to take them off half-way through due to
discomfort. They also reduce the pleasure of sex! Condoms come in lots
of different shapes and sizes, so if your man is using one, make sure
he's got a good fit!

How do I use it and how does it work?
It's rolled over the end of an erect penis. After ejaculation the semen
stays inside the condom. Make sure he holds onto the condom as you
withdraw from the vagina to avoid spillages. It can then just be thrown
away. Don't flush it down the loo and don't re-use it.
How effective is it?
If put on and used properly, it's 100% effective. Some oil-based body
lotions and creams can dissolve them and if it slips off or splits,
speak to your doctor or family planning clinic straight away.
What are the good points about it?
There are no major side effects of using one and if put on properly, it's completely effective. It can also protect from sexually transmitted diseases.
What are the bad points about it?
Some people can have mild allergic reactions to the lubricant used on
condoms and putting them on properly can sometimes be a bit tricky.
Using the wrong size condom can mean that they're more likely to slip
off or split.

Female condoms

Also known as: Femidom
How do I use it and how does it work?
How to put it in is described inside the packet, with diagrams. It has a
ring on the end of it which holds it in place and, if inserted
properly, stops the sperm getting into the womb. Always take care when
taking it out the packet because rings and long fingernails could rip
it. Also take care when you take it out after sex to avoid spillages. It
can then just be thrown away. Don't flush it down the loo and don't
re-use it.
How effective is it?
If put on and used properly it is 99.9% effective. If it slips or
splits, speak to your doctor or family planning clinic straight away.
What are the good points about it?
There are no major side effects of using one and if put on properly,
it's completely effective. It can also protect from sexually-transmitted
diseases. Femidoms aren't made of latex so this reduces the chance of
an allergic reaction, and being damaged by oil-based lubricants.
What are the bad points about it?
Putting them in can be difficult the first time and, because of this, they aren't as popular as male condoms. 

There are two types of injection in the UK: Depo-provera, which lasts for up to 12 weeks, and Noristerat which lasts for 8.

Also known as: Depo
Where can I get it and how does it work?
The contraceptive progestogen is injected into your bum at 8 or 12 week
intervals at your family planning clinic and some doctor's surgeries.
This hormone thickens the cervix so it's harder for sperm to get
through, it makes the womb lining thinner and it stops an egg being
produced.
How effective is it?
It's 99% effective.
What are the good points about it?
If you don't like taking pills, then injections are a good idea and you
can get them for free from your family planning clinic. It lasts for the
full 8 or 12 weeks. Both of the jabs have also been found to help
protect against  ovarian cysts and ectopic pregnancies.
What are the bad points about it?
You have to go back to the clinic to have it every 8 or 12 weeks. It can
cause heavy, irregular or longer periods and some women stop having
periods altogether. You can get headaches and experience weight gain and
it can take you, on average, up to 18 months to be fully fertile again
after you stop having it. They also don't protect you from sexually transmitted infections. You will need to use condoms during sex for this.

The implant is a small, bendy tube that is put under the skin in your
upper arm. In the UK the only one available, currently, is called
Implanon.

Where can I get it?
The implant is inserted into your arm using an injection. This is
usually done by your GP but some family planning clinics can do it too.
You're given a local anaesthetic and putting it in is quick and
painless, although you could get a slight bruise from the injection. You
can feel the implant, but not see it.
How does it work?
It lasts for up to three years, although it can be taken out sooner if
you want. Whereas the injection gives you a high dose of progestogen,
which decreases over 8-12 weeks, the implant releases a steady stream of
the hormone into your blood every day. This thickens the cervix so it's
harder for sperm to get through, makes the womb lining thinner and
stops an egg being produced.
How effective is it?
It's over 99% effective. Being obese can stop it from being as effective, so speak to your doctor if you're worried.
What are the good points about it?
Once it's in, that's it for three years. No worrying about booking
repeat appointments or taking pills. Your normal level of fertility
returns straight away, after it's removed. You can breastfeed with the
implant in too.
What are the bad points about it?
They can cause headaches, acne
and weight gain and your periods are likely to change. You might even
notice a change in sex drive too. Your doctor or clinic will need to
order the implants in so you'll need to talk to them, in advance, if you
want one. The doctor will also need to remove it too. They don't
protect you from sexually transmitted infections. You will need to use condoms during sex for this. 

It's very small - not much longer than a matchstick, and is T-shaped.
It's normally made of plastic and copper. Your womb (uterus) is
actually only about the size of your clenched fist so if you put a
matchstick in your palm that will show you how it fits.

Also known as: Intrauterine device, IUD
Where can I get it?
Some trained GPs and nurses can insert it, but it's most commonly
available through your family planning clinic. Gynaecologists can fit
them too. IUDs fold up and are then pushed through your vagina and
expand into your womb. All coils have either one or two little threads,
which hang down into your vagina. The doctor or nurse will use these to
check that it's in place. They will also use them to remove it.
How does it work?
The coil stops your partner's sperm from getting into your womb. It
changes the thickness of your cervix and makes it difficult for an egg
to settle in the womb lining. It can also last from between 5-8 years
depending on the make.
How effective is it?
It's 98% effective.
What are the good points about it?
Once it's in, that's it for 5-8 years. No worrying about booking repeat
appointments or taking pills. Your normal level of fertility returns
quickly after it's removed. Although some women find it painful when
it's inserted and taken out, this is quite rare.
What are the bad points about it?
They can make your periods heavier, longer and sometimes more painful.
Your doctor or clinic will need to order the coil in so you'll need to
talk to them in advance if you want one. They don't protect you from sexually transmitted infections. You will need to use condoms during sex for this. 

If you've had a mishap with your contraception - or you had
unprotected sex, you don't necessarily need to panic. You can now buy
the morning after pill, Levonelle, over the counter - and it's effective
up to 3 days after you had sex. You can also get EllaOne - which is
effective up to 5 days after having sex - on prescription.


Levonelle

Also known as: Levonorgestrel

How does it work? It uses hormones to prevent or delay ovulation and prevent an egg from implanting in the womb.

How do you take it? It is taken orally and can be used up to 72
hours (3 days) after sex. However, it is more effective the sooner you
take it. You can buy Levonelle over the counter (as long as you are over
16) or get it for free on prescription.

How effective is it? If it's taken within 24 hours of having
unprotected sex, it is effective about 95% of the time. Between 25 - 48
hours it is 85% effective and between 49 and 72 hours it is 58%
effective.

What are the good points about it? If your contraception fails or you forgot to use any, you can take this. Side effects are uncommon.

What are the bad points about it? It's not as reliable as planned contraception, so shouldn't be used regularly as contraception.

EllaOne

Also known as: Ulipristal acetate

How does it work? As with Levonelle, it uses hormones to prevent or delay ovulation and to stop an egg from implanting in the womb.

How do you take it? It is also taken orally and can be used up to
120 hours (5 days) after having unprotected sex. You can only get
EllaOne on prescription.

How effective is it? Trials show it is as effective as Levonelle
when taken within 3 days of having unprotected sex. New studies are
needed to show exactly how effective it is after 3 days.

What are the good points about it? Again, side effects are uncommon - and you can fall back on it if regular contraception fails.

What are the bad points about it? As you need a prescription to
get it, it could be more difficult to get hold of than Levonelle. And
it's not as reliable as planned contraception, so should only be used in
emergencies.

The coil

The IUD coil can also be used as emergency contraception - it prevents pregnancy if it is fitted within 5 days of having unprotected sex.

Family planning clinics
offer free, confidential advice and information on the best
contraception to use, how to go about getting it, as well as advice on
sexual health and pregnancy. You can also have STI checks.

Anyone can use a family planning clinic, even under 16s, and you can
either just turn up for an appointment or get referred there by your
doctor. Some clinics offer 'open surgeries' where you can turn up, take a
number and wait in line. For more specific information, or for fitting
implants and coils, you might need to make an appointment to see a
doctor.

The first time you go, you will have to give some contact details and
the details of your doctor. They will normally take your blood pressure,
weigh you, measure your height and ask you some questions about your
health.

Although clinics do differ, the majority provide the following services:

- advice about contraception, including vasectomy and hysterectomy
- the combined pill
- the mini-pill
- contraceptive injections
- free condoms
- free emergency contraception
- smear tests/cervical screening,
- free pregnancy tests,
- fertility advice
- fitting and checking of implants and coils (intrauterine devices or IUDs). Some clinics can remove them as well.

Some of them may also offer advice about rape and sexual abuse, abortion and the menopause and can refer you for counselling if necessary.

Continued below...


You can get details of your nearest family planning clinic from your phone book, doctor, hospital or from the Family Planning Association (FPA). 

 

 

 

 



 

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