What are the main methods of contraception?

A barrier method of contraception involves the use of a physical block that prevents sperm from reaching and fertilising an egg. The most commonly used type is the male condom, but women can use caps, diaphragms or female condoms instead.

Male condoms
Sometimes called ‘external condoms’, male condoms are worn over an erect penis. They’re up to 98% effective at preventing against pregnancy and protects against most STIs too.  

Female condoms 
Often called ‘internal condoms’ are put inside the vagina, loosely lining it. They’re up to 95% effective at preventing pregnancy and can also protects against some sexually transmitted infections (STIs).  

Diaphragms and caps 
These fit inside the vagina and cover the entrance to the womb (the cervix). These can be up to 92-96% effective at preventing pregnancy, but won’t protect you from STIs.  

Advantages of barrier methods: 

• The level of protection varies between 95%-98% if used perfectly as instructed
• Female and male condoms protect against most STIs, including HIV

Disadvantages:

• Diaphragms and caps to be used with spermicide and need to be left in for six hours after sex
• If the barrier isn’t in place (e.g. a condom breaks), there’s no protection against STIs or pregnancy

Hormonal contraception can only be used by women. The most popular forms are the combined contraceptive pill (like Rigevidon and Microynon), low-dose combined pills (like Gedarel 20) and the mini pill (like Cerazette). More information is available in our guide to contraceptive pills.

Combined pill 
The combined pill contains two hormones – oestrogen and progestogen. It works by stopping your ovaries releasing an egg, thickening the mucus in the cervix (which makes it harder for sperm to travel through) and thins the lining of the womb (which makes it harder for a fertilised egg to implant).  

It’s up to 99% effective when used perfectly.  

Mini pill 
The mini pill only contains progestogen – that’s why it’s also known as the progestogen-only pill (POP). All mini pills thicken the mucus in the cervix and thin the lining of the womb, like the combined pill. Mini pills containing desogestrel will also stop your ovaries from releasing an egg.  

With perfect use it’s up to 99% effective at preventing pregnancy.  

Advantages of the contraceptive pill: 

• Up to 99% effective if used correctly
• On the combined pill periods are  usually very regular  and predictable; they also tend to be lighter and shorter
• It can reduce menstrual cramps (period pain)
• Doesn’t interfere with sexual activity
• With the combined contraceptive, it’s possible to skip a period

Disadvantages of the contraceptive pill:

• You need to remember to take it at the same time daily
• No protection against STIs
• The mini pill can cause irregular bleeding 
• Prescription usually needed
• It doesn't work when you've got a stomach bug or vomiting or diarrhoea
• It can stop other medicines from working (for example anti-epilepsy medication)
• Some medicines and supplements can stop the pill from working

Both the patch and the ring work in similar ways. And like the combined pill, they contain oestrogen and progestogen. This means they’re classed as combined contraceptives. 

The patch (Evra Patch)
The patch is a small sticky pad that attaches to your skin and releases oestrogen and progesterone into your bloodstream. With perfect use, it’s up to 99% effective when preventing pregnancy.  

Vaginal ring (NuvaRing) 
The vaginal ring is a flexible plastic ring that’s inserted into the vagina and remains there for three weeks. Like other combined contraceptives, with perfect use, NuvaRing is up to 99% effective. 

Advantages of the patch or vaginal ring:

• With perfect use, both methods are up to 99% effective
• They can make periods lighter and more regular
• They can reduce menstrual cramps (period pain)
• The patch and the ring can be used to skip periods
• Doesn’t interrupt sexual activity

Disadvantages:

• They don’t protect against STIs
• Prescription needed
• They're not usually prescribed on the NHS
• The patch/ring can stop other medicines from working (for example anti-epilepsy medication)
• Some medicines and supplements can stop the patch/pill from working

These are long-term methods of contraception. 

The implant
The implant is a small flexible rod, about 4cm long. It’s inserted under the skin of your upper arm and releases a form of progesterone into your bloodstream, blocking pregnancy for up to three years. The implant is over 99% effective in preventing pregnancy. 

The injection 
There are three types of contraceptive injection – the Depo-Provera and Sayana Press are given every 12 weeks, whereas Noristerat is given every eight weeks, although it’s hardly ever used in the UK. With perfect use, the injection is 99% effective. 

Advantages of the implant or injection:

• The implant is 99% effective for three years
• The injection is 99% effective and lasts for three months
• Can stop periods completely
• Doesn’t interrupt sexual activity

Disadvantages of the implant or injection:

• The injection may cause weight gain
• May cause irregular menstrual bleeding or spotting at the start
• Any side effects could last for the full eight to 12 weeks for the injection, or until the implant is removed 
• Need to see your GP, nurse or attend a clinic every three months for the injection
• Doesn't protect against STIs

A small T-shaped device that’s inserted into the uterus by a trained medical professional. It releases a form of progesterone, which thickens cervical mucus and thins the womb lining preventing pregnancy.

Advantages of the IUS:

• Up to 99% effective
• Lasts up to five years, but can be removed at any time
• Periods may stop
• Can be used to help with endometriosis symptoms
• Can be used to manage heavy and painful periods

Disadvantages of the IUS:

• Can be painful to insert
• No protection against STIs

Non-hormone releasing copper is used to stop the sperm and egg surviving in the uterus and fallopian tubes. 

Advantages of the IUD:

• Doesn't contain hormones
• Up to 99% effective
• Only needs checking monthly at the time of period
• Long-lasting

Disadvantages of the IUD:

• Can be painful to insert and for a day or so after
• Not advised for anyone who normally has a heavy period normally, as they can make them heavier and more painful
• Can cause menstrual cramps

A procedure to block the fallopian tubes in women, or a vasectomy to block the tubes carrying sperm from the testicles in men.

Advantages of sterilisation:

• 99% effective
• After the operation you'll need to use contraception until your next period or for 3 months depending on the type of sterilisation.

Disadvantages of sterilisation:

• Sterilisation requires an operation for both men and women
• Difficult to reverse and requires another surgical procedure
• There’s a chance that the tubes that carry the sperm or eggs can rejoin after the procedure, making you fertile again

These identify the fertile time of the month. They range from calendar and observation-based methods to urinary hormone testing and technology-based approaches. The idea is that you will learn over time on which days of your cycle you need to use condoms (or not have sex) to avoid getting pregnant.

Advantages of FAMs:

• Natural
• Allows a woman to know her body and menstrual cycle
• Free

Disadvantages of FAMs:​​​​​​​

• Constant monitoring to pinpoint ovulation each month
• High risk from miscalculations
• Doesn’t protect against STIs