Information on non-hormonal contraception methods
Written by Dr Gigi Taguri
The contraceptive pill is a form of contraception for women. Each pill contains synthetic forms of naturally occurring hormones, which prevent you from getting pregnant. Despite the popularity of the pill, there are other types of contraception, including a number of short- and long-term methods, some of which do not contain hormones.
In this article we’ll look at the methods of non-hormonal contraception that are available, including the advantages and disadvantages of using these.
What is non-hormonal contraception?
Many contraceptives use synthetic hormones to stop you getting pregnant. The hormones used in hormonal contraceptives, like the pill, work by mimicking the hormones women produce naturally, such as oestrogen. These hormones can influence things like your mood, sexual desire and menstrual cycle.
Non-hormonal contraceptives don’t contain these hormones and in turn don't affect the reproductive hormones women create. Instead they use other ways to stop you from becoming pregnant.
Advantages of non-hormonal contraceptives
Sometimes it’s not safe for women to use hormonal contraceptives, or you may not want to. Non-hormonal methods include barrier methods like female condoms, male condoms, diaphragms and the copper coil (IUD). There are many advantages to using non-hormonal contraceptives, such as:
- No hormonal side effects such as mood swings
- Protection against pregnancy when used correctly
- Some offer long-term protection against pregnancy
- Some can be used just at the time you have sex
- Safer for some women to use
- Condoms protect against STIs
- Don’t interact with some medications
Side effects of hormonal contraceptives
Hormonal contraceptives can cause side effects such as spotting, breast tenderness, headaches, nausea, bloating and increased blood pressure. For this reason many people opt for non-hormonal methods of birth control.
What’s the best non-hormonal contraception for me?
The best method of non-hormonal contraception for you will depend upon what’s important to you. For example, do you want a long-term method like an IUD (the coil) which you can have inserted and then forget about. Or would you rather use a method that you only think about when you have sex such as condoms. These also protect against STIs, whereas other non-hormonal methods don’t.
We’ll explore the four main non-hormonal contraceptives to help you choose the right one for you. You can also talk to your GP or healthcare professional at a sexual health clinic for more advice.
Diaphragms
What is a contraceptive diaphragm?
The diaphragm is a flexible latex device inserted into the vagina. Diagrams are roughly palm size, dome shaped and usually made from rubber or silicone.
How does the diaphragm contraceptive work?
A diaphragm is a barrier method of contraceptive that stops sperm getting past. A diaphragm prevents sperm from entering the cervix and fertilising an egg. Spermicide is used with a diaphragm and this kills the sperm.
How effective is the contraceptive diaphragm?
The diaphragm is 92-96% effective. It needs to be used correctly with spermicide to be effective at preventing pregnancy.
You’ll be shown how to put the diaphragm in your vagina for the first time by a healthcare professional.
Advantages and disadvantages of diaphragms
Advantages:
- It doesn’t need to be worn all the time, only when you have sex
- You can put it in before you have sex, this could be hours before
- Latex and spermicide can cause irritation in some women and their sexual partners
- Many women find them easy to insert
Disadvantages:
- Doesn’t protect against STIs
- Not as effective as other types of contraception
- Can take a while to learn how to insert it
- Can cause cystitis
- It needs to be left in for 6 hours after sex
- You may not be able to use it depending on the position of your cervix and strength of your vaginal muscles
- Latex and spermicide can cause irritation in some women and their sexual partners
Female condoms
What is a female condom?
Female condoms are an internal type of condom that’s made from thin latex or synthetic latex. The soft material is inserted into your vagina before sex and removed after sex.
How do female condoms work?
The female condom lines the vagina and the area just outside, stopping sperm entering the vagina. They’re a barrier method of contraception. They also help to protect against STIs.
How effective are female condoms?
Female condoms are 95%. They need to be used correctly to prevent pregnancy.
Advantages and disadvantages of female condoms
Advantages:
- Protect against unwanted pregnancy
- Protection from sexually transmitted infections (STIs)
- Can be put in place hours before sex
- No serious side effects
Disadvantages:
- You need to make sure your partner’s penis goes into the condom and not between the condom and the vagina
- There is also a risk that the condom itself will get pushed into the vagina
- Can split or tear
- May interrupt sex, however they can be put in hours before
- Not widely available
- Can be expensive
Male condoms
What is a condom?
This is one of the most well-known types of contraception. Male condoms can prevent pregnancy and STIs. A barrier method of contraception, they’re made from thin latex, polyurethane or polyisoprene.
How do condoms work?
The man puts the condom over his erect penis just before sex, stopping sperm from entering the vagina. Male condoms also help protect against STIs.
How effective are condoms?
If used correctly, condoms are about 98% effective. Unfortunately, people sometimes don’t use them properly, and condoms are typically actually about 88% effective. Find out how to use a condom in our guide.
Advantages and disadvantages of condoms
Advantages:
- Only method of contraception that protects against STIs for both partners
- Only need to use them when you have sex
- Available in different sizes, textures and flavours
- No medical side effects
Disadvantages:
- Condoms can split, tear or come off during sex. If this happens you may need emergency contraception and a STI test
- You may not be able to use them if you have difficulty maintaining an erection
- Condoms may interrupt sex but they can be included in foreplay to counteract this
- Some people may be allergic to latex, however other types of condoms are available
The IUD (also known as the coil)
What is the coil?
The IUD is a small plastic and copper device that is fitted into the womb. A doctor or nurse fits the coil for you. Depending on the type of coil you are fitted with, it will last for five to ten years. If your plans change and you want to try for a baby, you can have it removed at any time.
How does the coil work?
The non-hormonal copper coil releases copper into the womb (uterus). The copper changes your cervical mucus. This makes it harder for sperm to reach an egg. It also stops a fertilised egg implanting in your womb.
How effective is the coil?
When inserted correctly, IUDs are more than 99% effective. Less than two out of 100 women using the coil will become pregnant over five years.
As long as you’re not pregnant, an IUD can be fitted any time during your menstrual cycle. It starts to work straight away to prevent pregnancy.
Advantages and disadvantages of the coil
Advantages:
- No hormones involved (although there is another form of the coil available, the IUS, that releases a small amount of hormones to thin the womb lining)
- You don’t have to regularly remember to take it
- More than 99% effective
- Lasts up to 10 years
Disadvantages:
- Fitting the coil can be uncomfortable
- It can make your periods heavier or more painful
- Doesn’t protect against STIs
Other types of non-hormonal contraception
There are other methods of non-hormonal contraception these include:
- Spermicide - Can be used with the diaphragm or condoms. Spermicide kills sperm.
- Vasectomy - For penis owners, this involves a tube being blocked so sperm are prevented from leaving the body.
- Sterilisation - For people with a uterus this involves blocking the fallopian tubes so that an egg can’t be released.
Conclusion
The four types of contraception, the diaphragm, female and male condoms and the IUD are the best known non-hormonal methods. Your GP or nurse at a sexual health clinic can help you decide which one is best for you.
Some people choose to practise methods such as pre-ejaculation withdrawal, or limiting their sexual activity to times when a woman is less likely to conceive. However, a doctor is very unlikely to advise these methods as they are not reliable enough.
For more information, see our article on long-term hormonal contraception methods that do not have to be administered on a daily basis.
References
https://www.nhs.uk/conditions/contraception/which-method-suits-me/
https://www.nhs.uk/conditions/contraception/contraceptive-diaphragm-or-cap/
https://www.nhs.uk/conditions/contraception/iud-coil/
