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What are the different types of contraceptives

There are many forms of contraception, but they can be broken down into four main categories. The main types of female contraception, with examples of each are listed below:

  • Hormonal or chemical contraceptives
  • Barrier methods
  • Awareness methods
  • Permanent methods
  • Combined/mini pills
  • Intrauterine device (IUD)
  • Condoms 
  • Diaphragms
  • Family planning 
  • Withdrawal 
  • Standard days method
  • Sterilisation

On this page, we’ll discuss each of the types of contraceptive methods to help give you a balanced idea of what options are available to you.

Contraceptive Pills

How many different types of birth control pills are available in India? Well, the short answer is there are lots. The reason there are so many different types of contraceptive pills is because they were first approved over 60 years ago .

Over the years, the pill has become increasingly available to women across the globe – it’s also become far safer to take. There have been several advanced versions of the pill since the sixties, known as ‘generations’. Each has aimed to reduce the risk of certain side effects while still guaranteeing a high level of contraceptive effectiveness.

Certain types of birth control pills contain two synthetic female hormones and some contain only one – but they can affect the body in similar ways, and the important thing is that they both guarantee very high levels of contraceptive protection when used correctly.

Combined pills (Combined oral contraceptive pills)

Combined contraceptive pills, the most commonly prescribed pill, contain two versions of naturally occurring female hormones - oestrogen and progesterone. There are also different versions of these synthetic hormones, which surround generational pill changes over the years, and some affect women in different ways. 

Each month, levels of oestrogen and progesterone rise and fall naturally which impacts how and when the female body prepares for pregnancy. Ovulation occurs, for example, and the uterus lining thickens to create a safe environment to receive a fertilised egg.

So how do contraceptive pills work? When you take combined contraceptive pills, natural levels of these hormones change.When this happens, the way in which the body prepares for pregnancy changes. Eggs don’t get released, vaginal mucus thickens which makes it difficult for sperm to pass through the cervix and the uterus lining remains thin - meaning in the event an egg does get fertilised, it will have a tough time implanting itself in the uterus where it would normally grow.

Typically, you take the combined pill for 21 days followed by a seven day break, although it is possible to take the combined pill without any breaks . Sometimes, you won’t take any pills during your break, or some pill packets will contain inactive pills that are included to help you maintain a routine. Certain other combined contraceptive pills are taken for 24 days, followed by only four days of taking placebo pills.

Combined pills are over 99% effective when used perfectly. (“Used perfectly” means that you never forget to take a pill and always take them at the time you’re supposed to.)

Common side effects associated with the combined pill can include feeling sick, stomach ache, putting on weight, headaches, depressive moods or mood swings and sore or painful breasts. However, because certain combined pill brands contain different versions of female hormones, depending on their version, switching pills can sometimes help reduce certain side effects.

Pros and cons of the combined pill

Advantages of the combined pill:

  • You’re in control, you can start and stop using the method whenever it suits you
  • Won’t interrupt sex in the same way a condom might
  • Can make periods more regular, lighter or less painful 
  • Reduces the risk of certain types of cancer, including of the womb and ovaries
  • Can reduce premenstrual symptoms
  • Can reduce acne
  • May reduce the chance of pelvic inflammatory disease
  • May reduce the risk of ovarian cysts and fibroids 

Disadvantages of the combined pill:

  • May cause side effects that become better over time, including headaches, feeling sick, tender breasts and mood swings. 
  • May increase blood pressure for some women
  • Doesn’t protect against STIs
  • Spotting is common for the first few months of using the pill 
  • Has been linked with a small but increased risk of blood clots and breast cancer.

Mini pills (Progesterone only pills)

Mini pills offer birth control without oestrogen, they’re also known as progestogen-only pills (POP). These might be more suitable for women who experience side effects to oestrogen when using the combined pill. They’re also a safer choice for women who shouldn’t take the combined pill due to their age, smoking habits or medical conditions.

Traditional mini pills prevent pregnancy by thickening cervical mucus, which stops sperm from reaching an egg. Mini pills which contain desogestrel as their active ingredient can also prevent ovulation from occurring.

Like combined pills, mini pills are over 99% effective when taken perfectly. When taken typically their effectiveness drops to around 91%. This means approximately nine out of every 100 women who use the mini pill will become pregnant.

You are supposed to take the mini pill every day without breaks in between packs. If you’re over the age of 35 and smoke, it’s safe for you to use the mini pill.

Common side effects associated with the progestogen-only pill include feeling sick, headaches, loss of libido, tender breasts, breast enlargement, mood swings, dizziness, fatigue, bleeding between periods and skipped periods.

Pros and cons of the mini pill

Advantages of the mini pill:

  • Doesn’t interrupt sex the same way a condom might
  • Can be taken postnatally and also when breastfeeding
  • Safe to use if you cannot take the oestrogen hormone
  • You can use it at any age
  • Safer for smokers than the combined pill
  • Can make periods less frequent, lighter or even stop

Disadvantages of the mini pill:

  • Your periods may change and become irregular
  • Doesn’t protect against sexually transmitted infections
  • You need to remember to take it daily and at a similar time each day (though this is dependant on the brand)
  • Certain medications can reduce mini pill effectiveness.
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Mini pill vs combined pill

What is the difference between combined pills and mini pills, and is the mini pill safer than the combined pill? The fundamental difference between the two is that combined pills contain two hormones (oestrogen and progesterone) and progesterone-only pills contain, as the name suggests, progesterone. Progesterone-only pills (POP) are often called mini-pills.

The mini pill is safer for certain women to take when compared with the combined pill – this includes women who smoke and are older than 35, and it can be taken by women of any age.

Best pill for heavy painful periods

Can birth control lighten periods? Yes, and birth control for heavy periods is also something you can discuss with your doctor or prescriber.

Both combined pills and mini-pills can be used to treat heavy or painful periods.

Combined pills can also help to regulate your menstrual cycle and reduce period pain. Some are specifically licensed for heavy periods, not just for contraception.

What is the best contraceptive pill?

Reading all of the above might have left you wondering – which pill is best for me? It’s quite natural to feel overwhelmed about the different types of pills, sometimes finding the best one for you is just a matter of trying out which one suits you best. A chat between you and your doctor can be a good starting point. But before you do so, it’s worth thinking about what’s important to you.

Finding the ‘best’ birth control pill isn’t always as straightforward as it sounds. Each has their own pros and cons and certain women may experience side effects when taking a particular pill, whereas others won’t. It’s quite common for your doctor to prescribe different pills a few times before you find the right one for you.

Non-pills

There are also other hormonal contraceptives that aren’t taken orally as tablets. These include condoms, IUDs and even surgical procedures. There are pros and cons to each, and the option that’s best for you can depend on a range of factors. Let’s take a look at each of these in more detail.

Contraceptive devices

Contraceptive devices, namely the intrauterine device (IUD) or the intrauterine system (IUS), are small, T-shaped devices that are inserted into the womb through the vagina. They’re also known as coils. This is because the copper in some devices is coiled around a tiny piece of plastic.

They need fitting by a specially trained healthcare professional in a clinic and the procedure can be uncomfortable, but once it’s fitted, it can stay there for five to 10 years, depending on the device.

IUD (Intrauterine device)

The IUD is a small, T-shaped plastic and copper device that’s inserted into the womb. The copper prevents sperm from reaching the unfertilised egg and reduces the chance of a fertilised egg implanting in the womb lining. It's not a ‘hormonal’ contraceptive method because it doesn’t contain or release hormones. Many women prefer it for this reason.

The IUD protects you from pregnancy for between five and 10 years, which might be beneficial if you don’t want to think about contraception regularly. It provides immediate protection and is over 99% effective. In fact, it's the most reliable contraceptive method available other than sterilisation.

Copper IUDs can make menstrual bleeding slightly heavier for some women, so if your periods are already heavy, IUDs probably won’t be your first choice.

Pros and cons of IUD

Advantages of the IUD:

  • You’re protected for five to 10 years, meaning you can forget about the IUD once it’s inserted
  • Works immediately
  • Hormonal side effects do not occur such as acne, headaches and nausea
  • Doesn’t interrupt sex the same way a condom might
  • Safe to use the IUD following birth and while you’re breastfeeding
  • Possible to get pregnant immediately after having the copper coil removed
  • IUD effectiveness isn’t impacted when you take certain medication

Disadvantages of the IUD:

  • Periods may get heavier, more painful or last longer
  • Doesn’t protect against sexually transmitted infections
  • Uncommon side effects include vaginal bleeding and discharge

Barrier methods

Barrier methods have been around for hundreds of years, specifically condoms which were initially used to prevent the transmission of sexual infections. Today, they are used to prevent STIs and pregnancy. They do so by preventing sperm from being ejaculated into the vagina and cervical canal.

Today, barrier methods mainly include condoms, but other examples include diaphragms and vaginal caps.

Condoms

Condoms are the most popular barrier method used in the UK. Condoms are made from thin latex and are either worn around the penis (external condoms) or worn inside the vagina (internal condoms).

Simply, condoms work by preventing sperm from passing into the vagina and cervix. This means sperm doesn’t reach eggs released during ovulation. Essentially, condoms are a thin layer which keep the penis and vagina ‘separated’ during sex.

When used correctly, external condoms can be up to 98% effective. Because condoms are not medication, they very rarely cause any side effects which is a major advantage over hormonal methods of contraception.

Pros and cons of condoms

Advantages of external condoms:

  • Reliable method of contraception when used correctly
  • Prevent sexually transmitted infections including chlamydia, gonorrhoea and HIV
  • You only need to think about condoms when you have sex, suitable for spontaneous or unplanned sexual encounters
  • Medical side effects from condoms are extremely unlikely
  • Easily available without prescription and tailored for different preferences

Disadvantages of external condoms:

  • Condoms can interrupt the flow of sex and ‘kill the mood’
  • Condoms are highly durable, but can split in rare circumstances when used incorrectly
  • If you’re allergic to latex or certain types of rubber, you may not be able to use condoms
  • You have to pull out soon after ejaculating and particularly before the penis gets soft, ensuring the condom remains in place while doing so

Diaphragms and caps

A contraceptive cap or diaphragm is a circular-shaped dome that’s inserted into the vagina and at the base of the cervix. Typically made from silicone, the contraceptive diaphragm blocks the entrance to the cervix and therefore prevents sperm from passing through to the fallopian tube, where it would normally fertilise an egg.

The contraceptive cap is between 92% and 96% effective at preventing pregnancy when used correctly. You may want to use spermicides while using the cap. Spermicides are a type of contraceptive gel that kills sperm.

You can still catch sexual infections while using diaphragms and they can be difficult to get the hang of at first. You can talk to your doctor or pharmacist if you need more advice. Though there aren’t many serious side effects associated with contraceptive caps, it is possible to develop bladder infections while using them.

You cannot use the contraceptive cap or diaphragm while you’re on your period as there is a link between doing so and toxic shock syndrome, a potentially life threatening condition.

Pros and cons of diaphragms and caps

Advantages of contraceptive diaphragms and caps:

  • You only need to use it when you have sex
  • You can insert it conveniently before sex. Use spermicide if you plan on having it in for three hours or longer

Disadvantages of contraceptive diaphragms and caps:

  • Not as effective as other methods of contraception
  • Doesn’t protect against sexually transmitted infections
  • Can take some time to learn how to use it properly
  • Can interrupt the flow of sex when inserting it
  • Bladder infection can be a problem for certain women who use caps
  • For some latex and spermicide can be irritating

Permanent

Permanent contraception refers mainly to either female sterilisation or male vasectomy. Sterilisation refers to any medical procedure or surgery which intentionally leaves a person unable to procreate.

It’s important to weigh up the advantages and disadvantages of permanent sterilisation and be 100% sure it’s what you want.

Sterilisation

Female sterilisation is a medical procedure that either blocks or seals the fallopian tubes to prevent eggs from being released during ovulation, meaning sperm cannot reach and fertilise them. Some procedures are performed while you’re asleep under general anaesthetic, but most are done while you’re awake under local anaesthetic.

Female sterilisation is over 99% effective at preventing pregnancy and, because it’s permanent, you don’t ever have to think about contraception again after it’s done. (Though sterilisation doesn’t protect you against STIs).

There aren’t many side effects associated with female sterilisation, namely a small risk of complications associated with the surgery including bleeding, infection or damage to other organs.

Male sterilisation, more commonly called a vasectomy, is a similar process that snips or seals the tubes which carry sperm. The procedure takes around 15 minutes and is performed typically under local anaesthetic. Men will still ejaculate semen when they climax but the semen doesn’t contain any sperm.

Male sterilisation is over 99% effective at preventing pregnancy, in fact it is the most reliable way of preventing pregnancy other than avoiding sex completely. You’ll need to use additional methods of contraception, like barrier methods, for up to 12 weeks after having a vasectomy and until tests show your semen is consistently free of sperm.

Side effects associated with the vasectomy include the scrotum becoming bruised, swollen or even painful and some men experience ongoing problems with their testicles following a vasectomy.

Both female sterilisation and male vasectomies are intended to be permanent - you need to think carefully before going through with either of them. They can be reversed, but reversal is fairly complex and is often unsuccessful. (It’s also highly unlikely to be funded by the NHS).

Pros and cons of sterilisation

Advantages of both male and female sterilisation:

  • Over 99% effective
  • Will not impact your hormones, your sex drive and won’t interfere with the flow of sex the same way condoms might

Disadvantages of both male and female sterilisation:

  • You’re not protected against sexually transmitted infections
  • Cannot be reversed easily
  • Small risks of complications are associated with both surgeries
  • Female sterilisation can cause internal bleeding, infection or damage to other reproductive organs. Male vasectomy can cause haematoma (blood inside the scrotum), sperm granulomas (hard lumps formed by leaking sperm), infection or long-term testicular pain
  • In very rare circumstances - both the vas deferens tubes and the fallopian tubes can reconnect and you can become fertile again.

Male vasectomies are generally said to be safer than female sterilisation, but are not effective immediately the same way female sterilisation is. You need to keep using contraception until tests show your semen is completely free of sperm.

Natural

‘Natural’ family planning or awareness contraception essentially refers to methods which don’t employ devices, systems or medication to prevent pregnancy. Instead they rely on self-awareness techniques and a good understanding of the menstrual cycle and the process of fertilisation. A woman can closely monitor her menstrual cycle to work out the days in which she is less likely to become pregnant.

Another ‘natural’ method of contraception is the withdrawal method, but this is more controversial and isn’t recommended by the NHS. This is because it tends to be less effective at preventing pregnancy when compared with the majority of other methods.

Fertility awareness

Fertility awareness refers to ovulation and menstrual tracking to understand the days in which you are least likely to get pregnant. These are the days you’re able to typically have sex without contraception. When natural family planning is performed consistently and correctly, it’s up to 99% effective.

You can track your temperature and vaginal mucus discharge daily to predict when you’ll ovulate, and you can also chart your menstrual cycle on a calendar. It can take several months before you fully learn how to track your fertility signals. But once you’re able to do it, it can be highly effective. There are also a number of websites and apps that help you record and chart this information.

There aren’t any side effects associated with fertility awareness methods, but illness or stress may affect the accuracy of your monitoring.

Pros and cons of natural family planning

Advantages of family planning and awareness methods:

  • Doesn’t cause any side effects
  • Awareness methods are acceptable to all cultures and religions
  • The vast majority of women can benefit from fertility awareness, provided they’re taught correctly how to do it
  • Just as you can use awareness methods to prevent pregnancy, you can also use them to help you get pregnant
  • Doesn’t involve hormones or procedures
  • Can help to make you aware of what normal and irregular discharge looks like
  • Helps you ‘get to know’ your body and menstrual cycle better

Disadvantages of family planning and awareness methods:

  • Doesn’t protect against sexually transmitted infections
  • You need to use additional contraception, or avoid sex, at the times you’re most likely to get pregnant
  • If you don’t follow fertility awareness methods properly they become less effective than other methods of birth control
  • Can take some time before you fully learn natural family planning methods
  • You need to keep daily records of your fertility signs
  • Your fertility signs can be affected by things like stress, lifestyle or illness

Withdrawal method

The withdrawal method, or ‘pulling out’, refers to the process of removing the penis from the vagina entirely before the point of ejaculation. The aim is to prevent any sperm from entering the vaginal canal and cervix.

How effective is the withdrawal method? Well, it requires an element of self-control, and even then can remain ineffective. It’s typically between 80% and 86% effective, meaning, at worst, 20 out of every 100 couples who practise this method will become pregnant. However, when it’s done perfectly every time, it can be up to 96% effective, which is as effective as certain methods of hormonal contraception.

Pros and cons of the withdrawal method

Advantages of the withdrawal method:

  • It feels ‘natural’, which some people feel condoms don’t
  • No side effects are associated with the withdrawal method
  • It can be used each time you have sex

Disadvantages of the withdrawal method:

  • It’s not very reliable
  • Pre-ejaculation, which can contain sperm, may be released before withdrawal
  • Some men have difficulty timing their ejaculation
  • You need to completely trust your male partner and their ability to properly withdraw entirely before ejaculation, not during or after
  • If your partner’s reflexes are slowed, if they’ve consumed alcohol for example, or if they get lost in the moment, they may not time their withdrawal correctly

Most effective contraceptive

The most effective birth control method may also depend on what is most preferable to you and how well you’re able to use it. Here is each birth control ranked by effectiveness:

Table design option for Elementor Tables
Method Perfect use Typical use
Combined pills Over 99% effective 91% effective
Mini pills Over 99% effective 91-93% effective
Intrauterine device (IUD) Over 99% effective n/a
Contraceptive implant Over 99% effective n/a
Female and male sterilisation Over 99% effective n/a
Male condoms 98% effective 82% effective
Diaphragms and caps 92-96% effective 71-88% effective
Family planning and fertility awareness Up to 99% effective Around 76% effective
Withdrawal method Up to 96% effective 80-86% effective

While the different types of birth control and effectiveness rates remain over 90% effective when perfect use or application is observed, most people will struggle to use them perfectly all the time. So keep in mind the ‘typical’ rates of effectiveness when you make your decision.

100% protection against pregnancy can never be guaranteed with any method of contraception, but you can massively lower the risk by ‘doubling up’. This means combining two methods – such as a hormonal method of birth control combined with a barrier method like condoms. Doing so will highly reduce the risk of pregnancy and also protect you against STIs.

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