Pregnancy / 30 October, 2019 / Dr Lizzie Kershaw-Yates

Recommended Top Five Birth Control Methods

Contraception has been around longer than you think. From injections to implants, and at one time even inserting half a lemon into the vagina! Birth control has never been so varied or accessible, so not getting pregnant should be easier than ever.

Choosing the right contraception for you is important. There are lots of factors to think about: your age, family plans, and personal preference. If you have just had a baby, one of the first things your midwife will ask is what type of contraception you plan to use. Your first thought might be ‘I won’t be needing that for a while’ – but you can ovulate very soon after giving birth and you are still at risk of pregnancy if you return to sexual intercourse without protection.

The five most common options are:

Combined oral contraceptive pill

Commonly known as ‘the pill’, this method of contraception is suitable for women up to the age of 50 with a BMI under 30.  It contains two hormones which stop the ovaries from releasing an egg each month.

Pros: as soon as you stop taking it, fertility generally returns, and it usually lightens your monthly bleed.  Can also bring relief for acne and premenstrual syndrome.

Cons: if you miss taking a pill, you may find yourself at risk of pregnancy.  It is also unsuitable if you are breastfeeding or have a family history of deep vein thrombosis.

Progesterone Only Pill

Also known as the ‘mini pill’, this method is suitable for most people.  This pill contains only one hormone and works by changing the mucus at the entrance to the womb so that sperm cannot pass through and fertilise the egg. You take this pill every day without the seven day break you have when taking the combined contraceptive pill.  The most important thing to remember is that it must be taken every day to ensure its effectiveness.

Pros: this pill can also be used when you are breastfeeding and there are no restrictions on your BMI or smoking status.

Cons: Bleeding can be erratic.  Although it is often light, the lack of predictability can be irritating.  However, some women never have a period again, so it’s worth a try!

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The Contraceptive Implant

This has been around for many years and contains a long-acting synthetic hormone.  It is inserted into the upper arm under local anaesthetic and can stay in place for 3 years.

Pros: If this works for you, you only have to think about contraception every 3 years

Cons: One of the side effects is irregular bleeding

IUD/ The Coil

The coil, with or without progesterone, offers up to 5 years of contraception. Slightly more uncomfortable than having your smear done, it is placed and then forgotten.

Pros: you only have to replace it every 5 years

Cons: some people experience heavy bleeding

The Contraceptive Injection

This used to be a trip to the doctor for an injection every three months, but a new product on the market will now allow you to administer the injection yourself at home.

Pros: 3 months and nothing to worry about remembering in between. Usually women stop having periods altogether.

Cons: It can take a while for fertility to return once you stop the injections.  In some younger, thinner women there is a reversible effect on bone density (causing a thinning of the bones) and therefore this may not be suitable for everyone.

Some things to remember when choosing contraception:

• Choose the method that is right for you
• Try and stick with any method for 3 months as side effects will often settle
• Don’t forget, no form of contraception covers you from sexually transmitted diseases, so ensure you use barrier contraception with new partners until you have both had a sexual health check up

Advice given by Dr Elizabeth Kershaw-Yates, GP and one of the medical team at The Online Clinic

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