It’s time to take back control of your birth control, here’s how…

Birth control. It’s something we all have to consider at some point in our lives but are we really aware of all of our options? Probably not, considering many of us were passed a prescription for the pill on our first visit to the doctor and haven’t questioned it since. And why would we? The introduction of the contraceptive pill in 1961 marked the liberation of women, the release from the fear of pregnancy and the ability to embrace our sexual agency.

But the fact is, medical technology has moved on in droves and there are so many alternatives out there that might be better suited to you. We decode the world of contraception so you can take back control…

It's time to take back control of your birth control, here's how...

THE COMBINED PILL

What is the combined contraceptive pill?

A combination of artificial versions of the female hormones oestrogen and progesterone. Together, these hormones prevent you from releasing an egg, thickens the mucus in the neck of the womb, making it harder for sperm to penetrate and thins the lining of the womb to reduce the risk of a fertilised egg implanting.

How effective is the combined pill?

A triple whammy of protection that, when taken correctly, is over 99% effective. The problem is, the pill is a user dependent form of contraception, meaning it depends on you taking it properly to be effective, so in reality and when considering human error, it’s far less effective.

To take it correctly, you must take it at the same time every day. If you have diarrhoea or vomiting, it can be less effective and you will need to use other methods of contraception for one week.

Plus points of the combined pill

The combination pill can make your periods more regular and lighter as well as alleviate premenstrual syndrome, so it is a great choice if you suffer from heavy bleeding.

There are many types of contraceptive pill, some better than others at addressing different concerns (for example, the pill Yasmin can help treat acne) and you may react differently to different types, so it’s well worth going back to your doctor to try a different one if you’re experiencing side effects.

The combined pill may reduce the risk of fibroids, ovarian cysts and ovarian and colon cancer.

Negatives of the combined pill

As with most medications, there are some potential side effects like nausea, breast tenderness and mood swings but there are also other more specific concerns.

If you experience high blood pressure, migraines or if you smoke, you might want to opt for a different form of contraception as this pill can increase your risk of thrombosis and stroke.

There is also evidence of a slightly heightened risk of breast cancer.

It doesn’t protect you from STDS, so you’ll still need to use condoms with a new sexual partner or if you and your partner haven’t had a recent sexual health check up.

On top of this, there are more recent concerns over the levels of synthetic hormones women are exposing themselves to and the potential risk of mental health issues. One study conducted by the University of Copenhagen of more than one million women over the course of 13 years confirmed a significant link between hormonal contraceptives and depression. Women taking combined oral contraceptives were 23 per cent more likely to be treated for the mental health condition.

10 things your gynaecologist is really thinking but doesn’t tell you

THE MINI PILL

What is the mini pill?

A progestogen-only pill (so no oestrogen) that is taken at the same time every day to thicken the mucus in the cervix to stop sperm reaching an egg and also stop ovulation.

How effective is the mini pill?

When taken correctly it can be over 99% effective, but like with the combination pill, in reality it is less effective with typical use seeing an efficacy rate of around 92%.

The only thing is there’s a much smaller window for error than the combined pill. You’ll need to take it at the same time everyday (within a three hour window) to be covered.

Plus points of the mini pill

If you suffer from migraines, high blood pressure or if you smoke, this is the pill for you as it doesn’t contain any oestrogen so has less effect on your risk of stroke or blood clots.

Many people feel more comfortable taking fewer hormones, especially with the potential links between oestrogen and breast cancer.

Negatives of the mini pill

As well a risk of nausea, breast tenderness and mood swings, the mini-pill can make you break out and more likely to get spots. It can also cause irregular periods and spotting (light bleeding throughout the month).

It doesn’t protect you from STDS, so you’ll still need to use condoms with a new sexual partner or if you and your partner haven’t had a recent sexual health check up.

In the same way as the combination pill, the mini-pill contains artificial hormones and the same study found those on the progestogen-only pill (known as the mini-pill) were 34 per cent more likely to be treated for depression.

Every single burning question you have about your period, answered

THE APP

What are contraceptive apps?

Contraceptive apps use intelligent algorithms to track and predict your menstrual cycle, alerting you to the days when you are fertile. Some apps like Natural Cycles require you to input your basal body temperature – your lowest and most stable temperature within a twenty-four-hour period – to track your hormone levels, alongside information on your mood and physical symptoms.

How effective are contraceptive apps?

Well, this one is still a bit up for debate. While Natural Cycles has been certified as a contraceptive device and boasts over 99% accuracy (an independent study published in The European Journal of Contraception & Reproductive Health Care, the rate of false green days within the fertile window when used correctly was found to be less than 0.1 per cent), it is still a user-dependent form of contraception, meaning the actual efficacy of protection for its users is much lower, due to factors like human error, forgetting to input your temperature, or just ignoring the advice the app provides and having unprotected sex on a fertile day.

Plus points of contraceptive apps

They are completely hormone free, meaning no unpleasant side effects. Plus, it doesn’t interrupt sex like condoms can do and doesn’t require a physical barrier between you and your partner.

Users also praise this form of contraception for allowing them to become more in tune with their bodies, and far more familiar with their cycles.

Negatives of contraceptive apps

Due to the high potential for user-related error, an app requires the utmost vigilance from the user. Even then, there could be blips in the algorithm resulting in incorrect advice.

It doesn’t protect from STDs, so it’s best to only use an app if you are in a committed relationship and both you and your partner have been tested at a sexual health clinic.

THE IUD

What is the IUD coil?

The intrauterine device, IUD, otherwise known as the coil, is a small, T-shaped device that’s put into your womb (uterus) by a doctor or nurse.

There’s a hormonal coil, which releases progesterone into the womb, and a non-hormonal version, which releases copper to prevent pregnancy.

How effective is the coil?

The coil is more than 99% effective and doesn’t rely on the user for its efficacy, meaning that once it’s in there, you can forget about it and still be covered.

Plus points of the coil

One IUD can last between 5 to ten years, depending on the type (your doctor will tell you), and doesn’t depend on the user for efficacy, so it’s a great, low maintenance safeguard against pregnancy.

There’s no oestrogen in it either, so you can use both varieties if you get migraines, smoke or have high blood pressure.

The copper coil is hormone-free so doesn’t interfere with the body’s natural state, which many people prefer in light of recent research casting doubt over the side effects of synthetic hormones.

Negatives of the coil

Insertion and removal can be slightly uncomfortable, and there’s a slight risk of infection from the procedure.

It doesn’t protect you from STDS, so you’ll still need to use condoms with a new sexual partner or if you and your partner haven’t had a recent sexual health check up.

Because the copper coil doesn’t contain hormones, there are none of the usual side effects that come with contraception, but can cause heavy bleeding. The hormonal coil has all the usual risks – mood swings, tender breasts and changes in skin.

[embedded content]

THE CONDOM

What is a condom?

Ah, the good old condom. A stretchy, latex (rubber), polyisoprene or polyurethane barrier worn around the penis to stop a man’s semen from coming into contact with his sexual partner.

How effective are condoms?

When used correctly, condoms are 98% effective, but there’s the issue of a condom breaking (usually due to snags caused by finger nails or jewellery), or else putting the condom on the tip of the penis the wrong way round, coating it in pre-ejaculation sperm, then flipping it over and using it anyway.

Plus points of condoms

Condoms are the only – yes, the only – form of contraction that protect against sexually transmitted infections. If you’re not in a committed sexual relationship where both people have had a recent check up, it’s a very good idea to use condoms.

They are hormone-free, meaning no unwanted side effects or health risks. Also, you don’t have to use them or even think about them any time other than when you’re about to have sex.

Negatives to condoms

They interrupt sex and can be a bit of a mood-killer. If your partner is a lingerer (if he likes to stay inside you after ejaculating) and his penis loses its erection, the sperm can leak out the sides of the condom – not ideal.

5 condom myth-busters (that will totally blow your mind)

THE VAGINAL RING

What is a vaginal ring?

Also known as the NuvaRing, a vaginal ring is a small soft, plastic ring that you place inside your vagina and sits at the base of your cervix.

It releases a continuous dose of the hormones oestrogen and progestogen into the bloodstream to prevent pregnancy by thickening the mucus at the base of the womb, thinning the lining and prevent release of an egg. Each ring lasts four weeks, and you remove and replace it yourself.

To insert it, you just squeeze it length-ways and insert into your vagina and move it around a bit until it feels comfortable. Don’t worry, it can’t ‘get lost’ inside.

How effective is the vaginal ring?

When used correctly, it is 99% effective. There’s a chance that the ring could fall out, but if that happens just rinse it and put it back in.

Plus points of a vaginal ring

It’s the lowest dose of hormones available in a hormonal contraceptive, and the release of them is localised, meaning there are less severe side effects in terms of mood swings and changes to skin.

The insertion and removal is easy and painless, and you can do it in the comfort of your own home.

It has your contraception covered for one month, so is pretty low maintenance, and your period will typically be lighter and less painful.

Negatives of a vaginal ring

It doesn’t protect you from STDS, so you’ll still need to use condoms with a new sexual partner or if you and your partner haven’t had a recent sexual health check up.

Your partner may be able to feel the ring when you’re having sex – but it’s not painful in any way, it might just take a bit of getting used to.

Because the ring releases oestrogen, it has all the associated risks (like an increased risk of breast cancer) and people who experience migraines, smoke or have high blood pressure shouldn’t use it.

THE IMPLANT

What is the implant?

The contraceptive implant (Nexplanon) is a little, flexible plastic rod that’s inserted under the skin in your upper arm by a doctor or nurse. It releases the hormone progestogen into your bloodstream to prevent pregnancy, lasting for 3 years.

How effective is the implant?

99% effective – and it doesn’t depend on you using it correctly so you’re totally covered without having to think about it.

Plus points of the contraceptive implant

Not having to think about it for three years, safe in the knowledge that you’re protected from getting pregnant.

Again, it’s oestrogen-free so is great for women who want to avoid taking the hormone.

Negatives to the contraceptive implant

Implanting can be a bit sore, with some bruising afterwards, but rest assured that this quickly passes. It doesn’t protect you from STDS, so you’ll still need to use condoms with a new sexual partner or if you and your partner haven’t had a recent sexual health check up.

It can make your periods stop altogether, which some women find off-putting (but others find liberating!).

Here’s how I learnt to live with polycystic ovary syndrome

THE INJECTION

What is the contraceptive injection?

The contraceptive injection (Depo-Provera, Sayana Press or Noristerat) releases the hormone progestogen into your bloodstream to prevent pregnancy and lasts between eight and 13 weeks.

How effective is the contraceptive injection?

99% effective, with no room for human error, too.

Plus points to the contraceptive injection

The one off injections covers you for weeks, meanings you don’t need to think about it again for a while.

It doesn’t contain oestrogen so you can still use it if you get migraines or want to avoid the associated risks.

Negatives to the contraceptive injection

Alongside the usual hormonal side effects (mood swings, acne, and irregular periods) it can also take up to one year for your fertility to return to normal after you stop using it, making it more difficult to conceive in that time.

It doesn’t protect you from STDS, so you’ll still need to use condoms with a new sexual partner or if you and your partner haven’t had a recent sexual health check up.

You’ll also have to go back to your doctor or local clinic every eight to 13 weeks and always remember to book an appointment.

Hey It’s OK…To Have Abnormal Cells: With Katie Snooks and Shannon Peerless