The Ultimate Guide to Different Types of Contraceptive Methods

Contraceptives are useful tools for avoiding unwanted pregnancies and some can also protect against STIs. However, there are many different types of contraceptives to choose from, so it can be difficult finding what’s right for you. We’ve collected key information on 16 commonly-used methods of contraception, sorted into 5 main categories to help you figure out how best to protect yourself.

There are a range of types of contraceptives available in the UK that come under a few different categories, including:

• hormonal methods like contraceptive pills, contraceptive patches, the contraceptive injection, contraceptive implants, the intrauterine system and the vaginal ring
• barrier methods like male and female condoms, contraceptive diaphragms and cervical caps
• emergency contraception, like the morning after pill and intrauterine devices
• long-term and permanent methods like male and female sterilisation, the contraceptive implant and contraceptive coils, like the intrauterine system and intrauterine devices
• ‘natural’ contraceptive methods like family planning, fertility awareness and the withdrawal method

Effectiveness of different contraceptive methods

When used properly most contraceptive methods are around 99% effective or more. That means that around 1% of people who use them for a year will get pregnant. In reality, the effectiveness is slightly lower because not everyone uses their contraception properly. It’s also worth noting that condoms are generally less effective than other methods, but they can help prevent STIs too. It’s a good idea to use condoms and other contraceptives to maximise protection.

Hormonal contraceptive methods contain man-made versions of hormones that naturally occur in the body. They usually contain either progesterones or progesterone and oestrogen together. They come as pills, injections, implants, patches,vaginal rings and devices.

“Hormonal contraceptives come with some extra benefits because of the effect the hormones in them have on your body. These can include improvements to acne, lighter, less painful periods and a reduction in premenstrual symptoms. On the other hand, these hormones come with a risk of some side effects too and not everyone can take them which is why we ask about your medical history before approving treatment.” - Dr Babak Ashrafi, Clinical Lead for Service Expansion.

The combined contraceptive pill is one of the 2 main types of contraceptive pills. It uses 2 hormones which work together to help prevent pregnancy. These are man made versions of hormones that occur naturally in the body – progesterone and oestrogen.

How does the combined oral contraceptive pill work?

Combined pills help prevent pregnancy by:

• thickening the mucus at the entrance to the womb to keep sperm out
• thinning the lining of the womb so any egg that does get fertilised can’t attached and grow
• stopping eggs from being released in the first place

How effective is the pill?

When taken perfectly, the combined pill is over 99% effective. However, because people sometimes miss pills, their effectiveness is more realistically around 93% (Trussell, 2011). If you want the most effective contraceptive protection, you need to take the pill exactly as advised.

More information

Because the combined pill contains oestrogen it can be better at improving some hormone-related health conditions than the mini pill, including acne and period problems. But it also comes with an extra risk of oestrogen-related contraceptive pill side effects like headaches, nausea and breast tenderness.

It’s not always easy to find the best contraceptive pill for you but our guide to contraceptive pill brands may help. Or you always get our doctors to recommend a pill for you.

The mini pill is another kind of contraceptive pill that only contains progesterone. This means it still prevents pregnancy but works slightly differently.

How it works

The mini pill works by:

• thickening the mucus at the entrance to the womb to keep sperm out
• thinning the lining of the womb so any egg that does get fertilised can’t attached and grow

Unlike the combined pill, not all mini pills stop eggs from being released. Only mini pills containing desogestrel do this. As well as desogestrel mini pills, there are a couple of other types of mini pills, including ones that contain levonorgestrel and norethisterone.

Similar to the combined pill, the mini pill is over 99% effective when taken perfectly, but 93% effective in practice (Trussell, 2011). Missing pills is easier with mini pills because there’s a smaller window for taking them than the combined pill, but it’s still possible to have over 99% protection if you keep on top of your doses.

More information

Mini pills don’t have the same chance of improving hormonal health conditions that combined pills have, but they can be better for endometriosis and heavy periods.

Although mini pills don’t come with the same risk of oestrogen-related side effects, like thrombosis, they do come with a risk of some side effects related to taking progesterone without oestrogen, including mood swings and acne.

The contraceptive injection is a shot of man made progesterone, the same type of hormone that’s in the mini pill. The injection lasts for 12 weeks and once given it cannot be reversed.

How it works

Like some other progesterone contraceptives, it stops the ovaries releasing an egg (ovulation). It can also thicken cervical mucus to stop sperm reaching the womb.

How effective is it?

Injectable contraceptives are more than 99% effective with perfect use, 96% with typical use (Trussell, 2011). The main thing that makes perfect use more difficult is remembering to get a new injection every 3 months.

More information

The contraceptive injection must be given by a doctor or nurse, who will discuss whether it’s suitable for you. Like other hormonal methods of contraception, injections do not protect from STIs.

Depo Provera and other injection contraceptives

There are a few different types of contraceptive injections available. Depo Provera is the brand name of a medroxyprogesterone injection.

Other injections include:

• Noristerat, which contains the progesterone norethisterone and lasts for 8 weeks
• Sayana Press, which contains medroxyprogesterone like Depo Provera and lasts for 13 weeks

The contraceptive implant is a long-acting reversible method of contraception, which means it lasts for a long period of time but can be stopped at any time. The implant is a matchstick-sized piece of plastic, inserted under the skin on your upper arm.

How it works

The implant works like the mini pill by releasing lab-made progesterone. This means it:

• thickens the cervical mucus to keep sperm out
• thins the lining of the womb to stop fertilised eggs growing

How effective is it?

It’s over 99% effective (Tressell, 2011). Unlike other methods that can be less effective in practice because of the way people use them, implants are always over 99% effective. This is because they’re inserted by healthcare professionals and work constantly without the need for patients to do anything.

More information

It can be safely left in place for 3 years but can be taken out at any time. The implant must be fitted and removed by a doctor or nurse. There is currently only one type of contraceptive implant (Nexplanon) available in the UK.

The contraceptive patch

The contraceptive patch is a patch containing hormones that help protect from unwanted pregnancies. Like a nicotine patch, the contraceptive patch is stuck to your skin and slowly releases medication into your body.

How it works

Like the combined contraceptive pill, the contraceptive patch contains artificial versions of the hormone oestrogen and progesterone. So it:

• stops ovulation (eggs being released from the ovaries)
• thickens cervical mucus to prevent sperm entering the womb
• thins the womb lining stopping fertilised eggs attaching

How effective is it?

Similar to combined and mini pills, the contraceptive patch is over 99% if used perfectly. In actual use, it’s about 93% effective as people forget to use patches or don’t use them properly (Tressell, 2011).

More information

If you’d like to start contraceptive patch treatment, you can order it online from ZAVA. Request Evra patch treatment easily online.

Coil contraception: the hormonal coil (IUS)

The contraceptive coil is a long-acting reversible method of contraception. It is a plastic, T-shaped device fitted in the vagina by a doctor or nurse. There are 2 types of coil – the intrauterine device (IUD) and the intrauterine system (IUS).

Only the IUS is hormonal, the IUD is non-hormonal and can be used as emergency contraception, so it’s discussed in detail in the ‘emergency contraception’ section.

How it works

The IUS releases lab-made progesterone. This means it works like other progesterone-only contraceptives. The IUS:

• thickens the mucus at the opening of the womb to keep sperm out
• thins the lining of the womb to stop any fertilised eggs from growing

How effective is it?

The IUS is over 99% effective (Tressell, 2011). Because it’s fitted by health professionals and requires no management by patients, it’s still over 99% effective in practice.

More information

Once it’s fitted, the IUS can stay in place for 3 or 5 years (depending on the brand) and can be removed at any time by a doctor or nurse.

The vaginal contraceptive ring

The vaginal ring is a piece of circular plastic that you place in the vagina. The ring works in the same way as the combined pill, releasing progesterone and oestrogen. And, like the combined pill it is prescription-only.

How it works

Because it contains both oestrogen and progesterone, it works the same way as other combined hormonal contraceptives. The vaginal ring:

• stops eggs from being released from the ovaries
• stops sperm entering the womb by thickening the mucus at the entrance
• stops fertilised eggs growing by thinning the womb’s lining

How effectives is it?

The vaginal ring is more than 99% effective with perfect use, and 93% effective with typical use (Tressell, 2011). This means because people don’t use it perfectly in practice the overall effectiveness across everyone who uses it is lower.

More information

You put the ring in place for 21 days then remove it for 7, when you’ll have a breakthrough bleed and then you replace it with a new ring.

Barrier methods of contraception usually work to prevent sperm, bacteria and viruses from being transferred. This means they can help avoid unwanted pregnancies and also help limit the spread of STIs.

While male condoms are the most well-known of this type of contraceptive method, there are others to consider.

Condoms

Condoms, particularly male condoms, are the most common and well-known barrier contraceptive. But, female condoms do exist and are almost as effective when used perfectly.

What is it?

Condoms are the most popular form of contraception that also helps to avoid getting STIs, even during oral sex. They are most commonly made of latex, but other types are available for people with latex allergies.

How it works

A male condom is a covering worn over the penis to stop sperm entering the vagina and getting into the womb.

How effective is it?

With perfect use, male condoms are 98% effective at preventing pregnancy, but with typical use this drops to 87% (Tressell, 2011).

More information

The condom is the most commonly used form of male contraception. They can be bought by people of any age from a variety of shops, including pharmacies, and supermarkets. You can also get them for free in many places, including contraception clinics and sexual-health clinics.

What is it?

Like male condoms, female condoms are worn during sex and can prevent STIs as well as unwanted pregnancies. They are most commonly made of latex but other types are available for people with allergies.

How it works

A female condom is worn inside the vagina instead of outside the penis and they also help stop sperm from entering the vagina and getting into the womb.

How effective is it?

The female condom is around 95% effective with perfect use and 79% effective with typical use (Tressell, 2011). And, like male condoms, they can protect from STIs.

They’re not found in as many places as male condoms but are sold in pharmacies and supermarkets. You can also get them at most contraception clinics and sexual-health clinics.

Contraceptive diaphragms and cervical caps (FemCap)

Diaphragms and cervical caps are another pair of similar barrier contraceptive methods. Both are fitted inside the vagina to stop sperm entering the womb. They are different sizes but they both require spermicide use. Unlike condoms, neither diaphragms nor cervical caps protect against STIs.

The contraceptive diaphragm

A diaphragm is inserted before sex and then kept in afterwards to help protect against pregnancy. It’s made of a soft silicone and is shaped like a shallow cup.

How it works

A diaphragm is placed inside the vagina to cover the lowest part of the womb (the cervix) to stop sperm getting in. It must be used with spermicide (commonly a gel or cream) which slows down the movement of sperm.

How effective is it?

With perfect use, the diaphragm is 92 to 96% effective. With typical use, it’s 88% effective (Tressell, 2011).

More information

You insert it before you have sex and should leave it in place for at least 6 hours afterwards. You should remove it within 24 hours of inserting to avoid getting bacterial infections. Depending on the material and type of the diaphragm, it can be reused many times.

Even though you don’t need a doctor’s prescription to get a diaphragm, a doctor will be able to tell you if the diaphragm is right for you. They will fit the diaphragm for you and teach you how to put it in place.

Cervical caps

The cervical cap (sold as FemCap) is a silicone cup, similar to a diaphragm but smaller. It also needs to be used with a spermicide.

How it works

Like the diaphragm, cervical caps block sperms from entering the womb and the spermicide used with it helps kill sperm as well.

How effective is it?

The cervical cap is 92 to 96% effective with perfect use and 77 to 83% effective with typical use (Tressell, 2011).

More information

The cervical cap must remain in the vagina at least 6 hours after sex and should be taken out within 48 hours.

Even though you can buy cervical caps without seeing a doctor or nurse, it’s a good idea to talk to one about whether the cap is suitable for you. They can also make sure that you fit it properly, and show you how to use it.

Cervical caps vs the diaphragm

Because cervical caps and diaphragms work in a similar way, there isn’t much difference in effectiveness between them. The main differences are you can leave in a cervical cap longer if that’s more convenient for you. You may also prefer the cervical cap since it’s smaller and may feel less uncomfortable to use.

Emergency contraception is used to stop you getting pregnant after you’ve had unprotected sex. It’s not recommended as a regular method of contraception. Emergency contraception needs to be used within 3 or 5 days of unprotected sex (depending on the method and brand used).

The 2 types of emergency contraception available include the morning after pill and the intrauterine device.

ellaOne

• Effectiveness: 98 to 99%
• How soon does it need to be used: ASAP, maximum 5 days
• How to use it: Take pill
• Where can I get it: Online

Levonelle

• Effectiveness: 97.4 to 99.4%
• How soon does it need to be used: ASAP, maximum 3 days
• How to use it: Take pill
• Where can I get it: Online

IUD

• Effectiveness: Over 99%
• How soon does it need to be used: 5 days
• How to use it: Have it inserted by professional
• Where can I get it: From a healthcare provider, like a sexual health clinic

The morning after pill is the most common form of emergency contraception. There are 2 kinds available, ones containing ulipristal acetate and ones containing levonorgestrel.

How it works

It’s a single pill containing synthetic hormones which stop or slow down the release of an egg (ovulation). This is why the pill versions only work as long as you haven’t ovulated yet. An IUD can also be used as emergency contraception, especially if you’ve already ovulated.

How effective is it?

How effective it is depends slightly on which kind you go for. According to the NHS, ulipristal acetate morning after pills are 98 to 99% effective and levonorgestrel ones are 97.4 to 99.4% effective.

More information

Morning after pills have to be taken as soon as possible, at the latest they should be taken within a few days of unprotected sex for them to work. For ones containing ulipristal acetate they must be taken within 5 days and for ones containing levonorgestrel it’s 3 days.

You can get the morning after pill through your GP, sexual-health clinic or pharmacist, or through our online doctor service. Morning after pills we offer include:

The IUD is a small T-shaped device that is inserted into the vagina by a doctor or nurse. It releases copper into the womb and is also known as the copper coil.

How it works

The copper in the IUD protects against pregnancy in 2 ways. Firstly, it makes it difficult for sperm to survive and enter the womb and secondly it also prevents eggs from surviving and entering the womb from the fallopian tubes.

How effective is it?

The effectiveness rate for the IUD is above 99% (Tressell, 2011). Since it’s fitted by a doctor, there’s a lot less chance of user error affecting your contraceptive protection.

More information

IUDs can also be used as a form of emergency contraception if the device is inserted within 5 days after unprotected sex. Unlike morning after pills, the IUD can be used as long-term contraception after it’s fitted.

Sterilisation is usually an operation performed by a doctor which permanently protects against pregnancy. It’s available to both men and women. Sterilisation offers more than 99% protection against pregnancy. In rare cases blocked tubes grow back and reconnect or tubes are not effectively blocked, which can result in unwanted pregnancies.

Tubal ligation (female sterilisation)

When people talk about ‘natural’ contraception, they tend to mean methods that don’t involve medications or devices. Natural methods of contraception are usually difficult to use effectively and often do not protect successfully against unwanted pregnancy when used by themselves.

Natural family planning (the fertility awareness method or calendar method)

If contraception is not used, approximately 85% of people who are sexually active and able to get pregnant will become pregnant within one year (Tressell, 2011). Also, if you do not use barrier methods like condoms and have new sexual partners, you have a much higher chance of getting an STI.

Which method of contraception is best for me?

Your choice of contraception will likely depend on your health, lifestyle, personality, and relationships. Sometimes finding the right type for you will mean trying out methods and then switching if it does not feel suitable. There might be some types of birth control that your doctor or nurse will recommend that you do not use, depending on your health or medications.

The effectiveness of some contraception methods depends on how carefully you use them. It’s a good idea to think about whether you will be able to reliably use the contraception types you choose, and how effective it will be.

Online tools and resources like the ones offered by Brook and the NHS are handy for thinking through your contraceptive options.

If you’re considering contraceptive pills, we can help. We offer a wide range of pills to choose from and our doctors can even recommend a pill they think might be right for you.