Contraception

Definition | Types of Contraception | Advantages and Disadvantages | Factors to Consider | Accessibility and Availability | References

Definition

Contraception refers to methods used to prevent pregnancy. These methods work by either preventing sperm from fertilising an egg or by inhibiting ovulation, fertilisation, or implantation. In the UK, contraception is widely available and free of charge through the National Health Service (NHS).

Types of Contraception

There are various types of contraception available in the UK, each with different mechanisms of action, effectiveness, and suitability for individuals based on their health, lifestyle, and preferences. The main types include:

• Barrier Methods:
  • Condoms: Male and female condoms provide a physical barrier to prevent sperm from reaching the egg. They also protect against sexually transmitted infections (STIs).
  • Diaphragms and Caps: These are inserted into the vagina before intercourse to cover the cervix and block sperm entry.
• Hormonal Methods:
  • Combined Oral Contraceptive Pill (COC): Contains both oestrogen and progestogen to prevent ovulation, thicken cervical mucus, and thin the uterine lining.
  • Progestogen-Only Pill (POP): Contains only progestogen, suitable for women who cannot take oestrogen. It thickens cervical mucus and may inhibit ovulation.
  • Contraceptive Patch: A patch that releases hormones through the skin to prevent ovulation.
  • Contraceptive Injection: Progestogen injection given every 8-13 weeks to prevent ovulation.
  • Contraceptive Implant: A small rod inserted under the skin that releases progestogen, effective for up to three years.
  • Vaginal Ring: A flexible ring inserted into the vagina that releases hormones to prevent ovulation.
• Intrauterine Devices (IUDs) and Systems (IUSs):
  • Copper IUD: A non-hormonal device that releases copper to prevent sperm from fertilising the egg, effective for 5-10 years.
  • Hormonal IUS: Releases progestogen to thicken cervical mucus and thin the uterine lining, effective for 3-5 years.
• Emergency Contraception:
  • Emergency Contraceptive Pill: Levonorgestrel or ulipristal acetate pills that can be taken after unprotected sex to prevent pregnancy.
  • Copper IUD: Can be used as emergency contraception if inserted within 5 days of unprotected intercourse.
• Permanent Methods:
  • Female Sterilisation: A surgical procedure to block or seal the fallopian tubes, preventing eggs from reaching the sperm.
  • Male Sterilisation (Vasectomy): A minor surgical procedure to cut or seal the tubes that carry sperm.
• Natural Methods:
  • Fertility Awareness: Involves tracking menstrual cycles, body temperature, and cervical mucus to identify fertile days and avoid unprotected intercourse during that time.
  • Withdrawal Method: The male partner withdraws before ejaculation to prevent sperm from entering the vagina. This method is less effective than others.

Advantages and Disadvantages

Each type of contraception has its own advantages and disadvantages. Some key points to consider include:

• Barrier Methods:
  • Advantages: Provides protection against STIs, can be used on-demand.
  • Disadvantages: Requires correct use every time, can interrupt sex, may cause allergies or irritation.
• Hormonal Methods:
  • Advantages: Highly effective, regulates menstrual cycles, reduces menstrual pain and acne.
  • Disadvantages: May cause side effects such as mood changes, weight gain, and increased risk of blood clots (especially with COC).
• IUDs and IUSs:
  • Advantages: Long-lasting, low maintenance, highly effective.
  • Disadvantages: Insertion can be uncomfortable, may cause heavier or irregular periods (with copper IUD), risk of uterine perforation.
• Emergency Contraception:
  • Advantages: Provides a last-minute option to prevent pregnancy after unprotected sex.
  • Disadvantages: Less effective than regular contraception, should not be used as a regular method, may cause nausea and other side effects.
• Permanent Methods:
  • Advantages: Permanent, highly effective, no ongoing maintenance.
  • Disadvantages: Irreversible, requires surgery, does not protect against STIs.
• Natural Methods:
  • Advantages: No side effects, low cost, acceptable for those who prefer non-hormonal methods.
  • Disadvantages: Less effective, requires careful monitoring and discipline, does not protect against STIs.

Factors to Consider

When choosing a method of contraception, several factors should be taken into account, including:

• Personal preference and lifestyle.
• Medical history and potential contraindications.
• Effectiveness of the method.
• Side effects and potential risks.
• Desire for future fertility.
• Need for protection against STIs.
• Religious or cultural beliefs.

Accessibility and Availability

In the UK, contraception is widely accessible through the NHS. Contraceptive services are available free of charge at:

• GP surgeries.
• Contraception clinics.
• Sexual health clinics.
• Some young people’s services.
• Pharmacies (for emergency contraception).

Contraceptive methods can be obtained with a prescription, and some methods, such as condoms, are available over the counter. Emergency contraception can be obtained without a prescription from pharmacies.

References

1. NHS (2024) Contraception Guide. Available at: https://www.nhs.uk/conditions/contraception/ (Accessed: 24 June 2024).
2. National Institute for Health and Care Excellence (2024) Long-acting Reversible Contraception. Available at: https://www.nice.org.uk/guidance/ng18 (Accessed: 24 June 2024).

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