We see lots of people every month wondering about their options when it comes to contraception. Happily there are lots of methods out there and couples will largely find one that suits them in most cases!
There is lots and lots of useful information online, some of which will be linked to here, so this article is by no means exhaustive, and the focus will be on the main points in relation to each method. Books and books have been written about contraception so the next few hundred words are merely a summary! If you have questions about family planning, please get in touch to see one of the team.
Choosing a method that is right for you
Essentially when you are choosing a method of contraception you should think about:
- When, if ever, you would like to get pregnant in the future?
- What are the potential risks & side-effects of each method?
- Are you taking other medications?
- Would you be ok about a minor procedure involved in commencing & stopping your preferred method?
- Are you reliable when it comes to taking medication? (can be more difficult with shift workers, those who travel, etc)
The Combined Pill
This is one of the most prescribed medicines in the world and it is a very effective form of contraception.
You can find lots of helpful information here. It is usually prescribed every six months and it is important that your doctor keeps an eye on your blood pressure whilst you are taking the pill. Side-effects are generally uncommon and it is thought to protect against breast and endometrial (womb/uterus) cancer. It is probably most suited to those in a steady relationship as it does not provide protection against sexually transmitted infections (STIs). Smokers and those who are overweight may not be able to take this medication and it is not prescribed for those who have a personal history of thrombosis (clots).
The Progesterone-only Pill (‘mini-pill’)
The Progesterone-only pill (POP) is designed for those who cannot take the Combined pill, for example those with a history of clots, those who are breastfeeding, smokers and those who are overweight, etc.
It can cause irregular periods and is slightly less reliable than the combined pill. It must be taken every day without a break. Please click on this link to read more on the pros and cons of this method, including medication interactions that are important when taking the POP.
The Contraceptive Patch
This is an increasingly popular contraceptive method and it works in the same was at the combined pill.
It has a similar side-effect and precautions profile. The main difference of course, is that instead of taking a pill every day for 21 days and then taking a 7 day break, you apply a patch every week for three consecutive weeks and then take a week long break. If you want to know more about the patch, this site is a very useful resource.
This consists to a 4cm implant that is inserted into your arm. It slowly releases Progesterone which acts as a contraceptive for you for 3 years. You can read all about it here.
This method is also increasingly popular. It takes about 20 mins to insert and 30 mins to remove. The main side-effect is bleeding but most of our patients don’t find this too much of an issue. The official patient information leaflet answers a lot of questions on this method. It is ok to have whilst breastfeeding and it usually is effective soon after insertion, depending on your menstrual cycle. We fit the Implant in here in Portmarnock GP Clinic, and are glad to be able to offer this service to you.
The Mirena Coil
This refers to a small plastic ‘coil’ that is inserted into your womb and can stay there for up to 5 years! It releases the hormone Progesterone slowly and has a similar side-effect profile to the POP and the Implant.
You can read more about it here. It is an extremely reliable method of contraception and is also getting increasingly popular. We fit and remove Mirena Coils here in Portmarnock GP Clinic. It takes about 15-20 minutes to insert and is a little bit like getting a cervical smear taken. It can be removed in 5-10 minutes or so.
The Contraceptive Injection
This is a Progesterone based injection that must be given every three months and it provides excellent contraceptive cover in that time.
It has a number of potential side-effects, but is useful as a ‘bridging’ method, for example if you are breast-feeding, travelling, if you lead a busy (or chaotic!) lifestyle or if you just want time to think through your options and are unsure about committing to something long term.
If used perfectly, condoms are an excellent method of contraception.
Unfortunately however they are sometimes forgotten about or used incorrectly. This website has a useful guide to condom usage. They are particularly useful for someone who wants to prevent STIs if they have a new partner or are in a casual relationship, or for those who are breastfeeding.
What is the best method of contraception?
Methods of contraception are rated by the ‘Pearl Index’ and this is the risk of pregnancy in a year per method. The list is below, so please have a look as it is helpful when deciding which method may suit you.
- No method 80% will have a pregnancy within a year
- Condoms 4-10% will have a pregnancy within a year
- Progesterone only pill 1% will have a pregnancy within a year
- Combined pill 0.2% (i.e. 1 in 500 will have a pregnancy within a year)
- Contraceptive injection 0.1% (1 in 1000 will have a pregnancy within a year)
- Mirena Coil 0.1-0.2% (i.e. approximately 1 in 500 to 1 in 1000 will have a pregnancy within a year)
- Implanon <0.1% (i.e. less than 1 in 1000 will have a pregnancy within a year)
Are there other methods?
Yes, some opt for a vasectomy or getting a tubal ligation, and these are procedures that your GP has to refer you for. We are, of course, happy to talk to you about these if desired, especially if you are certain that your family is complete or if you never want to get pregnant. A vasectomy or tubal ligation can in some cases be reversed but they should be thought of as permanent procedures.
In Portmarnock GP Clinic we offer a full family planning service whether you are trying to get pregnant or avoid getting pregnant! Dr Niall Breen fits and removes Implanons and Dr Laura O’Flynn inserts and removes Mirena Coils for suitable patients. All doctors can go through your contraceptive options with you and are happy to do so. Just call us on 01-8461335 or 01-8038881 or e-mail on firstname.lastname@example.org to make an appointment.
Posted by Dr Niall Breen