Contraception

Diaphragm/Cap

A contraceptive diaphragm or cap is a circular dome made of thin, soft silicone that's inserted into the vagina before sex. It covers the cervix so sperm cannot get into the womb (uterus) to fertilise an egg.

Benefits:

• easy to use
• suitable for unplanned sex – can be put in up to two hours before sex
• no health risks
• can be reused for up to a year
• no effect on periods
• diaphragm or cap is 92 to 96 per cent effective at preventing pregnancy.

Further information

More information on caps
Caya Diaphragm Insertion video 

Condoms (female)

Female condoms are made from soft, thin synthetic latex. They're worn inside the vagina to prevent semen getting to the womb. They are designed to stop a man's semen from coming into contact with his sexual partner. They can be used by women having sex with men to prevent pregnancy and protect against STIs. Each condom can only be used once, so protection only lasts as long as the condom is intact and worn inside the vagina.

Benefits:

• easy to insert into the vagina
• available in different shapes, sizes and flavours - no preparation is needed
• easy to carry around in your wallet or pocket
• if you're sensitive to latex, you can use polyurethane or polyisoprene condoms instead
• if used correctly, female condoms are 95 per cent effective.

More information on condoms (female)

Condoms (Male)

The male condom is a sheath or covering that is worn over the penis during sex. They can be used to prevent pregnancy and protect against STIs. Each condom can only be used once, so protection only lasts as long as the condom is intact and worn on the penis.

Benefits:

• easy to put on
• available in different shapes, sizes and flavours
• suitable for unplanned sex - no preparation is needed
• easy to carry around in your wallet or pocket
• If you're sensitive to latex, you can use polyurethane or polyisoprene condoms instead.
• effectiveness for perfect use is 98 per cent.

More information on Condoms (male)

Intrauterine devices (IUD)

An IUD is a small T-shaped plastic and copper device that is put into your womb (uterus) by a doctor or nurse. It releases copper to stop you getting pregnant, and protects against pregnancy. It's sometimes called a "coil" or "copper coil".

It is long-acting but is reversible and can be easily removed if you decide you want to become pregnant or when you want to get pregnant.

Benefits:

• works for five or 10 years (depending on devicetype used)
• you don't have to prepare for or interrupt sex
• you don’t have to remember to take a pill everyday
• it is hormone free
• not affected by other medicines
• more effective form of emergency contraception than the ‘morning after’ pill
• your fertility returns to normal once the IUD is removed
• it is 99 per cent effective at preventing pregnancy.

Visit the NHS website for more information on Intrauterine device (IUD)

Book an appointment

Find advice about your intrauterine contraception procedure below

Intrauterine system (IUS) Hormonal Coil

An IUS is a small T-shaped plastic and copper device that's put into your womb (uterus) by a doctor or nurse. It releases the hormone progestogen to stop you getting pregnant and lasts for three to eight years, depending on the brand. It is long-acting and reversible, so you can take it out when / if you want to get pregnant or use an alternative contraception.

Benefits:

• works for three or five years (depending on device used)
• you don’t have to prepare for or interrupt sex
• you don’t have to remember to take a pill everyday
• IUS can make your periods lighter, shorter, and sometimes less painful – they may stop completely
• for perimenopausal women, the IUS can be used as the progesterone component of HRT and manage heavy menstrual bleeding in addition to contraception
• fertility will return to normal when the IUS is removed
• the IUS is not affected by other medicines
• IUS is 99 per cent effective at preventing pregnancy.

Book an appointment

Visit the NHS website for more information on intrauterine system (IUS)

Advice about your intrauterine contraception procedure

Please ensure you read this information carefully prior to your appointment to have an IUD or IUS fitted or removed.

Assessing your pregnancy risk

When you come in for an IUD or IUS, you must not be at risk of pregnancy.

This means:

• Using a hormonal method of contraception (pill, patch, ring, injection or implant) or a barrier method of contraception eg condoms, reliably until the day of your appointment

Or

• Abstaining from sex for at least three weeks before your appointment, or since the start of your last period 

If you already have an IUD or IUS which has not expired and you wish to replace it, you must ensure you avoid any unprotected sex in the seven days prior to your appointment.

If your coil has expired and you are not using another effective contraceptive method, please ensure you have had no episodes of unprotected sex three weeks prior to your appointment.  If you have any concerns about pregnancy risk prior to your clinic appointment, contact the call centre on 0203 312 1225 to either book a telephone appointment with a doctor or nurse or re-schedule your clinic appointment.

There are circumstances when an IUD can be fitted as emergency contraception usually up to 120 hours after unprotected sex, in patients not using reliable and effective contraception. If you require emergency contraception contact the call centre on 0203 312 1225 to book a clinic appointment with the clinical team.

The FSRH supports the extended use of any 52mg LNG-IUD [Mirena®, Benilexa® and Levosert®] for up to eight years for contraception if the user is under 45 years old at the time of insertion.

If a 52mg LNG-IUD is inserted over the age of 45, it can be used for contraception until the age of 55.

There is no change to existing use of the 52mg LNG-IUD for heavy menstrual bleeding or endometrial protection as the progesterone component of Hormone Replacement Therapy [HRT]. 

The majority of women can book directly into an IUD/IUS fitting appointment either via the call centre on 020 312 1225 or online.

We recommend having a pre-insertion appointment to discuss the procedure with a doctor or nurse if:

• You are aged 50 or older
• You require a translator
• You have a history of gynaecological problems with your uterus or ovaries (eg fibroids)
• You have had a baby within the last 4 weeks 
• You have recently had an abortion or miscarriage
• You have had a difficult or failed insertion of an IUD or IUS in the past
• You have not fully understood the information above and wish to discuss it with a doctor or nurse in person

Please note: We do not fit the hormonal IUS eg Mirena for the purposes of hormone replacement therapy (HRT) or for the treatment of gynaecological conditions (eg endometriosis), unless you also require the IUS for contraception. 

Our clinics are staffed by our male and female clinical team — if you have a preference for a male or female clinician, please mention this when you call to book your appointment.

Having an IUD/IUS removed

If you wish to have an IUD or IUS removed and do not wish to have it replaced, please call the clinic to book an appointment on 020 312 1225. To avoid any risk of pregnancy following removal, please ensure you do not have any unprotected sex in the seven days before your appointment.

On the day of your appointment

Ensure you have had something to eat, such as a light breakfast or lunch. If you are fasting, please rearrange your appointment to a time when you are able to eat.

Please take pain relief tablets, such as ibuprofen or paracetamol, about 30-60 minutes before your appointment.

If you need to bring young children with you, please arrange for someone to look after them while you are in the clinic room having your procedure.

After the procedure, you may experience some cramping pain. You may wish to have someone accompany you home, but this is not essential.

You should plan to be in the clinic for up to one hour.

Combined Pill (COCP)

The combined pill (also known as ‘the pill’) that releases artificial versions of the hormones oestrogen and progesterone. They stop women from ovulating. It must be taken either every day or every 21 days or tailored with seven days off or tailored with no shorter breaks (see videos below). 

Benefits:

• usually makes periods regular, lighter and less painful
• does not interrupt sex
• may help with premenstrual symptoms
• reduces the risk of cancer of the ovary, uterus and colon
• improves acne in some women
• protects from pregnancy straight away if you start taking the combined pill in the first five days of your period
• when you stop using the pill your fertility will return to normal
• effectiveness for perfect use is 99 per cent.

Further information  

• more information on the COCP  
• risks and benefits of the COCP video
• how to take the COCP video
• what to do if I miss a pill?

Combined vaginal ring

The combined vaginal ring (CVR) is made of soft plastic and contains the hormones oestrogen and progestogen. This ring is inserted into the vagina and the hormones are released into your body. It needs to be replaced every 28 days.and provides contraception for one month.

Benefits:

• easy to put in and take out yourself
• does not interrupt sex
• doesn’t interrupt sex – can have sex with the ring in place
• you don’t need an examination before use
• usually makes periods regular, lighter and less painful
• contraception for 1 month, so you don’t need to think about it every day
• fertility returns to normal when removed
• effectiveness for perfect use 99 per cent

More information on combined vaginal ring.

Combined contraceptive patch

The combined contraceptive patch is a small sticky patch that releases the hormones oestrogen and progestogen into your body through your skin to prevent pregnancy. The patch's brand name is Evra. The patch will last for seven days and will need to be replaced weekly or every 21 days depending on your preference of use (see more information link below). 

Benefits:

• you only need to replace it once a week
• you don’t have to remember to take a pill everyday
• usually makes periods regular, lighter and less painful
• fertility returns to normal when removed
• for typical use effectiveness for perfect use is 99 per cent

More information on combined contraceptive patch.

Contraceptive implant

The contraceptive implant (brand name Nexplanon) is a small flexible plastic rod that is placed under the skin in your upper arm. It releases the hormone progestogen into your bloodstream to prevent pregnancy and lasts for years.

Benefits:

• works for three years
• does not interrupt sex
• suitable for those that can not cannot take oestrogen
• fertility returns to normal when removed
• may also give some protection against cancer of the womb
• effectiveness for perfect us is 99 per cent,

More information on contraceptive implants.

Book an appointment

Contraceptive injection

The contraceptive injection (brand names Depo-Provera, Sayana Press) slowly releases the hormone progestogen into your bloodstream to prevent pregnancy. Depo-Provera is given into the muscle by a healthcare professional and lasts for 13 weeks. Sayana Press also lasts for 13 weeks, but patients to be taught how to  administer the injection at home under the skin.

It can take up to one year for your fertility and periods to return to normal after the injection wears off, so it may not be suitable if you want to have a baby in the near future.

It can take up to one year for your fertility and periods to return to normal after the injection wears off, so it may not be right for you if you want to have a baby in the near future.

Benefits:

• you do not need to remember to take it every day.
• does not interrupt sex
• 94 per cent effective in preventing pregnancy.

Further information

More information on contraceptive injection.
Self-administering Sayana Press video 

Progesterone-only pills

Progestogen-only pills (POPs) contain the a progestogen hormone. POP prevents pregnancy by thickening the mucus in the cervix to stop sperm reaching an egg. POPs are different to the combined pills because they do no’t contain the hormone oestrogen. The progestogen-only pill needs to be taken every day either within a three or 12 hour window period to work.

Benefits:

• periods may be irregular (more or less frequent) or stop or become lighter or heavier
• may help with premenstrual symptoms or painful periods
• suitable for those who can not take combined hormonal contraceptives containing oestrogen or the combined pill 
• does not interrupt sex
• you are protected from pregnancy straight away if you start taking it on the first day of your period
• when you stop using the pill your fertility will return to normal
• effectiveness for perfect use is 99 per cent.

More information on progestogen-only pill.

Female sterilisation

Sterilisation involves permanently blocking or sealing the fallopian tubes, which link the ovaries to the womb (uterus). This procedure permanently prevents eggs reaching the sperm for fertilisation and reversal operations are not always successful.

If sterilisation is for you/your partner, please book an appointment with your GP who will be able to provide further advice.

Benefits:

• you don’t have to think about contraception again
• does not affect hormones within your body
• usually a minor operation where women can return home the same day
• no effect on sex drive or ability to enjoy sex
• female sterilisation is more than 99 per cent effective at preventing pregnancy

More information on female sterilisation

Natural family planning

Natural family planning or "fertility awareness" is a method of contraception where a woman monitors and records different fertility signals during her monthly menstrual cycle to plan for or avoid pregnancy. Using natural family planning means that you need to measure these changes carefully at the same time every day and abstain from sex or use condoms at the time when you are fertile. You need to monitor you fertility period for at least three cycles (three months) before it can be relied on.

This method is only suitable if your menstrual cycle is regular, which means it may not be right for you if you have recently started having periods or if you are close to the menopause. Fertility apps are available for your smart phone, which can help you monitor your menstrual cycle.

Benefits

• it's free
• does not require you to take or use any hormone treatment
• suitable at any age if your periods/menstrua cycle is regular
• does not affect other medication.
• effectiveness for perfect use is 86 to 92 per cent

Further information

How does it work?

More information on natural family planning

Male sterilisation (vasectomy)

Vasectomy is a surgical procedure which involves cutting and sealing or tying the tube that carries sperm from the testicles to the penis to permanently prevent pregnancy. Though you will still ejaculate, your semen will not contain sperm. It's usually carried out under a local anaesthetic, where you are 're awake but do not feel any pain. It takes about 15 minutes. If vasectomy is for you/your partner, please book an appointment with your GP who will be able to provide further advice.

Benefits

• you don’t have to think about contraception again
• quick and relatively painless procedure
• no effect on sex drive or ability to enjoy sex
• you will still have an erection and ejaculate normally
• simpler, safer and more reliable option than female sterilisation
• vasectomy is more than 99 per cent effective

More information on male sterilisation (vasectomy). 

Withdrawal method

Withdrawal, or 'the withdrawal method', acts as a form of natural contraception as the man withdraws his penis before ejaculation, limiting the amount of sperm entering the woman’s vagina. Withdrawal relies on the man being able to fully pull out of the vagina at the right moment. The point of ejaculation can be difficult to predict and control, so withdrawal a risky method for preventing pregnancy. Some sperm can be released in pre-ejaculate or ‘pre-come’, so there is still a chance of pregnancy even if the man comes outside the vagina. Withdrawal also interrupts sex (and is a bit messy), so can be less pleasurable for one or both partners. 

Typically, withdrawal is 78 per cent effective which means 22 our of 100 women using this method will get pregnant. More reliable contraceptive methods are available.

Benefits:

• suitable for unplanned sex if condoms or contraception not available - no preparation is needed
• free
• does not require you to take or use any hormone treatment
• can be used while breastfeeding
• does not affect other medication
• does not interrupt sex

Intrauterine device (IUD or coil)

The IUD can be fitted up to 5 days after unprotected sex, or up to 5 days after the earliest time you could have ovulated. It is more effective than the oral emergency pills at preventing pregnancy, with fewer than one per cent of women who use the IUD get pregnant. If you use the IUD as emergency contraception, it can be left in and used as your regular contraceptive method. You may feel some discomfort like period cramping when the IUD is put in, but painkillers can help. If you use the IUD as a regular method of contraception, it can make your periods longer, heavier or more painful.

Further information

More information on emergency contraception

More information on intrauterine device (IUD)

Emergency contraceptive pill (the "morning after" pill)

There are two types of emergency pills: Levonelle or ellaOne.

You need to take the emergency contraceptive pill within three days (Levonelle) or five days (ellaOne) of unprotected sex for it to be effective.  The sooner you take it, the more effective it will be. There are no serious side effects of using oral emergency pills.