The enormous range of contraceptive options out there can be overwhelming; we discuss all the varieties available and how they impact your menstrual cycle.
Access to reliable contraception has transformed the lives of women all over the world - giving us more control and choice over how we live our lives. But as there’s so many options available, choosing which contraception to use can seem like a bit of a minefield!
After a while, most of us get pretty used to our cycle and what’s normal for us. But starting or switching contraceptives can have us back at square one again when it comes to knowing what to expect from our periods. This can be annoying, but it’s ok to switch contraceptive methods until you find one that you’re happy with, that works for you and your body.
You’ve probably heard a few horror or success stories from friends about certain kinds of contraception! This will have possibly already shaped your view on which methods you’d be happy to try. But we’re all different, so it’s good to keep an open mind. Not everyone will have the same experience using the same type of contraception, as you’ll see from quotes we’ve included from women all over the UK about their own experiences.
After researching different methods, before deciding, speak with your GP or sexual health clinic. Once you’re trying a new form of contraception, listen to your body and pay attention to any changes. If you feel it’s not the right choice for you, it’s ok to stop and try something different.
There are all kinds of factors to take into consideration when choosing contraception, including age, lifestyle, medical history, potential plans for future pregnancies, and current medication. But ultimately, it’s your decision! In this guide, Yoppie delve into all contraception methods - hormone and hormone free - focusing on how they might affect your cycle and fit in with your lifestyle. So, if you’re feeling confused about what contraception could be right for you, read on! What we’re covering in this article is
Hormonal contraception including:
Non hormonal contraceptives including:
Almost all forms of contraception covered here are available for free from the NHS. Your local GP, sexual health clinics (GUM clinics) and some young people’s services should be able to help you organise an appointment to discuss your options and begin a new form of contraception.
If you want to try less popular methods like the female condom, for example, they are not always available from all contraception, doctors or sexual health clinics so you may need to call ahead to check.
Hormonal contraceptives use synthetic hormones to prevent pregnancy, and non-hormonal methods tend to stop sperm entering the uterus by introducing physical barriers. Both types of contraception are effective, and there are pros and cons to both.
Let’s dive in and look at the options in more detail…
Hormonal contraceptives (if used correctly) are very effective when it comes to preventing pregnancy. They can also be prescribed to reduce painful or heavy periods, or other conditions made worse by hormones linked to our cycle - from acne to endometriosis.
All hormonal contraceptives work by altering our bodies natural production of hormones to prevent pregnancy. This means they can also have an effect on our cycle and how we experience our periods. In some cases, hormonal contraceptives can significantly change our periods, from making them lighter and more regular, to stopping them completely. Any changes may last for a few days, weeks or months after you stop taking them.
Many hormonal contraceptives share a lot of the same advantages, disadvantages and possible side effects. But, we’re all different! Our bodies won’t all respond exactly the same way. So you might have to try a few forms of contraception until you find one that works for you and your cycle.
Combination oral contraceptive pills contain synthetic versions of the female sex hormones estrogen and progesterone. These work by suppressing ovulation, so although your uterus lining will thicken and shed every month you won’t release an egg. They also thicken the cervical mucus, making it a less friendly environment for sperm.
Designed to be taken orally at the same time every day, each sleeve contains 21 regular tablets and 7 dummy tablets. The dummy tablets allow your body to shed any uterine lining that has built up over the month. This is referred to as a withdrawal bleed, rather than a period.
You also have the option to take up to three sleeves of tablets consecutively2 (always double check with your doctor if this is ok for the type of combination pill you’re taking). So you can avoid a bleed for up to three months. This isn’t recommended to do regularly, but in some cases can be convenient - like if you’re on holiday or travelling. If you do double or treble up on packets, when you do bleed it’s likely to be heavier and possibly more painful than usual. You may also notice some breakthrough bleeding. But it is always a good idea to check with your doctor before you do this!
If taken correctly, the combination pill is over 99% effective at preventing pregnancy. However, with ‘typical’ use, like Ifif you’re generally a bit disorganised and prone to forgetting to take medication, the rates drop to 93%3 meaning - this may not be the right method for you!
You’re likely to notice your period becomes more regular - most people experience their monthly withdrawal bleed two to three days after beginning the dummy pills at the end of a pill packet. Still having a regular bleed each month can feel reassuring for some women, as it can help you feel more in tune with your body and, of course, confirm that you’re not pregnant.
Also, as your hormones affect all kinds of things, from your appetite and mood, to energy levels and sex drive, you may be likely to notice some other changes after beginning the pill.
After stopping the pill your body should start to return to producing hormones normally. Your natural cycle should return within a few weeks to months, although you could experience other side effects like acne or reduction in breast size. This can be due to the reduction in estrogen, or just part of your body naturally adjusting - especially if you’ve been taking the pill for a long time. Importantly, taking the pill for a long time has no significant effect on fertility, and the majority of women ovulate within 3 months of stopping the pill4. If you’re worried about any symptoms or your fertility, always check with your doctor.
Some advantages of the combined pill include:
Disadvantages of the combined pill include:
If you experience any of these side effects for more than a few weeks, it may just be because that particular pill isn’t right for you.
“I was on the combined contraceptive pill for 23 years. It took 6 years for me to find a pill that suited me. For me, I felt that the benefits outweigh the negatives. I experienced side effects ranging from sickness to horrendous mood swings before I found one that was right for me. I was in a long term relationship for the majority of the time and also used condoms after that ended when I had several different partners. For me, knowing that I was protected from pregnancy even if the condom split was hugely important in making the choice to stay on the pill after my relationship ended.” - Catherine, Newquay
“It seems like doctors just put you on the pill as a seemingly standard solution to every problem like PMS, pain, acne… What they don’t tell you is how much it could mess you up, even for years after coming off it. I didn’t have a proper period for two years after I stopped taking the pill.” - Alice, Bristol
“When taking the pill, my usual blemish prone /combination skin was really clear, but I had severe menstrual migraines and frequent mood swings, being overall quite irritable.” - Francesca, London
The progestogen-only pill works by thickening cervical mucus and thinning the lining in the uterus, stopping sperm from reaching the egg. It also suppresses ovulation, but not consistently. Like the combination pill, it is likely to be taken orally at the same time every day. Each sleeve contains 28 tablets, with no dummy tablets.
Over 99% effective in preventing pregnancy, if taken correctly at the same time each day.
Less than half of women will keep getting regular periods, , and for those whose continue, they are likely to can be lighter and less painful. Many women may have no periods at all whilst taking this type of pill, whereas some will have irregular bleeding.
Similar to the combined pill, once you stop taking the mini pill, your cycle should return to normal within a few weeks or months, and there is no long-term effect on fertility. If your periods stopped completely when taking the mini pill, they should begin again within a few weeks.
Side effects can be rarer with the progestogen-only pill compared to the combined (many women who don’t get on with the combined pill prefer the mini pill for this reason).
“I started taking the mini-pill after trying multiple combined pills and just not getting on with them. My periods stopped completely, which I was pleased about, and I didn’t get any of the unpleasant side effects like the headaches or mood swings I experienced with the combined pill.” - Alana, Portugal
“I was advised to swap from the combined pill to mini-pill due to the fact I was having frequent migraines. I found that the mini pill gave me far more regular periods and eventually my periods stopped entirely which was great!! I found that it didn't work well for me after I had a baby for some reason... the bleeding was irregular and my hormones were quite affected, so my husband decided to have a vasectomy.” - Georgia, Cornwall
Some advantages of the progestogen-only pill include:
Despite the name, the IUS doesn’t really look like a coil. It’s a small, T-shaped device made of plastic that when put into the uterus, releases the hormone progestogen to prevent pregnancy. There are, in fact, two types of coils. One contains the hormone progesterone, described here, and one is made of copper, also known as the IUD which is outlined below.
The IUS prevents pregnancy by thickening the cervical mucus and thinning the lining of the womb, much like the mini-pill. It can also reduce the likelihood of ovulation occurring, but most women continue to ovulate.
Depending on the brand, it can last 3-5 years before needing to be replaced.
The Mirena coil is one of the most popular IUS devices, but there are two newer and smaller hormone coils out now, which can make them slightly easier to fit and contain lower doses of the progesterone hormone.
A GP or nurse will fit it for you, after some initial health checks (for STDs and checks on the position and size of the uterus) which takes around 20 minutes. The actual fitting of the coil only takes around 5 minutes and it is inserted through the entrance of the cervix.
You should get a check within 6 weeks after the fitting to make sure everything is fine.
Over 99% effective if inserted correctly.
It can make your periods lighter, shorter or stop completely - which can be welcome for women who have painful or heavy periods. You might find that over time, periods become lighter and lighter and eventually stop by the first year after insertion.
Once you get an IUS removed, your periods and cycle should return to normal within a few weeks or months - and it’s also possible to get pregnant immediately.
Advantages of the IUS include:
“I chose a Jaydess hormone coil as it is smaller and has a lower dose of hormone. It lasts for 3 years instead of 5 like the Mirena, but I felt it was worth it as my anatomy is quite small (the doctor said there was no way I could have known this before, but I was right when they measured me!) and I wanted minimal hormones. It took a little time for my body to get used to it after the initial insertion; I had some bloating and bladder irritation, but that settled after a few weeks and I've been really happy with it ever since.
I recently had the old one removed and a new one put in, and the process was pretty simple. I can't pretend it's pain free, but it is bearable and I only had mild cramps for a couple of hours afterwards. Now I have another 3 years of no periods and not having to worry about pregnancy!
My ex said he couldn't feel the strings but a more recent partner said he could but it wasn't uncomfortable. Main pros for me: no periods and no pregnancy for at least 3 years. Main cons for me: pain of insertion, but bearable and passes quickly. Bladder irritation was annoying but did pass after a few days and I haven't had the same problem with the new one.
On balance, worth it! I appreciate others will have different views and I have heard some stories from friends (rejection where uterus has pushed it back out, ongoing cramps etc) but good to share a positive viewpoint!” - Esmé, Brighton
The hormone progesterone is given via an injection that lasts up to 13 weeks, depending on which brand is given. This is usually given by a doctor or nurse in the buttocks, but you can have it in your upper arm.
It works to suppress ovulation every month, as well as thinning the lining of the uterus so any fertilised egg is unlikely to implant. It also also thickens the cervical mucus to make it harder for sperm to move in the cervix - much like other progesterone based contraceptives.
Over 99% effective if administered properly.
Around one in ten women stop having periods after 3 months, which goes up to 50% after a year. The longer you have consecutive injections, the more likely you are to stop having periods until you switch methods or stop having the injection.
After you’ve had the injection for the first time, it’s pretty common to experience irregular bleeding, or even heavier prolonged bleeding. This should eventually cease: if it doesn’t, speak to your doctor.
Unlike the pill, you can’t just stop the injection. Even if you decide not to renew the contraceptive injection, your regular cycle and periods may not return its regular pattern for up to a year. If you decide to try for a baby, this could have an impact on how long it takes you to conceive.
Some advantages include:
Disadvantages can include:
“For about 7 years before I fell pregnant, I was on the injection. It worked wonders for me. No periods, no symptoms and no mood swings (as far as I’m aware). Prior to that I was on the progestogen only pill because I suffered from migraines (the one without a break). It was awful, massive weight gain and totally irregular periods, worse than my usual periods which were extremely heavy and never regular.
When I knew we were going to try for a baby, I came off the injection in March, went straight onto the pill until July and fell pregnant in September! 4 months after giving birth when I had stopped breast feeding, I have the mirena coil. Occasionally I get very light bleeding, with some cramping even when I don’t bleed, I can actually feel myself ovulating too but apparently that’s common after giving birth regardless of what contraception you go on. A year on and that’s working well for me too!” - Charlie, Bournemouth
“The injection was sold to me as my best option when I was 19. During my time on the injection which I had three times over 9 months, I gained over a stone in weight, I became clinically depressed, my periods completely stopped for two years and I lost my sex drive totally. I didn’t even want to be touched. After the third time getting the injection I immediately threw up. It took me years to get my periods back into a regular cycle. I instinctively knew the injection was bad for me and my body, although I was told repeatedly my symptoms had nothing to do with the contraceptive injection.” - Miranda, London
A small cylindrical flexible plastic implant is placed just under the skin in your upper arm by a nurse or doctor. The process is a bit like having an injection. It releases progesterone into your bloodstream gradually, to prevent pregnancy for up to 3 years. It’s main mode of action is by preventing ovulation, but it can also thicken the cervical mucus preventing sperm from swimming easily, and by thinning the lining of the womb to stop implantation.
The implant is more than 99% effective.
The implant usually makes periods lighter and less frequent, or your periods can stop altogether. It can also make periods less painful if you suffer from bad cramping. However it is important to note that some people can find they have irregular spotting or heavier, more prolonged bleeding than before.
As soon as you have the implant removed, you’re no longer protected against getting pregnant. But it could still take a little while for your regular cycle to return to normal again.
Some of the advantages are:
This small patch is stuck onto your skin and releases progestin and estrogen - the same hormones as the combined pill - to prevent pregnancy. It does this by stopping ovulation, thickening the cervical mucus to make it hard for sperm to mobilise through the cervix. Another effect is that it can thin the lining of the uterus (womb), preventing a fertilized egg from implanting.
Every patch lasts one week (7 days), so you can replace the patch each week for three weeks running and on the fourth week take a break. The fourth week is when you experience your withdrawal bleed, although not everyone will have one of these.
The patch is pretty hardy and waterproof, so you can go about any of your regular activities whilst using it. You can stick it pretty much anywhere but on smoother skin, or where it’s not likely to get rubbed off by tight clothing, is best.
The patch is more than 99% effective if used properly and replaced regularly.
The patch might make your monthly bleed lighter, more predictable and less painful. Your periods may stop altogether whilst you’re using it.
Some of the advantages are:
The disadvantages can be:
The vaginal ring is a small, soft, flexible ring made from plastic that is designed to be placed inside the vagina. You leave it in for 21 days at a time, removing it for 7 days at the end of your cycle to induce allow a withdrawal bleed (not everyone will experience a withdrawal bleed).
It releases a steady dose of the hormones oestrogen and progestin into the bloodstream to prevent pregnancy4. Like other forms of contraception with oestrogen and progestin, it works by inhibiting ovulation, thickening cervical mucus and thinning the lining of the womb to prevent implantation.
If used correctly, the vaginal ring is over 99% effective at preventing pregnancy.
As the ring inhibits ovulation, your monthly bleed will be a withdrawal bleed rather than a regular period. This will mean it will probably be lighter and less painful than usual, or you may not have one at all.
Some of the advantages are:
Although you can also get the copper IUD inserted as a form of emergency contraception, here we are focussing specifically on the medical forms of emergency contraception, known as the 'morning-after’ pill.
The emergency contraceptive is designed - you may have guessed - for use in emergencies! Not as a planned, or regular form of contraception.
It comes in pill form (either one or two pills, depending on the brand) and you take it as soon as possible after having unprotected sex to prevent pregnancy.
It releases hormones to prevent pregnancy - most contain levonorgestrel, a synthetic version of progesterone.
If you need to take the morning after pill you should do it as soon as possible. How well pregnancy can be prevented will depend on where you are in your menstrual cycle, because unprotected sex during the fertile window will carry the highest likelihood of resulting in pregnancy. It is recommended that you take it within 24 hours, but if you take it within 72 hours there’s just a 1-2% chance of getting pregnant overall.
This is because the emergency contraceptive is designed to block pregnancy by preventing the release of an egg so it cannot be fertilized. If you’re already pregnant, this pill won’t work as a contraceptive.
It can make your next period heavier, earlier or later. If your period is more than seven days late you’ll need to take a pregnancy test.
The advantages are:
Sometimes hormonal contraceptives aren’t suitable. This can be for all kinds of reasons, from health to lifestyle.
It’s true that non-hormonal methods might not have some of the practical advantages of hormonal methods. And they often require more planning and thought. But they also don’t have many of the disadvantages or side effects that some people experience using hormonal contraceptives. They also don’t affect your natural hormonal cycle in the same way - which allows your body to just do its thing without interference.
The coil gets its name from the fine coil of copper that surrounds part of this small T-shaped device. It’s placed through your vagina by a nurse or doctor, and sits in the neck of the womb where it gradually releases copper to stop pregnancy.
Due to the presence of copper ions in the uterus, the coil creates an inflammatory response which prevents sperm from reaching the egg to fertilise it.
When inserted correctly it’s more than 99% effective and it lasts for 5-10 years.
Your periods can become longer, heavier and more painful. This isn’t ideal if you already struggle with heavy periods. However this effect may gradually settle over time after the first 6 months.
Because there are no added hormones it shouldn’t cause any changes to your moods, headaches, migraines or increase breast tenderness.
Some of the advantages are:
The disadvantages are:
Condoms are usually made of stretchy latex (although they’re also available in materials suitable for people with latex allergies). They’re designed to be rolled onto an erect penis by pinching the tip of the condom (leaving some space at the top for semen) and rolling it down towards the base of the penis until it stays in place securely.
After ejaculation the condom should be securely held at the base before withdrawing the penis from the vagina.
Condoms are single use, and should be disposed of in a bin (not a toilet). Only buy condoms with the CE mark or BSI Kitemark on the packet. This shows they’ve been tested to the highest safety standards. It’s also a little known fact that condoms have an expiry date, so make sure you check yours is in date!
98% effective when used correctly.
Condoms don’t affect your hormones in any way, so your natural cycle should continue unchanged.
The advantages are:
Disadvantages can be:
Although not as popular as the male condom, you can also get condoms for women. Designed to be fitted inside the vagina before sex, they are clear latex tubes that look similar to a large, unrolled male condom.
The advantages are:
Disadvantages can be:
It’s a small semi circular shaped cap made of soft, flexible silicone that fits below the cervix to stop sperm entering. It only works if you also use it with spermicide.
It needs to be left in place for at least 6 hours after sex. You can insert it into the vagina yourself, but it may take some practice.
When used correctly with spermicide, it’s 92-98% effective.
It won’t affect your regular cycle at all.
Some of the advantages are:
Some of the disadvantages are:
This is where a man would withdraw his penis from a woman's vagina before he ejaculates. Instead of ejaculating inside her vagina during intercourse.
Around 78% effective. On average, out of 100 couples using the withdrawal method, 22 will get pregnant within a year. That’s around one in five.
As sperm can be released from the penis before ejaculation (in a substance called pre-ejaculation) even if the withdrawal method is used correctly every single time, there’s still a higher chance that you can fall pregnant than if you use other forms of contraception.
Generally this method shouldn’t be used if you definitely don’t want to get pregnant.
The withdrawal method doesn’t affect your hormones in any way, so your natural cycle should continue unchanged.
Some of the advantages are:
This involves only having sex on certain days of the month when fertility is low - or using alternative contraception on those days. Fertility is monitored using basal body temperature readings alongside charting your monthly cycle in a calendar and inputting other information such as cervical secretions. Basal body temperature (if taken extremely accurately) can help determine when a woman is ovulating. This is because temperature is higher on ovulation days.
This method can also be used alongside ovulation kits which measure levels of hormone in the urine. You can also chart observed changes in cervical mucus which can help to indicate fertility levels during the month. As the temperature rises, a date is calculated for predicted ovulation. No additional contraceptive precautions are required for sex that has occurred from 3 days after the temperature rise until the start of menstruation. In women wishing to avoid a pregnancy, avoidance of sex, or use of additional contraceptive precautions, is then required until higher temperatures have again been recorded on three consecutive days in the next cycle.
As a woman is only fertile for a certain amount of days per month, (before, during and immediately after ovulation) the rhythm method is designed to help avoid having sex during this fertile period. This is why this method is best for people only with an extremely regular menstrual cycle.
This can depend. Because sperm can survive in the reproductive tract for five to seven days, you can still get pregnant even if you have sex several days before ovulation or some days afterwards.
Also, for most women it’s very difficult to determine when the safe times to have sex are. This is because ovulation isn’t always regular and varies between women. A very accurate thermometer and method of temperature taking is needed for taking basal rates. And it can mean up to 10 or more days of abstinence (or alternative contraception methods) per month.
The rhythm method is around 80-87% effective at preventing pregnancy, but only when used accurately. So, it may not be the best method to use by itself if you definitely don’t want to fall pregnant.14
This method doesn’t affect your natural cycle at all, and can help you get to know your body better.
Some of the advantages are:
“I use the rhythm method now after having been on the combined pill for 13 years. I much prefer it to the pill, but you have to be much more careful. I’m also in a committed relationship so if I did get pregnant it wouldn’t be a disaster, although I don’t feel ready to yet! I just prefer how my body is when I’m not taking additional hormones. Periods are more painful, but I feel like it’s the best decision for me.” - Katherine, Scotland
“I used the rhythm method with the aid of an app, but without using temperature monitoring when I was actually trying to get pregnant after coming off the mini-pill. After around seven months, when I used a digital ovulation test, I found that I was ovulating at a completely different time to what I thought - and what the app was telling me. Once I knew when I was ovulating I became pregnant right away. This made me realise if I’d been trying to avoid getting pregnant, this app would definitely NOT have worked since I ovulated on what it told me were “low risk” days! Just goes to show you definitely can’t trust an app on its own.” - Carly, Leeds
There is no right or wrong choice when it comes to contraception. It’s a personal choice that depends on your individual body and circumstances.
It’s also impossible how to tell, beforehand, how your body will adapt to most contraception methods. Some people find one that works for them right away. But many women have to try a few different methods before settling on one they’re comfortable with.
Whichever methods of contraception you choose, no form of contraception is 100% effective, but as long as you’re using it correctly, in most cases there’s only an extremely low chance that you’ll become pregnant.
The best way to make an initial decision is based on the information you’ve researched and advice from your GP or sexual health clinic.
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