Contraception is a tricky one.
It shouldn’t be, given that it’s 2017 and the pill was first introduced in 1961 (only to married women, mind you) but despite school sex education, our own experiences and conversations with our mums and friends, plenty of women and girls still feel completely overwhelmed and confused when it comes to contraception.
There are actually 15 different methods of contraception available to women in the UK. A lot of women tend to go on the pill hassle-free but, for others, it’s not always the best option. The pill can cause a range of side effects which may not suit everyone, plus there’s that small major detail of remembering to take it every day. Given its popularity, and the assumption that it is the norm, other methods of contraception which might be more suitable for others can get side-lined. But where are we supposed to start when there are 15 choices?
As we have been raised in the era of technology, more often than not we turn to Google for life advice. And apparently there’s no difference when it comes to sexual health.
We asked Google Trends the top ten questions entered into the search engine when it comes to contraception and, with help from the Family Planning Association – who provide sexual health and contraception advice – we got the answers.
1. What is contraception?
Essentially, methods and devices which stop you from getting pregnant when you have sex. They range from permanent and long-term methods, like the pill, to those which you need to physically use during sex, like condoms.
Some are known in the health service as long-acting reversible contraception (LARCs) and include methods that don’t rely on a person having to remember to take or use them to be effective; like the implant, injection and coil.
2. How does the contraceptive pill work?
How the pill works can be confusing because there are two types of contraceptive pill: The combined pill and the progestogen-only pill.
The combined is the first option doctors usually go for and mainly works by stopping the ovaries from releasing an egg each month aka ovulating. No egg, no baby.
It also thickens the mucus from your cervix, making it more difficult for a sperm to swim through, reach an egg and fertilise it. As another step in mission no pregnancy, the pill makes the lining of the uterus thinner so the uterus is less likely to accept a fertilised egg.
The Progestogen-only pill, also known as the mini pill or POP, varies. All of them thicken the amount of mucus in the cervix and make the lining of the uterus thinner but one group called desogestrel POPs, like Cerazett, also stop the ovary releasing an egg in the same way the combined pill does.
3. Which contraception is best for me?
Everyone is different; what works for your best friend might not work for you. Finding the right contraception may take time and can be a case of trial and error.
Karin O’Sullivan, a sexual health nurse and clinical lead at the FPA, broke down what might and might not work for certain people.
“If you really hate needles, then the injection’s probably not the way to go, and if you’re pretty forgetful then something you have to remember to take every day – like the pill – might not be your safest bet,” she said. “On the other hand, if you have very heavy periods then the combined pill can help reduce them, and if you’ve had difficulty with a variety of hormonal methods then you might want to use the extremely effective IUD, also known as the copper coil.”
There might also be medical reasons which make you less suitable for certain types of contraception so it’s always best to discuss with a doctor.
The FPA have a very handy ‘My Contraception Tool’ on their website which can also provide guidance on the right contraception for you.
4. Is contraception free?
Yep, absolutely. It’s one of the only prescriptions that’s completely free.
5. How effective is the pill?
So you’re taking measures to stop becoming pregnant, but you jussssstttt want to really, really make sure it means no pregnancy.
Both the combined and mini pill are 99 per cent effective BUT that’s as long as they’re taken according to instructions.
“If not, they’re both only around 91 per cent effective – so it’s worth making sure you know how to take your pill properly, and what to do if you miss one,” O’Sullivan says.
Read the instructions, guys, and remember that – unfortunately – no method of contraception is 100% effective.
6. How long does the contraceptive pill take to work?
It depends on two things: The type of pill and what your menstrual cycle is like. Most pills can be taken on day one to five of your period and protect you against pregnancy immediately. But, if you have a short menstrual cycle, with your period arriving every 23 days or less (instead of the average of 28) you may not be protected if you start the pill as late as the fifth day. Talk to your doctor if this could apply to you.
O’Sullivan reminds us that if you start the pill at any other time than day one to five of your period, you are not protected straight away and either need to avoid sex or use additional contraception like condoms for the first two days of pill-taking if its the POP, first seven days for most combined pills or first nine days if you’re taking a pill called Qlaira.
7. What to do if you miss a birth control pill?
As mentioned, the pill is only 99% effective if it is taken exactly as it is supposed to. So, if you’ve missed one that could be an issue depending on what pill you’re on, when you forgot to take it and how many you have forgotten.
If you’re taking the POP, and you’re more than three hours late in taking your next pill (12 hours if you are taking a desogestrel POP), you’re no longer protected against pregnancy.
Here’s what to do: Take the pill as soon as you remember and then take the next one at the normal time, which might mean taking two pills in one day. For the next two days, use additional contraception like a condom. If you have had unprotected sex during this time, seek immediate advice as you might need the morning-after-pill.
If you’re taking the progestogen-only pill, and you’re less than three hours late in taking your next pill (12 hours if you are taking a desogestrel POP), then you’re still protected from pregnancy so don’t worry. Just take the pill as soon as you remember and carry on as normal.
If you’re on the combined pill, more factors come into play such as how many you’ve missed and where you are in the pack.
As a general rule with the combined pill, missing ONE pill anywhere in your pack, or starting the new pack one day late shouldn’t be a problem and you should still be protected from pregnancy.
BUT missing two or more pills, or starting the pack two or more days late, may affect how protected you are. It’s more risky to start a pack late and miss more than one pill. This is because during the seven day break your ovaries aren’t getting any effects from the pill so if the break or placebo week ends up being longer then you might release an egg and ovulate.
If for any reason you’re not sure or are confused, continue to take your pill and use condoms if you have sex – there’s no harm, after all. If you have had unprotected sex during any time you were potentially unprotected, get medical advice in case you need emergency contraception.
8. How long does the contraceptive injection last?
For people who might be slightly forgetful or just can’t be dealing with taking a pill every single day, the contraceptive injection can be a good choice. It works by thickening the mucus in the cervix, thinning the lining of the uterus and in some cases preventing ovulation. It is more than 99% effective, if used correctly, and is applied through an injection in the bum or upper arm.
How long it last depends on the injection. For the Depo-Provera or Sayana Press injection, another shot is needed every 13 weeks. For the noristerat injection, it lasts for eight weeks.
9. Where can I get the morning-after-pill for free?
While contraception is free, some outlets sell the morning-after-pill and charge various prices for it.
If you’ve had unprotected sex or think your contraception has failed, you can get the morning-after-pill for free from: Your GP if they provide a contraceptive service, any contraception clinic, a young person’s service or Brook clinic, a sexual health clinic and some GUM clinics or NHS walk-in centres.
O’Sullivan adds that while emergency contraception is associated with the morning-after-pill, it is not very well known that the most effective emergency contraception is the copper coil (otherwise known as the IUD).
“This can be fitted within five days of unprotected sex, or five days after the earliest time you could have ovulated (released an egg). It’s always best to try and get emergency contraception as soon as possible though,” she says.
10. Where can I get the contraceptive pill?
From your GP – as long as they provide contraceptive services or a sexual health or contraception/family planning clinic.
Remember, all contraceptive treatment and consultations are confidential. So don’t be afraid to ask anything you want.