Family planning options explained

Choosing contraception is personal. It depends on whether you want children later, how often you would remember a daily pill, your medical history and what side effects you can live with. Confidential counselling is available at clinics and through telemedicine.

Short-acting methods

• Combined pill: taken daily. Can make periods lighter and more predictable. Not suitable for everyone, including some women with migraine with aura, high blood pressure or a history of blood clots.
• Progestogen-only pill: taken daily at a consistent time. Often used while breastfeeding or when oestrogen is unsuitable.
• Injection: given every few months. Convenient and private, though return to fertility can take longer after stopping.
• Condoms: the only method that also reduces sexually transmitted infections. Useful alongside another method.

Long-acting reversible methods

• Implant: a small rod placed under the skin of the upper arm, effective for several years and removable at any time.
• Intrauterine device (IUD): hormonal or copper, placed in the womb, lasting several years. The copper IUD contains no hormones.

These are among the most effective methods because they do not depend on remembering anything daily. Fertility returns after removal.

Permanent methods

Tubal ligation for women and vasectomy for men are intended to be permanent. They suit people certain they do not want more children. Counselling before the procedure is important.

Emergency contraception

Emergency pills can reduce the chance of pregnancy after unprotected sex, and work best the sooner they are taken. A copper IUD can also be used as emergency contraception within a set window. Emergency pills are not intended as a regular method.

Side effects: what to expect

Changes in bleeding patterns are the most common reason people stop a method. Spotting, lighter periods or no periods at all can be normal with hormonal methods. Give a new method a few months unless side effects are severe, and go back rather than simply stopping if it does not suit you. There is almost always an alternative.

Breastfeeding and after birth

Some methods are suitable soon after delivery, including while breastfeeding. Fertility can return before periods do, so discuss contraception at your postnatal visit rather than afterwards.

Questions worth asking

• How effective is this in everyday use, not just perfect use?
• How quickly can I become pregnant after stopping?
• What are the common side effects, and what would mean I should come back?
• Does it interact with any medicine I take?
• Does it protect against sexually transmitted infections? (Only condoms do.)