Condoms on, withdrawal out – Forms of contraception explained

There are so many contraception options out there that sometimes it can be a little overwhelming. Contraception was developed for some very good reasons; to prevent unplanned pregnancy, and to reduce the risk of getting Sexually Transmitted Infections (STIs). However, when the facts get confusing, it’s no wonder that people often take risks and practise unsafe sex. With an estimated 40% of pregnancies being unplanned[1], and an estimated 1 million STIs being acquired every day worldwide[2], it’s vitally important for your sexual health to use contraception when having sex, even with someone you know and love. In this article, we lay out the real facts about some different contraceptive methods, so you can choose the method that’s right for you and your partner.

The Withdrawal Method

It can be very tempting to use the withdrawal method. It doesn’t involve any preparation and when done perfectly, couples will only have a 4 per cent chance of pregnancy within a year.[3] However, this is the problem. It gives a low chance of pregnancy when done perfectly, but of course, humans don’t always do things perfectly. On average, the withdrawal method has a 22% failure rate[4], making it actually quite an ineffective method of contraception.   

The Pill

A widely taken contraceptive method by women, when taken properly, has a 99% effectiveness rate against unwanted pregnancy.[5]However, the pill has very specific stipulations on how it’s used. The most common pill, the combined pill (COC), must be taken every day, or 21 days out of 28 in a woman’s menstrual cycle.[6] During the seven day break, the woman will usually have her period, before she begins the next course of pills.  Another common pill is the Progestogen-only pill (POP) which must be taken every day, with no breaks between pills.[7] Its high effectiveness relies heavily on these stipulations being followed, and if they aren’t, its effects may be weakened.

Diaphragms

This form of contraception works by keeping the egg apart from the sperm and should be inserted into the vagina before sex, covering the cervix. When used with spermicide and used correctly, it is between 92 - 96% [MS1] effective against unwanted pregnancy.[8] However, some women may not like using it because it should be left in the vagina for at least six hours after sex for it to be effective. In addition to this, as a result of using diaphragms, some women are at risk of developing cystitis and unlike condoms, diaphragms only offer some protection from STIs.[9]

Intrauterine System (IUS)

The IUD is a long-term method of contraception, lasting around 5-10 years. It involves a plastic device being inserted into the uterus to stop ovulation, and has a 99% effectiveness rate.[10] There is a belief amongst some that it can affect future fertility, but this is a misconception. They are safe to use, [11] but they may not suitable to use for some women, for example, if you have an untreated STI.[12] Also, some women may be put off by the prospect of a medical procedure.^[13]

Vaginal Ring

The vaginal ring is a small ring made of soft plastic that is placed inside the vagina. It should be left in your vagina for 21 days, then removed and put in the bin (not thrown down the toilet) in a special disposal bag. Seven days after removing the ring, a new one should be inserted for another 21 days.  When used correctly, effectiveness studies illustrate that the ring could be more effective than the COCs. However, it can cause bleeding in the vagina for the first few months of use, and it doesn’t protect against STIs.[14]

Contraceptive Patch

The contraceptive patch, also known as the birth control patch, is a relatively new form of contraception, having been introduced onto the market in 2002.[15] A bonus of this contraceptive method is that it can be placed on most areas of the body, as long as the skin is clean, dry and not too hairy. A patch should be applied once a week for three weeks, before having a patch-free week. During the patch-free week you will get a withdrawal bleed akin to a period, although this may not always occur. Whilst it is very easy to use and can make periods more regular and less painful, it can cause skin irritation and soreness, and does not protect against STIs.[16]

Condoms

Some people may not use condoms because they think they may not be safe, or may break easily. However, male condoms have a 98% effectiveness rate and when used correctly, is a very safe method of contraception.^[17] They are also one of the only forms of contraception that protect from both pregnancy and STI’s. The male condom is widely available, and is also easy to put on. However, another common myth is that condoms lessen the sensation of having sex. While this might have been an issue with early condoms, with huge developments in condom manufacturing, this no-longer needs to be a concern. Fetherlite condoms are one of our finest condoms created to enhance feeling between you and your partner, bringing you closer through sex. 18[MS2]