Comparison of Contraceptive Methods

Method Name	Type	Effectiveness (Typical use)	Duration	How It Works	Advantages	Disadvantages	STI Protection	Administration	Suitability	Side Effects	Cost	Availability	Reversibility	Not Suitable For	Additional Notes
Combined Pill	Hormonal	91%	Daily	Prevents ovulation, thins womb lining, thickens cervical mucus	Can regulate periods, reduce pain and make them lighter.	Must take daily; effectiveness reduced if any diarrhoea/vomiting, St John's Wort and enzyme-inducing medications.	No	Oral	Those who want to self-administer the method and are happy with the benefits generally outweighing the risks	Nausea, headaches, skin changes, breast tenderness, bloating, mood changes, increase blood pressure, increase risk of DVT	Private prescription cost plus £30 (for 3 months supply)	Pharmacy, Prescription Only Medicine	Yes, immediate but could take a few months for some	Smokers over 35, migraine with aura, BMI over 35, history of DVT or other complex medical conditions that increase the risk of a stroke or blood clot. Family history of VTE under 45 years. Those under 6 weeks post-delivery and breastfeeding. Individuals who don't want to increase their risk.	Non-contraceptive benefits can include helping with skin, regulating periods, helping with premenstrual symptoms. Can be taken continuously to avoid periods and increase effectiveness.
Condoms	Barrier	82%	Before sex and replaced after each ejaculation	Prevents sperm from entering the uterus	Non-hormonal method.	Single use, interrupts sex, lower effectiveness	Yes	Placed on the erect penis prior to any penetration	Anyone needing STI protection without a latex allergy. Used as a second method to other contraception	Can cause some to have erectile difficulties due to loss of sensation.	Approximately 50 pence each	Pharmacy	Yes, immediate	Latex allergy but can use latex-free. Individuals with multiple piercings as will not get an airtight fit.	Must use a new condom every time and check for any damage before disposing of in general waste. Can be made less effective by oil-based products
Copper Coil (IUD)	Non-Hormonal	99%	5-10 years	Prevents fertilization and implantation	Long-term, no hormones	Requires fitting and removal by a specialist, intimate examination	No	Inserted by a specialist, then remains in the uterus	Those wanting long-term, non-hormonal	May experience heavier and/or more prolonged periods, cramping. Can take a few months to settle.	£350	Coil fitting Clinic. Need to have no pregnancy risk or be within emergency contraception guideline for fitting.	Yes, immediate	Those with Wilson's disease. Under 4 weeks since delivery. Those with an STI, PID, unexplained vaginal bleeding. Cervical and endometrial Cancer. Major uterine cavity distortion	Effective from day of fitting. Can be used as emergency contraception. If fitted over the age of 40 can remain until menopause. Can be fitted after delivery
Diaphragm	Barrier	88%	Before sex and can be used for multiple episodes	Blocks sperm from entering the uterus	Reusable, no hormones	Must be used correctly each time, with spermicide and left in for 6 hours after sex. After 3 hours, add in more spermicide if further sexual contact.	No	Inserted vaginally before sex, together with spermicide	Those who want non-hormonal, reusable, not long term. Must be comfortable with own body and inserting the device into the correct position and removal.	Possible irritation, UTI risk. If not the correct fit can cause discomfort for both parties.	£50 for a one size fits most product.	Pharmacy	Yes, immediate	Under 6 weeks since delivery. Poor pelvic floor tone. Allergy to spermicide. Prone to UTI or cystitis. Dexterity issues.	Must be used with spermicide every time. Clean, dried and checked for any damage after every use. Replaced after 2 years
Fertility Awareness Based Methods	Behavioral	76-88%	Need to be compliant with daily monitoring every day	Tracks fertility indicators to highlight fertile days, so sex can be avoided.	No side effects, low cost	Requires daily monitoring and discipline, less effective if unwell. Avoid sex at fertile times	No	Daily monitoring of cycle	Those who prefer no hormones and are disciplined in tracking and avoiding sex at the fertile times.	Could cause issues in relationships as sex would have to be timetabled and not as spontaneous. Both partners have to be invested in the method.	Low. Fertility indicator equipment or Natural cycle app	Requires education and tracking for at least 6 months before safe to use	Yes, immediate	During viral or bacterial illnesses that can affect body temperature readings. Medication that can alter Basal body temperature.	Requires partner cooperation and regular cycles. Can be problematic for shift workers. Can be used to conceive.
Hormonal Coil (IUS)	Hormonal	> 99%	3-8 years	Thickens cervical mucus, thins the womb lining and prevents ovulation	Long-term, lighter periods or no periods. Fewer or no systemic side effects as working in the uterus.	Requires fitting and removal by a specialist, intimate examination.	No	Inserted by a specialist, then remains in the uterus	Those wanting long-term hormonal method. Those who want to manage bleeding problems or premenstrual symptoms	Irregular bleeding, unscheduled bleeding or stopping periods, small chance of headaches, skin changes, breast tenderness, mood changes	£450	Coil fitting Clinic. Need to have no pregnancy risk this cycle or on effective method	Yes, immediate	Under 4 weeks since delivery. Those with an STI. Those with PID. Unexplained vaginal bleeding. Current Breast cancer. Cervical and endometrial Cancer. Major uterine cavity distortion. Caution with heart and liver disease.	May reduce menstrual pain and bleeding. If fitted over 45 can remain until age 55. Can be used to manage perimenopause changes. Used as part of HRT. Suitable if breastfeeding
Implant	Hormonal	> 99%	3 years	Prevents ovulation	Very effective, low maintenance	Requires minor procedure. Effectiveness reduced with St. John's Wort and other enzyme-inducing medications	No	Inserted under skin by a specialist, then remains in the arm	Those wanting a medium-term solution	Irregular and/or prolonged bleeding, no bleeding, headaches, skin changes, breast tenderness, bloating, mood changes. Discomfort and bruising in the arm for a couple of weeks.	£300	Implant fitting Clinic. Can be quick started if pregnancy risk.	Yes, immediate	Previous and current breast cancer. Liver tumours. Cirrhosis. Unexplained vaginal bleeding. Enzyme-inducing medication can make it less effective.	A small scar will be visible, approximately 2mm for the fit. Requires small incision when removed. Surgical paper stitches are used plus a dressing. Can be used straight after delivery or abortion. Suitable if breastfeeding
Injectables	Hormonal	94%	3 months	Prevents ovulation	Good for those who can't use estrogen	Injection every 12-14 weeks	No	Injected either in buttock area by a specialist, or self administered in thigh/abdomen	Those wanting a short-term solution	Weight gain, mood changes, skin changes, headaches, bloating, irregular or unscheduled bleeding, no bleeding. Bone density loss.	£100	Clinic/Pharmacy	Yes, delayed	Vascular disease. Current ischemic heart disease. Previous and current breast cancer. Liver tumours. Cirrhosis. Enzyme-inducing medication can make it less effective.	Can take up to a year for fertility to return. Bone density is affected during usage. This returns once the method is stopped. Can be used straight after delivery. Suitable if breastfeeding
Patch	Hormonal	91%	Weekly	Prevents ovulation, thins womb lining and thickens cervical mucus	Can regulate periods, reduce flow and pain	Visible on skin, can be sensitive to glue or come off	No	Patch applied to skin every 7 days	Those who prefer not taking daily pills or having devices inserted into the body	Nausea, headaches, skin changes, breast tenderness, bloating, mood changes, increase blood pressure, increase risk of DVT	Private prescription cost plus £30 (for 3 months supply)	Prescription Only Medicine	Yes, immediate	Smokers over 35, migraine with aura, BMI over 35, history of DVT or other complex medical conditions that increase the risk of a stroke or blood clot. Family history of VTE under 45 years. Those under 6 weeks post-delivery and breastfeeding. Individuals who don't want to increase their risk.	Visible if worn on exposed skin. Can come off during extreme exercise/swimming
Progestogen-only Pill	Hormonal	91%	Daily	Thickens cervical mucus, thins womb lining and can prevent ovulation	Suitable for those who can't take estrogen	Must take daily; effectiveness reduced if any diarrhoea/vomiting, St John's Wort and enzyme-inducing medications.	No	Oral	Those who cannot take estrogen or not happy with the extra risks	Irregular bleeding, unscheduled bleeding or no bleeding. Headaches, skin changes, breast tenderness, bloating, mood changes	Private prescription cost plus £30 (for 3 months supply)	Pharmacy, Prescription Only Medicine	Yes, immediate	Previous and current breast cancer. Liver tumours. Cirrhosis. Unexplained vaginal bleeding. Enzyme-inducing medication can make it less effective.	May be used while breastfeeding
Sterilisation	Surgical	99.50%	Permanent	Blocks fallopian tubes, so that eggs and sperm do not meet	Permanent, no hormones	Surgical procedure - Inpatient with general anaesthetic or a spinal block	No	Surgery	Those wanting a permanent solution	Surgical risks and recovery from the procedure.	High, one-time	Hospital setting	No	Those that are not sure they have completed their family. High BMI can increase the risks involved in surgery and anaesthetic.	Not reversible
Vaginal Ring	Hormonal	91%	Every 3 weeks	Prevents ovulation, thins womb lining and thickens cervical mucus	Can regulate periods, reduce flow and pain	Sits inside the vagina. Could cause discomfort during sexual activity	No	Self insertion into the vagina, then let it remain inside the body for 3 weeks.	Those happy to insert a ring into their vagina, remove and replace	Nausea, headaches, skin changes, breast tenderness, bloating, mood changes, increase blood pressure, increase risk of DVT	Private prescription cost plus £30 (for 3 months supply)	Pharmacy, Prescription Only Medicine	Yes, immediate but could take a few months for some	Smokers over 35, migraine with aura, BMI over 35, history of DVT or other complex medical conditions that increase the risk of a stroke or blood clot. Family history of VTE under 45 years. Those under 6 weeks post-delivery and breastfeeding. Individuals who don't want to increase their risk.	Can be removed for sexual contact and replaced afterwards.
Vasectomy	Surgical	99.90%	Permanent	Blocks vas deferens, so sperm do not leave the body	Permanent, no hormones	Surgical procedure - outpatient with local anaesthetic	No	Surgery	Those wanting a permanent solution	Surgical risks	£750	Clinic setting	No	Those that are not sure they have completed their family. Anatomical abnormalities that may require a hospital surgical procedure, rather than outpatient.	Not reversible