Not all contraception is suitable for every person. For those who wish to find an alternative, there are a number of other choices.
Additional contraception includes monitoring your own fertility, other physical barriers which prevent sperm reaching the egg and alternative ways of introducing hormones into your body to stop ovulation.
Natural Family Planning
Natural family planning – or ‘fertility awareness’ – is where a woman monitors her menstrual cycle and avoids sex or uses other contraception when fertile.
If followed correctly, it is 99% effective. However, it does require careful thought and consistency – and cannot protect against STIs.
You have to keep a daily record of your fertility signals, such as your temperature and the fluids coming from your cervix. It often takes a number of menstrual cycles to become totally familiar.
There are no physical side effects as no additional hormones or drugs are entering your body. However, if you want to have sex during the time when you might get pregnant, you’ll need to use other contraception such as a condom.
Care is needed as your fertility signals can be affected by illness, stress and travel.
It’s important to understand that natural family planning cannot protect you against STI’s. The best protection against infection is to use a male or female condom.
Diaphragm or Cap
A contraceptive diaphragm or cap is a circular dome made of thin, soft silicone that’s inserted into the vagina to cover a woman’s cervix so that sperm cannot enter the womb.
In addition, it should be covered in spermicide which actively kills sperm. Spermicide should be reapplied if you have sex again or the diaphragm is in place more than 3 hours.
A diaphragm must fit neatly over your cervix as it stays in place by suction. As such, it is typically fitted through consultation with a doctor or nurse.
As it does not use any hormones, there are no side effects but is not suitable for everyone. A diaphragm is around 92-96% effective at preventing pregnancy but cannot help against STIs.
Vaginal ring is a small plastic ring placed within the vagina which releases oestrogen and progestogen into the bloodstream to prevent pregnancy.
The typical way to use the ring is to leave it in place for 21 days, then remove it for 7 days during your period.
One ring provides contraception for a month after which it must be replaced. You can typically have sex with the ring in place.
If used correctly, it is more than 99% effective.
The contraceptive patch is a small sticky square which is placed on the skin and slowly releases hormones into your body to prevent pregnancy.
In the UK, the brand which is prescribed is called Evra.
The patch contains the same hormones as the combined pill – oestrogen and progesterone. They prevent the ovaries from releasing an egg each month (ovulation), thicken the mucus in the neck of the womb to make it harder for sperm to enter and thin the lining of the womb so that a fertilised egg cannot implant itself.
Each patch is typically worn for 7 days. Every 3 weeks (when you anticipate your monthly bleed) you will go 7 days without a patch, before beginning again.
Like the pill, the patch can cause temporary side effects at first but these typically pass.
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