Contraception

A condom and pill packet against a denim background
If you don't want to be a Daddy/Mummy just yet, there are ways to stop this from happening. But some ways are better than others!
  • Not having sex - or abstinence - totally reliable - stick with it as long as you can.
Otherwise if you are going to have sex then use some kind of contraception, otherwise known as birth control, such as:
  • Putting something in the sperm's way like condoms. Good if you have to have sex - and also helps to stop you getting nasty bugs or sexually transmitted diseases like AIDS whilst having sex.
  • Making sure the woman's egg or 'ovum' doesn't work - the combined pill- great as long as you remember to take the pills, and even better if you use it with condoms. Works by stopping ovulation - stops any eggs being released. You take it every day for 21 days then have a week break. Failure rate less than 1%. Helps to regulate bleeding patterns, reduces pain, reduces risk of ovarian cancer, womb cancer and colon cancer. There is a slightl increased risk of breast cancer but risk goes back to normal after you stop using the pill. Slightly increases risks of blood clots in the legs and strokes but overall risk still very small for most healthy women. Some conventional medicines, such as antibiotics and alternative medicines, such as St John's wort, can interact with it.
  • Making it more difficult for the sperm to get through to the egg and make sure the egg doesn't work - the progestogen-only pill - not quite so safe as the combined pill. The failure rate of this pill varies and can be less than 1% when used correctly. You take it continually, with no break. No increased risk of breast cancer or stroke or clots. Bleeding patterns can be irregular and can affect mood and acne. Must be taken at same time every day. Can be affected by other medicines.
  • The intra-uterine device or intra-uterine system- small plastic tube that can be inserted into the womb via a vaginal examination. Takes 5 minutes to put in and lasts for between 5 to 10 years depending on the device. Low failure rate- between 1-2%. No delay in return to fertility when it is taken out. Can alter bleeding patterns. Small risk of infection when inserted. Small risk of perforation and expulsion. Not affected by other medicines.
  • The implant - progestogen only - a small plastic tube is put under the skin in your arm. Takes 5 minutes to put in. Lasts for 3 years. Failure rate less than 1%. No delay in returning to fertility when taken out. Can alter bleeding patterns and can affect acne. Some medicines do interact with it
  • The progestogen only injection. Takes less than a minute to have. Taken every 12 weeks. Usually into your arm or upper part of leg. Failure rate less than 1%. Slight delay in fertility when stopping of up to 1 year. Can alter weight gain and bleeding pattern. Can reduce bone thickness but not enough to cause broken bones and goes back to normal when stopped. Not affected by other medicines.
  • Contraceptive ring - this is a new product. Ring is inserted into your vagina for 3 weeks of every cycle and then you have 1 week without it. Awaiting more information.
  • Contraceptive patch - new product. You wear the patch for 3 weeks then have 1 week without it. Awaiting more information.
  • Don't have sex when the woman is releasing an egg - the rhythm method or safe period or some people rely on the man withdrawing just before he comes- otherwise known as coitus interruptus - both lousy - don't risk it, but better than nothing.
  • Putting other barriers in the sperms way - like the cap/diaphragm - not popular amongst the young as a bit messy and has to be thought about well ahead of having sex.
  • Emergency Contraception Pills: these pills contain progesterone hormones, which stop any fertilised egg from settling into the wall of the uterus(womb) and developing into a baby. Works best if taken within 72 hours of having had unprotected sex.
  • Emergency intra-uterine device - small plastic tube put inside the womb via the vagina which stops the fertilised egg settling into the wall of the womb. Works for up to 5 days after unprotected sex.
  • If all else goes wrong you can consider whether you should have an abortion or not.

For more information go to www.fpa.org.uk or www.youthhealthtalk.org

Abstinence

An image of the virgin mary against a floral background
Original photograph courtesy of Diana Galletly

How does it work?

You simply don't have sex, maybe because:
  • you don't feel ready.
  • your body says 'go' but your heart says 'no'.
  • you don't think it's right yet.
  • you'd only be doing it to keep up with your friends.
  • it's illegal under 16.
  • you absolutely don't want to risk getting pregnant or a sexually transmitted disease at this time.

The 'oops' factor

None. The only method with a 0% 'ooops' factor and total protection against AIDS and other nasties. Gives you time to find out who you are and what you want first.

Advantages

  • Gives you time to find the right person to have sex with. Makes you normal - 80% of girls and 75% of boys under 16 haven't had sex.
  • Makes family life easier (Mum & Dad often find the thought of their children having sex v. scary).

Disadvantages

No full sex. That doesn't mean no tickles / cuddles / squeezes / touching / kissing / stroking... or using your imagination.

If you do decide to abstain from sexual intercourse at this time, it is still a good idea to find out more information about it so you are prepared when the time comes. You can get all sorts of information from http://www.youthhealthtalk.org/.

Cap / Diaphragm

A diaphragm within a pink case

How it Works

You pop a rubber 'cap' popped into your vagina before sex. It sits covering the entrance to your cervix and it stops a man's sperm swimming any further up than your vagina - so they do not get to fertilize the girls egg. You get it fitted at your GP or family planning clinic.

The 'oops' factor

Can be pretty good, as long as you always remember to use spermicide. 6% oops factor and up to 9% oops factor in younger women.

Advantages

  • Easy as putting a tampon in.
  • No messing with hormones.

Disadvantages

  • You need to use a spermicide (sperm-killing stuff) with it, which can be messy.
  • Got to keep it in there 6 hours after sex.
  • You have to see a doctor or nurse first to get make sure that you have one that fits.
  • You have to think about putting it in before having sex.
  • If you add / lose more than 10 lbs, you need to get a new one fitted.

Combined pill

A hand holding a pill packet

How it works

It's got two hormones in it, called oestrogen and progestogen. They stop the egg in a woman from being released. You have to get it from the GP or family planning clinic.

The 'oops' factor

It is very reliable - only 0.1% 'oops' factor. That is as long as you remember to pop one every day.

Advantages

  • It's free as long as you get it from the doctor or clinic
  • No messing around when it comes to the big moment.
  • Lighter, more regular periods. Less cramps.
  • It reduces risk of some cancers in ovary, colon and uterus when you're older.
  • Some combined pills get rid of zits.
  • it is very good at stopping you getting pregnant

Disadvantages

  • You have to remember to take it regularly whether you're going to have sex or not.
  • No protection against AIDS, chlamydia, herpes etc.
  • Some women don't like taking hormones.
  • A few women get headaches, get fatter and feel fed up.
  • Risk of blood clots, strokes and heart attacks increases although overall risk is still very small.
  • Very small risk of breast cancer (disappears 10 years after you come off it) and cervical cancer.
For more info go to www.fpa.org.uk or www.youthhealthtalk.org
This is also known as just the pill

Condoms

A hand holding a condom in a packet with a blurred image of a teenage boy behind

Also known as...

Rubber, Sheath, Johnny, Durex, French Letter, Japanese Wrinkle

How do they work?

It's a stretchy rubber tube, which unrolls over the bloke's penis. The sperm all get caught in it and can't swim anywhere.

Where can you get them?

  • at the chemists
  • in some toilets
  • Brook Advisory Centres http://www.brook.org.uk - 0808 802 1234 for your nearest
  • any family planning clinic- www.fpa.org.uk. 0845 122 8690
  • other young people's clinics

Advantages

  • Makes sex less messy.
  • You only use it when you have sex, not every day.
  • Protects you from AIDS, chlamydia and other nasty sexual infections like herpes.
  • Also protects girls against cancer of the cervix.
  • Easy and cheap. Less than 75p each from if you buy them yourself. Or free from clinics like the Brook Centres http://www.brook.org.uk.
  • Lots of choice- different sizes, latex free etc.

Disadvantages

  • They are slippery.
  • Can split if your fingernails are sharp.
  • Don't work if used with certain oils or vaseline as these make the condom split
  • 2-minute condom 'breaks' can be a turn-off (not if she puts it on him, though).
  • Not too 'sensitive' but improving.
  • They don't flush down the loo afterwards but try putting some lav paper down with them.

The oops factor or failure rate

If used perfectly the failure rate is 2% but with typical use this increases to 15%.

Emergency contraceptive pill

A worried looking teenage girl holding a pill packet

How it works

The emergency contraception pill contains progestogen hormones, which stop any fertilised egg from settling into the wall of the uterus(womb) and developing into a baby. It is sometimes called the 'morning after' pill - but in fact it works for up to 72 hours - which is the same as 3 days - after having unprotected sex.

'Unprotected' sex means when you did not use any contraception or the condom breaks or a pill was not taken correctly. Most girls get emergency contraception from their family doctor (with a free prescription) or a family planning clinic or a young peoples clinic. If you are over 16 you can buy emergency contraception over the counter from a chemist - but it's not cheap getting it this way.

The oops factor

Very good - only 2% ooops factor. The sooner you take it the better it works (but you don't need to wake the doctor in the middle of the night). Remember if you run out of time and it's more than 72 hours (3 days) all is not lost. You can still use an emergency intra-uterine contraceptive device.

Advantages

  • It's free from your doctor.
  • It stops you getting pregnant.
  • It prevents you possibly needing an abortion.
  • It's very easy to use.
  • It has few side effects.
  • You can use more than once

Disadvantages

  • You have go get the pill.
  • You have to remember to take the pill.
  • It gives you no protection against sexually transmitted infections - AIDS, chlamydia, herpes etc.
  • Some women feel a bit sick after taking the pills- if you vomit within 2 hours of taking it, you need to take another dose.
  • Some doctors are unhappy about prescribing it - if you find one of these doctors ask to see another one.
  • Can interact with some medicines

Emergency intra-uterine device

An intra-uterine contraceptive device in its orange casing

How it works

It makes the egg and sperm less likely to be successful at developing into a baby and it stops the fertilised egg from settling into the wall of the womb. It is a small tube that contains copper and it can be inserted into the womb via a vaginal examination. It only takes 5 minutes to insert and can be used up to 5 days after unprotected sex or even up to 5 days after ovulation.

Advantages

  • Works up to 5 days after unprotected sex or even longer.
  • Is free from a doctor.
  • Stops you getting pregnant and avoiding having to have an abortion.
  • Doesn't interact with any medicines.
  • Can become your continuing method of contraception or it can be removed after the next normal period.

Disadvantages

  • It sometimes takes longer to organise than the emergency pill.
  • You have to get a doctor or family planning nurse to insert it.
  • There is a slight risk of infection at time of insertion.
  • There is a very slight risk of perforation of the womb.
  • It gives no protection against sexually transmitted diseases.

Intra-uterine device

An intra-uterine contraceptive device in its orange casing

How it works

It's a very small copper tube that sits in a woman's uterus (womb) and that kills off sperm and therefore prevents fertilisation of the egg.

How is it fitted?

It has to be put into your uterus by a specially trained doctor or nurse. They will need to see you first to ask you some questions and see if you need any tests for infections before it is inserted.

Once you are ready to have it put in, the actual procedure only takes about 5 minutes. It involves lying on a couch and having the small tube inserted into your uterus through your vagina. You may feel a little bit of crampy pain during the procedure.

For 24-48hrs after the procedure, you can still get some pain and a little bleeding which then settles down. Taking some paracetamol normally helps. If it doesn't settle down, then you should go back to see your doctor. You must have a follow-up appointment at 6 weeks.

When you put your fingers inside your vagina, you can feel tiny threads that connect to the device in your womb. You must check these every month to make sure the device has not come out. These threads cannot normally be felt by the man during sex.

The 'oops' factor

Very low. Less than 2%.

Advantages

  • Once it's in, that's all you need to do, and you can forget about it.
  • Lasts for 5-10 years.
  • Doesn't interact with any medicines.
  • Doesn't increase risks of strokes or clots.
  • Useful as an emergency contraceptive.
  • Will stop pregnancy if you put it in up to five days after unprotected sex.

Disadvantages

  • Can make periods heavier.
  • Doesn't protect against AIDS or other sexually transmitted infections.
  • Small risk of perforation and expulsion.
  • Small risk of infection at time of insertion.

Not doing it!

A view from behind of a teenage couple holding hands by a lake
The majority of young people have NOT had sexual intercourse by the age of sixteen. It is illegal and most young people who have had sex under the age of 16 say that they regretted it and wished that they hadn't. You certainly should not feel pressurized into it by your girl friend or boyfriend or your peers. In fact only about one in four girls and one in three boys have had actual sexual intercourse by the age of 16. So you can and should absolutely say 'no' if you don't want to have sex. There are also a large number of very sexy things that you can do with your partner without having sexual intercourse itself - kissing, hugging, touching one another are amongst them. The huge advantage is that you are much less likely to get pregnant or to get a sexually transmitted disease doing these things rather than having sexual intercourse. But, but, but - even if you do decide to abstain from having sex you should try and learn as much as you can about having sex and using contraception as you possibly can. The better informed you are the safer you are once you do decide to do it.

Most people under the age of 16 have not had sex

Progestogen-only pill

A hand holding a pill packet

How it works

The hormone in it:
  • changes the mucus near the woman's cervix (neck of her utuerus or womb) to stop sperm getting through.
  • stops the fertilized egg from bedding down in the uterus.

The 'oops' factor

Less reliable than combined pill, but still very good. Failure rate varies but when taken correctly can be less than 1%.

Advantages

  • It's free if you get it from your doctor.
  • Doesn't get in the way of sex.
  • It stops you getting pregnant.
  • Doesn't increase your risk of clots or strokes like combined pill.

Disadvantages

  • You have to remember to take the damn thing regularly (pill).
  • Sometimes affects your bleeding pattern.
  • Offers absolutely no protection against AIDS, chlamydia and other sexually transmitted infections.
  • Can affect your mood and and give you acne.

Rhythm method

A female finger pointing to a line on a complex chart of data.

How it works

The woman takes her temperature regularly, or tests her mucus or her urine to find out when she is just about to, or has, released an egg (ova). Then she has no sex until it is a safe period in her cycle again. The rhythm method therefore relies heavily on using a calendar.

The 'oops' factor

Not brilliant - between 2 and 10 % 'oops' factor if you've had training. In real life, it doesn't work so well because periods aren't always on time and it is not always easy to know exactly when a woman is releasing an egg. Best leave this method to your parents.

Advantages

  • No hormones, no rubber, no nothing.

Disadvantages

  • No protection against AIDS or other sexual infections
  • The unsafe time of the month is often the time you most want to have sex.
  • Only suitable for couples who don't mind getting pregnant if things do not work out as you want them to.

This method is otherwise known as natural family planning or the safe period

Spermicide

Extreme close-up of some sperm
Illustration of some sperm

How does it work?

It usually comes as a gel, cream or foam that kills sperm. You can buy it a chemist. Follow the instructions on the packet - some condoms have a spermicide built in. Get them at any chemist.

The 'oops' factor

Using spermicides by just by themselves without some other form of contraception is NOT good - much better with diaphragm (cap) or condoms.

Advantages

  • Kills any sperm carrying AIDS virus (though not the virus itself).
  • Makes your vagina less dry.

Disadvantages

  • Can be a bit messy (think backwash...).
  • Some people are allergic to them.
  • No good as a contraception by themselves.

Sterilisation

Two pairs of overlapping scissors on a surgical blue sheet

How does it work?

The woman has an operation to cut or clip her fallopian tubes. Or the man has an operation to cut and knot his spermatic tubes. Probably best for old age like your mum and dad - rather than you...

The 'oops' factor

Almost perfect (providing the doctor does it right).

Advantages

No kids - ever, ever, ever.

Disadvantages

What if you change your mind? Reversing it is extremely complicated and difficult and may not work.

Withdrawal method

A red stop sign and a traffic light with a red light

How it works

The bloke pulls out just before he comes. That is the theory anyhow.

The 'oops' factor

Big big big problems. Like trying to brake while going down a cliff. Usually the bloke fails to do what he says he will!

Advantages

  • It's a last resort at the last moment.

Disadvantages

  • No fun. Neither of you will actually want to pull out at the time.
  • Doesn't work well anyway because men leak sperm before they come.
  • No protection against AIDS or other sexual infections.
The withdrawal method is also known as coitus interruptus