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ZoomDoc’s guide to contraception

April 4, 2023
ZoomDoc’s guide to contraception
April 4, 2023

Right now in the UK, there are 15 methods of contraception available, including everything from condoms to vasectomies. That’s a lot to choose between. So where do you even start and how do you know which is best for you? 

‘Talking to your doctor can help,’ says ZoomDoc GP, Dr Sohini Kar. ‘We know what’s available and we know your health status and health history too, so although it’s a personal choice to make, your GP is a good place to start if you’ve never used contraception before or aren’t getting on well with your current option,’ she says.

There’s no need to switch if you’re happy with your current method, but if you’ve read this month’s health headlines, you may be feeling a little concerned about some of the health risks attached to hormonal choices, such as the pill. 

Keep reading to find out what your contraceptive choices consist of, including what the risks actually are, as well as the benefits and effectiveness of them.

 

Contraception – what are my options?

 

Contraception is used to prevent an unplanned pregnancy.

 

 

The most common forms of contraception in the UK are the pill closely followed by condoms. Long-acting reversible contraceptives, such as intrauterine devices (IUD) also called ‘the coil’ are also fairly popular with older women who’ve had children and want to be protected but be able to forget about contraception longer term.

 

The full list of contraception offered by the NHS are:

  • contraceptive implant 
  • intrauterine system, or IUS
  • intrauterine device, or IUD, also called the coil 
  • contraceptive injection 
  • combined pill 
  • progestogen-only pill 
  • contraceptive patch 
  • vaginal ring
  • symptothermal method of natural family planning 
  • male condom
  • female condom
  • diaphragm or cap with spermicide 
  • female sterilisation 
  • male sterilisation (or vasectomy)

 

How effective is contraception?

 

Fewer than 1 in 100 who use the combined pill as contraception will get pregnant in a year.

 

 

Nothing is 100% effective because when taking or using any form of contraception there’s always room for human error. You might forget to take it, not put it in or on correctly and so on.

 

Everything listed above is still highly effective – ranging from between 96–99%, about as high as you can get. The key to making sure yours does its job (whether stopping you getting pregnant or protecting against sexually-transmitted disease (STI) or both) is to use it correctly, explains Dr Sohini. 

 

‘If you take the pill every day it is considered 99% effective, but that can fall if you forget to take it or don’t follow the correct rules,’ she says.

 

‘IUDs and implants, which last for years, are considered more than 99% effective. As are female sterilisation and vasectomies but obviously these are usually better suited to after you’ve had children as the results are permanent,’ she says.

 

The ‘least’ effective contraceptives are female condoms and diaphragms. ‘These are still very effective but there’s room for mistakes. If they’re not used properly, they won’t work as well as they should,’ says Dr Sohini. 

 

Does the pill cause cancer?

 

Because birth control pills contain synthetic versions of these female hormones, they could potentially also increase cancer risk.

 

 

There are two types of pill, the combined pill (containing artificial versions of hormones oestrogen and progesterone hormones) and the progestogen-only pill.

 

The combined pill has known health risks attached to it, as well as many health benefits. Risks include an increased risk of blood clots and breast cancer, but benefits include reducing your risk of other cancers. Any health risks are considered ‘temporary’ while you’re taking the medication. As soon as you come off the pill, your risk returns to ‘normal’. As every medication carries some risk, the pill is always prescribed by a doctor. This way they can make sure it’s suitable for you and that any benefits outweigh the risks. 

 

Until recently, there has been less safety data linked to the progestogen-only pill. This is because far fewer people have used it, until fairly recently. This month a new study released findings that the progestogen-only pill and intrauterine system (IUS) which releases the hormone progestogen into the womb) have a similar effect on the risk of breast cancer as the combined pill. 

 

‘This doesn’t mean that the progestogen-only pill causes cancer, which some headlines may suggest and it’s important not to stop taking the pill without an alternative to switch to, so talk to your doctor about any concerns you may have,’ says Dr Sohini.

 

Here’s what Cancer Research UK says about the latest research:

 

‘The take-home message around cancer and contraception has not changed – for most women, the benefits of using contraception still outweigh the risks. The information from this new study means most women can continue using their contraception with a new level of understanding about their choices.

 

‘To put this into context, it’s estimated that in the UK, around 400 breast cancer cases are caused by the pill every year. Around 4,400 are caused by alcohol. This difference is partly because drinking alcohol is much more common than taking the pill.

 

‘If you’re worried about using contraception, speak to your doctor. The best way to lower your risk of cancer is to stop smoking, eat a healthy, balanced diet, be physically active and keep a healthy weight.’

 

Which contraceptives protect against STIs?

 

Condoms are the only type of contraception that can both prevent pregnancy and protect against sexually transmitted infections.

 

The only form of contraception that protects you against a sexually transmitted disease is a condom, ‘which should be used every time you have sex,’ says Dr Sohini.

‘Other methods protect against pregnancy only so to be really safe and protected against both you need to double up and use an implant, pill, IUD or patch as well as a condom,’ she says.

Always talk to your doctor about your contraceptive choices, particularly if you’re sexually active, planning a family or want to switch methods. To talk to a ZoomDoc GP at a time to suit you, download the ZoomDoc app.

Want to know more?

Our team of Doctors are available via the ZoomDoc App for any medical questions or queries.