You may find some of the below information useful when considering what might be right for you and can be discussed further in your CASH clinics appointment.

Hormonal contraception should protect you against pregnancy but will not protect you against sexually-transmitted infections (STIs), therefore it is sensible to consider also using barrier contraception, such as condoms.

Combined Oral Contraceptive (COC) Pill

• Contains both oestrogen and progesterone
• 99% effective when taken correctly
• Taken daily for 21 days with a 7 day break (to allow a monthly or 3-monthly period)
• Can help bleeding and period pains
• Not suitable if you are over 35 and smoke. Talk to your GP if you are overweight or have any medical issues (including high blood pressure or certain types of migraines)

Progesterone-Only Pill (POP)

• Only contains progestogen
• 99% effective when taken correctly (must be taken at a similar time each day)
• Taken daily with no break
• Periods may become lighter or stop altogether
• Can be taken alongside HRT used for perimenopausal symptoms
• You may have irregular periods. It may not work if you do not take it correctly

Long-acting Reversible Contraception (LARC)

Long-acting Reversible Contraception is provided by the CASH clinic on a Wednesday afternoon, at City Walls Medical Centre.

LARC may be the right choice for you, if you wish to have a reliable form of contraception and you do not wish to take a tablet every day, or if you frequently forget to take your contraception.

Remember that all LARC is reversible and can be removed, if you find that it does not suit you. Further information is available below and can be discussed with your nurse or GP at your appointment.

1. Coil with hormones (IUS)

A T-shaped device that is placed inside the womb. It releases progestogen which thickens the mucous and prevents sperm from entering the womb. It also thins the womb lining to prevent an egg from implanting.

• Continues to work for 5 years
• May help periods become lighter and less painful
• It is not affected by other medications and can be used if the COC is not suited to you
• Can also be taken alongside HRT used for perimenopausal symptoms
• You may have irregular periods or spotting within the first 6 months
• There is a risk of pelvic infections if you develop an STI whilst it is in place
• The IUS is 99.8% effective, however if you fall pregnant with the IUS there is a higher chance of developing an ectopic pregnancy (pregnancy outside the womb)

2. Coil without hormones (IUD)

Copper coils are placed into the womb

• Continues to work for either 5 or 10 years, depending on what your needs are
• Your periods may be longer, heavier or more painful
• There is a risk of pelvic infections if you develop an STI whilst it is in place
• The IUS is 99% effective, however if you fall pregnant with the IUD there is a higher chance of developing an ectopic pregnancy (pregnancy outside the womb)

3. Implant

A small flexible rod is placed into the underside of your upper arm

• Over 99% effective
• Continues to work for 3 years
• May reduce heavy, painful periods
• Some women may develop irregular periods (sometimes this happens after 12 months from insertion)
• May not be suitable for women taking certain medications (including certain medications used to treat epilepsy)

4. Contraception Injections Depo-Provera / Sayana Press

A small injection of the hormone progestogen is given into your thigh, administered at the surgery (DepoProvera) or at home by yourself (Sayana Press)

• Over 99% effective
• Continues to work for 13 weeks
• Sayana-Press is convenient as it allows you to administer it to yourself at home every 13 weeks
• Some women experience weight gain, mood swings, breast tenderness and irregular/heavy/light periods
• There is a small risk of allergy/skin dimpling at the injection site. You may be advised to have a break after 2 years to keep your bones strong

	COC Pill	Pop	Coil with hormones (IUS)	Coil without hormones (IUD)	Implant	Depo / Sayana Press	Condoms
How do I use it?	Take one every day with a 7 day break	Take one every day	“Fit and forget”	“Fit and forget”	“Fit and forget”	Injection at surgery or at home	Use before sex
How effective is it at preventing pregnancy?	99% (when taken correctly)	99% (when taken correctly)	99.8%	>99%	>99%	>99%	85-98% (depending on use)
How long does it last?	Month-by-month protection	Month-by-month protection	5 years	5 or 10 years	3 years	13 weeks	Single use
Will it affect my fertility?	No	No	No	No	No	Yes (see FAQ below)	No
Will it affect my periods?	Periods may become lighter and less painful	Periods may stop completely	Periods often stop after 12 months, but may be irregular for the first 6 months	Periods may become heavier or more painful	Periods may become less painful but may become irregular or prolonged	Periods may become irregular and may take 1 year to return which may delay fertility	No
Is it safe to use while breastfeeding?	Yes, if more than 6 weeks after birth	Yes	Yes (no effect on milk supply)	Yes (no effect milk supply)	Yes (no effect on milk supply)	Yes, if more than 6 weeks after birth	Yes
When will I need to be reviewed?	Annual review (please use our online tool to complete your annual review)	Annual review (please use our online tool to complete your annual review)	Check up around 6 weeks after insertion to confirm correct position.We advise you to regularly check for threads. Review at 5 years for removal	Check up around 6 weeks after insertion to confirm correct position. We advise you to regularly check for threads. Review at 5/10 years for removal	Review at 5 years for removal	You will need a further injection at surgery / home every 13 weeks. You may need a break every 2 years to protect your bones	No
Will it protect me from sexually-transmitted infections?	No	No	No	No	No	No	Yes

FAQs

Q: I’m interested in having a coil fitted – Will it be painful?
A: Many women find taking over-the-counter pain relief (such as paracetamol or ibuprofen) helps them to feel more comfortable when having a coil fitted. You may experience some strong period-like cramping during the procedure. We also use a special spray to numb your cervix.

A few women can feel faint during the procedure, so we advise that you eat a light meal before arriving to your appointment.

Q: Will I have any discomfort after the procedure?
A: Most women experience 2-3 days of cramps/discomfort afterwards. This can be helped with over-the-counter pain relief and/or hot water bottles.

A few women may experience pain for a little longer but we would advise you to book an appointment to get checked if you have any concerns.

Q: Are there any risks involved?
A: Pain and spotting are the most common risks after the procedure.

Infection is an uncommon risk, as the procedure is performed sterile. The greatest risk is during the first few weeks after insertion and we advise women to inform us of any unusual pain or discharge. The risk is higher if you have an STI.

Approximately 1 in every 2000 women may develop a small hole in the womb during the procedure; occasionally this hole may need to be repaired by surgery.

Coils are extremely effective (>99%) at preventing pregnancies; however in the unlikely event that you did get pregnant, there is a higher chance of ectopic pregnancies (where the egg implants outside the womb).

Q: I have never had a child can I still have a coil?
A: Yes. Smaller coils (with a lower hormone dose) are also available Some women (including those who have never had children or are under 18 years) sometimes opt for a smaller coil.

Page last updated: 10 April