Getting and using contraception

Contraception aims to prevent pregnancy.

A woman can get pregnant if a man's sperm reaches one of her eggs (ova).

Contraception tries to stop this happening by keeping the egg and sperm apart, or by stopping egg production, or by stopping the combined sperm and egg (fertilised egg) attaching to the lining of the womb.

Contraception is free for most people in the UK. With 15 methods to choose from, you can find one that suits you best.

Barrier methods such as condoms are a form of contraception that help to protect against sexually transmitted infections (STIs) and pregnancy. You should use condoms to protect both your sexual health and that of your partner, no matter what the other contraception you're using to prevent pregnancy.

The 15 methods of contraception

Don't be put off if the first type you use isn't quite right – you can try another. Read about the different methods of contraception:

• caps
• combined pill
• condoms (female)
• condoms (male)
• contraceptive implant
• contraceptive injection
• contraceptive patch
• diaphragms
• intrauterine device (IUD)
• intrauterine system (IUS)
• natural family planning
• progestogen-only pill
• vaginal ring

There are two permanent methods of contraception:

• female sterilisation
• male sterilisation (vasectomy)

Where to get contraception

Contraceptive services are free and confidential. This includes services for people under 16, as long as they're mature enough to understand the information and decisions involved – there are strict guidelines for healthcare professionals who work with people under 16.

You can get contraception for free from:

• most GP surgeries (talk to your GP or practice nurse) 
• community contraception clinics
• some genitourinary medicine (GUM) clinics
• sexual health clinics (these offer contraceptive and STI testing services) 
• some young people's services

Many of these services also offer information, testing and treatment for STIs. If you've had unprotected sex and think there's a chance you might get pregnant, you're also at risk of catching an STI.

Before you make an appointment, try to find out as much as possible about the contraceptive options available. Your choice of contraception may vary over time, depending on your lifestyle and circumstances.

Some methods of contraception are more effective than others. You need to follow the instructions and use your chosen method correctly for it to be as effective as possible. 

With some methods there is no need to remember to take or use them. These are known as methods with no user failure.

They include the implant, injection, IUS (intrauterine system) and IUD (intrauterine device, or coil).

No contraceptive is 100% reliable and some can have side effects. Find out about all the methods available so you can decide which method is right for you.

All 15 methods are listed here, together with how effective they are.

Male and female condoms

• Male condoms: 98% effective if used correctly. This means that 2 women in 100 whose partners use a condom will get pregnant in a year.
• Female condoms: 95% effective if used correctly. Five women in 100 who use a female condom will get pregnant in a year.

Diaphragms and caps

• Diaphragms: latex diaphragms are 92-96% effective if used correctly. Between 4 and 8 women in 100 who use latex diaphragms with spermicide will get pregnant in a year.
• Caps: latex caps are 92-96% effective if used correctly. Between 4 and 8 women in 100 who use latex caps with spermicide will get pregnant in a year. Silicone caps are less effective.

Contraceptive pill

• Combined contraceptive pill: more than 99% effective if taken correctly. Less than 1 woman in 100 will get pregnant in a year while taking the combined pill.
• Progestogen-only pill: 99% effective if taken correctly. One woman in 100 will get pregnant in a year while taking the progestogen-only pill.

Long-active reversible contraceptive (LARC) methods

• Contraceptive injections: more than 99% effective. They last for 8 or 12 weeks, depending on the type of injection. Less than 1 woman in 100 will get pregnant in a year when using contraceptive injections.
• Contraceptive implants: more than 99% effective. They work for three years but can be taken out earlier. Less than 1 woman in 100 will get pregnant over three years when using contraceptive implants.
• Intrauterine system (IUS): more than 99% effective. An IUS normally works for five years but can be taken out earlier. Less than 1 woman in 100 will get pregnant over five years when using an IUS.
• Intrauterine device (IUD): more than 99% effective. An IUD can stay in place for 5 to 10 years depending on the type, but can be taken out at any time. Less than 1 woman in 100 will get pregnant in a year, depending on the type of IUD. Older types of IUD are less effective.  

Patch and ring

• Contraceptive patch: more than 99% effective if used correctly. Less than 1 woman in 100 will get pregnant in a year when using the contraceptive patch.
• Vaginal ring: more than 99% effective if used correctly. Less than 1 woman in 100 will get pregnant in a year when using the vaginal ring.

Sterilisation (permanent contraception)

• Female sterilisation: more than 99% effective. One in 200 women will become pregnant in their lifetime after being sterilised.
• Male sterilisation or vasectomy: about 1 in 2,000 men can become fertile again in their lifetime after a vasectomy.

Natural family planning

Natural family planning can be up to 99% effective, but the methods need to be followed precisely. These include monitoring cervical secretions and monitoring your basal body temperature. It's more effective if more than one method is used and it's taught by specialist teachers.

Up to 1 woman in 100 will get pregnant in a year when using natural family planning correctly. However, natural family planning is not suitable for some women, or it may be less effective.

Contraception clinics offer free and confidential advice and information about contraception and sexual health. Most types of contraception are free through the NHS.

Contraception clinics can be used by women, men and young people, including those who are under 16. In most areas, the NHS also has specific services for young people. Call our sexual health line on 0800 22 44 88.

You can go directly to a contraception clinic yourself (this is sometimes called "referring yourself", or "self-referral"), or you can be referred by your GP or another healthcare worker.

However, you may need to book an appointment to see a healthcare professional at a contraception clinic. You can ring the clinic first to find out. Many contraception clinics also have walk-in clinics, where you can turn up on the day and wait for an appointment.

Healthcare services provided by contraception clinics

Contraception clinics offer a range of services and can provide:

• confidential advice about contraception
• the combined oral contraceptive pill
• the progestogen-only pill
• progestogen contraceptive injections
• insertion or removal of the contraceptive implant
• limited supplies of free condoms
• free emergency contraception
• confidential advice about STIs and STI testing
• cervical screening
• unplanned pregnancy advice
• free pregnancy tests
• pre-conception (pre-pregnancy) advice and information on fertility problems
• fitting and checking of caps, diaphragms, IUDs (intrauterine devices, or coils) and IUSs (intrauterine systems, or hormonal coils)

Some contraception clinics may also offer specialist services, including:

• counselling for incest, rape and sexual abuse
• vasectomy (male sterilisation) counselling and procedures
• pre-abortion and post-abortion counselling and referral
• gynaecology clinics 
• menopause clinics
• female sterilisation counselling and referral
• "well woman" screening

You can get a contraceptive implant fitted or removed:

• at a contraception or sexual health (GUM) clinic
• by a GP or practice nurse

Only a specially trained doctor or nurse can fit or remove contraceptive implants.

Contraceptive implants are available for free on the NHS.

Fitting and removing your contraceptive implant

A contraceptive implant is a thin, flexible tube about 4cm long and 2mm thick. It’s inserted under your skin on the inside of your upper arm. You won’t need any stitches after your implant has been fitted.

To numb the area, your doctor or nurse will give you a local anaesthetic injection before your implant is fitted or removed.

Your contraceptive implant will work for up to three years before it needs to be replaced. You can have it removed earlier than this if you no longer want it.

Replacing your contraceptive implant

If you want to continue using a contraceptive implant after three years, you can get the old one removed and a new one put in at the same visit.

Nexplanon and Implanon

Implants fitted after October 2010 are called Nexplanon. Implants fitted before this are called Implanon. They work in the same way, but Nexplanon is designed to reduce the risk of insertion errors and is visible on an X-ray or CT scan. There is no need for existing Implanon users to have their implant removed and replaced by Nexplanon ahead of its scheduled replacement time.

Read more about the contraceptive implant.

Condoms are the best way to protect yourself against sexually transmitted infections (STIs) and unwanted pregnancy. Condoms are a barrier contraceptive made from latex rubber, a synthetic rubber called polyisoprene or a very thin plastic called polyurethane.

Condoms are available free from:

• contraception clinics (sometimes called family planning clinics)
• sexual health, or genitourinary medicine (GUM), clinics
• some GP surgeries

You can also buy condoms from:

• shops
• pharmacies
• supermarkets
• garages
• vending machines in some public toilets

When buying condoms, make sure that they carry the British Standards Institution (BSI) kitemark, or the European CE symbol as proof of quality. This means they have been tested to the required safety standards. Also, check that the expiry date is clearly visible on the packet.

Types of condom

There are two basic types of condom available in the UK – male and female. The female condom is sometimes called a femidom, because Femidom is its brand name in the UK.

Male condoms

During sex, male condoms are worn on the penis to prevent semen (sperm) from entering the woman's vagina when the man ejaculates (comes). The condom should be put on when the penis is erect (hard) and before it comes into contact with your partner's body.

To use a male condom correctly, follow these steps:

• carefully open the foil packaging that the condom is wrapped in, taking care not to tear the condom
• hold the tip of the condom between your forefinger and thumb to make sure it is put on the right way round, and that no air is trapped inside (the condom may split if air is trapped inside)
• place the condom over the tip of the penis
• while squeezing the tip of the condom, roll it down over the length of the erect penis
• if the condom will not unroll, it is probably on inside out – start again with a new condom as there may be sperm on it

Make sure that the condom stays in place while you are having sex. If it comes off, stop and put on a new one.

After ejaculation (when the man has come) and while the penis is still hard, hold the condom in place and carefully withdraw the penis from your partner's body. You should only take the condom off the penis when there is no further contact with your partner's body. Wrap the used condom in a tissue and put it in the bin. You should never flush condoms down the toilet because they may block the toilet and can cause environmental damage.

Female condoms

Female condoms allow women to share the responsibility of choosing what type of contraception to use before having sex with their partner. Female condoms can be inserted at any time before sex, but must always be inserted before the penis touches the genital area.

To use a female condom, follow these steps:

• carefully remove the female condom from its packaging, taking care not to tear it
• place the closed end of the condom into the vagina, holding the soft inner ring between your forefinger or middle finger and thumb
• use your other hand to separate the folds of skin (labia) around the vagina, then put the squeezed ring into the vagina
• put your index or middle finger or both in the open end of the condom until the inner ring can be felt and push the condom as far up the vagina as possible, with the outer ring lying against the outside of the vagina
• the outer ring of the condom should rest closely on the outside of the vagina at all times during sex – if the outer ring gets pushed inside the vagina, stop and put it back in the right place
• make sure that the penis enters the condom – take care to ensure that the penis does not go between the condom and the wall of the vagina

Immediately after sex, slightly twist and pull the end of the condom to remove it, taking care not to spill any sperm inside the vagina. If this happens, you will need to seek advice about emergency contraception from your GP or pharmacist.

Lubricants

If you use a lubricant when having sex, make sure that it is water based. Oil-based lubricants, such as lotion or baby oil, can damage latex and polyisoprene condoms, and increase the likelihood that they will break.

What to do if your condom splits

If your condom splits while you are having sex, you should visit your GP or go to your local sexual health or genitourinary medicine (GUM) clinic as soon as possible.

Emergency contraception, such as the emergency pill or the intrauterine device (IUD) can be used to prevent pregnancy. Emergency contraception is available free from contraception clinics, GPs that provide contraception services, Brook clinics, sexual health clinics and some GUM clinics, but not all are able to fit the IUD. The emergency contraceptive pill Levonelle and ellaOne can be bought from most pharmacies and some provide it free to young people. 

Most types of contraception are available for free in the UK. Contraception is free to all women and men through the NHS. Places where you can get contraception include:

• most GP surgeries – talk to your GP or practice nurse
• community contraception clinics
• some genitourinary medicine (GUM) clinics
• sexual health clinics – they also offer contraceptive and STI testing services
• some young people's services (call the our Sexual Health Line on 0800 22 44 88 for more information)

Contraception services are free and confidential, including for people under the age of 16.

If you're under 16

If you're under 16 and want contraception, the doctor, nurse or pharmacist won't tell your parents or carer, as long as they believe you fully understand the information you're given, and your decisions.

Doctors and nurses work under strict guidelines when dealing with people under 16. They'll encourage you to consider telling your parents, but they won't make you.

The only time that a doctor or nurse might want to tell someone else is if they believe you're at risk of harm, such as abuse. The risk would need to be serious, and they would usually discuss this with you first.