Which contraception is right for me?
Contraception gets a bad reputation on social media. Particularly as getting to know your menstrual cycle is a trendy topic at the moment. Picking a contraception is a big decision, because we often end up on that same one for years. Everyone is different, with different requirements or medical history, and so it’s important to consider all the options to ensure you pick the best option for you, and not disregard a potentially compatible fit, just because you read a bad review online.
When selecting a contraception, consider the following questions:
- What is my requirement?
Usually, we decide to go on contraception with the aim of preventing pregnancy, but they often have other benefits. Hormonal contraception like the combined oral contraceptive pill (“The pill”) or Mirena intrauterine system (“The coil”) can also have benefits treating symptoms of endometriosis, painful heavy periods, fibroids, acne, pre-menstrual syndrome and PCOS. If you experience these, then doubling up your contraception to help treat these might be the best choice for you. On the contrary, if you don’t have sex that often, or you also need to ensure protection from sexually transmitted infections (STIs) then barrier methods like condoms might be your best choice!
- Do I want regular periods or no periods?
Using condoms will continue your period, or even the pill will have a withdrawal bleed to mimic a period once a month, and some people like the comfort or reassurance of having this.
On the other hand, many forms of contraception like the progesterone only pill (“The Pop”) or the long-acting forms, copper or more a coil, injection or implant often stop periods altogether, which some people find convenient.
- Do I have contraindications?
Chat to your doctor about this, but if you have some factors in your medical history, you might be more suitable for one form of contraception compared to another. For examples, in women with history of blood clots, migraine with aura or a close family history of breast cancer, oestrogen containing contraceptives like the combined oral contraceptive pill are avoided.
- Am I at risk of STIs?
We forget contraception isn’t just about preventing pregnancy! Barrier method contraception like condoms protect against many STIs and are useful if you change partners, or if you both haven’t had a negative STI check.
- How long do I want this contraception to last?
For some people, remembering to use a condom every time, or take a pill every day can be an issue, one which can reduce the effectiveness of that contraception. There are some longer acting forms of contraception that take out the ‘user-dependent’ aspect to this, like the coils, implant or injection which last longer. Of course, they don’t protect from STIs, so you need to consider this.
- Do I want to get pregnant soon?
It’s one to think about as your priorities may change. Coils are often fitted for a number of years and having them removed requires booking an appointment to have them taken out. Other forms like the injection can take a few months to wear off, so may not be the best choice if you want to try to conceive as soon as you stop your contraception.
- Is it a total disaster if I got pregnant?
This one is probably the most controversial one as cycle tracking is trendy at the moment with many public ‘anti-hormone’ campaigns. However, fertility awareness methods like cycle tracking require you to be really on the ball. You are required to track your menstrual cycle dates, body temperature and vaginal discharge daily, and then abstain from unprotected sex during the ovulation windows. Now this might be a great option for some, particularly those who cannot take contraception for whatever reason, but on paper it is less effective than other methods.
The data shows that compared to other methods fertility awareness is only 76% effective (meaning out of 100 women using this method, 24 will become pregnant), compared to over 90% effectiveness for pills, or 99% for longer acting methods which aren’t user dependent.
This increased risk of pregnancy might be fine for you and your situation, or you may be a total whizz with tracking your temperature and cycle. But that’s not the case for everyone and if avoiding getting pregnant is completely your contraceptive priority, then bare these stats in mind!
There’s a great website to read more about all the different options below, and if you can, I would chat to your own doctor.
Dr Frankie
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