Birth control options compared: how each method works and how well

Long-acting methods: the most effective

Long-acting reversible contraception (LARC) works for years once it's in place, and fertility returns once it's removed.

• Implant — a small flexible rod placed under the skin of your upper arm. Releases a progestogen hormone. Lasts several years. Bleeding patterns can change and may be irregular.
• Hormonal coil (IUS) — a small T-shaped device placed in the womb that releases progestogen. Lasts several years and often makes periods lighter.
• Copper coil (IUD) — a hormone-free device placed in the womb. Lasts several years, but can make periods heavier or more painful for some people.

All are more than 99% effective. Fitting involves a short procedure, which some people find uncomfortable, so ask about pain relief options.

Short-acting hormonal methods

• Combined pill — contains oestrogen and progestogen, taken daily. Can make periods lighter and more regular.
• Progestogen-only pill — taken daily without a break. An option for many people who can't take oestrogen.
• Patch — a sticky patch changed weekly.
• Vaginal ring — a soft ring you insert yourself, usually replaced monthly.
• Injection — given every few months. It may take a while for fertility to return after stopping.

With perfect use, these are more than 99% effective. With typical use — missed pills, late patches or late injections — they're less effective; for the pill, around 9 in 100 people may get pregnant in a year. Methods containing oestrogen aren't suitable for everyone, for example if you have migraines with aura, a history of blood clots, or smoke and are over 35.

Barrier methods

• External (male) condoms and internal (female) condoms — used each time you have sex. They're the only methods that also help protect against sexually transmitted infections (STIs).
• Diaphragm or cap — inserted before sex and used with spermicide.

Barrier methods are less effective than hormonal and long-acting methods with typical use; with condoms, more than 1 in 10 people may get pregnant in a year. Many people use condoms alongside another method for extra protection and STI prevention.

Fertility awareness and permanent methods

Fertility awareness means tracking signs like your temperature, cervical mucus and cycle to identify fertile days. It's hormone-free, but it needs careful daily tracking and is much less effective with typical use. It works best when taught by a trained practitioner.

Sterilisation — tubal surgery for women or vasectomy for men — is more than 99% effective and intended to be permanent. It's a big decision, and long-acting methods are as effective and reversible.

Emergency contraception

If you've had sex without contraception or your method failed, emergency contraception can help prevent pregnancy. Options include emergency pills and the copper coil, which is the most effective. The sooner you use it, the better. A pharmacist, doctor or sexual health clinic can advise quickly.

How to choose what's right for you

Think about:

• how important it is to avoid pregnancy right now
• whether you'd rather not think about contraception daily
• whether you want to avoid hormones
• how you feel about periods changing — lighter, heavier, irregular or stopping
• your health history, including migraines, blood clots and medicines you take
• whether you need STI protection
• when you might want to get pregnant

Side effects vary from person to person, and if one method doesn't suit you, another might. A doctor, nurse or sexual health clinic can help you compare options confidentially.

When to get medical help

Seek urgent help if you're using hormonal contraception and get pain or swelling in one leg, chest pain, sudden breathlessness, a severe headache or vision changes, as these can be signs of a blood clot. Also get checked if you have severe pelvic pain or think you might be pregnant while using a coil.