Contraception: Where Do I Start?

Contraception can feel like a lot to get your head around. There are pills, patches, injections, implants, coils, condoms, apps and a whole load of advice that can make it sound as though you should already know exactly what you're doing.

You don't.

Whether you're having sex for the first time, changing methods, starting a new relationship or simply trying to understand your options, it's completely normal to have questions.

There isn't one contraceptive method that's right for everyone. The best place to start is with what matters to you, what fits your life and what a qualified healthcare professional can help you use safely.

First: what do you want contraception to do?

For many people, contraception is about preventing pregnancy. You might also want a method that makes periods lighter or less painful, doesn't involve hormones, or doesn't require you to remember something every day.

It's worth knowing one important distinction:

Condoms help protect against both pregnancy and sexually transmitted infections (STIs). Most other contraceptive methods prevent pregnancy but don't protect you from STIs. You may decide to use condoms alongside another method for extra protection.

If pregnancy isn't possible from the sexual activity you're having, you may not need contraception for pregnancy prevention, but STI protection and testing can still be relevant.

What are the main options?

Here's a plain-English introduction. It isn't a complete medical guide, but it should help you work out what you'd like to ask about.

Condoms

External condoms are worn on the penis. Internal condoms are placed inside the vagina.

You use them when you have sex.
They're hormone-free.
They're the main contraceptive option that also helps protect against STIs.
They need to be used correctly every time.

Check the packet is in date, open it carefully and use a new condom for each act of sex. With latex condoms, use water-based or silicone-based lubricant rather than oil-based products, which can damage latex.

The pill

There are two main types:

Combined pill: contains oestrogen and progestogen.
Progestogen-only pill: often called the mini pill.

Depending on the type, the pill may need to be taken at a particular time each day. Some people like having control over a method they can start or stop with professional advice; others find remembering a daily pill difficult.

The pill isn't suitable for everyone. Your medical history, other medicines and personal preferences matter, so speak to a clinician or pharmacist about which options are appropriate for you.

The implant

A small flexible rod is placed under the skin of your upper arm by a trained healthcare professional. It releases a hormone and provides long-acting contraception.

You don't have to remember a daily pill or do something every time you have sex. Changes to bleeding patterns are common, so ask what you might expect and what support is available if side effects bother you.

The injection

A healthcare professional gives you a contraceptive injection at regular intervals. It can suit people who don't want to take a daily pill, but you need to keep track of when your next injection is due.

Ask about possible side effects and how quickly fertility may return after stopping it, as this can vary.

The coil: IUD or IUS

These are small devices placed inside the womb by a trained healthcare professional.

IUD (copper coil): doesn't contain hormones and can also be used as emergency contraception.
IUS (hormonal coil): releases a progestogen hormone.

Both are long-acting methods. They can be removed by a trained professional if you decide you want to stop using them or try to get pregnant.

The patch and vaginal ring

The contraceptive patch is worn on the skin and changed on a schedule. The vaginal ring is placed in the vagina and replaced according to its instructions.

Both release hormones. They can be alternatives for people who don't want to take a pill every day, but they aren't suitable for everyone.

Other methods

Other options include diaphragms or caps used with spermicide, fertility-awareness methods, and permanent contraception such as vasectomy or female sterilisation. These methods differ in how they work and how reliably they prevent pregnancy in everyday use.

Withdrawal (pulling out) is not considered a reliable way to prevent pregnancy. If avoiding pregnancy is important to you, discuss more effective options with a healthcare professional.

How effective are the different methods?

Some methods are more forgiving if you forget or are busy. Others depend more on using them correctly each time or remembering them on schedule.

The NHS publishes effectiveness estimates for different methods, including the difference between typical use and perfect use. Typical use reflects real life, where people may miss a pill or use a condom incorrectly or inconsistently.

Long-acting methods such as the implant and both types of coil are over 99% effective at preventing pregnancy. The pill, patch and vaginal ring are around 91% effective with typical use, while external condoms are around 82% effective with typical use. These figures describe pregnancy prevention over a year, not the risk from one sexual encounter.

No method is 100% effective, and the right choice isn't just about the numbers. A method that suits your routine and that you're comfortable using matters too.

For the latest figures, see the NHS guide to how well contraception works.

What about side effects and hormones?

It's reasonable to ask about side effects before choosing a method.

Hormonal contraception can affect people differently. Some experience changes to their bleeding pattern, headaches, breast tenderness, mood or skin. Some methods can help with period symptoms; others may cause side effects that make someone want to change methods.

Non-hormonal options are available, including condoms and the copper IUD. They have their own practical considerations and possible side effects.

You don't have to put up with side effects that are affecting your life without asking for help. A clinician can discuss what might be related to your method, what else could be going on and whether another option would suit you better.

Don't stop or change a prescribed method without understanding what you need to do to stay protected. If you want to switch, ask how to make the change safely and whether you need condoms or another method during the transition.

How do I choose?

You might find it useful to think about these questions before an appointment:

Do I want a method that's hormone-free?
Would I prefer something I use only when I have sex, something I take regularly, or something long-acting?
How would I feel about changes to my periods?
Is remembering a daily pill realistic for me?
Do I want contraception that I can control myself, or am I comfortable having a clinician fit or give it?
Am I taking any medicines or managing any health conditions that could affect my options?
Do I need protection against STIs as well as pregnancy?
Is there anything about a method that worries me?

You don't need to have all the answers. The point is to start a conversation, not pass a test.

Where can I get contraception?

In the UK, many contraception services are available free and confidentially through the NHS. What is available and how you access it can vary by nation and local area.

You may be able to get advice or contraception from:

an NHS sexual health or contraception clinic
your GP surgery
a pharmacy offering contraceptive services
a young people's sexual health service
a specialist service recommended by your healthcare professional

Some pharmacies in England can provide certain contraceptive pills without a prescription following a consultation. Availability and eligibility vary, so check with the pharmacy.

Start here: NHS — where to get contraception.

If you're studying at university, your student health service or students' union may also be able to point you towards local services. You don't have to use a university service if you'd rather not.

Will it be confidential?

NHS contraception services are confidential, including for young people. There are limited safeguarding circumstances where a professional may need to share information to protect you or someone else from harm.

If confidentiality is worrying you, ask the service how it works before you share anything you're unsure about.

You deserve clear information and respectful care, without being judged for asking questions.

What if I've already had sex and I'm worried?

If you've had sex without contraception, a condom split or slipped, or you think your usual method may have failed, you may need emergency contraception.

Don't wait for your next routine appointment if time may matter. Emergency contraception works best when accessed as soon as possible. Depending on the method, it needs to be used within three to five days after sex. A copper IUD is the most effective emergency contraception and may be suitable for some people; emergency contraceptive pills are also available.

Contact a pharmacist, sexual health clinic or GP service promptly for advice on the options and what is suitable for you. Read the NHS emergency contraception guidance.

If there may also have been STI exposure, remember that emergency contraception does not protect against STIs. A sexual health service can advise about testing and any time-sensitive care you may need.

A few things worth remembering

You can ask questions before choosing a method.
You can change methods if the first one doesn't suit you.
Condoms help protect against STIs; most other contraceptives don't.
The most effective method on paper isn't automatically the best fit for your life.
You don't have to make the decision alone. A clinician or pharmacist can help you weigh up your options.

You don't need to know the name of a particular method before asking for help. You can simply say:

"I'm looking for contraception, but I'm not sure what's right for me. Can someone talk me through the options?"

That's a perfectly good place to start.

Where to find reliable information

Where Can Students Get Free Sexual Health Advice?
STI Testing: What Actually Happens?
Emergency Contraception: What Should I Do?
Talking to a New Partner About Sexual Health?
What Is Consent?

This article provides general information and is not a substitute for individual medical advice. Contraceptive suitability, availability and access arrangements can vary across the UK. Speak with a qualified healthcare professional or pharmacist about your circumstances, medical history and any medicines you take. If you may need emergency contraception, seek advice as soon as possible.