A jargon-free guide to contraception

First things first: contraception is a minefield. There are so many different methods out there - too many to cover in this one guide - and that’s even without mentioning all the accompanying (mis)information about side effects and efficacy rates.

This is a topic that’s been on my mind a lot recently. Having recently switched from the pill to the hormonal IUD, I’ve been unpleasantly shocked by the impact on my skin, but have very much welcomed getting fewer migraines.

The really annoying thing is, unless you’re one of the lucky few who find a method that works well right off the bat, birth control will likely be the topic of many late-night internet searches and despairing discussions with friends for a good few years yet. And don’t get me started on the difficulty of trying to secure a GP appointment to chat things through…

Bearing all this in mind, how do you know which birth control method is right for you?! We’ve teamed up with LloydsPharmacy Online Doctor to answer common contraception questions and set the record straight on some of the biggest misconceptions.

Hormonal vs non-hormonal?

When weighing up your contraception options, the first thing to figure out is whether you want a non-hormonal or hormonal method.

The latter works by mimicking the hormones found naturally in the female body to stop you from getting pregnant.

“These can influence things like your mood, sexual desire and menstrual cycle,” Dr Bhavini Shah, GP and Clinical Audit Lead at LloydsPharmacy Online Doctor, told The Know.

There are different types of hormonal contraception available. The combined pill, for example, contains both oestrogen and progestogen - but other methods, such as the mini-pill, patch, hormonal IUD (intrauterine device) or vaginal ring, are progestogen-only.

The most common non-hormonal methods include the copper coil (a non-hormonal IUD), diaphragms and condoms - and, without wanting to sound like a secondary school PSHE teacher, condoms are the only way to protect against STIs.

Hormonal contraception can cause side effects, such as “spotting, breast tenderness, headaches, nausea, bloating and mood swings”, said Dr Shah - which is why some women opt for non-hormonal methods.

But the pill, patch and hormonal IUD can be extremely effective at preventing pregnancy and can carry other benefits, such as helping with heavy periods (if this is something that concerns you, it’s definitely worth speaking to a healthcare professional).

And if you’re just looking to manage your period - for example, by delaying it when you go on holiday - birth control isn’t the only option available. Period delay tablets, which can be taken three days before your expected period, are a way of postponing your cycle for up to 17 days (if this is something you’re interested in, find out more here).

As there are *so* many methods of contraception out there, deciding which one to opt for is all about figuring out what matters most to you. LloydsPharmacy Online Doctor has a handy guide to the different types and their benefits and limitations.

Don’t let the past put you off

It’s also worth noting that if you’ve had a bad experience with a hormonal method in the past, it doesn’t mean that you’ll have a bad experience with every method.

For example, if you haven’t got on well with an oestrogen-containing combined pill, you could try switching to a low-dose pill that could reduce some side effects - or a progestogen-only one. Equally, you may prefer to opt for a more targeted hormonal method such as the vaginal ring.

This is something to chat through with a healthcare professional, for example via LloydsPharmacy Online Doctor, where NHS-experienced clinicians offer simple online consultations so you can receive the right treatment and advice.

Which method is the most popular?

A 2019 study by The Guardian found that the pill remains by far the most popular form of prescribed contraceptive among women in England, with nine in 10 women who receive contraception from their GP or pharmacies taking either the combined pill or “mini-pill”.

There are *so* many different types of pill to choose from and they can be filed under branded and generic names (for example, Microgynon and Rigevidon, which are two of the most commonly prescribed pills in the UK, are composed of the same hormones). Confused? This guide can help.

But popularity doesn’t mean it’s the best method for you. If you’re like me and can’t remember to take a pill regularly, a long-acting reversible contraceptive method (snappily known as LARC), could be the answer.

Or, perhaps you’re the sort of person who doesn’t want to think about your method of contraception at all. In this scenario, the copper coil or hormonal IUD (which gets replaced every five years at a minimum) might be the best bet. However, this option does mean going to a GP and a more invasive procedure, so it might not be your thing.

It really is a matter of preference - and again, chatting through concerns and preferences with a professional is always worthwhile.

Which method is the most effective?

When looking at efficacy rates, a lot of stats and figures get floated around. Generally, efficacy looks at whether a method is used “perfectly” or “typically” (i.e., missing a pill or getting the injection later than you should).

For example, the pill is more than 99% effective with perfect use (meaning fewer than one in 100 women would get pregnant a year when taking it correctly), but 91% effective with typical use. Other methods - such as the implant or IUD - have no user failure.

Interested in learning more? The NHS has this handy guide.

Will birth control make my skin better or worse?

This was something I was seriously keen to get to the bottom of before chatting with Dr Shah, given my own experience. Thankfully, I found the answer!

“Acne is caused by hair follicles in the skin becoming blocked with oil and dead skin cells - and the build-up of sebum is often caused by changing hormone levels. This is where the term hormonal acne comes from, with some women experiencing flare-ups before their period in particular,” explained Dr Shah.

The combined contraceptive pill is known to help hormonal acne for some women by balancing hormone levels - and this is what happened in my case. Certain types (such as Yasmin or its generic version Lucette) are prescribed specifically to treat acne. But on the other hand, the progestogen-only pill or contraceptive implant is thought to make acne worse.

If improving your skin is on your mind, this is something to factor in when discussing your options with a professional. It’s also worth noting that contraception is definitely not the be-all and end-all when it comes to treating acne - with other treatments including topical retinoids, topical antibiotics, azelaic acid and antibiotic tablets.

LloydsPharmacy Online Doctor also has a specific acne clinic if you’re looking for more specialised advice on this subject.

How long should I wait to see if a method is right for me?

“Ideally you should wait three months when trying a type of contraception to let any side effects or hormonal changes settle,” said Dr Shah.

It’s absolutely fine to try and test different methods of contraception - you shouldn’t settle for negative side effects!

However, you “have to be careful to switch correctly, so you can make sure you’re still protected from pregnancy,” added Dr Shah.

That’s why it’s worth speaking to a professional before you make any changes. If you can’t wait for a GP appointment - and we all know that feeling! - LloydsPharmacy’s online consultation offers same-day collection from a pharmacy or delivery to your house for max convenience. In London, next-day collection is available from more than 7,000 convenient locations.

What questions should I ask my healthcare provider to get the contraception that’s right for me?

It’s always helpful to go to a GP or other healthcare appointment armed with your medical history. For example, if you’re suffering from headaches and think it may be because of the pill you’re on, can you pinpoint when in your cycle they occur?

At the same time, your healthcare provider should ask you lots of questions, too. If you feel like you’re not being given the time you need to chat things through, a contraception-specific online consultation could be the answer.

We know firsthand how difficult it can be to advocate for yourself in a healthcare environment - but wanting to find the right birth control is entirely valid; you shouldn’t have to put up with side effects or suffer in silence! We hope that this guide - featuring expert advice from LloydsPharmacy Online Doctor - will help you feel that bit more confident when choosing the contraception that works for you.

LloydsPharmacy Online Doctor’s sponsorship of The Know is keeping news that’s conscious of your mental health free and available to all.