It is a subject that many girls have not yet studied at school, or about which many women are poorly and incompletely informed - or even incorrectly: contraceptive methods! And yet, it's such an important family planning topic that affects all aspects of our lives.

It's your right to know! And we are here from the desire to help you be as well informed as possible about the contraceptive methods that exist (because since the ancient and unique coitus interruptus, today there are dozens of other options) and the advantages and disadvantages of each, so that you can decide which is best for you and your partner. That being said, we have a lot to talk about today - so let's get started!

What is the most effective contraceptive method?

The best… We are all looking for the best solution to problem x, y and z. But when it comes to a woman's body, each of us is different. You are unique, so is your body, and so are your preferences. Moreover, when we talk about sex life, things become even more particular: each relationship is unique, as are each partner and his preferences.

Under these conditions, therefore, we are not talking about a "best" universal contraceptive method because there is not the same "best" for everyone. We're talking about what's best, convenient, handy and efficient for you. We recommend that you talk to your gynecologist and your partner, and that way you will be able to decide which is the most suitable contraceptive method for you and your partner.

Types of contraceptive methods

Perhaps the oldest method of contraception that we know from the time of ancient civilizations is coitus interruptus. The withdrawal method has been used for many years to reduce the chances of an unwanted pregnancy - but we have become increasingly aware of its vulnerabilities over time. The fact that it is not 100% efficient. The fact that it does not provide protection against sexually transmitted diseases.

Later, in an attempt to come up with more and more effective solutions, people began to use other methods. Condoms made from materials of animal origin, silks or plants. Spermicides made with salt, honey or acacia. And many more. Needless to say, many of them weren't very friendly to vaginal pH, nor were they always successful.

Fortunately, medicine has advanced tremendously. So did the research. And nowadays, there are many, many different methods of contraception, so you can choose the one that is most suitable for you and your partner. Depending on the role of the method, the duration for which it is effective, price, accessibility, how easy it is to use and which of the partners uses it, there is an option suitable for every couple who do not want a pregnancy.

Below we tell you what they are, and more useful information about each of them (including why you might or might not want to use them):

Barrier contraceptives

You can probably already tell from their name how they work: barrier contraceptive methods are those that prevent pregnancy because they prevent the access of seminal fluid and spermatozoa to the vagina - as a barrier between them.

Because they do not act hormonally or long-term, barrier contraceptives are also characterized by the fact that they must be used every time you have sex in order for them to work. Even a single sexual intercourse without the use of a barrier contraceptive can result in a pregnancy, because it means that the barrier was no longer there to stop the sperm from reaching the vaginal canal.

However, barrier contraceptive methods have the advantage of being affordable and fairly easy to use, and most of them can be used without medical assistance. Here are the options:

The male or female condom

The condom is the only dual-role method of contraception that provides both protection against unwanted pregnancy and the transmission of sexually transmitted diseases or infections.

This is because it does not allow the female sexual organs to come into contact with the male ones at all: the male condom is like a thin cap that covers the penis before penetration, and the female condom is like a ring that is inserted inside the vagina before penetration. Both provide a protective layer that prevents direct intimate contact and thus protects the sexual health of both partners.

Condoms can be made of latex or non-latex, are thin and elastic, have very affordable prices and are used directly by partners right before sexual intercourse, without medical intervention. Used correctly every time, they are 98% effective against an unwanted pregnancy.

Diaphragm

The diaphragm is a device that is inserted into the vagina to cover the cervix, so that it acts as a barrier that prevents sperm from reaching the uterus. It should be inserted 6 hours before sexual intercourse, and left there for another 6-8 hours after contact, not exceeding 24 hours.

There is no need for a gynecologist to do this procedure every time, you can insert the diaphragm yourself. But you will need a gynecological consultation before you use it for the first time, because the doctor will help you choose the right size for you and show you how to insert and remove it correctly.

The main disadvantage of the diaphragm is that it can increase the risk of vaginal irritations and infections, as well as toxic shock syndrome or allergic reactions if you leave it in for more than 24 hours. It also has a higher price compared to the condom. But it only needs to be replaced every 1-2 years, so in the long run it can be even less expensive.

Vaginal cover

Also known as a cervical cap, or cervical cap, the vaginal cap is another barrier method made of soft silicone that covers your cervix and thus blocks sperm from entering the uterus and fallopian tubes. Basically, it is very similar to diaphragm, with small differences:

• The vaginal cover is usually smaller than the diaphragm.
• The diaphragm is cup-shaped, the vaginal cap is hat-shaped.
• You can wear the diaphragm for a maximum of 24-30 hours, while the vaginal cap can remain in the vagina for up to 2-3 days.
• According to statistics, the vaginal cap has an efficiency of 71-86%, while the diaphragm has an efficiency of 83%.

Otherwise, things are, as I said, quite similar to the diaphragm. The vaginal cap must be filled with spermicide before use, and the right size for you must be determined together with your gynecologist. The doctor will also explain the correct way of use.

The contraceptive sponge

Another method used since ancient times, but which has been modernized for greater efficiency, is that of the contraceptive sponge. It's pretty intuitive how to use from the name: a round sponge with a soft texture, which is soaked in spermicide and inserted into the vagina before intercourse.

For it to work, you need to leave it in your vagina for at least 6 hours after intercourse. But at the same time, you must be very careful not to leave it there for more than 24 hours, because allergic reactions, irritations or even toxic shock syndrome can occur, due to the changes it could cause in the flora vaginal.

The efficiency of the correctly used contraceptive sponge is 76-88%. On the one hand, it is inserted up to the level of the cervix and constitutes a barrier between the spermatozoa and the uterus. And on the other hand, it slows down or destroys sperm due to its spermicide content.

The spermicides

The last contraceptive method in this category is the one that I have already mentioned several times so far, because it is used together with the diaphragm, the vaginal cover, and the contraceptive sponge. Spermicide is actually a substance in the form of a spray, cream, gel or ova , which kills spermatozoa.

Be careful, though: spermicides are made to be used in conjunction with one of the barrier contraceptive methods we talked about above, so as to increase their effectiveness as much as possible. Used as the only method of contraception, without any other tool, it has a reduced efficiency of only 60-80%.

The spermicide is inserted into the vaginal canal one hour before intercourse and must be left there for at least 6-8 hours afterwards, during which time the chemicals can destroy the sperm. The disadvantage of this method is that it can cause allergic reactions and irritation.

Hormonal contraceptives

Barrier methods act locally, just like a barrier, which is why they usually do not cause hormonal reactions or major changes in the body - they are non-invasive. In contrast, when we talk about hormonal contraceptives, they act directly on hormones to prevent pregnancy.

In other words, in order to get pregnant, there must be ovulation. So to inhibit this natural biological function and avoid a pregnancy, hormonal contraceptive methods introduce hormones into the body that:

• or prevents ovulation;
• either it causes thickening of the cervical mucus which in turn prevents the access of spermatozoa to the uterus;
• or causes thinning of the uterine lining, which does not allow fertilization of the fertilized egg;
• or have two or all three of the above effects.

So when we talk about hormonal contraceptives, we are talking about introducing substances into the body that act directly on your hormones.

And since hormonal balance is extremely important for all body functions, this aspect must be approached carefully, only by a specialist. That is why it is not recommended to use a contraceptive method "by the ear": even if it is effective for your friends, it may not be the most suitable for you. A hormonal contraceptive method is chosen only together with the gynecologist, and is used regularly according to his recommendations.

Although birth control pills are the most well-known method of hormonal contraception, they are not the only one. There are many hormonal contraceptives, in different forms, and each of them is used differently. If oral contraceptives must be taken every day to work, there are other methods such as contraceptive injections or implants, which are done once every 2-3 months, respectively up to 3 years. See below what they are and how they can protect you from an unwanted pregnancy.

Oral contraceptives (contraception)

You've certainly heard of oral contraceptives - as we've already said, birth control pills are among the most common forms of hormonal contraception. They are affordable pills and easy to administer (you just have to swallow them), and if they are used correctly (ie you don't forget to take the pill one day, you don't forget to buy a new foil from the pharmacy, etc.) they are effective increased by 93%.

In turn, contraceptives differ according to the substances they contain. So depending on your state of health, the doctor may recommend:

• The combined pill (or combined pill): contains synthetic estrogen and progesterone that prevent ovulation (ie prevent the ovaries from releasing an egg), cause the cervical mucus to thicken (to block sperm from entering the uterus) and thin the uterine lining (so that it does not a fertilized egg can be implanted). All these effects of the combined pill result in preventing a possible pregnancy, but also possible side effects (headaches and stomachaches, mood swings, breast tenderness, high blood pressure and thrombosis). To work effectively, this type of contraceptive must be taken for 21 days, every day, as much as possible at the same time so that you get used to them and do not skip a dose.
• The monohormonal pill (mini-pill): contains not two, but one synthetic hormone - progestin - in small doses (hence the name "mini-"), which also reduces the risk of thrombosis as an adverse effect. Otherwise, the monohormonal pill works identically to the combined pill, and can reduce bleeding and menstrual pain. The side effects are also similar, namely spotting outside periods, breast tenderness, headaches or nausea. It has the advantage of lowering the risk of pelvic inflammatory disease and ovarian/endometrial cancer.

In addition to their role in protecting you from pregnancy, oral contraceptives can also be recommended for regulating the menstrual cycle, reducing menstrual cramps, or in the treatment of endometriosis and premenstrual syndrome. I talked more about these in another blog article, where I told about everything you need to know about birth control pills .

Contraceptive injections

One of the most effective contraceptive methods, the contraceptive injection prevents pregnancy in 96% of cases, and has the advantage that it is not administered daily and that it is confidential. You only need to repeat it once every 3 months (that's 4 injections per year), and you are protected from pregnancy without having to do anything else. The gynecologist is the one who will give you this injection, intramuscularly.

The hormone that enters your body through the contraceptive injection is progesterone, but there are also combinations of progesterone and estrogen.

These hormones act in a similar way to the birth control pill: on the lining of the cervix, causing it to thicken and become very viscous, so that sperm can't pass through to the uterus. At the same time, the uterine lining is thinned so that implantation does not take place even if the fertilized egg reaches the uterus. Ovulation also no longer occurs as a result of injecting synthetic hormones.

Side effects such as irregular bleeding, headaches and breast tenderness, mood swings and osteoporosis may occur if taken long-term.

Subdermal contraceptive implants

A contraceptive method that has become increasingly popular in recent years is the subdermal contraceptive implant, whose main advantage - besides the fact that only you know about its existence - is that it can stay there for up to 5 years. In addition, like the intrauterine device, it has an extremely high efficiency, preventing pregnancy in 99% of cases.

This means that for up to 5 years after implantation, you no longer have to worry about an unwanted pregnancy. It is a very suitable option for women who are sure that they do not want to get pregnant in the near future.

The subdermal contraceptive implant is done only by the gynecologist, with local anesthesia. It is shaped like a small rod made of a soft and flexible plastic that contains a synthetic hormone similar to natural progesterone. The implant is inserted in the arm, under the skin, and for the next 3-5 years it will constantly and slowly release the active substance into the body.

Like other progestin-based hormonal contraceptives, the subdermal implant acts on ovulation (by preventing this function) and on the lining of the cervix and uterus. And the possible side effects are the same, namely headaches and breast tenderness. There is also the possibility of irregular menstrual cycle and the risk of local scarring that makes it difficult to extract the implant after 5 years.

The contraceptive patch

The contraceptive patch, which contains estrogen and progesterone, is 93% effective in preventing pregnancy and works almost the same as oral contraceptive pills. The difference is that you don't have to take pills every day, you just stick the patch on your lower abdomen or thigh (not on your breasts!) for 3 weeks a month (must be replaced every week). In the fourth week, the patch no longer sticks to the body and menstruation occurs.

In addition to the side effects common to all hormonal contraceptives already discussed above, the patch also comes with the risk of skin irritation and blood clot formation, stroke and heart attack in people over the age of 35 and who are smokers.

Vaginal ring

The vaginal ring is also worn for 3 weeks a month, which is actually used and acts very similar to the contraceptive patch, having a 93% efficiency in preventing pregnancy. Once a month it is removed for a week to allow menstruation to occur after 1-2 days, after which a new ring will be inserted for another 3 weeks of pregnancy protection.

As you can already tell from the name, it is a device in the form of a small ring, made of a flexible and transparent plastic, which is inserted into the vagina. As I said, it acts similar to patches because it contains the same active substances, estrogen and progesterone, which are released slowly and gradually over the 3 weeks of use and prevent ovulation, the access of spermatozoa to the uterus and the implantation of the fertilized egg.

The side effects are also identical to those of contraceptive patches.

Intrauterine device

With similar advantages to the subcutaneous contraceptive implant, the intrauterine device (which you most likely know as the IUD) is 99% effective for 3 to 12 years. It's an equally confidential intervention (only you know it's there!) that prevents fertilized eggs from attaching and prevents pregnancy without the need to use any other method of contraception.

The elements by which they differ from the contraceptive patch are the appearance, location and active substance. So here's what the IUD looks like, where it's inserted and how it works:

• The IUD is a small, T-shaped device.
• It is made of a soft and flexible plastic.
• It is inserted and removed only by the gynecologist, at the level of the uterus.
• There are two types of IUDs, depending on the substance it contains: progestin or copper.
• The intrauterine device with progestin can be used for up to 3-6 years and prevents pregnancy in the same way as other hormonal contraceptives (leads to lack of ovulation and thickening of the lining of the cervix to block the access of sperm)
• The copper IUD can be used for up to 10-12 years to prevent pregnancy, as it has a small amount of copper wrapped around it that prevents a fertilized egg from implanting in the uterus.

Although it is very effective in preventing pregnancy, it can have side effects such as irregular menstrual cycles, amenorrhea or bleeding outside of periods, and it can also promote the occurrence of pelvic infections and inflammations.

For this reason, this form of contraception is generally recommended for women who have already become mothers and do not plan to become pregnant again. It is not a permanent contraceptive method, but because of the risk of infertility it is not recommended for people who have not yet had children.

Emergency contraception

Before we talk about this type of unwanted pregnancy prevention, it is very important to emphasize one thing: the emergency contraception method is used as an emergency, that is, only when the used contraception method has failed (for example, if the condom has broken) or if had sexual contact without using any other contraceptive method (for example, in the case of an unexpected, unplanned sexual act, for which you and your partner have not prepared another method).

But under no circumstances should emergency contraception be used daily or regularly, like normal barrier or hormonal contraception. And that's because it has a high content of hormones, which if administered regularly could lead to hormonal imbalances and health problems based on them. Whereas a barrier method or a hormonal method of contraception either does not contain hormones, or introduces small amounts into the body, with a slow and controlled release, so that it does not cause major disturbances.

Once we've established how important it is not to over-rely on emergency contraception because it can be dangerous to your health, here are the options available:

• The morning-after pill: It is the most popular emergency contraceptive method, and it is easy to use. You can get it from the pharmacy without a prescription, and it prevents ovulation due to higher amounts of estrogen and progesterone compared to contraceptives. To effectively prevent pregnancy, the morning-after pill should be taken no later than 12-72 hours after unprotected sexual intercourse. The sooner you take it, in the first 24 hours, the more effective it will be. It is recommended not to use this method more than twice a year (once every 6 months). One more thing to keep in mind here, even if you took the morning after pill you will need to continue to protect yourself with some form of contraception with each subsequent intercourse to prevent pregnancy. The morning-after pill does not prevent pregnancies that may result from sexual contact that occurs after administration!
• The copper intrauterine device: I talked about it above, and it can also be used as an emergency contraceptive method if it is inserted no later than 5 days (ie 120 hours) after unprotected sex. As I said above, its effectiveness in preventing pregnancy is 99%, and the advantage is that after its introduction you are still protected for up to 10-12 years, without having to use any other contraceptive method.

Definitive contraception

The last category of medically effective contraceptive methods we are talking about is the definitive one, that is, the methods by which you make sure that no more sexual contact will be able to result in pregnancy.

Both women and men can opt for a permanent method of contraception if they are sure that they do not want to become parents and will not want to do so in the future. Both procedures result in the impossibility of sperm reaching the uterus, and their efficiency is 99.9%.

There are methods that are performed only by the specialist doctor, through surgical intervention, which are not always reversible. Or, even if they are, it does not guarantee that it will be possible to successfully conceive a child.

Therefore, it is a decision whose consequences are long-term, possibly permanent, and therefore must be taken after informing yourself, thinking carefully, and after open discussions with your partner and gynecologist.

Vasectomy

Vasectomy consists in interrupting the channels that start from the testicles and through which the sperm is ejaculated, which results in the inability of the sperm to reach the penis. So that when an ejaculation occurs, spermatozoa will no longer be able to be eliminated in the vagina and therefore the egg will no longer be fertilized.

The procedure takes place surgically, is carried out by the urologist and begins to work after a period of 3 months. In the meantime, it is recommended to use another "backup" contraceptive method in parallel, until the result of the spermogram indicates the complete absence of spermatozoa.

Recovery from a vasectomy can take up to 7 days.

Tubal ligation

And women can choose a definitive contraceptive method, by tying (ligating) the fallopian tubes. Naturally, the egg and sperm meet in the fallopian tubes to produce fertilization and pregnancy. Thus, following the sectioning and ligation of the tubes, this process can no longer take place, so the occurrence of a pregnancy becomes impossible.

The procedure is performed by the gynecologist, and today the medical equipment is advanced so that the operation is minimally invasive, through a small incision at the navel level (laparoscopic). The main risk after this procedure is that of an ectopic pregnancy, when the pregnancy develops in the fallopian tubes, but it is a very low risk.

Recovery time after tubal ligation can take up to 2 weeks.

Natural methods

I was talking about the category of permanent contraception as being the last medically effective category that we are talking about in this article. Because we are going to tackle one more, but which has a major disadvantage: that of ambiguity, and the fact that the chances of failure are very high due to incorrect planning/calculation.

They are natural methods, used to prevent pregnancy since ancient times, when so many contraceptive methods with almost 100% efficiency did not yet exist or were not known. However, they are also a better option than nothing (that is, than not using any other method), so let's also see what natural methods of contraception are.

Withdrawal method

Also known as coitus interruptus , the withdrawal method has been used since Antiquity, and requires that during unprotected sexual intercourse, the partner stops penetration and withdraws the penis from the vagina before ejaculating. Theoretically, without ejaculation and without the sperm reaching the vagina, they will not be able to reach the cervix and fertilize an egg.

Practically, however, there are many risks with this method. The most known reasons why the withdrawal method can fail are:

• Lack of reaction speed: if the partner does not have very good self-control and does not withdraw in time, there is a risk of ejaculation in the vagina.
• Inappropriate choice of the place of ejaculation: even if the partner withdraws in time, if he ejaculates near the vulva/vagina (for example on the partner's thighs or abdomen), the spermatozoa can reach the vagina very quickly and easily.
• Sperm content of pre-ejaculatory fluid: Even without ejaculation, pre-ejaculatory fluid may contain sperm and lead to an unwanted pregnancy following penetration.

The calendar method

The calendar method involves planning unprotected sexual contact only during the infertile periods of the menstrual cycle. So you're supposed to know very accurately when your fertile period is, when you ovulate, and what your infertile window is each month, based on signs like your body temperature and the texture of your vaginal secretions.

Which is very difficult, especially for people who have an irregular menstrual cycle, but also quite stressful because you have to keep a daily record of secretions and body temperature. That is why the inaccuracy of these records can be very high, resulting in the failure of the calendar method in 20-25% of cases for inexperienced couples. If you still want to read more about this method, I explained everything in detail HERE .

Frequently asked questions about contraceptive methods

We've tried to give you as much information as possible about each contraceptive method throughout the article, but we're sure there are still unanswered questions. So in this section we also want to answer the most frequently asked questions about contraceptive methods.

Where can I get contraceptives?

In principle, all types of contraceptives can be found at the pharmacy, but there are exceptions. It is very important to know which contraceptive methods you can buy in other places, and which must be taken only with a medical prescription and only from a pharmacy.

For example, you can also find condoms at the supermarket, sex shop or other stores, and you can use them calmly because they are not invasive. Conversely, although there are contraceptive pills from other sources, it is recommended to buy them only from the pharmacy and only on the recommendation of the gynecologist. Because they involve the introduction of a quantity of hormones into the body, and an incorrect administration in doses or with unsuitable active substances can cause hormonal imbalances and serious health problems. So, it is best to seek the advice of the specialist doctor.

Which contraceptive method is right for me?

There is no identical answer for every woman. Every body, every relationship and every woman is different. The right contraceptive method for you differs depending on how often you want to use it, which partner wants to use it, whether or not you want to have children later, and many other characteristics. It is best to choose a contraceptive method together with your gynecologist, who will help you make the best decision based on your medical history, needs and future plans.

How to use contraceptive methods after childbirth?

Theoretically, after birth, during breastfeeding, prolactin prevents ovulation and therefore menstruation can occur even a year postpartum. However, you should keep in mind that breastfeeding for prolactin secretion is not an effective contraceptive method and ovulation may occur, leading to a new pregnancy. So it's best to ask your doctor for a recommendation, and he or she will walk you through your birth control options.

Can I use contraceptive methods if I am breastfeeding?

Yes, you can also use hormonal contraceptive methods during breastfeeding, without them affecting your baby. The subcutaneous contraceptive implant, the contraceptive injection, the mini-pill, and the IUD are some methods that can be safely used after childbirth. But always talk to your gynecologist to see what's okay and what's not for you.

What risks am I exposed to if I use contraceptive methods?

The biggest risk with all methods of contraception except the condom is that of contacting sexually transmitted diseases. Apart from the condom (female or male), no other contraceptive method protects you from HIV, genital herpes, Gonorrhea, Chlamydia or other sexually transmitted infections. You also expose yourself to the risk of side effects related to the method of contraception used, starting from headaches, migraines, sensitivity and mood swings, to other diseases such as thrombosis, osteoporosis or infertility (rarely).

Do contraceptives also treat period pain?

Some yes, some no. Hormonal contraceptives such as oral contraceptives, for example, are often recommended to relieve cramps in case of very painful periods (including in the treatment of endometriosis). If you have severe pain during your period, tell your gynecologist so that he can do more investigations and find a suitable solution.