Choosing contraception: the main options

Contraception is any method used to lower the chance of pregnancy during sex. Methods work in different ways: some stop ovulation, some block sperm from reaching an egg, and some change the conditions inside the uterus. Most methods do not protect against sexually transmitted infections, which is why condoms are often used alongside another method.

There is no single best method. The right choice depends on health, preferences, how much day-to-day effort someone wants, whether they want hormones, and their plans for pregnancy in the future. Contraceptive counselling with a clinician, nurse or pharmacist is designed to talk through exactly these questions.

Barrier methods physically stop sperm from reaching an egg. The condom, worn on the penis, and the internal condom, placed inside the body, are the only methods that also reduce the risk of many STIs. People with a latex allergy can choose condoms made from other materials.

The diaphragm, cervical cap and contraceptive sponge cover or sit near the cervix and are usually used with spermicide. They are less widely available than they once were and depend on being used correctly every time, so they suit people who are comfortable planning ahead.

Hormonal contraception uses synthetic versions of estrogen and progesterone, or a progestogen alone. The combined pill contains both and is usually taken with a regular break or a run of inactive tablets. The progestogen-only pill is taken every day without a break. The contraceptive patch and the vaginal ring deliver similar hormones without a daily tablet.

Short-acting methods depend on remembering them. A missed pill can lower protection, and the rules for what to do vary by pill type, so it helps to keep the leaflet or ask a pharmacist. Light breakthrough bleeding is common in the first months and often settles.

Long-acting reversible contraception, or LARC, includes the contraceptive implant and both kinds of IUD: the hormonal IUD and the copper IUD, which contains no hormones. Once in place they work for years without daily effort and can be removed whenever someone wants. The contraceptive injection sits in between, lasting several weeks per dose.

Sterilisation is intended to be permanent. A vasectomy blocks or seals the tubes that carry sperm, and tubal ligation blocks, seals or removes the fallopian tubes. Because reversal is not reliable, these are choices for people who are sure they do not want a pregnancy in future.

When comparing methods, look at typical use rather than perfect use. Perfect use describes a method used exactly as directed every time; typical use includes real-life slips such as late pills or a condom put on too late. Methods that do not rely on daily action, such as LARC, show the smallest gap between the two. Researchers also use the Pearl Index to compare failure rates.

Methods based on behaviour, such as fertility awareness or the withdrawal method, can work for some people but are much more sensitive to timing and mistakes. Abstinence, choosing not to have sex for a time, is also a choice some people make.

If a condom breaks, a pill is missed or no method was used, emergency contraception can reduce the chance of pregnancy. Options include the emergency contraceptive pill and the copper IUD. They work best the sooner they are used, so it is worth acting quickly and asking a pharmacist, clinic or doctor.

A pregnancy test can confirm whether a pregnancy has started. People who are pregnant and unsure what to do can talk through their options, including continuing the pregnancy or abortion, with a health professional. This guide is general information, not individual medical advice.