Contraception

Emergency Contraception

If you have had unprotected sex and may be at risk of unwanted pregnancy please ask for help within 72 hours. Ideally as soon as possible.

Emergency contraception prevents conception after sex without causing an abortion. This can be done by taking tablets or by fitting an intrauterine contraceptive device (coil). There are two types of tablet available. The most recent advance is Levonelle which is the safest, easiest to use and remarkably free of side effects. You can only use tablets if you take them within 72 hours of unprotected sex and you have not any other episodes of unprotected sex since your last period. Occasionally, it may be more appropriate to offer to fit an intrauterine contraceptive device (coil) and if so, this will be discussed with you.

Like all consultations, requests for emergency contraception are completely confidential. Please never be put off consulting if you are told that your doctor is fully booked. A polite but insistent request for a same day appointment with our practice sister or doctor is all that is required.

Local chemists can also provide free emergency contraception for under 25 year olds.

To find other local services try www.ruthinking.co.uk or NHSDirect on 0845-4647

Following treatment we would like to see you again to discuss ongoing contraceptive care or if you have any worries after taking emergency contraception.

Condoms

Many people use condoms: very few have ever read the instructions! Used correctly they are a very effective contraception and are much less likely to fall off or break. If this happens, you need emergency help, with 72 hours (see Emergency Contraception). They provide good protection against sexually transmitted diseases such as herpes. warts and AIDs. 

It is possible to learn your monthly cycle and to predict which bit of the month you are fertile and which bit you are not. If you have a regular cycle you can avoid intercourse or use condoms in the fertile bit and need no contraception for the rest of the month. This method (The rhythm method) requires practice and understanding of your body, but can be very effective.

Pills

Pills come in two main varieties, combined (oestrogen and progestogen) and mini (progestogen only)

Combined pills

The standard pill used by the majority of women. Taken as a pill a day for three week with a weeks gap, during which you will have a period. There are at least three varieties with several brands of each, so we can usually find a brand to suit you. As long as you do not forget to take them, pills are extremely effective in preventing pregnancy. They can also be used to control erratic periods and to treat period pains.

Every pill has a long list of possible side effects although the majority of people do not get any of them. Acne and weight gain are often predicted but it is usually possible to  avoid them by changing the type of pill.  All pills increase your risk of blood clots in the leg (deep vein thrombosis, DVT) and high blood pressure. Smoking with the pill increases these risks ten times. so stop smoking before worrying about the pill! These risks increase with age, so most people stop the pill in their forties (smokers by 35). There is no known limit to the number of years you can take the pill.

Yasmin is a new combined pill with a new progesterone that may be better for patients with severe bloating and/or acne.

Mini pills

Progestogen only pills. Taken every day without a break. Need to be taken at the same time ever day. These do not control your cycle as well as combined pills, but do not have the same risks either. No oestrogen means no risk of blood clots or blood pressure and no age restrictions.

Implanon

A progesterone implant that will lasts for three years. The implant is inserted under the skin of the upper arm under local anaesthetic, a procedure taking 2 – 3 minutes. It is extremely effective, and particularly good for those who cannot take the combined pill, or those who forget to take it  It is completely unobtrusive once fitted.

20% of women have no periods with Implanon, 25% have light periods, 30% have a normal cycle, but 25% have an erratic cycle, which can occasionally be a problem.
Fertility returns to normal immediately after is has been removed.

Drs Louden, Peckham and Rickard are happy to fit Implanon.

Mirena Coils

The Mirena coil is a small "T" shaped device which has progesterone incorporated in its make up. It is inserted into the womb without the need for anaesthetic. Its contraceptive effect lasts five years and takes periods away in more than half of users. It is extremely efficient at preventing pregnancy (as good as a sterilisation), but can also be used to help control heavy periods, after appropriate investigations have taken place.
Please note that a chlamydia swab must be taken prior to a coil fitting, to make sure you have no underlying infection present.

Drs Louden, Peckham and Rickard are happy to fit coils.

Depo-Provera.

Depo-Provera is a very effective and safe contraceptive injection that has been available for many years. Given as a muscle injection every three months, it provides very effective contraception and reduces or stops periods.

One potential side effect, which has been studied for a long time, is how Depo-Provera affects bones. Depo-Provera works by lowering levels of the female hormone, oestrogen. Low oestrogen levels can reduce bone mineral density. The effect seems to be greatest in the first 2-3 years of use of Depo-Provera, following which bone strength stabilises. There appears to be some recovery after Depo-Provera is stopped but it is not yet known whether recovery is complete and if this could increase the risk of osteoporosis in later life.

The latest advice, particularly for teenagers considering contraceptive options or already on Depo-Provera, is that it may reduce bone mineral density at a time it should still be increasing. Therefore, it is important to consider all other choices in contraception first, to see if another method may be more suitable for you. Talk about this with your doctor, or with Sister Robinson  in the Well Woman Clinic.