Contraception

Emergency Contraception

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.
If you have had unprotected sex and may be at risk of unwanted pregnancy please ask for help within 72 hours. Ideally it should be as soon as possible and within surgery hours.
Our practice nurses are able to arrange emergency contraception in tablet form. 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.

The 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. 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 people. Taken as a pill a day for three weeks with a weeks gap, during which you will have a period. There are at least three varieties with several brands of each, so there is usually one brand that suits everyone. 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 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. Do not control your cycle as well as combined pills, but do not have the risks either. No oestrogen means no risk of blood clots or blood pressure and no age restrictions.

Implanon

A progesterone implant that will last for 3 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.
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 3 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 there is no 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. New research about this effect has resulted in updated information and new guidance about using Depo-Provera. Depo-Provera works by lowering levels of the female hormone, oestrogen. Low oestrogen levels can reduce bone mineral density (BMD). 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.

If you are already using Depo-Provera, there is no need for you to discontinue it. If you are a teenager, it would be wise to come in to discuss alternatives. If you are over 20 years of age and have been using Depo-Provera for over 2 years, you should attend for routine review to consider if Depo-Provera is still the best contraceptive option for you.