#### What is it?

A vasectomy (male sterilisation) is a surgical procedure to cut or seal the tubes that carry a man's sperm to permanently prevent pregnancy. It is carried out under local anaesthetic, where you're awake but don't feel any pain, and takes about 15 minutes. A vasectomy is almost 100% effective against pregnancy. It should be noted that it is not effective against STDs. A couple of months after your vasectomy your doctor will do a semen analysis test to check for sperm. They will then tell you when there is no sperm in your semen and when your vasectomy is working.

#### How does it work?

The doctor makes one or two small cuts in the skin of your scrotum. Through these cuts, the tubes that carry sperm are blocked off. Sometimes, a tiny part of each tube is removed. The tubes may be tied, blocked with surgical clips, or closed with an electrical current. The whole thing takes about 20 minutes, and then the cut is stitched up. You may feel some discomfort or pain after your vasectomy. Icing your genitals can help ease any pain and you should not do any hard exercise or physical work for at least a week afterwards. Most people tend to recover a few days after their vasectomy and you can usually start to have sex a week after, but you should wait to get the greenlight from your doctor. It will take around three months after for your semen to become sperm free.

#### Pros :

-   They are effective 
-   They are convenient 
-   Can make your sex life better

#### Cons:

-   They are meant to be permanent. Even if you get it reversed there's no guarantee that your fertility may come back. 
-   Comes with some risks.  
-   Does not protect you against STDs

#### For more information and resources refer to:

Planned parenthood

<a href="https://www.plannedparenthood.org/learn/birth-control/vasectomy/how-do-i-get-vasectomy" class="freyjabutton">Read more</a>

NHS: 

<a href="https://www.nhs.uk/conditions/contraception/vasectomy-male-sterilisation/" class="freyjabutton">Read more</a>

Vasectomy 

#### What is it?

Female sterilisation is an operation to permanently prevent pregnancy. The fallopian tubes are blocked or sealed to prevent the eggs reaching the sperm and becoming fertilised.

#### How does it work?

Sterilization prevents eggs from travelling down your fallopian tubes. Therefore, eggs cannot meet the sperm and fertilization cannot occur. This is 99% effective at preventing pregnancy but does not prevent STDs.

#### What happens during the procedure?

There are different kinds of sterilization. With a tubal ligation, the doctor will either block or remove small sections of your fallopian tubes. With a bilateral salpingectomy, the doctor will remove your tubes completely. There are a few different ways to do sterilization procedures.

Laparoscopy: you will receive a local or general anesthetic. They then pump gas into your stomach and use a laparoscope to find your fallopian tubes. These are then closed off or removed completely through the laparoscope or a second cut. This procedure takes around 20-30 minutes.

Minilaparotomy: this procedure is usually done after childbirth. A small cut is made near the belly button (with anesthetic). The fallopian tubes are then brought up through the cut and a small section of the tubes is removed and your tubes are blocked with clips, or entirely removed. This procedure will take a couple of days to recover from.

#### Benefits of sterilization:

-   Sterilization is very effective 
-   It is convenient 
-   Does not change your hormones 
-   Can improve your sex life

#### Disadvantages of sterilization:

-   It is permanent 
-   Can have some health risks 
-   Can prevent STDs

For further information on female sterilization please refer to the following resources:

Planned Parenthood

<a href="https://www.plannedparenthood.org/learn/birth-control/sterilization" class="freyjabutton">Read more</a>

 Mayo Clinic
 
 <a href="https://www.mayoclinic.org/healthy-lifestyle/birth-control/basics/sterilization/hlv-20049454" class="freyjabutton">Read more</a>
 
  NHS 
	
	<a href="https://www.nhs.uk/conditions/contraception/female-sterilisation/" class="freyjabutton">Read more</a>

Female Sterilisation 

#### What is it?

Emergency contraception prevents pregnancy after you have had unprotected sex or if the contraception failed. Here are the two types of emergency contraception: the emergency contraceptive pill or the IUD/Coil. It should be noted that the emergency contraception is for emergencies, and should not be used as a form of consistent birth control as this can lead to health risks.

#### How does it work?

Emergency contraception must be taken within three days for Levonelle or 5 days of ellaOne after you have had unprotected sex. The IUD can be fitted up to five days after you have had unprotected sex. The emergency pill will not continue to protect you against pregnancy. If you have unprotected sex again you will need another pill. This is not a regular form of contraception. It's for emergencies.

#### When do you need to take it?

-   If you forgot to take your pill 
-   If a condom split 
-   If you didn't put your patch or ring incorrectly.

#### What are the side effects?

-   Headaches 
-   Stomach pain 
-   Changes in your period
-   Nausea (you'll need to get medical attention if you are sick within 2 hours of having taken the pill).

#### How does the IUD work in emergencies?

The IUD can be inserted up to 5 days after having unprotected sex. The IUD is the most effective method of emergency contraception. However, the IUD may not be suitable if you have an untreated STI, problems with your womb/cervix or unexplained bleeding.

#### What are the side effects of the IUD?

-   Infection 
-   Pain 
-   Womb damage 
-   IUD displacement 

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For further information and resources on emergency contraception please refer to the following: 

NHS

<a href="https://www.nhs.uk/conditions/contraception/emergency-contraception/" class="freyjabutton">Read more</a>

Planned Parenthood

<a href="https://www.plannedparenthood.org/learn/morning-after-pill-emergency-contraception" class="freyjabutton">Read more</a>

emergency-contraception

#### What is it?

The patch is a small patch that sticks on your skin, releasing hormones into your body. This in turn prevents pregnancy.

#### How does it work?

You place the patch on your skin and wear it for seven days. The patch can be placed on most areas of your body that are clean, dry, and not too hairy. Never put the patch on sore/irritated skin, any area that may get rubbed, or your breasts. After that, you remove the patch and replace it with a new one. You should do this for three weeks and then take a one-week break. If you start using the patch on the first day of your period, and up to and including the fifth day of your period, you'll be protected from pregnancy straight away. If the patch is placed on any other day then you should still be using condoms for the first seven days.

If you've forgotten to take the patch off then you need to remove it before it goes over two days, and place a new one on, and keep to your usual changing day. If you've exceeded t48 hours place a new patch on ASAP and use additional forms of contraception.

#### What happens if it comes off?

The patch is quite sticky, so it shouldn't fall off. Nevertheless, if the patch does fall off for less than 48 hours you should put a new patch on and change it on your normal day. But, if it's been off for more than 48 hours you should put a new patch on, change it on your normal day, and in your third week start a new patch cycle and miss your usual patch-free week. If you're worried you might be pregnant you may need emergency contraception.

#### Pros and cons of using the patch:

The great thing about the patch is that it is easy to use and it still works if you've been sick or have diarrhea. In addition, the patch can make your periods more regular and relieve some premenstrual symptoms. However, the patch is visible and can cause some skin irritation. It does not protect you against STDs and can cause some mood swings + irregular bleeding. You should not use the patch if you've previously had blood clots. Speak with your doctor or a health professional about any pros, cons, and side effects regarding the patch. 

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For more information on the patch please refer to the following: 

NHS

<a href="https://www.nhs.uk/conditions/contraception/contraceptive-patch/" class="freyjabutton">Read more</a>

Planned Parenthood

<a href="https://www.plannedparenthood.org/learn/birth-control/birth-control-patch" class="freyjabutton">Read more</a>

The Contraceptive Patch 

#### What is it?

Yup, it's true female condoms are a thing! The female condom is made of a soft, thin synthetic latex and is worn inside the vagina. In turn, this prevents semen from getting into the womb. A female condom needs to be placed inside the vagina before it makes contact with a penis.

#### How effective is it?

If you use a female condom correctly then it is 95% effective and also protects you against STDs.

#### How to use it:

You should put the female condom in your vagina before sex. Make sure that a penis does not come into contact with it beforehand. When you open the condom be careful not to tear it. You must squeeze the small ring at the closed end of the condom and place it into your vagina. Ensure that the large ring at the open end of the condom covers that area around the vagina. You can add a water-based lube for extra lubrication. When having sex make sure that the penis goes into the condom. After sex, you should gently pull the condom out. Try twisting the large ring to prevent semen from leaking out. 

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For further information on the female condom please refer to the following: 

NHS

<a href="https://www.nhs.uk/conditions/contraception/female-condoms/" class="freyjabutton">Read more</a>

Planed Parenthood

<a href="https://www.plannedparenthood.org/learn/birth-control/internal-condom" class="freyjabutton">Read more</a>

The Female Condom 

#### What is it?\
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The contraceptive injection releases the hormone progestogen into your bloodstream which then prevents pregnancy.

#### How Effective is it? 

‍

The contraceptive injection is more than 99% effective and lasts for 8 or 13 weeks. The duration depends on which injection you have. This is useful for people who find it difficult to remember to take the pill every day. However, it does require you to take a repeat injection before it expires or becomes ineffective. It should be noted that it does not protect you against STDs so you should still be using a condom. The injection can be taken at any time during your cycle (if you're not pregnant). If the injection is taken within the first 5 days of your period then you will be immediately protected against pregnancy. If you have the injection at another time during your cycle then it will take 7 days to become effective. 

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#### What are the risks?

When getting the injection there is a small risk that you may develop an infection or have an allergic reaction. The depo-Provera injection may lead to thinning of bones, however, this does not increase your risk of breaking a bone. Yet, once you stop the injection the bone replaces itself so does not seem to cause any long-term problem.\
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For further information on the injection please refer to the following:

NHS
<a href="https://www.nhs.uk/conditions/contraception/contraceptive-injection/" class="freyjabutton">Read more</a>

Planned Parenthood
<a href="https://www.plannedparenthood.org/learn/birth-control/birth-control-shot" class="freyjabutton">Read more</a>

The Contraceptive Injection 

#### What is it?

The implant is a long-term contraception solution. It is a flexible plastic rod that is placed under the skin of the upper arm. The implant releases a low, steady dose of a progestational hormone to thicken cervical mucus and thin the lining of the uterus. Contraceptive implants typically also suppress ovulation.

#### How does it work?

Once placed, it will steadily release the hormone progestogen into your bloodstream. In turn, this prevents the release of an egg every month. The implant should begin to work five days after you've fitted it.

#### How it is fitted?

The procedure takes around a minute or so. Bit the preparation takes longer. During the procedure, you will lie on your back. The doctor or nurse will locate a groove between the triceps and biceps on the side side of your upper arm. They then inject a local anesthetic and use an applicator to insert the drive beneath your skin. After the procedure, they may do an ultrasound or X-ray to ensure that the implant has been properly inserted. Then they will place a pressure bandage on you, that you keep on for about 24 hours. It is common that you may have some bruising and pain after the insertion. However, if you have severe side effects you should contact your doctor.

#### How is it removed?

The implant needs to be removed at the three-year mark. You can remove it prior to this too. For removal, they will inject a local anesthetic into your arm underneath the implant. Then they make an incision into your skin and will push the implant toward the incision until the tip is visible and can be taken out with forceps. This usually takes less than 10 minutes. If you wish you can insert a new device afterward.

#### How effective is it?

The implant is more than 99% effective. What's great about the implant is that you don't have to take anything or do anything for three years. Therefore, it can be a good fit for people who forget to take their pills. If you have side effects you can take the implant out.

#### Advantages and disadvantages of the implant:

The great thing about the implant is that it works for three years and is good if you cannot use oestrogen based contraception. Likewise, it is safe to use whilst breastfeeding and may reduce heavy periods or period pain. However, it can lead to side effects such as headaches, nausea, and mood swings. Your periods may become irregular or entirely stop. The implant can also lead to increased acne. 

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For further information on the implant please refer to the following: 

NHS
<a href="https://www.nhs.uk/conditions/contraception/contraceptive-implant/" class="freyjabutton">Read more</a>

Planned Parenthood

<a href="https://www.plannedparenthood.org/learn/birth-control/birth-control-implant-nexplanon" class="freyjabutton">Read more</a>

The Implant 

#### What is it?

The vaginal ring (also known as the NuvaRing) is a hormonal birth control device for people with vaginas. It is a flexible, latex-free plastic ring. This is inserted into the vagina. The ring contains the hormones estrogen and progesterone. These are released over three weeks. After three weeks you remove the ring and then insert a new ring after menstruation.

#### How does it work?

The ring steadily releases hormones into your bloodstream which then prevents the release of an egg. The ring also thickens the cervical mucus making it more challenging for sperm to enter the cervix. You should put the ring in, and remove it after 21 days for 7 days. Then after a 7-day break, you place a new ring in. Make sure to use additional forms of contraception for the first seven days of using the ring. In addition, the ring does not protect you against STD's so make sure that you are still using a condom when having sex.

#### How effective is it?

The ring is more than 99% effective. What's great about the ring is that it provides contraception for a month, so you don't have to worry about missing a pill. However, some women may have temporary side effects such as vaginal discharge, breast soreness, and headaches. Nevertheless, the ring may ease premenstrual symptoms.

#### How to put it in:

Before putting the ring in, always make sure that you have cleaned your hands. Then squeeze the ring between your thumb and fingers. Then you should insert the tip of the ring into your vagina and push it further up until it feels comfortable. The ring does not need to cover the cervix in order to be effective. You can always use your fingers to check that the ring is still in place.

#### How to remove the ring:

Once again, make sure that your hands are clean! Then place a finger (or two) into your vagina and slowly pull out the ring. Then throw out the ring. If you have any pain when removing the ring you should contact your doctor.

#### What happens if you forget to take it out?

If you've kept the ring longer than three weeks you should take it out and place a new one in a straightway. Make sure to use additional forms of contraception. If you had sex with an expired ring then you may need the emergency pill, so speak to a pharmacist or doctor for advice.

#### What happens if the ring comes out?

Your ring may come out on its own during sex or if it was not put in properly. If the ring was out for less than 48 hours and you've used it for less than three weeks, you should wash it and re-insert it asap. However, if the ring has been out for more than 48 hours and it is within the first week of using it you should insert a new ring and use additional contraception for 7 days. You may need emergency contraception.

#### What are the advantages and disadvantages of using the ring?

The great thing about the ring is that it is easy to take out and put in, and you don't have to worry about taking a pill every day. Likewise, its effectiveness does not change if you've had diarrhea or vomited and it may help with premenstrual symptoms or heavy bleeding. However, the ring can lead to spotting or bleeding and you may not feel comfortable inserting it. Additionally, the ring does not protect you against STIs. It should be noted that some medicines may make the ring less effective.

#### Possible risks:

There is a very small number of people using the vaginal ring that may develop a blood clot. You should not use the ring if you have had a blood clot before. In addition, research has suggested that some people who use the vaginal ring have a small increased risk of being diagnosed with breast cancer compared to those who do not use the ring. 

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For further resources on the ring please refer to the following: 

NHS
<a href="https://www.nhs.uk/conditions/contraception/vaginal-ring/" class="freyjabutton">Read more</a>

Planned Parenthood
<a href="https://www.plannedparenthood.org/learn/birth-control/birth-control-vaginal-ring-nuvaring" class="freyjabutton">Read more</a>

The Ring 

#### What is it?

The diaphragm is a form of birth control that prevents sperm from entering the uterus. It is made of thin, soft silicone. You insert the diaphragm into your vagina before sex. The diaphragm is only effective at preventing pregnancy if it is used with spermicide.

#### How does it work?

The diaphragm is a barrier method of contraception. You will only need to use this when you have sex and leave it in afterwarsd for 6 hours. When you first start to use the diaphragm your doctor or nurse will advise you on the correct sized diaphragm for you. You should not use this during your period as it is linked to Toxic Shock Syndrome.

In terms of putting your diaphragm in, you should ask your doctor for advice. Always make sure that your hands are clean. Firstly, apply spermicide. You should fill the diaphragm's bowl with about 15 ml of spermicide. You should then spread a thin layer of spermicide around its rim with your fingers. Remember to only use water based lubes! Then place your finger on top of the diaphragm and squeeze it between your thumb and the rest of your fingers. Then slide the diaphragm into your vagina and upwards. This will then cover your cervix. You must always check that the cervix is covered. If it is not covered then try again. It is easier if you squat when placing it in, or try lying down. Whatever is easiest for you! When removing your diaphragm, hook your fingers under it and gently pull it downwards.

#### How effective is it?

If the diaphragm is used correctly with spermicide it is between 92-96% effective at preventing pregnancy. However, make sure you're still using a condom, as the diaphragm does not protect you against STDs. The diapgrahm needs to be kept in place for at least 6 hours after having sex.

#### How to look after your diaphragm:

Once removed, you should wash your diaphragm with warm water and soap. Then leave it to dry and place it back in its container. You should never boil your diaphragm or use disinfectant or oil-based products as this can damage the diaphragm. Lastly, before you use your diaphragm always check it beforehand to make sure that it is not damaged in any way. 

For further resources on the diaphragm please refer to the following: 

NHS
<a href="https://www.nhs.uk/conditions/contraception/contraceptive-diaphragm-or-cap/" class="freyjabutton">Read more</a>

Planned Parenthood

<a href="https://www.plannedparenthood.org/learn/birth-control/diaphragm/how-do-i-use-a-diaphragm" class="freyjabutton">Read more</a>

The Diaphragm 

####\
What is it?

The pill contains artificial versions of female hormones oestrogen and progesterone, which are produced naturally in the ovaries. The pill is over 99% effective at preventing pregnancy.

#### How does it prevent pregnancy?

The pill prevents sperm from joining with the egg, so it prevents fertilization by stopping ovulation. No ovulation means that there is egg and so no pregnancy. It should be noted that the pill does not protect you against STDs.

#### How do you take it?

Usually you take one pill every day for 21 days with a 7 day break. This 7 day break is when you will have your period. You then start to take the pill again after these 7 days. You should try to take the pill at the same time every day. It is important that you remember to take your pill otherwise you can become pregnant. Try putting reminders in your phone or use a birth control reminder app. In addition, make sure that you always keep your pill pack in your bag. 

Moreover, some pills have a shorter break period but you should speak to your doctor about which pill will suit you more.

#### How long till it works?

This depends on when you start to take the pill and the type of pill that you are using. You should use a backup birth control method for up to 7 days.

#### Types of pill:

Monophasic 21-day pills:

e.g . Microgynon, Marvelon and Yasmin

This is one of the most common types of birth control pills. One pill is taken each day for 21 days and then has a 7 day break.

Phasic 21-day pills:

E.g. Logynon

This type of pill contains 2-3 sections of different coloured pills which all contain a different level of hormones. You should take one pill for 21 days and then none for 7 days. These pills must be taken in the right order. Speak with your doctor or nurse for advice and instructions.

ED pills:

E.g Microgynon ED

ED pills contain 21 active pills and 7 inactive pills. These two types of pills look different. You are to take one pill each for 28 days with no break between the packets or the pills. These pills must be taken in the right order. Follow the instructions and speak with your doctor or nurse.

#### What lowers the effectiveness of birth control?

If you do not take the pill everyday, then you will lower its effectiveness and can become pregnant. Here are some other factors which can reduce the pills effectiveness:

-   Vomiting or diarrhea 
-   Certain HIV medicines 
-   Rifampin 
-   Griseofulvin

Always use condoms as a backup!

#### Possible side effects:

Below is a list of possible side effects from the pill. You should note that most side effects usually go away within 2-3 months. However, you should not feel super sick and uncomfortable. So, if you do speak with your doctor. Sometimes you'll need to try a couple different types of birth control till you find the right one for you.

-   Headaches 
-   Nausea 
-   Changes in your menstrual cycle 
-   Sore breasts 
-   Spotting

For further information on the pill please refer to the following: 

NHS

<a href="https://www.nhs.uk/conditions/contraception/combined-contraceptive-pill/" class="freyjabutton">Read more</a>

Planned Parenthood

<a href="https://www.plannedparenthood.org/learn/birth-control/birth-control-pill" class="freyjabutton">Read more</a>

The Pill 

#### What is it? 

The Intrauterine device (IUD) is a type of long-acting reversible contraception that is placed inside the uterus. Some IUDs are non-hormonal and others are hormonal, containing the progestin levonorgestrel. IUD's are a highly effective form on of birth control. Out of 100 people who use an IUD, less than 1 will become pregnant within the first year. Once an IUD is placed, it can be used for three to 10 years depending on the type. 

#### Does it hurt? 

We'll be honest with you. Getting an IUD inserted isn't the most fun way to spend a day, and yes, it does hurt. You can take pain killers before the insertion with may help to ease the pain and cramping. After the first 48 hours you shouldn't feel any more discomfort. 

#### Do IUD's cause infections or affect long term fertility? 

The risk of pelvic infection associated with IUD use is very low. Likewise, modern IUDs do not affect future fertility. Data from several studies show that among people who removed their IUD at the average age of 25 to 31, in order to become pregnant, 71-91% of IUD users became pregnant within their first year of removal. 

#### Side Effects 

Changes to your period are common with IUDs. Irregular bleeding and spotting is most common in the first few months. The hormonal IUDs cause a decrease in bleeding and so you may not get a period for a couple of years, bit it will return when you remove the IUD. 

#### Will your partner feel it? 

Partners may be able to feel the IUD during sex. However, you can always get your doctor to cut the IUD strings shorter if this becomes a problem.

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Contraception

Vasectomy

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Female Sterilisation

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emergency-contraception

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The Contraceptive Patch

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The Female Condom

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The Contraceptive Injection

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The Implant

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The Ring

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The Diaphragm

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The Pill

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The IUD Explained

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Contraception Quiz

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