Contraception Methods

FSH, or follicle-stimulating hormone, is released by the pituitary gland and stimulates egg maturation in the ovaries. Oral contraceptives contain hormones that inhibit FSH production. With less FSH stimulation, eggs do not mature, so there is no mature egg available for fertilisation. For example, oestrogen in a contraceptive pill inhibits FSH production.

Hormones can also be delivered through an injection, implant or skin patch. These release contraceptive hormones steadily, inhibiting the maturation and release of eggs. Progesterone, or hormones with similar effects, is used in contraceptive injections and implants.

The delivery method affects how often the user must remember to act. A pill is taken daily. An injection provides protection for several months, while an implant can work for several years. A skin patch delivers hormones through the skin but is replaced weekly: it should not be confused with a device that stays in place for years.

These methods are reversible rather than intended to be permanent. However, they can have disadvantages. Pills must be remembered, implants can cause irregular bleeding, and injections can delay the return of fertility after use stops. The combined pill also carries a small risk of blood clots. Hormonal contraception does not protect against sexually transmitted infections, or STIs.

Barriers stop sperm reaching an egg

A barrier method physically separates sperm from the egg. A condom prevents sperm from entering the reproductive tract. A diaphragm is placed inside the vagina over the cervix—the opening into the uterus—so sperm cannot pass through towards the egg.

Condoms and diaphragms are hormone-free and are used when needed, rather than continuously altering hormone levels. Their effectiveness depends on correct use. A condom may split or slip off, and a diaphragm must be positioned correctly.

A diaphragm is used with spermicide, a chemical that kills or disables sperm. Spermicide is therefore a chemical method, whereas the diaphragm itself is a physical barrier. Combining them provides two obstacles to sperm reaching an egg.

Condoms also help protect against STIs. A diaphragm does not provide reliable STI protection, so the benefits of different barrier methods are not identical.

Intrauterine devices act inside the uterus

An intrauterine device, or IUD, is a small device fitted inside the uterus. Intrauterine contraception can prevent implantation of an embryo or release a contraceptive hormone.

A copper IUD is hormone-free. Copper also interferes with fertilisation, preventing sperm from successfully fertilising an egg. A hormonal coil, often called an intrauterine system or IUS, releases a hormone and thins the uterine lining.

Both types provide long-lasting protection without the user having to remember a daily pill. They are highly effective and can be removed if pregnancy is wanted later. However, fitting requires a procedure that can be uncomfortable. Copper IUDs can cause heavier or more painful periods; hormonal coils can reduce heavy periods.

Avoiding fertile periods and using sterilisation

A non-hormonal approach is to abstain from sexual intercourse when an egg may be in the oviduct. Fertility-awareness methods track the menstrual cycle to identify fertile times. They avoid hormone side effects, but require consistent tracking and cooperation. Ovulation does not always occur at exactly the same point in each cycle, making fertile-period avoidance less reliable in everyday use than many other methods.

Sterilisation is surgery intended to permanently prevent reproduction. In male sterilisation, called a vasectomy, the sperm ducts are cut or blocked. Sperm cannot enter the semen and therefore cannot reach an egg.

In female sterilisation, the oviducts are cut, tied or blocked. This prevents sperm and an egg meeting. Neither procedure works by stopping reproductive hormone production.

Sterilisation is highly effective and removes the need for a daily contraceptive routine. Its main disadvantage is permanence: reversal is difficult and may not succeed. It is therefore unsuitable for someone who may want children in the future.

Effectiveness depends on the method and its use

Effectiveness figures describe how well a method prevents pregnancy over a stated period, usually one year. Perfect use means correct, consistent use. Typical use includes everyday mistakes, such as forgetting a pill or a condom coming off.

For example, 91% effectiveness means that around 9 out of 100 women using the method would experience an unintended pregnancy during the first year. It does not mean a 9% pregnancy risk each time intercourse occurs.

The small difference between typical and perfect use for implants and coils reflects their low dependence on daily user action. The larger difference for pills and condoms shows why correct use matters.

Evaluating which method is suitable

An evaluation weighs benefits against limitations rather than simply naming the method with the highest effectiveness.

For someone wanting long-term but reversible protection, an implant or coil may be suitable because it is highly effective without a daily routine. Someone wanting protection against both pregnancy and STIs needs to consider condoms, even if another method is also used. Someone who may want children later would need to weigh the permanence of sterilisation carefully.

A justified choice considers effectiveness, ease of use, possible side effects, STI protection and future plans for pregnancy. Health, personal preferences and religious or ethical beliefs can also affect suitability. No single method has every advantage.

• Pill: contraceptive hormones inhibit FSH → eggs do not mature.
• Injection, implant and patch: release hormones that inhibit egg maturation and release. Injections last months, implants years; patches are replaced weekly.
• Condom and diaphragm: physically prevent sperm reaching an egg.
• IUD: prevents implantation or releases a hormone; copper also prevents fertilisation.
• Spermicide: kills or disables sperm, often used with a diaphragm.
• Fertile-period abstinence: avoid intercourse when an egg may be in the oviduct.
• Male sterilisation: blocks sperm ducts, preventing sperm entering semen.
• Female sterilisation: blocks oviducts, preventing sperm and egg meeting.

Essential comparisons

• Perfect use: correct and consistent. Typical use: includes mistakes.
• Typical-use effectiveness: implant/coils over 99%; injection 94%; pill/patch 91%; external condom 82%; natural family planning 76%.
• Implants and coils: highly effective, long-lasting and reversible; require fitting and may cause side effects.
• Condoms: hormone-free and help protect against STIs; can fail through damage or incorrect use.
• Sterilisation: highly effective but intended to be permanent.
• Fertility awareness: hormone-free but less reliable in everyday use.

Evaluation

Compare effectiveness, user dependence, side effects, STI protection and reversibility. Give a conclusion linked to the person's needs.