Contraception
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Contraception
All contraceptive methods explained — effectiveness, how to choose, and UK prescription options.
Key fact: There are more than 15 types of contraception available in the UK. Long-acting reversible contraceptives (LARCs) are the most effective, with failure rates below 1% — yet fewer than 25% of women in the UK use them. Choosing the right method depends on your health, age, lifestyle and future plans. Access Doctor provides prescription contraceptives following a confidential online consultation.
Overview of Contraceptive Methods
Contraception can be divided into short-acting hormonal methods, long-acting reversible contraception (LARC), barrier methods, permanent methods and emergency contraception. Effectiveness is expressed as the percentage of women who do not become pregnant within one year of use.
| Method | Typical Use | Perfect Use | Duration | Reversible? |
|---|---|---|---|---|
| Combined pill | 91% | 99.7% | Daily | Yes — immediately on stopping |
| Progestogen-only pill | 91% | 99.7% | Daily | Yes — immediately on stopping |
| Contraceptive patch | 91% | 99.7% | Weekly | Yes |
| Vaginal ring | 91% | 99.7% | Monthly | Yes |
| Contraceptive implant | >99% | >99% | 3 years | Yes — on removal |
| Hormonal IUS (Mirena) | >99% | >99% | 5–8 years | Yes — on removal |
| Copper IUD | >99% | >99% | 5–10 years | Yes — on removal |
| Contraceptive injection | 94% | 99.8% | 13 weeks | Yes — fertility may be delayed up to 1 year |
| Male condom | 85% | 98% | Single use | Yes — only method protecting against STIs |
STI protection: No hormonal or LARC method protects against sexually transmitted infections. Only condoms (male or female) reduce the risk of STI transmission. Women who are not in a mutually monogamous relationship should use condoms alongside their chosen contraceptive method.
Combined Oral Contraceptive Pill (COCP)
The combined pill contains both oestrogen (usually ethinylestradiol) and a progestogen. It works primarily by suppressing ovulation, and secondarily by thickening cervical mucus and thinning the uterine lining. It is the most widely used prescription contraceptive in the UK.
Benefits beyond contraception
- Regulates and lightens periods; reduces dysmenorrhoea (period pain)
- Reduces symptoms of premenstrual syndrome (PMS)
- Improves acne in many women
- Reduces the risk of ovarian cysts, endometrial cancer and ovarian cancer with long-term use
- Can be used to manage endometriosis symptoms
How to start and what to expect
If started on days 1–5 of a natural period, the combined pill is effective immediately. If started at any other time, additional contraception (condoms) should be used for the first 7 days. Most combined pills are taken for 21 days followed by a 7-day pill-free interval during which a withdrawal bleed occurs. Some formulations are taken continuously (365 days) to eliminate withdrawal bleeds entirely.
Get the Combined Pill Online
Access Doctor provides a range of combined oral contraceptive pills following a confidential online consultation with our GPhC-registered pharmacist independent prescribers. No GP appointment required.
View Combined Pill Options →Progestogen-Only Pill (Mini-Pill)
The progestogen-only pill (POP) contains only progestogen and no oestrogen. Traditional POPs (containing norethisterone or levonorgestrel) work mainly by thickening cervical mucus; they have a strict 3-hour window for daily pill-taking. Desogestrel-containing POPs (such as Zelleta, Cerazette) also suppress ovulation in around 97% of cycles and have a more forgiving 12-hour window.
Who is the mini-pill particularly suited for?
- Women who cannot take oestrogen — including those over 35 who smoke, or who have a history of migraines with aura
- Women with certain cardiovascular risk factors where oestrogen is contraindicated
- Breastfeeding women (safe from 6 weeks postpartum; combined pill not recommended until 6 months)
- Women who experience oestrogen-related side effects on the combined pill (e.g. nausea, breast tenderness)
Get the Mini-Pill Online
Access Doctor provides a range of progestogen-only pills following a confidential online consultation with our GPhC-registered pharmacist independent prescribers.
View Mini-Pill Options →Long-Acting Reversible Contraception (LARC)
LARCs are the most effective contraceptive methods available and are recommended by NICE as first-line options for all women who want effective contraception. Once fitted or inserted, they require no daily action and are immediately reversible when removed.
Contraceptive implant (Nexplanon)
A 4cm flexible rod inserted subdermally in the upper arm by a trained clinician. Releases etonogestrel continuously. Over 99% effective. Lasts 3 years. Fertility returns immediately on removal. May cause irregular bleeding — particularly in the first 3–6 months.
Hormonal IUS (Mirena, Kyleena, Jaydess)
A T-shaped device inserted into the uterus, releasing low-dose levonorgestrel locally. Over 99% effective. Significantly reduces menstrual bleeding — periods often stop entirely. Mirena lasts 8 years; Kyleena 5 years; Jaydess 3 years. Requires insertion by a trained clinician.
Copper IUD
A non-hormonal T-shaped device that prevents fertilisation by creating an environment toxic to sperm. Over 99% effective. Lasts 5–10 years. No hormones — suitable for women who cannot use hormonal methods. May increase menstrual flow in the first few months. Also the most effective emergency contraceptive when fitted within 5 days.
Contraceptive injection (Depo-Provera)
Medroxyprogesterone acetate given by intramuscular injection every 12–13 weeks. Over 99% effective with timely injections. Particularly useful for women who find daily pill-taking difficult. Fertility may take 6–12 months to return after stopping — not ideal if pregnancy is planned soon.
Emergency Contraception
Emergency contraception (EC) prevents pregnancy after unprotected sex or contraceptive failure. It is not intended as a regular method. Time is critical — the sooner EC is used, the more effective it is.
| Method | Window | Effectiveness | Notes |
|---|---|---|---|
| Levonorgestrel pill (Levonelle, Levonelle One Step) | Within 72 hours of unprotected sex | Up to 95% if taken within 24 hours; reduces to ~58% at 49–72 hours | Available OTC; less effective in women over 70kg — consider ellaOne or copper IUD instead |
| Ulipristal acetate (ellaOne) | Within 120 hours (5 days) | Maintains effectiveness across the full 120-hour window; more effective than levonorgestrel throughout | Prescription required; do not take hormonal contraception for 5 days after; not suitable if breastfeeding |
| Copper IUD | Within 120 hours (5 days) of unprotected sex, or within 5 days of expected ovulation | >99% — the most effective emergency contraceptive method available | Provides ongoing contraception; requires fitting by a trained clinician; suitable for women of any weight |
Time matters: Do not delay taking emergency contraception. If in doubt about which option is most suitable, start with whatever is immediately available and seek further advice promptly. The copper IUD is the most effective option at any point in the 120-hour window and is also suitable for women who are overweight.
Get Emergency Contraception Online
Access Doctor provides emergency contraception — including ulipristal acetate (ellaOne) — following a confidential online consultation. Fast dispatch. No GP appointment required.
View Emergency Contraception →How to Choose the Right Contraception
The Faculty of Sexual and Reproductive Healthcare (FSRH) recommends contraceptive choice is made through shared decision-making, based on a woman’s individual circumstances, preferences and medical eligibility. Key questions to consider:
| If you want… | Consider |
|---|---|
| The most effective protection with no daily action | LARC — implant, IUS, or copper IUD |
| A pill-based method with additional benefits (period regulation, acne) | Combined oral contraceptive pill |
| A pill you can take if you can’t use oestrogen | Progestogen-only pill (mini-pill) — particularly desogestrel type |
| A non-hormonal method | Copper IUD; condoms; fertility awareness (with training) |
| To stop periods entirely | Hormonal IUS (Mirena); continuous combined pill; implant |
| Pregnancy in the near future | Avoid injection (delayed return of fertility); pill, implant, IUD offer immediate reversibility |
| Protection against STIs as well | Condoms — only contraceptive method that also protects against STIs |
Who Cannot Use the Combined Pill
The FSRH UK Medical Eligibility Criteria (UKMEC) classifies conditions where the risks of combined pill use outweigh the benefits (UKMEC 4 — absolute contraindication) or where careful assessment is needed (UKMEC 3). Absolute contraindications include:
- Age 35 or over AND currently smoking (any quantity)
- Personal history of venous thromboembolism (DVT or pulmonary embolism)
- Migraine with aura (at any age)
- Ischaemic heart disease, stroke or TIA
- Uncontrolled hypertension (systolic ≥160mmHg or diastolic ≥100mmHg)
- Multiple cardiovascular risk factors (diabetes, hypertension, smoking, obesity — combined)
- Breastfeeding a baby under 6 weeks old
- Active or recent liver disease
- Known or suspected oestrogen-dependent cancers
Clinical assessment is required: All prescription contraceptives require a clinical consultation that assesses your medical history, blood pressure and eligibility. Access Doctor’s online consultation process reviews all relevant factors before any prescription is issued.
When to Seek Help
Seek clinical advice if:
- You are unsure which contraceptive method is most suitable for you
- Your current contraception is causing side effects affecting your daily life
- You have had unprotected sex and need emergency contraception
- You have missed pills or had a contraceptive failure (e.g. condom split)
- You want to become pregnant and need advice on stopping contraception
- You have new symptoms you think may be related to your contraception
Seek urgent medical attention if you develop sudden severe chest pain, shortness of breath, severe leg pain and swelling, or sudden visual disturbance while taking the combined pill or using the patch — these may be signs of a blood clot (venous thromboembolism). Call 999 or go to A&E immediately.
Contraception Guides
In-depth guides on contraceptive methods and the options available through Access Doctor:
Frequently Asked Questions
What is the most effective contraception?
Long-acting reversible contraceptives (LARCs) — the implant, hormonal IUS, copper IUD and contraceptive injection — are the most effective methods with failure rates below 1% in typical use. They are more effective than the pill because they remove the risk of user error. The combined pill and progestogen-only pill are over 99% effective with perfect use but approximately 91% with typical use.
What is the difference between the combined pill and the mini-pill?
The combined pill contains both oestrogen and progestogen and works primarily by preventing ovulation. The progestogen-only pill (POP or mini-pill) contains only progestogen and works mainly by thickening cervical mucus; desogestrel-containing POPs (such as Zelleta) also suppress ovulation in most users. The mini-pill is suitable for women who cannot take oestrogen.
What emergency contraception is available in the UK?
Three options are available: the levonorgestrel pill (Levonelle) within 72 hours; ulipristal acetate (ellaOne) within 120 hours — more effective, especially later in the window; and the copper IUD fitted within 5 days, which is the most effective method at over 99%. Time is critical — the sooner emergency contraception is taken, the more effective it is.
Who cannot take the combined pill?
The combined pill is not suitable for women who smoke and are aged 35 or over; those with a history of blood clots, stroke or cardiovascular disease; women with migraine with aura; those with uncontrolled hypertension; women with certain liver conditions; and those breastfeeding a baby under 6 weeks. A clinical assessment is required before prescribing.
Does contraception protect against STIs?
No hormonal contraceptive method protects against sexually transmitted infections. Only condoms reduce the risk of STI transmission. Women not in a mutually monogamous relationship are advised to use condoms alongside their chosen contraceptive method.
Can I get the contraceptive pill online in the UK?
Yes. Access Doctor provides prescription contraceptive pills — including the combined pill, progestogen-only pill and emergency contraception — following a confidential online consultation with GPhC-registered pharmacist independent prescribers. No GP appointment required. Discreet next-day delivery.
Prescription Contraception — Online Consultation
Access Doctor provides a full range of prescription contraceptive options. Complete a short online consultation reviewed by our GPhC-registered pharmacist independent prescribers — delivered to your door across the UK.
View All Contraception →References
- National Institute for Health and Care Excellence (NICE). Contraception: Clinical Knowledge Summary. Updated 2024. cks.nice.org.uk/topics/contraception
- Faculty of Sexual and Reproductive Healthcare (FSRH). UK Medical Eligibility Criteria for Contraceptive Use (UKMEC). FSRH, 2023. fsrh.org/ukmec
- Faculty of Sexual and Reproductive Healthcare (FSRH). Emergency Contraception. FSRH Guideline, 2023. fsrh.org
- NHS. Contraception guide. NHS.uk, 2023. nhs.uk/conditions/contraception
Medical disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional for diagnosis and treatment. In a medical emergency, call 999.
