Alternatives to the Contraceptive Pill: 5 Reasons Women Switch
Side effects, missed pills, medical risk factors, wanting to avoid hormones and changing life circumstances — and the UK alternatives that suit each one.
When to get urgent help: Call 999 or go to A&E if you have chest pain, breathlessness, coughing up blood, painful swelling in one leg, a sudden severe headache or stroke signs (face drooping, arm weakness, slurred speech), or sudden severe tummy pain and could be pregnant. Contact NHS 111, your GP or a sexual health clinic (free, confidential, no GP registration needed) the same day if possible if you need emergency contraception, develop migraine with aura on a combined method, or have pain or a fever after a coil fitting.
Part of the Contraception Guides.
Key fact: If the pill is not working for you, there are at least eight other methods available free on the NHS. Long-acting reversible contraception (the implant and coils) is more than 99% effective because it does not rely on remembering anything, while the pill, patch and ring are about 91% effective with typical use.
Contraception Online
Access Doctor provides the combined pill, mini pill, Evra patch and NuvaRing following a GPhC-regulated online consultation with our pharmacist independent prescribers.
See contraception options →1. Managing side effects from the pill
Many people take the pill without problems, but others get side effects that affect their day-to-day life. Both the combined pill (oestrogen and progestogen) and the progestogen-only pill (mini pill) can cause them, and they often settle within the first three months.
Common side effects of the pill
- Mood changes or low mood
- Headaches
- Feeling sick
- Breast tenderness
- Bleeding between periods (breakthrough bleeding), especially in the first few months
- Changes in sex drive
- Irregular periods, particularly with the mini pill
If side effects last longer than three months, or affect your mood or quality of life, it is worth talking to a prescriber about a different pill or a different method. Switching to another combined pill with a different progestogen can help some people.
Other combined methods
Evra patch (weekly)
Contains the same type of hormones as the combined pill, absorbed through the skin. No daily tablet to remember. It releases about 34 micrograms of oestrogen a day, similar to a higher-strength combined pill, and its risk of blood clots may be up to twice that of pills containing levonorgestrel, so it is not a way to reduce oestrogen side effects.
NuvaRing vaginal ring (monthly)
A soft ring that releases a low, steady dose of oestrogen and progestogen. One ring is used for three weeks, followed by a ring-free week.
The patch and ring work in the same way as the combined pill, so people who cannot take the combined pill for medical reasons usually cannot use them either.
Want to avoid hormones altogether? The copper coil (IUD) is more than 99% effective and contains no hormones. See reason 4.
2. Finding it hard to remember a daily pill
The pill is more than 99% effective when taken perfectly, but with typical use — including the occasional missed or late pill — it is about 91% effective. If you travel, work shifts or simply find a daily routine hard, a less frequent method may suit you better.
| Method | What you do | Hormones |
|---|---|---|
| Evra patch | A new patch once a week for three weeks, then a patch-free week | Oestrogen and progestogen |
| NuvaRing | One ring for three weeks, then a ring-free week | Oestrogen and progestogen |
| Contraceptive injection | An injection every 8 to 13 weeks, depending on the type | Progestogen only |
Long-acting reversible contraception (LARC)
For the least effort, LARC methods give years of protection with nothing to remember. All are more than 99% effective and can be removed at any time, after which fertility returns quickly.
5 yrs
Contraceptive implant (progestogen only)
3–8 yrs
Hormonal coil (IUS), depending on type
5–10 yrs
Copper coil (IUD), hormone-free
Implants and coils are fitted by a GP, practice nurse or sexual health clinic. For a full overview of every method, see our guide to contraceptive options in the UK.
3. When the combined pill is not suitable for you
The combined pill, Evra patch and NuvaRing all contain oestrogen, which slightly increases the risk of blood clots. For some people that risk is too high. This is a safety check, not a dead end: progestogen-only methods and the copper coil remain highly effective options.
UK prescribers use the UK Medical Eligibility Criteria (UKMEC) to decide which methods are safe for you. The NHS lists these situations as reasons the combined pill is usually not suitable:
| Condition or risk factor | Combined pill, patch or ring | Progestogen-only methods and coils |
|---|---|---|
| Migraine with aura | Not suitable | Usually suitable |
| Blood clots now or in the past, or a close relative with a clot before 45 | Not suitable (close relative only: usually not suitable) | Often suitable — assessed individually |
| Stroke, narrowed arteries or heart disease | Not suitable | Assessed individually |
| High blood pressure | Usually not suitable | Usually suitable |
| Aged 35 or over and smoking | Usually not suitable | Usually suitable |
| BMI of 35 or over (at BMI 30 to 34 a combined method can usually still be used) | Usually not suitable | Usually suitable |
| Breastfeeding a baby under 6 weeks old | Wait until 6 weeks after the birth | Pill, implant and injection usually suitable; coils within 48 hours of birth or from 4 weeks |
| Breast cancer now or in the past | Not suitable | Hormonal methods usually not suitable; the copper coil may be an option |
This table is a general guide only. A prescriber, GP or contraceptive nurse will check your full medical history, blood pressure and BMI before recommending a method. Tell them about every medicine you take.
If you have migraines, our guide to contraception and migraine with aura explains your options in more detail.
4. Wanting hormone-free contraception
Some people prefer to avoid hormones because of past side effects, medical reasons or personal choice. Hormone-free contraception is effective and free on the NHS.
Copper coil (IUD)
The copper coil is a small device fitted in the womb. It releases copper, which stops sperm and eggs surviving and may also stop a fertilised egg from implanting. It contains no hormones, so your natural cycle continues.
| Benefits | Things to consider |
|---|---|
| More than 99% effective | Periods may become heavier, longer or more painful, especially in the first 3 to 6 months |
| Lasts 5 to 10 years, depending on the type | Needs fitting by a trained clinician |
| No hormones | Small risk of infection soon after fitting, and of the coil moving or coming out |
| Works as soon as it is fitted and can be removed at any time | Not suitable for everyone, for example with some womb or cervix conditions or a copper allergy |
| The most effective form of emergency contraception, if fitted within 5 days of unprotected sex | Does not protect against STIs |
Other hormone-free options
Condoms
Male condoms are 98% effective and female condoms 95% effective with perfect use. They are the only method that also protects against STIs, and are free from sexual health clinics.
Diaphragm or cap
Used with spermicide each time you have sex, and 92 to 96% effective with perfect use. You need to be shown how to use one by a trained professional.
Fertility awareness
Tracking your cycle to avoid sex on fertile days. It needs training and commitment, is less reliable with irregular cycles, and is less effective with typical use than most other methods.
5. Life changes and changing needs
The method that suited you at 22 may not be the best choice at 32 or 42. It is worth reviewing your contraception when your circumstances change.
- Planning a pregnancy soon: fertility usually returns quickly after stopping the pill, patch, ring, implant or coils. The contraceptive injection can delay the return of fertility by up to a year, so it is less suitable if you want to conceive soon.
- Travel or shift work: the patch, ring or a LARC method avoids the problem of taking a daily pill across time zones.
- After having a baby: the progestogen-only pill and the implant can usually be started at any time. If you are not breastfeeding, a combined method can usually be started from day 21 after the birth. If you are breastfeeding, wait until at least 6 weeks after the birth; the patch and ring are not usually recommended while breastfeeding.
- New relationship: only condoms protect against sexually transmitted infections, so use them alongside your usual method if STIs are a concern.
Which alternative might suit you?
Side effects on the pill
A different combined pill, the progestogen-only pill, the implant, the hormonal coil or the copper coil.
You keep forgetting pills
The weekly patch, monthly ring, or a LARC method with nothing to remember.
You cannot take oestrogen
The progestogen-only pill, implant, injection, hormonal coil or copper coil.
You want no hormones
The copper coil, or barrier methods such as condoms or a diaphragm.
All methods at a glance
| Method | How often | Hormones | Effectiveness |
|---|---|---|---|
| Evra patch | Weekly | Oestrogen and progestogen | Over 99% perfect use; about 91% typical use |
| NuvaRing | Monthly | Oestrogen and progestogen | Over 99% perfect use; about 91% typical use |
| Progestogen-only pill | Daily | Progestogen only | Over 99% perfect use; about 91% typical use |
| Injection | Every 8 to 13 weeks | Progestogen only | Over 99% perfect use; about 94% typical use |
| Implant | Up to 5 years | Progestogen only | Over 99% |
| Hormonal coil (IUS) | 3 to 8 years | Progestogen only | Over 99% |
| Copper coil (IUD) | 5 to 10 years | None | Over 99% |
| Male condom | Every time | None | 98% perfect use |
| Female condom | Every time | None | 95% perfect use |
| Diaphragm or cap | Every time | None | 92 to 96% perfect use |
UK safety and prescribing information
- Free on the NHS: all contraception, including the pill, patch, ring, injection, implant and coils, is free on the NHS from GPs, sexual health clinics (no GP registration needed) and some pharmacies. In England, many pharmacies can start or continue the pill through the NHS Pharmacy Contraception Service.
- Legal status: the combined pill, Evra patch, NuvaRing and most progestogen-only pills are prescription-only medicines (POM), and they can only be supplied with a prescription or under specific NHS arrangements, such as the patient group directions used in the NHS Pharmacy Contraception Service. Some desogestrel progestogen-only pills (such as Hana and Lovima) can be bought from a pharmacy after a consultation with the pharmacist. Access Doctor supplies MHRA-licensed UK medicines, dispensed by our GPhC-registered pharmacy (#9011198) after a prescriber’s assessment.
- UKMEC: UK prescribers use the UK Medical Eligibility Criteria, which rate each method from UKMEC 1 (no restriction) to UKMEC 4 (unacceptable health risk — must not be used) for each medical condition. Combined methods are UKMEC 4 for people with migraine with aura.
- Interactions: enzyme-inducing medicines (for example carbamazepine, phenytoin, rifampicin and St John’s wort) can make the pill, patch, ring and implant less effective. Tell your prescriber about everything you take.
- Emergency contraception: the copper coil is the most effective option (up to 5 days after unprotected sex); emergency pills are available free from sexual health clinics and GPs, and from many pharmacies.
- STIs: only condoms protect against sexually transmitted infections. STI testing and treatment are free and confidential at NHS sexual health clinics.
Pregnancy and after birth: stop hormonal contraception and speak to your GP or midwife if you become pregnant. After birth, progestogen-only pills and the implant can usually be started at any time; a coil can be fitted within 48 hours of birth or from 4 weeks afterwards. If you are not breastfeeding, a combined method can usually be started from day 21 after the birth. If you are breastfeeding, wait until at least 6 weeks after the birth; the patch and ring are not usually recommended while breastfeeding.
Not Sure Which Method Suits You?
Complete an online consultation and our pharmacist independent prescribers will check your medical history and advise which methods are safe for you. Coils and implants are fitted by your GP or a sexual health clinic.
Start a contraception consultation →Frequently Asked Questions
Is the Evra patch as effective as the contraceptive pill?
Yes. With perfect use, the Evra patch is more than 99% effective, the same as the combined pill. With typical use, both are about 91% effective. The patch is changed once a week rather than taken daily, which makes it easier for some people to use correctly.
Can I feel the NuvaRing during sex?
Most people cannot feel it, including during sex, although some partners notice it. If it comes out or you take it out, protection is not reduced as long as it is out for less than 3 hours. Rinse it in cool or lukewarm (not hot) water and put it back in as soon as possible.
What is the most effective method of contraception?
Long-acting reversible contraception (LARC) — the implant, the hormonal coil (IUS) and the copper coil (IUD) — is the most effective, at more than 99%. Once fitted, it does not depend on remembering to take or change anything.
Are there any contraceptive methods with no side effects?
No method is completely free of side effects. Hormone-free methods such as the copper coil and condoms avoid hormonal side effects, but the copper coil can make periods heavier or more painful, especially in the first few months. A prescriber or contraceptive nurse can help you weigh this up.
How long does it take to get pregnant after stopping the pill?
You can get pregnant as soon as you stop the pill, and fertility usually returns quickly. The same applies to the patch, ring, implant and coils. The exception is the contraceptive injection, which can delay the return of fertility by up to a year.
What are the best alternatives if I keep forgetting to take the pill?
The Evra patch (changed weekly) and NuvaRing (used for three weeks at a time) need less frequent attention. For no routine at all, the implant or a coil gives years of protection after a single appointment.
Can I get an online contraceptive consultation in the UK?
Yes. Access Doctor offers online consultations for the pill, patch and ring, reviewed by GPhC-registered pharmacist independent prescribers. If a method is suitable, it is dispensed by our GPhC-registered UK pharmacy. Implants and coils need to be fitted by a GP or sexual health clinic.
Is contraception free in the UK?
Yes. All methods of contraception are free on the NHS across the UK. You can get them from your GP, from NHS sexual health clinics, where you do not need to be registered with a GP, and from some community pharmacies. Sexual health clinics also offer free, confidential STI testing and emergency contraception.
References
- NHS. Your contraception guide: methods of contraception. nhs.uk
- NHS. Combined pill: who can take it. nhs.uk
- College of Sexual and Reproductive Healthcare. UK Medical Eligibility Criteria for Contraceptive Use (UKMEC) 2025. cosrh.org
- National Institute for Health and Care Excellence. Clinical Knowledge Summaries: Contraception. cks.nice.org.uk
- Electronic Medicines Compendium. Evra transdermal patch and NuvaRing: Summaries of Product Characteristics. medicines.org.uk
- Medicines and Healthcare products Regulatory Agency. Yellow Card scheme: report a suspected side effect or a fake medicine. yellowcard.mhra.gov.uk
Medical disclaimer: This article is for informational purposes only and does not constitute medical advice. Speak to a prescriber, GP or contraceptive nurse about your medical history before changing your method of contraception. Always consult a qualified healthcare professional for diagnosis and treatment. In a medical emergency, call 999.
Reporting side effects: If you think a medicine has caused a side effect, you can report it to the MHRA through the Yellow Card scheme at yellowcard.mhra.gov.uk or the Yellow Card app. You can also report suspected fake or unlicensed medicines. Reporting helps keep medicines safe for everyone in the UK.