Contraceptive Options in the UK: A Complete Guide to Every Method
Key fact: Long-acting reversible contraceptives (LARCs) — the implant, IUS, IUD, and injection — are over 99% effective in typical use because they remove the risk of human error entirely.
>99%
Effectiveness of the contraceptive implant (perfect & typical use)
15+
Contraceptive methods available in the UK
91%
Typical-use effectiveness of the combined pill
5 days
Window for the copper IUD as emergency contraception
With over 15 different contraceptive methods available in the UK, choosing the right one can feel overwhelming. The best option depends on your age, health history, lifestyle, whether you want protection for months or years, and whether you can safely use oestrogen. This guide explains every main method — how it works, how effective it is, and who it suits — to help you make an informed decision with a healthcare professional.
Understanding Contraceptive Effectiveness
All contraceptive effectiveness figures are expressed as the number of people per 100 who become pregnant within one year. Two measures are used:
- Perfect use: Effectiveness when used correctly and consistently every time.
- Typical use: Effectiveness in real-world conditions, accounting for human error such as missed pills or incorrect application.
The gap between perfect and typical use is largest for user-dependent methods such as pills, patches, and condoms. Long-acting reversible contraceptives (LARCs) have near-identical perfect and typical use rates because once fitted or injected, they require no ongoing action from the user.
Comparison of All UK Contraceptive Methods
| Method | Typical Use Effectiveness | Duration | Contains Oestrogen? |
|---|---|---|---|
| Implant (Nexplanon) | >99% | 3 years | No |
| IUS (Mirena / Levosert) | >99% | 5–8 years | No |
| IUD (Copper coil) | >99% | 5–10 years | No |
| Contraceptive injection (Depo-Provera) | 94% | 8–13 weeks | No |
| Combined oral contraceptive pill | 91% | Daily | Yes |
| Progestogen-only pill (mini pill) | 91% | Daily | No |
| Contraceptive patch (Evra) | 91% | Weekly (3 on, 1 off) | Yes |
| Vaginal ring (NuvaRing) | 91% | Monthly | Yes |
| Male condom | 85% | Per use | No |
| Diaphragm / cap + spermicide | 88% | Per use | No |
| Female condom | 79% | Per use | No |
Source: NHS Contraception Guide; FSRH UK Medical Eligibility Criteria 2019 (amended 2023); NICE CKS Contraception Overview 2023.
Hormonal Contraceptive Pills
The Combined Oral Contraceptive Pill (COCP)
The combined pill contains synthetic versions of both oestrogen and progestogen. It prevents pregnancy primarily by suppressing ovulation. It also thickens cervical mucus and thins the womb lining, providing additional protection. Most regimens involve taking one pill daily for 21 days followed by a 7-day hormone-free interval, during which a withdrawal bleed occurs. Continuous and tailored regimens are also available on prescription.
Key advantages
Can reduce period pain and heavy bleeding, may improve acne, and is fully reversible — fertility typically returns within 1–3 months of stopping.
Not suitable for
Women with a history of blood clots, migraine with aura, uncontrolled hypertension, breast cancer, or those who smoke and are aged over 35. Individual clinical assessment is required.
The Progestogen-Only Pill (POP / Mini Pill)
The mini pill contains only progestogen — no oestrogen — making it suitable for women who cannot or prefer not to take oestrogen. There are two main types available in the UK.
Desogestrel-based POPs (such as Cerazette and Zelleta) work primarily by suppressing ovulation and carry a more forgiving 12-hour missed-dose window. They are the most widely prescribed mini pills in the UK. Norethisterone-based POPs work mainly by thickening cervical mucus and carry a narrower 3-hour window for missed doses.
Zelleta (desogestrel 75 mcg) is a popular oestrogen-free mini pill. Read our full guide: Zelleta Mini Pill — Uses, Side Effects & How It Works.
The mini pill is suitable for breastfeeding women, women over 35 who smoke, those with a history of venous thromboembolism, and those for whom oestrogen is contraindicated under UKMEC criteria.
Missed pill rule (desogestrel POP): If you are more than 12 hours late taking your pill, take it as soon as you remember and use additional contraception (condoms) for the next 48 hours. If you had unprotected sex during the missed interval, consider emergency contraception.
The Contraceptive Patch (Evra)
The Evra patch delivers oestrogen and progestogen transdermally (through the skin). One patch is worn for 7 days, then replaced; after 3 patches, a patch-free week follows. It is as effective as the combined pill with typical use, and suits women who prefer not to take a daily tablet. It is not suitable for women in whom oestrogen is contraindicated.
The Vaginal Ring (NuvaRing)
A small flexible ring inserted vaginally for 21 days, then removed for 7 days. It releases a low dose of oestrogen and progestogen locally, reducing systemic side effects compared to the pill in some women. It is also contraindicated in women who cannot take oestrogen.
Get Contraception Prescribed Online
Access Doctor offers confidential online consultations for the combined pill, mini pill, and emergency contraception. GPhC-registered pharmacy #9011198. Discreet UK delivery.
View Contraception Options →Long-Acting Reversible Contraceptives (LARCs)
NICE and the FSRH both recommend LARCs as first-line contraceptive options for most women because they are the most effective methods available in routine practice, require no daily action, and are fully reversible.
Contraceptive Implant (Nexplanon)
A small, flexible plastic rod (40 mm × 2 mm) inserted under the skin of the upper arm by a trained clinician under local anaesthetic. It releases etonogestrel (a progestogen) continuously, suppressing ovulation. It is effective for 3 years and has a failure rate of less than 1 in 1,000 users. It contains no oestrogen. Fertility typically returns within days of removal.
Intrauterine System (IUS — Mirena, Levosert, Kyleena)
A small T-shaped plastic device fitted inside the uterus by a healthcare professional. It releases a low dose of levonorgestrel (progestogen) locally into the uterine cavity. Effective for 5–8 years depending on the device. The IUS often significantly reduces or stops periods — around 20% of users have no periods after one year — which many women find a key benefit. No oestrogen.
Intrauterine Device (IUD — Copper Coil)
A small copper T-shaped device fitted inside the uterus. It contains no hormones whatsoever — copper ions have a spermicidal effect and create a uterine environment hostile to fertilisation and implantation. Effective for 5–10 years depending on device type. It is the only highly effective non-hormonal long-term method available, and is an option for women who experience adverse effects from all hormonal methods.
Emergency use: The copper IUD can be fitted up to 5 days after unprotected sex as emergency contraception — it is the most effective post-coital method available (>99%) and simultaneously provides ongoing long-term contraception.
Contraceptive Injection (Depo-Provera / Sayana Press)
An injection of medroxyprogesterone acetate (a progestogen) administered every 12–13 weeks (Depo-Provera by clinic; Sayana Press self-injectable at home after training). No oestrogen. Effective and convenient, but two important considerations apply: fertility can take 6–12 months (and occasionally longer) to return after stopping, and prolonged use may reduce bone mineral density — bones typically recover after the injection is discontinued. The FSRH advises reassessment after 2 years in younger women.
Planning a pregnancy? If you wish to conceive within 12 months, the contraceptive injection may not be the most suitable choice given the delay in fertility return. Discuss alternatives with your prescriber.
Barrier Methods
Male Condoms
Male (external) condoms are the only contraceptive method that also protects against sexually transmitted infections (STIs). For this reason, NHS and BASHH guidance recommends using condoms alongside another contraceptive method (“dual protection”) in new or non-monogamous relationships — particularly for those under 25, who account for the majority of STI diagnoses in England. With typical use, male condoms are approximately 85% effective; with perfect use (applied correctly each time), this rises to 98%.
Female Condoms
Female (internal) condoms also protect against STIs and can be inserted up to 8 hours before sex. Typical use effectiveness is approximately 79%, rising to 95% with perfect use. They are available free from sexual health clinics and some pharmacies.
Diaphragm and Cervical Cap
The diaphragm and cervical cap are reusable silicone devices inserted into the vagina before sex to cover the cervix. They must be used with spermicide gel to be effective. Initial fitting and sizing is carried out by a healthcare professional. Typical use effectiveness is around 88%. They provide no STI protection.
Emergency Contraception
Emergency contraception (EC) should be used as soon as possible after unprotected sex or contraceptive failure. Three options are available in the UK:
- Levonorgestrel (Levonelle 1500 mcg): Effective up to 72 hours (3 days) after unprotected sex. Effectiveness declines with time — take as soon as possible. Available without prescription from pharmacies and sexual health clinics.
- Ulipristal acetate (ellaOne 30 mg): Effective up to 120 hours (5 days) after unprotected sex and maintains its effectiveness more evenly across the full 5-day window compared to levonorgestrel. Requires a prescription. Do not take if you are already using a progestogen-based contraceptive method.
- Copper IUD: Up to 5 days after unprotected sex. The most effective EC option (>99%). Requires insertion by a trained clinician at a sexual health clinic or GP, but simultaneously provides long-term ongoing contraception.
Important: No method of emergency contraception is 100% effective. If your period is late or you experience pregnancy symptoms after using EC, take a pregnancy test. Emergency contraception does not protect against STIs.
How to Choose the Right Method for You
No single contraceptive method is right for everyone. The UK Medical Eligibility Criteria for Contraceptive Use (UKMEC), published by the FSRH, provides a framework that classifies which methods are safe for women with specific medical conditions. A prescriber will use this alongside your personal health history to guide your choice.
Key questions to discuss with your prescriber include:
1
Can you take oestrogen?
Women with a history of blood clots, migraine with aura, certain cardiovascular conditions, or who are breastfeeding should use oestrogen-free methods. Options include the mini pill, implant, IUS, IUD, and injection.
2
How long do you want protection?
If you want protection for several years without needing to remember a daily pill, a LARC (implant, IUS, or IUD) is likely the most suitable and effective option.
3
Are you planning a pregnancy soon?
The pill, patch, ring, and implant allow rapid return to fertility. The injection can delay fertility return by several months — plan accordingly.
4
Do you need STI protection?
If you are not in a long-term mutually monogamous relationship or have not both had recent STI screening, use condoms alongside your chosen contraceptive method.
Combined Pill
Combined Oral Contraceptive
Oestrogen + progestogen. 99%+ with perfect use. Prescription required.
Order online →Mini Pill
Zelleta (Desogestrel 75 mcg)
Oestrogen-free mini pill. 12-hour missed-dose window. Suitable if oestrogen is contraindicated.
Read the Zelleta guide →Get Your Contraception Prescribed Online — Confidential & Convenient
Our GPhC-registered pharmacist independent prescribers (GPhC #9011198) provide safe, clinical online consultations for contraceptive pills and emergency contraception. Discreet delivery across the UK.
Start Your Consultation →Frequently Asked Questions About Contraception
What is the most effective form of contraception in the UK?
Long-acting reversible contraceptives (LARCs) — including the implant, IUS (Mirena), IUD (copper coil), and contraceptive injection — are over 99% effective because they remove the risk of user error. The contraceptive implant (Nexplanon) is the single most effective reversible method available in the UK.
Can I get the contraceptive pill online in the UK?
Yes. Access Doctor is a GPhC-registered online pharmacy (registration #9011198). Our pharmacist independent prescribers can prescribe the combined pill, the mini pill (including Zelleta), and other hormonal contraceptives following a confidential online consultation, with discreet delivery across the UK.
What contraception is safe for women who cannot take oestrogen?
Women who cannot take oestrogen have several highly effective oestrogen-free options: the progestogen-only pill (mini pill, e.g. Zelleta or Cerazette), the contraceptive implant (Nexplanon), the IUS (Mirena/Levosert), the copper IUD, and the contraceptive injection (Depo-Provera). Your prescriber will assess which is most appropriate for your individual health history using UKMEC criteria.
How quickly does the combined pill work?
If you start the combined pill on day 1 of your period, it is effective immediately. If started on any other day of your cycle (days 2–5 is still within the quick-start window for most pills), use additional contraception such as condoms for the first 7 days.
What should I do if I miss a contraceptive pill?
For the combined pill: if less than 24 hours late, take it as soon as you remember and continue as normal. If more than 24 hours late, take the missed pill immediately and use condoms for the next 7 days. For the desogestrel mini pill (Cerazette/Zelleta): if more than 12 hours late, take it immediately and use additional contraception for 48 hours. Always check the patient information leaflet for your specific pill.
Does contraception protect against sexually transmitted infections (STIs)?
Only condoms — both male (external) and female (internal) condoms — protect against STIs. All other contraceptive methods, including hormonal pills, the implant, IUS, IUD, injection, patch, ring, and diaphragm, do not provide any STI protection. Using condoms alongside another method (“dual protection”) is recommended in new or non-exclusive relationships.
How long after stopping contraception can I get pregnant?
For most hormonal methods (combined pill, mini pill, patch, ring, implant, IUS), fertility returns quickly — often within days to weeks. For the copper IUD, fertility returns immediately after removal. The exception is the contraceptive injection (Depo-Provera): fertility may take 6–12 months (occasionally longer) to return after the last injection, so it is not recommended for women who wish to conceive in the near future.
What is the difference between the IUS and the IUD?
Both are intrauterine devices fitted by a healthcare professional. The IUS (e.g. Mirena) releases a small amount of progestogen (levonorgestrel) locally and typically reduces or stops periods. The IUD (copper coil) contains no hormones — it works through the spermicidal effect of copper — and may make periods heavier or more painful. Both are over 99% effective and suitable for women who cannot use oestrogen.
Can I use the mini pill while breastfeeding?
Yes. The progestogen-only pill (mini pill) is safe to use while breastfeeding and is recommended by the FSRH as a suitable contraceptive option from 6 weeks postpartum (or earlier following individual clinical assessment). Combined pills containing oestrogen are generally avoided while breastfeeding as oestrogen can reduce milk supply.
Is emergency contraception the same as the abortion pill?
No. Emergency contraception (Levonelle, ellaOne, or the copper IUD) works by preventing or delaying ovulation, preventing fertilisation, or preventing implantation — before a pregnancy is established. The abortion pill (mifepristone + misoprostol) is a medical treatment that terminates an already-established pregnancy and is an entirely different medication requiring different clinical oversight.
References
- NICE. Contraception — overview. Clinical Knowledge Summary. Updated 2023. cks.nice.org.uk
- FSRH. UK Medical Eligibility Criteria for Contraceptive Use (UKMEC). 2019, amended 2023. fsrh.org/ukmec
- NHS. Contraception guide. nhs.uk/conditions/contraception
- FSRH. Clinical Guideline: Progestogen-only Pills. 2022. fsrh.org
- FSRH. Clinical Guideline: Emergency Contraception. 2017 (updated 2020). fsrh.org
- GPhC. Standards for registered pharmacies. pharmacyregulation.org
Medical disclaimer: This article is for informational purposes only and does not constitute personal medical advice. Contraceptive choices should always be made in consultation with a qualified healthcare professional who can assess your individual medical history. The combined pill, mini pill, patch, ring, and emergency contraception (ellaOne) are prescription-only medicines in the UK — they must be prescribed following a clinical assessment. In a medical emergency, call 999.