Women's health
Choosing contraception is a personal decision.
Understanding the available options, potential side effects, and how they fit into your life can help you make an informed choice.
Choosing contraception starts with the right advice
Contraception is about more than preventing pregnancy. Your health, lifestyle, plans for future pregnancy, and access to healthcare all play a role in finding a method best suited to you.
There are many contraceptive options available, including oral contraceptives, injectables, implants, intrauterine devices (IUDs), condoms, and emergency contraception. Permanent options, such as female sterilisation and or partner’s vasectomy, may also be considered by people who are certain they do not want future pregnancies. The World Health Organization (WHO) provides an overview of the different contraceptive methods available.
Choosing not to have sexual intercourse is also a personal choice. Contraceptive counselling should give people the information and support they need to make informed decisions about their reproductive health.
With World Contraception Day falling on 26 September, Julie Storm, a professional nurse and the founder and practice owner of Fleur Women's Wellness at Panorama Medical Centre, answers six common questions.
1. What contraceptive method is right for me?
There is no single method that works for everyone. Factors such as your medical history, lifestyle, future pregnancy plans, effectiveness, and how easily you can access the method all matter.
Storm says women should be given information about all the available contraceptive options, including their effectiveness, advantages, disadvantages and practical considerations, before deciding.
Oral contraceptives are not one-size-fits-all. Different pills contain different hormonal combinations, including combined pills containing oestrogen and progestogen and progestogen-only pills (POPs).
For women who are breastfeeding, a progestogen-only contraceptive may be an option, depending on their individual circumstances. Breastfeeding alone should not automatically be relied on to prevent pregnancy, as its contraceptive effectiveness depends on specific conditions being met. A healthcare professional can advise on suitable contraception after giving birth.
Medical history can also affect which oral contraceptive is appropriate. Some contraceptive formulations may be suitable for certain people who experience migraines, while others may not be recommended depending on the type of migraine and other individual risk factors.
Oral contraception needs to be taken regularly, while longer-acting options can reduce the need for frequent appointments or daily reminders.
Longer-acting methods that reduce the need for repeated visits include:
- Hormonal IUDs (small, T-shaped plastic devices placed inside your uterus)
- Subdermal implants (small, flexible plastic rods inserted just beneath the skin of your upper arm).
Both devices must be fitted by a healthcare professional.
For people who are certain they do not want future pregnancies, permanent contraception may also be an option. Female sterilisation involves blocking or sealing the fallopian tubes to prevent pregnancy, while a vasectomy prevents sperm from entering semen. The decision to undergo either procedure should be carefully considered because they’re intended to be permanent.
A hysterectomy, which involves surgically removing the uterus, also means a woman can no longer become pregnant. However, it’s a major surgical procedure and not generally performed solely as a contraceptive method. It may be recommended for some medical conditions when removal of the uterus is clinically necessary.
Emergency contraception is another option when there is a risk of pregnancy after unprotected sex or contraceptive failure. It can be an option for people who are worried about unintended pregnancy and should be accessed as soon as possible.
2. Can contraception affect my future fertility?
If you may want children in the future, you may wonder whether contraception could affect your fertility.
Fertility generally returns after stopping contraception, although the timing varies depending on the method and the individual.
"The science shows us that 85% of women fall pregnant within the first year of stopping their contraceptive method," Storm says.
She notes that the return to fertility can potentially take up to 18 months after injectable contraception. Age is also a key factor, as fertility naturally changes over time.
If having children in the future is important to you, discuss your plans when choosing contraception so you understand how your preferred method may affect the timing of a return to fertility.
Permanent contraception needs careful thought if you think you may want children in the future. Female sterilisation and vasectomy are meant to be permanent. A hysterectomy permanently removes the ability to become pregnant.
3. What side effects can contraception cause?
Side effects vary between contraceptive methods and individuals. So, your medical history is an important factor in choosing the right option for you.
This is why it’s important for a healthcare professional to take a proper medical history and understand the individual before recommending a method.
Oral contraceptives, for example, can cause side effects such as headaches, mood changes, and nausea. Certain medical conditions may also influence which methods are suitable. Contraceptive counselling should consider an individual's medical history rather than treating every woman the same, Storm emphasises.
The response to a particular method can also differ from person to person. “It’s not one-package-fits-all. We find the perfect fit for you.”
If you experience side effects that worry you, speak to a healthcare professional about whether your method needs to be reviewed.
4. What are some common myths and concerns about contraception?
Misinformation can make it difficult to make informed decisions.
One myth is that contraception causes permanent infertility. Storm says this is not true, although the time it takes for fertility to return can vary depending on the method.
Many women believe they will gain weight. This is not always the case – but rather than dismissing a patient's experience, Storm believes healthcare professionals should listen to changes women notice in their bodies.
“It’s important to listen to our patients and what they’re experiencing because it's their bodies in the end,” she says.
Young women may also believe that withdrawal is an effective contraceptive method. Storm says it is unreliable and carries a risk of pregnancy.
She stresses that young people need access to accurate reproductive health information, including guidance about healthy relationships and caring for themselves.
“We have to empower them by helping them understand what a healthy relationship looks like,” she says.
Storm says reproductive health education should help young people make safe, informed decisions rather than simply focusing on the mechanics of sex.
Choosing whether to have sexual intercourse is also a personal decision. People should know that they have a choice and can decide whether they’re ready to have sex. Understanding consent and healthy relationships forms an important part of broader sexual and reproductive health education.
5. Do I still need condoms if I'm using another contraceptive method?
Yes, if you need protection against sexually transmitted infections (STIs).
"Contraception doesn’t protect you against sexually transmitted diseases," warns Storm. "So please protect and look after yourself."
Condoms can be used alongside another contraceptive method to help reduce the risk of STI transmission.
6. When should I reconsider my contraceptive method?
Your contraceptive needs can change as your health, lifestyle, and circumstances change.
Pregnancy, breastfeeding, and perimenopause are examples of life stages that can affect your contraceptive needs. Storm says women who are breastfeeding may have different contraceptive options available to them.
New symptoms or changes in how you respond to a method may also be a reason to reassess your options.
"It’s a continuous process," Storm says. “Each season in your life will bring new things and you need to constantly re-evaluate if this is still working for you because our bodies change.”
Contraception can also have a role beyond pregnancy prevention. Storm highlights its use in managing women's health concerns such as endometriosis or polycystic ovary syndrome (PCOS).