Main contraceptive methods

Contraceptive methods are the devices, medicines and techniques used to prevent pregnancy. The most effective are the implant, IUDs and sterilisation, with fewer than 1 pregnancy per 100 people a year. Only condoms also protect against sexually transmitted infections (STIs).

Perfect use and typical use: reading the figures

Effectiveness is measured as the number of pregnancies per 100 people using a method for a year. Perfect use means using it correctly every time; typical use reflects real life, with missed pills and mistakes. The more a method depends on remembering, the bigger the gap. The figures below (perfect use vs typical use) come from the World Health Organization (WHO) family planning handbook, 2022 edition:

• Implant: 0.1 in both cases.
• Hormonal IUD (levonorgestrel): 0.5 vs 0.7.
• Copper IUD: 0.6 vs 0.8.
• Vasectomy: 0.1 vs 0.15. Female sterilisation: 0.5 in both cases.
• Progestogen injection: 0.2 vs 4.
• Pill, patch and ring: 0.3 vs 7.
• External condom: 2 vs 13. Internal condom: 5 vs 21.
• Diaphragm with spermicide: 16 vs 17.
• Fertility awareness methods: 3–5 vs 12–23, depending on the method.
• Withdrawal: 4 vs 20.

With no method at all, about 85 in 100 people become pregnant within a year.

Barrier methods

These stop sperm reaching an egg. The external condom goes on the erect penis before any genital contact; the internal condom is placed in the vagina or anus. Both protect against pregnancy and most STIs. To make them work, avoid the most common condom mistakes. The diaphragm and cervical cap cover the cervix, are used with spermicide and do not protect against STIs.

Hormonal methods

They mainly work by stopping ovulation or thickening cervical mucus. The hormones enter the bloodstream, including with the ring or patch. They do not protect against STIs.

• Combined pill (oestrogen and progestogen): one a day.
• Progestogen-only pill: useful when oestrogen isn't suitable, for example while breastfeeding or with some cardiovascular risk factors.
• Patch: one a week for three weeks, then a week off.
• Vaginal ring: left in for three weeks, then removed for one.
• Injection: every three months.
• Implant: a small rod under the skin of the arm that lasts several years, depending on the brand.

IUDs: hormonal and copper

An IUD is a small device a clinician places inside the womb. The hormonal IUD (IUS) releases progestogen in the womb and lasts 3 to 8 years, depending on the brand; it often makes periods lighter. The copper IUD is hormone-free, lasts 5 to 10 years and can make periods heavier. Both can be removed at any time, and fertility returns quickly. You can use one even if you have never given birth.

Permanent methods

Female sterilisation and vasectomy are considered permanent, so the decision needs careful thought. Vasectomy is the simpler procedure, but it doesn't work straight away: use another method until a semen test confirms there are no sperm left.

Fertility awareness and withdrawal

Fertility awareness methods identify fertile days using temperature, cervical mucus or a calendar. They take learning and regular cycles, and fail often with typical use. Cycle-tracking apps are based on the same methods. Withdrawal (pulling out before ejaculation) is one of the least reliable methods. If you are trying for a baby, this knowledge helps too: see our fertility and conception guide.

Emergency contraception: time limits

It is for use after sex without protection or when a method fails, such as a split condom. The sooner, the better. According to the NHS:

• Levonorgestrel pill: up to 72 hours (3 days) afterwards.
• Ulipristal acetate pill: up to 120 hours (5 days) afterwards.
• Copper IUD: up to 5 days afterwards. It is the most effective emergency method and keeps working as ongoing contraception.

It does not cause an abortion and does not protect against STIs. In the UK, emergency contraception is free from NHS sexual health clinics and GP surgeries, and the emergency pill is also free from most pharmacies.

Dual protection and common myths

Dual protection means combining condoms with another method: it prevents pregnancy and lowers STI risk. If there is a risk of infection, check how often to get tested for STIs and read our page on sexually transmitted infections.

• "The pill makes you put on weight": studies don't show significant weight gain with the combined pill.
• "You need a break from the pill": there is no need.
• "You can't get pregnant during your period": it is less likely, but possible.
• "Two condoms are safer than one": false; friction makes them more likely to tear.