Choosing a contraceptive: a practical comparison

There is no single best contraceptive — only the one that fits your body, your plans and your routine. Here is how the main options compare so you can arrive at your family planning visit with good questions.

The options at a glance

Combined pill — taken daily, also helps with acne, painful and heavy periods. Not suitable if you smoke over 35, have migraine with aura, or have clotting risk. Progestogen-only pill — safe while breastfeeding and for many women who cannot take oestrogen; needs strict timing. Injection (every 2–3 months) — private and convenient; periods often stop; return to fertility can take several months. Implant (3 years) — inserted in the upper arm in minutes, over 99% effective, nothing to remember; irregular spotting is the main complaint. IUD, copper (up to 10 years) or hormonal (up to 5 years) — the most effective reversible option; copper is hormone-free, hormonal usually lightens periods. Condoms — the only method that also protects against HIV and STIs; use alongside any of the above. Emergency contraception — most effective within 24 hours, still useful up to 5 days.

Questions we will ask you

Do you want children in the next year, or in five years? How heavy or painful are your periods, and would you like them lighter? Are you breastfeeding? Do you have migraine, high blood pressure, clotting history, or take chronic medication? Would you prefer something you never have to think about, or something you control day to day?

What to expect at the visit

Blood pressure, weight and a short medical history. A pregnancy test where needed. A discussion of the options that suit you, including cost and how long each lasts. Insertion of an implant or IUD, or your first injection, on the same day where appropriate. A follow-up date and clear guidance on what is normal in the first three months.

Side effects worth knowing about

Irregular bleeding in the first 3–6 months is common with implants, injections and hormonal IUDs, and usually settles. Mood changes, headache, breast tenderness and appetite changes can happen and are worth reporting. Heavier periods and cramps are common in the first few cycles with a copper IUD. Come back rather than stopping quietly — switching methods is easy and we would rather adjust than have you fall pregnant unintentionally.

Changing your mind

Every method here is reversible. Implants and IUDs can be removed at any time and fertility returns quickly. Book a family planning consultation and we will find the fit together.