Contraception Choices: A Practical Checklist

The available methods of preventing pregnancy and how they compare in practice. The difference between perfect use and typical use is large for the methods most people choose, and small for the ones they are rarely offered.

Key takeaways

• Most effective methods: implant, IUD and IUS
• Long-acting methods: do not depend on remembering anything
• Most useful single change: Ask specifically about long-acting reversible methods.
• Commonest mistake: Assuming typical use matches perfect use.
• See a doctor if any of the signs under "When to speak to a doctor" below apply to you.

Do

• Ask specifically about long-acting reversible methods
• Get emergency contraception as early as possible; pharmacies supply it
• Review your method when circumstances or medications change
• Use condoms alongside for STI protection

Do not

• Assuming typical use matches perfect use
• Combined hormonal methods with migraine with aura, or smoking over 35, without discussion
• Stopping contraception before menopause is confirmed

The numbers behind the list

Here are the figures the checklist is drawn from.

If you change one thing

Ask specifically about long-acting reversible methods. That is the opening item above. Doing only that is still doing something.

Where to go next

• Contraception Choices at a Glance
• The Evidence on Contraception Choices, Without the Hype
• Contraception Choices — the reference entry
• What the Guidance Really Says About HIV
• What the Guidance Really Says About Cervical Screening and HPV

When to speak to a doctor

Seek urgent medical help for calf pain or swelling, chest pain, severe breathlessness, sudden severe headache, weakness on one side or vision loss while using combined hormonal contraception. Tell your prescriber about migraine with aura, smoking over 35, high blood pressure or a history of blood clots.

Where this comes from

• NICE — Contraception clinical knowledge summary
• NHS — Contraception guide

How this page was put together

Every figure, recommendation and warning above is taken from the guidance named in Where this comes from. Nothing on this page is inferred, summarised or generalised beyond what those bodies publish: where they give a number, it is their number, and where they are silent, so are we. Pages are rebuilt whenever the underlying record changes. Sign-off by a named clinician, where it has happened, is shown at the top of the page along with the date.

Medical disclaimer

This article is general information, not medical advice. It cannot account for your own history, medication or circumstances. Always speak to a GP, pharmacist or another qualified health professional before making changes that affect your treatment, and never delay seeking medical advice because of something you have read here. In an emergency, call 999.