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The Choice is Yours
New research just out highlights that today, women could be denying themselves the benefits of medical innovations in contraception because of a reticence to try anything `new`.
With so much choice available it can be difficult to know exactly which one is right for you. However, choosing an effective and reliable method of contraception is an ongoing process rather than a one-off decision. Circumstances can change throughout the course of a woman's life and your choice of contraceptive should reflect your lifestyle and lifestage. Making positive choices about contraception and sexual health is important not just for your physical health, but also for your general well-being.
This information does not replace medical advice. For more information about the contraceptive choices available to suit your individual needs, speak to your doctor/family planning nurse or contact the fpa nationwide helpline on 0845 310 1334 or visit <www.fpa.org.uk.
| Sophie wants to know: "I've been on the pill for ten years - will it affect my fertility?" | |
| Anne Szarewski said: | The pill doesn't affect people's fertility. However what can happen is that you go on the pill at 16 and maybe you come off at 36 and of course your fertility isn't the same at 36 as it was at 16. That’s how women sometimes get the impression that the pill has made them less fertile. But it's simply that while they are on the pill there fertility isn't being tested because the pill is such an effective contraceptive. So, if you are using condoms for example you will notice if your periods become very irregular or you will realise that you haven't used the condoms consistently. So this would alert you to the possibility of a fertility problem. However when you are on the pill, your own cycle is removed and so you simply don't know what might have happened. |
| Sarah wants to know: "Should I take regular breaks from the pill, I've been told I should only be on it for 4 years at any one time?" | |
| Anne Szarewski said: | There is absolutely no need to take breaks from the pill. The only thing that happens during breaks is pregnancy scares and unwanted pregnancies. If you smoke, you need to stop the pill at the age of 35, but if you don't smoke and you are otherwise well, you can take the pill until you're 50. |
| Gurinder wants to know: "I'm 13 and have very heavy periods. Will using the pill make my periods any lighter?" | |
| Anne Szarewski said: | The pill certainly helps a lot of women with period problems. Not just heaviness but also pain. So I am sure if you go on the pill you find your bleeds less painful and lighter and easier to cope with. |
| Sarah wants to know: "What is the best pill - I am 26, been on the pill since I was 16 and have regular sex with my boyfriend?" | |
| Anne Szarewski said: | The best pill is the one that suits you. There is no one very best pill on the market. Depending on your own medical history and any side effects you may have had on the pill before your doctor should be able to choose the pill you are happy with. |
| Ems wants to know: “I have always had a bit of a problem when I'm on the pill. I get terrible mood swings and kinda take things out on my very lovely and patient boyfriend, what would be a suitable replacement which is just as effective but will cut down on my mood swings?" | |
| Anne Szarewski said: | It would have helped to know which pill you have been taking as some types of pill are more prone to this problem than others. For example, if you are taking a Triphasic pill (one that has three different colour pills in the packet) you're quite likely to get PMT like symptoms. Similarly the solution to that problem is to change to monophasic pill (i.e. the same dose all month) However, even on monophasic pill some women find that the older pills are less mood friendly than the ones that contain newer progestogens in which case the solution would be to try one of the newer pills. |
| Jackie wants to know: "I've been on the pill for 15 years now and thinking of starting a family. How long will it take for the pill to get out of my system? " | |
| Anne Szarewski said: | Basically, if you stop the pill tomorrow, you may be pregnant within a month. So don't assume that there will be any delay in conceiving. It used to be thought that you should stop the pill a few months before you start trying to get pregnant. But it's not necessary. However, I would advise you if you are thinking of trying for pregnancy that you should start taking folic acid as this has shown to be beneficial in early pregnancy. |
| Saz123 wants to know: "Do I have to go to my doctor to get my pills?" | |
| Anne Szarewski said: | Yes, in this country you can't buy the pill over the counter. So you need to go to a GP or a family planning clinic but nurses as well as doctors can prescribe the pill. However, the emergency pill is now available through pharmacies without needing to see a doctor or a nurse. |
| Amy wants to know: "I have been on the pill for several years but recently I have started feeling sick and my breasts hurt a lot just before my period - should I change or give it a break for a while?" | |
| Anne Szarewski said: | It would be useful to know whether you are taking a triphasic pill (one with three different colours in the packet). As I mentioned earlier triphasic pills can give problems with breast tenderness, irritability and bloating in the last week of the packet. If this is the case you just need to change to a monophasic pill. If you are already taking a monophasic pill, then you should see your doctor to check if a change of pill might help. |
| Gogirl wants to know: "My boyfriend does not like wearing condoms - I don't get on with the pill - what can we do?" | |
| Anne Szarewski said: | There are a lot of alternatives to the pill. First of all there is a pill that does not contain any oestrogen (the progestogen only pill). Also, there are implants, injections and intrauterine systems, all of which contain only the progestogen hormone. These do not have the same side effects as the combined pill; the most common side effect is irregular periods. Also, there are copper intrauterine devices that have no hormone at all. You should probably try and get hold of a leaflet about these methods so that you can read more about them before making any decisions. |
| Kik wants to know: "What are the benefits of using an implant contraceptive in comparison to the pill?" | |
| Anne Szarewski said: | The nicest thing about the implant is that once it's put in you don't have to worry about your contraception for three years. So there is no trying to remember your pill everyday. The implant is even more effective than the pill and has very few side effects. Its main side effect is that it can make your periods irregular, particularly in the first six months to a year. |
| Jenny wants to know: "I am terrified of needles but like the idea of implants from a convenience point of view but am worried that I won't be able to actually have it done. What actually happens?" | |
| Anne Szarewski said: | The good thing about having the implant fitted is that it is quite quick and then you don't have to have anything else done for three years. The implant is fitted under local anaesthetic so you wont feel it going in. However of course the local anaesthetic does involve one injection. So you would have to grit your teeth and somehow cope with that. |
| Pen wants to know: "What happens if I have an implant and then change my mind. Can I just have it removed or do I have to wait for it to be out of my system?" | |
| Anne Szarewski said: | The nice thing about the implant is that it is instantly reversible. So when you have it taken out the hormone literally vanishes within a few days. |
| Petra wants to know: "Can you explain how the implants work inside your body?" | |
| Anne Szarewski said: | The implant works by stopping the release of an egg from the ovaries (ovulation). Its efficacy is approximately 100%. |
| Tonya wants to know: "Do implants protect against STDs?" | |
| Anne Szarewski said: | Unfortunately, implants don't offer protection against STDs. It's a good idea to use condoms in addition to whatever more effective contraceptive you choose, to protect against STDs. |
| Shy wants to know: "Barrier or hormonal? What would you recommend for someone in a relationship?" | |
| Anne Szarewski said: | This depends what stage you are at in the relationship. I would always recommend the use of condoms in any new relationship to protect against the possibility of sexually transmitted infections. However, in terms of contraception condoms are not particularly effective with a failure rate in practice of around 15%. So if it's important for you to avoid pregnancy you should consider using one of the more effective contraceptives in addition to the condom. Which method you choose will depend on your medical history and your lifestyle at any given time. Both of those may change and so you may want to review what you are using every now and again. |
| Paul wants to know: "I may be in a male minority asking about women’s contraception, but my girlfriend has often mentioned and I have noticed that the pill actually puts her off sex, however neither of us like the idea of using condoms or using internal methods like coils, diaphragms etc. Can you suggest another "hands free" method i.e. drug-based that will have fewer side effects, but be as reliable. It seems pointless to take a pill to prevent pregnancy after sex if that pill puts you off it in the first place. Please help!" | |
| Anne Szarewski said: | Your girlfriend should probably ask her doctor whether a different type of pill might be worth trying because even different combined pills can affect libido in different ways. Otherwise, there are also progestogen only methods which may be worth considering. |
| MPS wants to know: "I have seen your answer to Petra's question but think that if it stops ovulation, does that mean you wouldn't have a period at all for the time the implant is in? That doesn't sound very healthy?" | |
| Anne Szarewski said: | In practice what happens with implants is that the majority of women do still see periods, but they bleed irregularly. In fact, periods are not at all necessary for good health. If you think about it, if you were using no contraception and having sex you would be pregnant virtually all the time and of course during pregnancy women do not have periods for nine months. No one has ever suggested that is unhealthy and conversely certain cancers (breast, ovary, endometrium) are all less common in women who have had fewer periods. |
| dream2: "I know you can receive the Pill free on the NHS, but can you get implants on the NHS too?" | |
| Anne Szarewski said: | Yes, implants are free on the NHS. |
| Saz wants to know: "What is the most statistically effective form of contraception (other than celibacy obviously!!)" | |
| Anne Szarewski said: | In fact, celibacy has a very high failure rate! The most effective methods of contraception are implants, intrauterine systems and devices and injections. The pill is also very effective though not quite as effective as those I have just mentioned. The least effective methods are the barrier methods (condoms and caps) and natural family planning mainly because they rely so heavily on the user (as does celibacy). |
| susu wants to know: "I know I don't want to have any more children, is there any disadvantage of having a hysterectomy or am I better off just staying on contraception until I reach the menopause naturally?" | |
| Anne Szarewski said: | Hysterectomy is quite a major operation and unless there is also a medical reason it is unlikely you would be offered that to stop having children. Even sterilisation is not always the best option - you should think about what might happen if your relationship ended and you wanted children with a new partner. There are a number of reversible contraceptive methods that are as effective as sterilisation, particularly implants and intrauterine systems. You should find out a bit more about these before you make a decision. |
| jb wants to know: "My husband's just had a vasectomy but I'm worried that if I come off the pill - microgynon 40 - that I will get the heavy periods and terrible moods swings that taking the pill put an end to." | |
| Anne Szarewski said: | This relates to the question I've just answered. Indeed, many women have a nasty surprise when either they or their partner has been sterilised and their so-called normal periods return. You may well find that you are happier staying on your pill even though your husband has had a vasectomy. |
| Lou wants to know: "Is there a safe and reliable male pill or implant yet. I am keen for my husband to start to take on some responsibility but don't want to take any risks!" | |
| Anne Szarewski said: | There are trials going on particularly in London and Edinburgh looking at implants for men so your husband might be able to volunteer for one of those. However, it is unlikely that these methods will be generally available for several years yet. |
| Gem wants to know: "I only know 2 people who've been on the contraceptive injection and they both got VERY moody! Is this common?" | |
| Anne Szarewski said: | Unfortunately many women get moody and it's very easy to blame a contraceptive method. There is no scientific evidence showing that any contraceptive method is more likely to affect your mood. |
| Jess wants to know: "I have an implant and am due to start a course of antibiotics. When I was on the Pill, I know this could have an effect on the effectiveness of it but do I need to worry if I now have an implant?" | |
| Anne Szarewski said: | Common antibiotics (e.g. for cystitis and chest infections) don't affect implants. However, it is always best to check with the doctor in case you have been prescribed the less common antibiotics which can also affect implants. |
| Helena wants to know: "I used to be on the pill but found that I put weight on while using it - I've been using condoms for the last few years which are a little 'unromantic' to say the least! I was considering using the implant but am concerned that I will put weight on with this as well." | |
| Anne Szarewski said: | You are very unlikely to put on weight because of the implant and this is also usually true of the pill. Unfortunately, both men and women have a tendency to put on weight and it's so much easier to blame the pill than the chocolates!! |
| Ann wants to know: "Is it true that the pill makes it harder for your body to absorb vitamin B? What can I do to counteract this?" | |
| Anne Szarewski said: | There has been a suggestion that the pill might interfere with vitamin B6 in some women but there isn't really any good evidence of this. If you eat a balanced diet there shouldn't be any need to worry about vitamin supplements. |
| Jones_345 wants to know: "What is the future of contraception - what's next?" | |
| Anne Szarewski said: | The male pill or the male implant is likely to become available in the next ten years. Further into the future scientists are looking at things like contraceptive vaccines. There is also a lot of interest in new spermacides that might also have some protective effect against HIV. Thank you for your questions. I hope the answers have been helpful. For more information log on to www.fpa.org.uk |
