General advice on contraception

Everybody, both women and men, has the right to reliable contraception when a pregnancy is not desired. When used correctly, modern contraceptive methods allow reliable birth control. Condoms are extremely valuable as they protect against STD infections. In terms of contraception, however, they are not as effective as hormonal contraceptives or intrauterine devices (IUDs, also known as coils). The most suitable contraceptive method is chosen individually. The choice of method depends on your own wishes and those of your partner, sometimes your attitudes, life situation, the type of contraception required, how regularly contraception is required, your current and previous health, and factors such as smoking. When considering the choice of contraceptive method, it is therefore important that you have sufficient information on the different methods and guidance on how to use them. You are most likely to use contraception correctly if both you and your partner are happy with the method you are using. It is up to the doctor to make sure that the method chosen is suitable for the woman's health and safe for her. If you wish, your partner is also welcome to accompany you and discuss contraception during a visit to a doctor or public health nurse.

Hormonal contraception is a good option for a healthy young woman who has not given birth. The term combined hormonal contraception refers to oral contraceptives ("the pill"), contraceptive patches and vaginal contraceptive rings, all of which contain both oestrogen and progestogen. Progestogen-only pills ("mini pills"), contraceptive implants and hormonal intrauterine devices (hormonal IUD, hormonal coil) only contain progestogen and are therefore known as progestogen-only contraceptives. Combined hormonal contraceptives have been available for more than 50 years and have become the preferred contraceptive method especially for women who have not given birth. When used correctly, their contraceptive efficacy is good and the woman's menstrual periods are regular and can be controlled. Combined hormonal contraceptives can also be used to treat conditions such as heavy menstrual bleeding, menstrual pain, polycystic ovary syndrome (PCOS), endometriosis and acne. Hormonal contraception is medication, and a doctor is responsible for its use and follow-up. For health reasons, combined hormonal contraception is not suitable for all women - even those who are young. The woman may also have to discontinue its use because of adverse effects or changes in health during use (oral contraceptives). It is important that hormonal contraception is followed up and the woman has good and confidential contact with health care professionals.

Progestogen-only contraception can often be used by women who, for health reasons, cannot use combined hormonal contraception. Progestogen-only contraceptives cannot be used to time menstruation; menstrual bleeding occurs individually in those using mini pills and contraceptive implants. The woman's periods may also stop, which is not dangerous to health and does not signify impaired effect, actually quite the contrary. In those using a hormonal coil, menstrual bleeding usually becomes much lighter and stops completely in a large proportion of users. The use of coil (IUD) contraception has increased, even among women who have not given birth, and several studies have shown that the method is also suitable for this group of patients. The increase in the risk of pelvic inflammatory disease has turned out to be lower than expected, since the risk mostly depends on the woman's sexual behaviour and not on her contraceptive method. A woman who has not given birth can use a coil if her womb is of normal structure and large enough for a coil and if she needs regular contraception, preferably in a long-term relationship. Both copper and hormonal coils are used for five years. Copper coils are particularly important if the woman wants a reliable nonhormonal contraceptive method for health reasons or for other reasons. 

This article was written by
SV, 21 Nov. 2013

Key words: Oral contraceptives, Contraception