The oral contraceptive pill (the Pill) is a combination of two female sex hormones that prevents pregnancy by changing the hormone balance in your body to stop ovulation (the monthly release of the egg from the ovary). If taken according to instructions, it is at least 98 to 99 percent effective.

To be effective to stop pregnancy, the Pill must be taken at a regular time. Periods tend to become shorter, regular and lighter. The Pill also tends to stop painful periods. The Pill can interfere with the quantity and quality of breast milk, so it is better to use other contraception during breastfeeding. Antibiotics, Vitamin C, vomiting and diarrhoea may affect the pill and therefore extra protection is necessary whilst continuing to take the Pill and for seven days after. The most common side effects are nausea (feeling sick), breast tenderness and breakthrough spotting. These side effects often disappear after a couple of months on the Pill. Not all women can take the Pill. Women who have blood-clotting tendencies, hormone-dependent tumours (such as breast cancer), high blood pressure and diabetes or are heavy smokers (especially over the age of 35) should consider alternative methods.

Take the forgotten pill as soon as possible, even if it means taking two pills in one day. Take the next pill at the usual time and finish the course. If you forget to take the missed pill for more than 12 hours after the usual time, there is an increased risk of pregnancy and so you should use another form of contraception (such as condoms) for 7 days. If these 7 days run beyond the last hormone pill in the packet, miss out the inactive pills (or 7 day group) and proceed directly to the first hormone pill in the next pack. If you miss your next period, pregnancy needs to be excluded, either by seeing your doctor or doing a urine pregnancy test (which may be purchased from the pharmacy or supermarket).

There are new concerns about the risk of the oral contraceptive pill before a woman has her first child. Combined findings from medical studies showed using the pill for 4 years or more before the first full-term pregnancy was associated with a slightly increased risk of pre-menopausal breast cancer. Bearing in mind, there are known benefits of the pill, such as protection against uterine and ovarian cancers. It is important to discuss these issues with the doctor.

Taking antibiotics, anti-epileptic medication, high doses of Vitamin C, some anti-fungal medication, St John’s Wort, vomiting, diarrhoea and rapid weight gain can all affect the Pill and make it less effective. Remember the “seven-day rule” (see above).

The minipill contains a very small amount of only one hormone, progesterone. It is sometimes called the progesterone-only pill. It works mainly by making the mucus at the entrance of the uterus (womb) thicker, so that sperm cannot get through to meet an egg. It also works by changing the lining of the uterus. In some women it can stop the monthly release of the egg. The minipill prevents pregnancy but is not quite as effective as the combined pill. The minipill needs to be taken at exactly the same time every day. Often women who are breastfeeding take the minipill as it will not affect the milk supply. There are very few side effects with the minipill, but it is fairly common to have spot bleeding between periods and periods may be further apart or closer than usual.

The IUD (also known as Intrauterine device, Loop or Coil) is a small plastic or plastic and copper object that is placed in the uterus via the vagina. IUDs are 94 to 96 percent effective. The IUD has a string attached to it for removal. About 3cm of string is present in the vagina but neither the IUD or the string can be felt by the woman or the partner. IUDs come in different types and sizes. IUDs prevent pregnancy by stopping a fertilised egg from attaching to the uterus by causing chemical changes to the lining of the uterus. Since this lining comes away when you menstruate this is not harmful. Side effects associated with IUDs include heavier bleeding and cramping for the first few months, usually improving with time.

The more popular and more effective IUS is system that releases progesterone into the uterine cavity – IUS. It can make bleeding much lighter and some women stop having periods altogether. It is the most effective reversible contraception available. It lasts for five years, but may be removed at any time. Studies have shown that if 1,000 women use the system for one year, no more than 2 women may become pregnant. It works in numerous ways: thickening the cervical mucus so that it is difficult for the sperm to get through to fertilise the egg, inhibits the normal sperm function, and reduces the monthly growth of the lining of the uterus. It has minimal side effects and may be used whilst breastfeeding.

The diaphragm is a thin rubber dome with a circular spring around its edge, and is placed in the vagina to prevent pregnancy. Normally after vaginal sex some sperm enters the uterus through the cervix to go along the tubes to where the egg is fertilised. A diaphragm prevents sperm from entering the cervix. There are several different sizes of diaphragms and it is necessary for you to be fitted with the right size. The great advantage of the diaphragm is it is virtually free of side effects, need only be used when needed, does not necessarily require partner co-operation and can be inserted well before intercourse begins. A pregnancy rate of 2 to 4 percent can be expected with a diaphragm but it can only be effective if it is used every time.

The contraceptive 3 month injection is a contraceptive injection of a hormone similar to the natural hormone called progesterone, which is produced in the body by the ovaries. Each injection protects you from pregnancy for about 12 weeks. It works by preventing the release of an egg from the ovary. If the egg is not released, you cannot become pregnant.

The contraceptive 3 month injection is a very effective contraceptive. If 1,000 women were each to use it for one year, only four or five would become pregnant. The main side effect of the injection involves periods. Periods often become irregular and sometimes last longer. Bleeding is not usually heavy and you may have continual light bleeding. When you stop using the injection your periods will return to their regular cycle although this may be up to 18 months in some cases. If you are trying to fall pregnant, the average return to fertility is approximately 7 months, bearing in mind that the injection lasts for 3 months of that time. The number of injections has no effect on how long it takes you to become pregnant. Some women experience weight gain, headaches or depression whilst on the injection. Side effects can last for 3 months or longer. There are concerns about the effects on bone mineral content in long-term users. It is recommended that use be restricted to 5 years.

It is a thin plastic rod that is inserted under the skin of the upper arm. It lasts for three years but may be removed at any time with full reversibility. It is more than 99 percent effective at stopping pregnancy. It releases a progesterone-like hormone that inhibits the release of eggs from the ovaries. Periods may become irregular and approximately 20 percent of women stop them altogether. Weight gain, acne and mood changes are other reported side effects, but most women tolerate it without any problems.

Chlamydia is the fastest growing sexually transmitted infection and the most common. It often goes unnoticed and therefore can be left untreated. It often does not produce any symptoms in its early stages. It is very easily treatable but if it is left untreated, it can lead to more serious health problems. These include pelvic inflammatory disease (infection of the uterus and fallopian tubes), which can lead to infertility problems. It can also lead to tubal pregnancies (ectopic) and chronic pelvic pain. A simple test is all that is required to identify men and women with this infection, followed by a short course of antibiotics.

Chlamydia Information

Postinor-2 is an emergency contraceptive and may be purchased from the pharmacy without a prescription. It comprises 2 tablets and these are taken exactly 12 hours apart. It is used to prevent pregnancy when taken within 72 hours of unprotected intercourse. It is estimated that it will prevent 85 percent of pregnancies. It is not intended as a regular method of contraception and will not prevent sexually transmitted infection.

If you do not get a period within 3 weeks of taking the tablets you must see your doctor as you may be pregnant.