A Smart Woman’s Guide to

contraception
Questions
to consider before
CHOOSING a contraceptive

Your contraceptive
options

What the
experts say

Match
your profile
A Smart Woman’s Guide to

Contraception
Life is busy and everyday routine is hectic enough without
having to add the thought of contraception into the mix.
Innovations in contraception mean that there are now
a wide variety of options to choose from and finding a
method that suits your lifestyle can mean that you will have
one less thing to think about, leaving you time to plan
ahead for the nicer things in life.

This guide has been designed to provide you with:

• A
 quick and easy overview of some of the factors to
consider when choosing a contraceptive
• A look at some of the options available to you
• Insight into what the experts say
Why finding the Many women may choose to use the same contraceptive method throughout their
lives; however there are many different life-stage opportunities, such as going to
college or giving birth, these are good times to reassess your current contraceptive

‘right’ contraceptive
method and ask if it’s the right one for you at that time.

Despite there being a range of different methods, many women aren’t aware of
the full choice available to them and how their contraception can complement

is important
their lifestyle. For example, there are two main types of contraception: short term
contraception and long-acting contraception.

Along with avoiding unintended pregnancies, of which approximately 80 million

occur globally1, contraception can also offer additional health benefits, such as the
alleviation of heavy or painful periods. Choosing a method that fits your body and
life-stage could be one of the most important health decisions you make and it’s
important that you don’t settle for anything but the best for your particular needs.

Consistent use of contraception is the most effective way to reduce

the risk of experiencing an unwanted pregnancy or acquiring a
sexually transmitted infection. Despite this, many individuals, including
those who do not want a pregnancy and those who are not in a
monogamous relationship, fail to adhere to a regular contraceptive
routine.
In Ireland, for women, 1 in every 7 pregnancies was a crisis
pregnancy2.
Questions to consider
before selecting a
contraceptive
Choosing a contraceptive is a Do I have a preference in
highly personal decision so it is always
how the contraceptive is
useful to ask yourself a couple of
questions to help you weigh up the administered?
options and select the one that is right Would you prefer a method that is
for you. Consider these questions: self-administered, or are you open
to the idea of having a contraceptive
Where am I in my administered by your doctor?
life-stage and how
can my contraception DO I SUFFER FROM HEAVY
fit around this? PERIODS?
Would you like a method of
Are you planning to have a family
contraception that reduces or lightens
soon, within the next few years or
your bleeding?
not at all? Will you be requiring a
contraceptive that will complement
these plans and not affect short-term
DO I NEED ADDITIONAL
fertility? PROTECTION?
If you are not in a monogamous
What type of method relationship or know that your
will I be able to use most partner has a Sexually Transmitted
consistently? Infection (STI), barrier method should
be considered as the hormonal
Are you someone who is able to contraception mentioned in this leaflet
remember to take something daily, do not prevent against STIs.
or does your current lifestyle mean
that you would you prefer something Keep your answers to these questions
longer lasting that you don’t have to in the back of your mind as they will
remember to take on a daily basis? help you decide which method might
be best for you when we go through
the options. Of course, remember that
your contraceptive needs can change
over time. It is also very important
to talk with your healthcare provider
before making a final decision on
what is most appropriate for you.
 There are two main types of contraceptives available: short-acting or long-acting,
with the latter being split into whether the contraceptive is long-acting and reversible
or non-reversible. This guide will only explore reversible methods, however please
speak with your healthcare provider if you would prefer a more permanent option.

Short-acting contraceptives
What are they?
Methods of contraception that are user-dependent and require frequent
administration, on either a daily, weekly, or monthly basis.
Who are they suitable for?
• Women who prefer to administer the contraceptive themselves
• Women who prefer to take contraception with added benefits.
• Women who want to able to control the stopping and starting of the contraception very
easily.
What are the options?
1. The combined pill3 When used correctly, it is three weeks (21 days) after
The combined pill, more over 99% effective, it may delivery in women who are
commonly just referred to help with premenstrual not breastfeeding.4
as ‘the Pill’, is taken orally symptoms and painful
periods. It can also be used 4. The vaginal ring7
every day for usually 21
days, followed by one ‘pill while breastfeeding and The vaginal ring is a small,
free’ week, during which can be taken starting from flexible, plastic ring that is
the woman will bleed; 21 days after delivery in inserted (by the user) inside
afterwards, a new pack is breastfeeding women.4 the vagina and contains the
started. Nowadays, there hormones estrogen and
3. The contraceptive progestogen. After 21 days,
are also options which patch6
are taken every day or 24 it is taken out to allow the
active pill days, followed by The contraceptive patch is woman to have a monthly
a 4-placebo pill days. The a small plaster applied to bleed, before putting in a
Pill contains the hormones the skin that releases the new ring for the next cycle.
estrogen and progestogen, hormones, estrogen and It is more than 99%
is over 99% effective if used progestogen, to prevent effective, can be worn when
consistently and can help pregnancy. It is worn having sex and can be used
to regulate menstruation. continuously for seven days, to regulate periods and
The Pill can be started from and then is replaced with a even make them lighter. The
three weeks (21 days) after fresh patch on the eighth ring can be started

The contraceptive
delivery in women who are day. After three weeks of from three weeks (21 days)
not breastfeeding.4 use, users have a patch-free after delivery in women
week, during which the who are not breastfeeding.4
2. The progestogen-only woman may bleed. The

OPTIONS
pill (POP)5 patch is over 99% effective
The progestogen-only pill, when used correctly and
sometimes called the ‘Mini is not recommended for
Pill’, is a pill that has to be breastfeeding mothers. The
taken every day to work. patch can be started from
Long-acting reversible
contraceptives, (LARCs)
What are they?
LARCs are contraceptives that offer the convenience
of being administered on a less frequent basis
compared with methods such as the Pill. Awareness
of LARC methods are low amongst women and
many family planning and health authorities are
calling for a greater awareness of this method among
women who have had children.8
Who are they suitable for?
• W
 omen who prefer the convenience of a non-
daily contraceptive
• W
 omen who want to space the time between
the births of their children and require flexibility
in terms of reversibility
• W
 omen who have completed their families but
do not want a permanent form of contraception
• Breastfeeding mothers

Research suggests that 80%

of LARC users are satisfied
with their method 9
What are the options?
1. Intrauterine contraception (IUC)10
IUCs are methods of contraception that are fitted into the uterus by a
doctor. While this may seem daunting, they are among the most effective
contraceptives available and once inserted, they provide protection for
between three and ten years. IUCs can be removed at any point and will
generally provide an immediate return to fertility on removal; they can
also be used while breastfeeding. There are two types of IUC:

a) Copper intrauterine device (IUD)11

A copper intrauterine device (IUD), also known as a copper coil, is 99%
effective and can usually be used for five to ten years. IUDs contain no
hormones and work to prevent the egg and sperm from meeting; the
copper also acts as a spermicide. An IUD can be inserted from four weeks
after delivery. Some women may experience heavier, longer periods when
using it. This type of IUD can also be use for emergency contraception.

b) Intrauterine system (IUS)12

The intrauterine system (IUS) is a plastic T-shaped device which is more
than 99% effective and lasts for up to five years. It releases daily small
doses of progestogen hormone called levonorgestrel directly into the
womb. It can be inserted starting from six weeks after delivery, and can
be used during breastfeeding. Your periods usually become much lighter
and shorter, and sometimes less painful. They may stop completely after
the first year of use. It can also be used as a treatment for heavy periods.

2. Implant14
An implant is a small flexible rod inserted into a woman’s arm by a short
surgical procedure. Once in place, it can be felt with the fingers but
not seen. It contains a progestogen hormone called etonogestrel and is
over 99% effective up to three years. Some women using an implant
experience reduced or absent periods, however others might experience
heavier, longer periods. The implant can be inserted from three weeks (21
days) after delivery and can be used while breastfeeding.4

3. Injection13
The injection contains progestogen-only and lasts for 3 months. It is over
99% effective. Injections can be given from four weeks after delivery, and
can be used during breastfeeding. It may sometimes take many months
for fertility to return. Irregular bleeding may continue for some months
after you stop the injections. Other adverse effects may be experienced
such as weight gain.19
Match your
PROFILE
Four women with four different life-stages, using four different
contraceptives; match your life-stage to the profiles below to
see which contraceptive might be right for you:

Clarissa Helen Jessica Sarah

Clarissa is 28 years-old and after three Helen is 42 years-old, has three Jessica is 19 years-old and has been in a
Sarah is 24 years-old, and has just
years of taking the contraceptive pill, children and has completed her family. relationship with her boyfriend for eight
entered into a serious relationship with
she decided that it was time to start With a hectic work schedule, Helen months; having previously used barrier
her partner; having relied on barrier
planning for a family with her husband. wanted the convenience of a long- methods, she decided to visit her doctor
methods in the past, she was conscious
Two years after she stopped taking term contraceptive, but one that is not about alternative contraception now
about having to remember to take a
the pill, she became pregnant and permanent. She was recommended an that her relationship is stable. It was her
daily pill and wanted a method that
gave birth to her daughter. Juggling IUC, and opted for the IUD, effective first time using hormonal contraception
doesn’t interfere with intercourse -
busy motherhood, Clarissa wanted a for up to five years. and so her doctor recommended the
she was recommended an implant,
contraceptive with no daily routine, one combined oral contraceptive pill, to be
effective for up to three years.
that she could use while breastfeeding taken daily.
and one that offers flexibility so that
she can plan to expand her family
within the next few years. Her doctor
recommended an intrauterine system
and fitted it for her during her six week
post-birth check-up.
What the experts SAY
Talking with your doctor at important life stages:
did you know...
Going to College:
What are the recommended types of contraception for this life stage. Short
term contraception can be a good option for a person who may want to change
contraception according to their changing needs. Many of the short term
contraceptives have added benefits which you may want in addition to contraception.
If one of these types of contraception are not suiting you , they are easily changed.
For those who have recently given birth:
Healthcare professionals recommend that all new mothers attend their six to
eight week post-birth check up to ensure that they are coping both physically and
emotionally. This is also the time when the subject of contraception will likely arise,
and there are a couple of misconceptions around fertility and contraception that
should be addressed. For example, did you know that:
Women can return to fertility as early as early as two to three weeks after
delivery.15

Fertility levels between women can vary after the birth of a child. However it is still
possible to get pregnant within a few weeks, even if a new mother’s period has not
returned.

Breastfeeding is not a guaranteed method of contraception.16

While breastfeeding can postpone ovulation, this is not a guarantee and ovulation
can occur even when a woman is breastfeeding.

While it may initially seem daunting to talk with your doctor about some of the more
personal changes to your body after delivery, remember that you are not alone and
all new mothers will be going through similar changes. Consider writing a list of
things you’d like to discuss with your doctor and don’t be afraid to speak up should
you have any worries or concerns. Contraception will most likely form part of this
discussion and so be sure to do your research and come armed with any questions
that you might have to ensure that you select an option that is right for you.
Remember that there is no one size fits all approach to contraception and it is
important to talk with your doctor about the different options available to help you
make an informed, collaborative decision about what will work best for you. For
more information check out www.mycontraception.ie
 REFERENCES
Spiedel J and Harper CC. The potential of long-acting reversible contraception to decrease unintended pregnancy.
1

Contraception 2008; 78: 197-200

2
Crisis Pregnancy: Irish Contraception and Crisis Pregnancy Study 2010 (ICCP-2010) : http://crisispregnancy.ie/wp-
content/uploads/2012/06/ICCP-2010_REPORT.pdf Date accessed: 10/12/12
3
Family Planning Association. Combined Pill [online] Available at: http://www.fpa.org.uk/helpandadvice/contraception/
combinedpill Date accessed: 1/8/12
World Health Organisation. (2009) Medical Eligibility for contraceptive use. 4th Ed.
4

5
Family Planning Association. Progestogen only pill. [online] Available at: http://www.fpa.org.uk/helpandadvice/
contraception/progestogenonlypillpop Date accessed: 1/8/12
6
Family Planning Association. Contraceptive Patch. [online] Available at: http://www.fpa.org.uk/helpandadvice/
contraception/contraceptivepatch Date accessed: 1/8/12.
7
Family Planning Association. Vaginal Ring. [online] Available at: http://www.fpa.org.uk/helpandadvice/
contraception/contraceptivevaginalring Date accessed: 1/8/12.
8
Faculty of Sexual & Reproductive Healthcare Clinical Guidance [online]. Available at:
http://www.fsrh.org/pdfs/CEUGuidancePostnatal09.pdf Date accessed: 1/8/12
9
Peipert, J.F. et al. (2011) Continuation and Satisfaction of Reversible Contraception. Obstertics and Gynecology.
117( 5)1107-1113

Faculty of Sexual & Reproductive Healthcare Clinical Guidance [online] Available at: http://www.fsrh.
10

org/pdfs/CEUGuidanceIntrauterineContraceptionNov07.pdf Date accessed: 1/8/12

Family Planning Association. Intrauterine Device. [online] Available at: http://www.fpa.org.uk/
11

helpandadvice/contraception/iud Date accessed: 1/8/12

Family Planning Association. Intrauterine System. [online] Available at: http://www.fpa.org.uk/
12

helpandadvice/contraception/ius Date accessed: 1/8/12

Family Planning Association. Contraceptive Injection. [online] Available at : http://www.fpa.org.uk/
13

helpandadvice/contraception/contraceptiveinjection. Date accessed: 10.12.12

Family Planning Association. Contraceptive Implant. [online] Available at: http://www.fpa.org.uk/
14

helpandadvice/contraception/contraceptiveimplant Date accessed 1/8/12

http://www.babyhopes.com/articles/what-are-the-chances-of-getting-pregnant-soon-after-giving-
15

birth.html
16
http://www.webmd.com/sex-relationships/guide/birth-control-contraceptive-myths
Gemzell-Danielsson, K et al. (2012) Use of contraceptive methods and contraceptive
17

recommendations among health care providers actively involved in contraceptive counselling —

results of an international survey in 10 countries. Contraception. Epub ahead of print.

17 L.IE.WH.12.2012.0040
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