Contraception - the most and least effective types of birth control

So, here’s our guide to contraceptives: how they work, what you need to know, and how effective they really are – ranked from most effective to least.

Click the below link to jump to your chosen method, or keep scrolling to read about ‘em all...

• Vasectomy
• Female Sterilisation
• IUD/Non-Hormonal Coil
• IUS/Hormonal Coil
• Contraceptive Injection
• Contraceptive Implant
• Combined Pill
• Progestogen-Only Pill
• Male Condoms
• Diaphragm
• Natural Family Planning

Vasectomy/'The Snip' (Male Sterilisation)

How does it work? If you and your partner have both agreed you don’t want any more children, you may want to discuss a vasectomy - male sterilisation where two tubes are blocked or cut and sperm is stopped from entering a man's semen.

How long does it last? Vasectomies are permanent. You’ve probably heard of vasectomies being reversed. It is very difficult to do, if even possible – so you and your partner have got to be 100% sure before having one.

How effective is it for protecting against pregnancy? More than 99% effective, says the NHS. It does not protect against STIs.

How soon does it start protecting you? Once your partner’s had a vasectomy, you’ll need to use another form of contraception for approximately 3 months following the op, as some sperm may still be in his tubes.

Post-op, your doc will give you 2 separate sperm tests before it’s confirmed to be successful.

Possible side effects after the op include:

• Bruising of the scrotum
• Blood in the semen
• Bleeding/blood clot in the scrotum
• Pain/discomfort
• Chronic pain
• Swelling
• Fluid build up in the testicle
• Cysts or sacs developing

What else? Keep in mind that vasectomies, though the side effects sound horrible, are actually considered low-risk procedures.

How can you get it? The first step is making an appointment with your GP, who’ll be able to refer you to the right department.

What our mums say: Members of our MadeForMums community have lots of experience with their partners getting vasectomies - we've even heard a few tales of pregnancy post-vasectomy. The procedure, they say, wasn't too hard on their other halves.

"My Hubby has recently just had it done, in and out of hospital same day, went in for 8am and was back home by 11 am.

"Few stitches and bit of swelling/bruising, was given anti-flammatory and painkillers which at first he didn’t take as he said it wasn't that painful, but I told him to take the anti-inflam ones just to help ease/aid recovery.

"He could have been back in work within 2 days but was already off for the week. He said the following day he felt a bit stiff, as in walking, but that was all," says Sarah.

"Our referral took a few weeks, I think we were told 6 weeks but he got an earlier cancellation, " says Cath. "I took him in as he was advised not to drive after and we were there about an hour I think.

"Lots of bruising so was very sore / tender for that day and achey for the next day, spectacular bruising for a week or so, but he had the procedure on Tuesday afternoon and was at work on Thursday.

"He does have a desk job though and would have had another day or so off if he needed to be active I think."

‘Getting Your Tubes Tied’ (Female Sterilisation)

How does it work? This operation sees your fallopian tubes get blocked, to prevent eggs making their way to your partner’s sperm.

How long does it last? It’s completely permanent. Once you go there, you can’t really come back.

How effective is it for protecting against pregnancy? More than 99%. Not an option for protecting against STIs.

How soon does it start protecting you? It’s not immediate – you’ll need to use other protection until the operation and your next period.

In some cases, you may need other contraceptives for 3 months following the op. Check in with your doc for the best advice that’s suited to your personal situation.

Possible side effects include:

• Like any surgery, there are small risks of complications, such as internal bleeding. Small risks, we must emphasise, but risks nonetheless
• It can’t be easily reversed, and you are not likely to get a reversal op on the NHS
• Any pregnancy you do have after the op (it’s not 100%), comes with an increased risk of ectopic pregnancy

What else? When you get sterilised, you’re effectively kissing goodbye to the possibility of more children (or no children at all), so make sure you are 110% sure it’s what you want.

Fortunately, you won’t experience any hormonal changes, and it shouldn’t impact your sex life at all. Getting docs to agree to the op is a process in itself, though, and you may need other contraception in place while you go through it.

How can you get it? The first step is making an appointment with your GP, who’ll be able to refer you to the right department. It’s likely you’ll have to jump through a fair few hoops for this – especially if you’re a young woman, or don’t have any children.

What our mums say: Admittedly, not many mums in our MadeForMums community have had their tubes tied... many are still in the pregnancy and baby phase, or are keen to have more.

However, we do know that one of our mums, sadly, came to regret her decision and found herself wanting another child.

"I had 5 children with my ex husband.. tied my tubes 8.5 years ago... divorced and had my heart broken when he had more kids.

"Moving forward and seriously dating a new guy... never late or had a missed period... early period last month and now I'm 3 days late... bloated to the max... nauseous... with no signs of period in site....could it be a miracle??? Or am I getting too excited and jumping to conclusions??" – Emmy.

Another member of our community reckons the burden should fall to men, adding: "I do personally think that unless having [your tubes tied during] a C-section, that it should be blokes that have it done.

"After all, their bits are just hanging around, waiting for that little nick that will sort the tubes - probably under local anaesthetic instead of a GA (women have to have GA). It is a lot more involved for a woman!" – Nicole.

Intrauterine Device/Non-Hormonal Coil (IUD)

This is the proper name for the Copper coil.

How does it work? It’s the same device as an IUS – a small, T-shaped device that sits in your womb. However, instead of releasing hormones, it releases copper, which stops you getting pregnant.

How long does it last? 5 – 10 years, depending on the type you have.

How effective is it for protecting against pregnancy? More than 99% effective, when it’s in properly. (If it’s not fitted correctly, you’ll likely know about it sooner rather than later. You can also check it’s still in place using 2 threads that hang down – your doc/nurse will show you how.)

How soon does it start protecting you? Straight away! This is the same after you’ve given birth, too, though you will need to wait 4 weeks post-labour before getting it fitted.

Possible side effects include:

• uncomfortable/painful insertion – yep, getting the coil in’s not always pleasant
• periods may become heavier, longer or more painful vaginal bleeding
• discomfort or pain
• if the IUD shouldn’t work properly, and you do become pregnant, there is a risk of ectopic pregnancy.

What else? After you’ve had it fitted, you need a check-up 3 to 6 weeks later, to check it’s all A-OK. Don’t forget to check the strings from time to time, to make sure your coil’s still in the right place.

How can you get it? Via your GP or nearest sexual health/GUM clinic.

What our MadeForMums community members say: “Most people I know didn’t like the IUD – it caused them loads of bleeding and cramps that didn’t ever calm down. But for me? I’ve had mine in for the full 5 years.

“It makes my infrequent/irregular periods 100% regular, and though I get a bit more cramping throughout the month, the trade-off is worth it for protection… and no hormones, which was the most important requirement to me, as I've felt awful on every form of hormonal contraception (and I've tried most of them!)” – Sally

Intrauterine System/Hormonal Coil (IUS)

This is the official term for the Mirena Coil, or the other most-used brand in the UK, the Jaydess.

How does it work? Essentially, an IUS is a small, t-shaped device that a trained doc or nurse will place into your womb. It’ll also release the hormone progestogen to help prevent pregnancy.

How long does it last? 3 – 5 years. So, ideal if you’re a forgetful type, or don’t want the worry of taking a pill each day.

How effective is it for protecting against pregnancy? More than 99%, when fitted correctly. (If it’s not fitted correctly, you’ll likely know about it sooner rather than later. You can also check it’s still in place using 2 threads that hang down – your doc/nurse will show you how.) It doesn’t protect against STIs.

How soon does it start protecting you? Straight away, if fitted in the first 7 days of your cycle. Use condoms for 7 days in any other case, just to be safe.

Possible side effects include:

• stopped/irregular periods
• vaginal bleeding
• discomfort or pain
• mood changes
• loss or change of libido
• headaches
• breast tenderness
• an uncommon side effect could see you develop “small fluid-filled cysts on the ovaries – these usually disappear without treatment”, says the NHS
• if the IUS doesn't work properly, and you do become pregnant, there is a risk of ectopic pregnancy.

What else? We know the coil – IUS or IUD – can be really uncomfortable for some women. You’ll never know until you try, but if you suffer lots of pain and heavy bleeding that doesn’t stop, don’t be afraid to get it taken out by your doc/nurse, and try something else.

How can you get it? Via your GP/nearest sexual health or GUM clinic.

What our MadeForMums community members say: We've had a real mixed bag of those who LOVED the Mirena and those who've HATED it, but here's a balanced view...

"Have had the Mirena coil in twice, for a total of 7 years and it took a few months for my periods to regulate themselves, then basically I hardly bled at all every month, to the point where I used mini tampax but most panty liners!

"I also had a copper coil after my daughter was born 13 yrs ago and that was a complete nightmare and would never recommend that... I bled so badly every month it was awful...I flooded at night and would always have to wear a tampax and a pad during the day...

"I will definitely be having a Mirena back in at my 6-week check (was going to try for 4th baby but think I will play safe for a while!!!) and yes it is uncomfortable for a few seconds, it doesn't really hurt!

"I took my baby with me, had some ibuprofen before I went and breathed through the insertion...having my belly button pierced was far worse!!!" - Carolyn

"I had Mirena fitted after birth of 2nd baby. Insertion wasn't painful at all but afterwards i felt ill and couldn't drive home for a couple of hours. Good thing I'd left baby with my mum.

"I had Mirena removed after 3 months of almost constant bleeding, it just didn't agree with me. Removal was fine, doctor said "cough" and pulled it out, lol" - Shelly

Contraceptive implant

How does it work? The implant (nexplanon) is a little plastic rod that sits in your arm, and slowly puts in the hormone progestogen into your blood.

How long does it last? The implant lasts for 3 years. Once your doc or a nurse has put it in, then you don’t need to do anything to remain protected, other than renew your contraception once the 3 years is up.

How effective is it for protecting against pregnancy? More than 99% effective. It doesn’t protect against STIs, though.

How soon does it start protecting you? Between days 1 – 5 of your cycle, you’ll be protected straight away. Getting it done any other time? Use condoms for 7 days.

HOWEVER if you’ve just given birth, the rules are slightly different. If you get it put in up to 21 days after the birth, you’re protected straight away. Anytime after, use condoms for 7 days.

Possible side effects include (especially during the first few months):

• headaches
• nausea
• breast tenderness
• mood swings
• acne
• irregular periods.

What else? Some medications – including a number of antibiotics – can affect the implant. So, always chat to your doc before taking anything.

How can you get it? The usual suspects: your GP, or a sexual health/GUM clinic.

What our MadeForMums community members say: "I had it and I got on with it fine. Didn't notice any side effects. I'm on the injection at the minute but will have it again when I'm done having babies because it lasts 3 years so don't wanna have it taken out in a year or so when I want another!

"That was the only problem, DR took ages to get it out - it was a bit of a faff, not really a problem though" - Kelly.

"Personally I HATED it!!!! I had constant pg symptoms, bloated, boobs killed and i put on weight,I know everyone reacts differently but it wasn't for me, really screwed up my cycle....we're trusting Mr Durex 'til we ttc again next year" - Kim.

Contraceptive injection

The most common type of birth control injection in the UK is called Depo-Provera. Some GPs may also offer Sayana Press, but it’s much less common. There’s one called the Noristerat, but it lasts for less time than the above.

How does it work? It works by releasing the hormone progestogen into your body, which works to prevent pregnant. Usually, the injection’s done in your bum cheek. You may also be able to get it in your upper arm.

How long does it last? 13 weeks, and then to remain protected you need to get another injection. Only 8 weeks for the Noristerat.

How effective is it for protecting against pregnancy? More than 99%, when used properly (i.e. when you get your injections on time). It’s about 94% when you think about how women are actually using it.

How soon does it start protecting you? If you get your first injection during days 1 – 5 of your menstrual cycle, job’s done! Otherwise, you should use condoms for at least 7 days, as it’ll take a little while to make sure you’re protected.

HOWEVER if you’ve just given birth, the rules are slightly different. If you get it put in up to 21 days after the birth, you’re protected straight away. Anytime after, use condoms for 7 days.

Possible side effects include:

• heavy bleeding, especially in the first few weeks after giving birth
• period changes – of all kinds. If you’re happy with how your period is now, we’d suggest avoiding
• headaches
• acne
• hair loss
• decreased sex drive
• mood swings

What else? The Depo or other injections aren’t for you if you’re planning to get pregnant in the next year or so – as it could take just as long for your periods to come back, after your final injection’s stopped working.

Probably not one for needle-phobes, either, or those who are forgetful when it comes to remembering appointments.

How can you get it? Via your GP or nearest sexual health/GUM clinic.

What our MadeForMums community members say: "I did 9 months and bled constantly for 7 months (the last 7), some days just spotting but mostly a constant period, I've been on the mini pill now for a few weeks and for me it's a lot better.

"But every women is different: I had a friend whose periods completely stopped with the Depo injection" - Alison.

"I was on it too on and off for about 5 years. Never had any problems with it - no bleeding, no weight gain and didn't seem to have an effect on my sex drive whereas the pill made me gain weight and made my boobs huge (big enough already) so for me the injection was fab xx" – Holly.

“I hated the injection,” says Sally. “It did the job, and I didn't have periods at all, but after I came off it, I had a horrible experience.

"Just my hormones rebalancing, I think. It was very uncomfortable. Lots of back pain, general malaise and fatigue, extreme tiredness. I also put on weight around that time.”

Progestogen-only pill

There are 2 types of progestogen-only pill, the 3-hour pill (known as ‘traditional’ and the 12-hour pill (‘desogestrel’).

How does it work? The progestogen pill is different to the combined pill, in that it thickens your cervical mucus to stop the sperm reaching the egg and prevent pregnancy.

You have to take it within 3 hours/12 hours of the same time each day for it to work, depending on which pill you’re taking.

How long does it last? You also have to take it every day, at the same time each day, though unlike the combined pill there is no 7-day break.

How effective is it for protecting against pregnancy? More than 99% effective – when taken correctly. Experts reckon it’s actually about 92% effective when considering how women usually take it. It doesn’t protect against STIs.

How soon does it start protecting you? If you begin taking it during days 1 – 5 of your menstrual cycle, job’s done! Otherwise, you should use condoms for at least 2 days, as it’ll take a little while to make sure you’re protected.

Possible side effects include:

• getting spots
• feeling like your breasts are tender.

What else? You can take this one if you’re over 35 and smoke, unlike the combined pill. You may also need to check none of your other medication affects your chosen pill, before taking it.

How can you get it? Either from your GP (if they do that at your local practice), or a sexual health/GUM clinic.

• Can you get pregnant when you're on the pill? All the facts

Combined pill

There are lots of different combined pills out there, including Microgynon, Logynon and Yasmine.

How does it work? You take a small pill that contains the hormones oestrogen and progesterone. This stops an egg from releasing from your ovary. Typically, you’ll take the pill daily for 21 days, at which point you’ll have a 7-day break, and start again.

How long does it last? You have to remember to take the pill every day, at around the same time each day, for it to work.

How effective is it for protecting against pregnancy? More than 99% effective, IF you take it as you should. Obviously, the less you remember to take it, the more chance there is of you getting pregnant. It’s thought to be around 91% successful. It doesn’t protect against STIs.

How soon does it start protecting you? If you begin taking it on the first day of your period, you’ll be protected straight away.

Possible side effects include:

• becoming rather moody and feeling a range of heightened emotions
• feeling like you’re going to be sick
• breast tenderness
• headaches
• weight gain, maybe? There’s no actual evidence for this, other than pill users reporting this symptom themselves.

On the plus side, if you have awful PMS or have endometriosis, the pill might actually help with those symptoms.

What else? The effectiveness of the pill can be affected by whether or vomiting or suffering severe diarrhoea – as the pill will have left your system.

It might also be affected by other meds you’re taking – just tell your doc what medication you’re on before starting the pill.

How can you get it? If you’re medically OK’d to have it (people with certain conditions or over 35s who smoke can’t), then you can get the pill from your GP, local nurse or sexual health clinic.

What our MadeForMums community members say: "I feel so much better in myself for coming off it. Not so many headaches and moods. I have lost some weight and my boobs seem to be shrinking though! I was on the pill for about 15 years." – Kate.

"I am taking Micronor whilst breastfeeding. You do have to take it at the same time each day and if you are more than 3 hours late you need to use extra protection for a week. No problems with it apart from forgetting to take it a few times x" - Laura.

Male condoms

This one might seem a bit obvious, but hear us out…

How does it work? Condoms are worn during sex, over the man’s penis, to stop sperm entering the vagina.

How long does it last? One condom per sex session, so you need to use one Every. Single. Time.

How effective is it for protecting against pregnancy? 98% effective, according to the NHS. More like 82% considering how often they’re used quite carelessly. They DO protect against STIs, though. The only thing that does!

How soon does it start protecting you? As soon as it's put on. If it breaks or slips off, you’re not protected.

Possible side effects include:

• There aren’t any typical ‘side effects’ – though obviously condoms can break or slip. If this ever happens, you’ll need emergency contraception and possibly an STI test.

What else? Make sure you’re using the right lube for sex with condoms. Water-based is the way to go for latex condoms or polyisoprene condoms, and oil-based (like lotion or Vaseline) definitely isn’t.

We'd also argue that this is a good option for someone who isn't having sex all the time, just every once in a while.

How can you get it? They’re available free from your local sexual health/GUM clinic, or you can buy them from pharmacies and other shops like Boots.

What our MadeForMums community members say: "We used condoms before we started TTC for 2 years 'cos I'm rubbish at taking the pill and Durex seems to be the best xx" - Vicky.

Diaphragm

We don’t hear a lot about diaphragms here in the UK – though they are a popular birth control method in the US.

How does it work? A diaphragm is a soft, bendy silicone cup that you put in your vagina before you have sex, and covers your cervix – stopping your partner’s sperm getting in there. Often, it’s used with spermicide (a gel that basically kills sperm).

How long does it last? Your diaphragm itself will last a good while (approx. 2 years), but it’s only gonna work when you’ve put it in for the duration of sex, properly.

You shouldn’t put it in any earlier than 2 hours before sex (because that’s how long spermicide lasts!), and you need to leave it in for 6 hours after.

How effective is it for protecting against pregnancy? In a perfect world where you use a diaphragm flawlessly every time, it’s 94% effective.

In real life, the way they’re actually used, you’re probably looking at a success rate of around 88%. It doesn’t protect against STIs.

How soon does it start protecting you? Straight away.

Possible side effects include:

• spermicide can irritate you down below or make your vagina sore
• Urinary Tract Infections can be quite common for diaphragm users
• it’s possible your body won’t agree with the material in the diaphragm, and that could be uncomfortable, too.

What else? The diaphragm’s not for you if:

• you gave birth in the last 6 weeks
• you’re very sensitive down there
• you’re not cool with frequently putting your fingers deep into your vagina
• you’ve ever had Toxic Shock Syndrome, or you/your partner has HIV/AIDS
• you’ve ever had an abortion in the later stages of pregnancy
• you’re allergic to silicone or spermicide.

You may also want to avoid it if your weight fluctuates a lot - every time you go up or down more than 10lbs, you'll likely need a new diaphragm to be fitted.

Finally, if you have a lot of sex, you may find putting the diaphragm in rather annoying, so may work best for someone who is having sex less frequently.

How can you get it? Talk to your GP or local sexual health/GUM clinic for info on how to get a diaphragm.

Natural family planning

Essentially, natural family planning involves knowing your cycle inside out, and avoiding sex when you know you’re ovulating.

This is often the best option for women who follow certain religions, where use of other contraceptive methods is forbidden or frowned upon.

How does it work? There a number of natural family planning methods you can try, as well as apps and products available to help – all of which involves one or more of the following:

• monitoring your periods and your menstrual cycle daily
• recording your body basal temperature (BBT)
• daily recording your cervical mucus/secretions to know exactly when in your cycle you are fertile, and when you’re not.

How long does it last? For as long as you’re willing to put in the work, really. If you slip up and have sex when you’re fertile, it may well not last very long. If you’re absolutely diligent about it, it could work wonders.

How effective is it for protecting against pregnancy? That’s a tricky one. The NHS website says it can be up to 99% effective when done correctly… but how likely is that?

We’ve seen some stats suggest that typical use (i.e. how most women are doing natural family planning) can have a 12 – 24% failure rate. That’s a 76 – 88% success rate. Not quite as promising. It doesn’t protect against STIs, either.

How soon does it start protecting you? We’d say you need to get to know your cycle, how regular it is, and practice the method before you use it as your only form of contraception. So, give it a few months, at least.

Possible side effects include:

• None. There aren’t any side effects, because, effectively, all your doing is monitoring your body and recording its every move.
• However, there are lots of things that can affect your periods, and therefore your planning, such as stress, and other lifestyle factors.

What else? There are MANY women for whom natural family planning is not the best option, says the NHS website, especially women who:

• have just given birth
• are breastfeeding
• have irregular periods
• have an STI, vaginal thrush or pelvic inflammatory disease
• are taking medication that affects cervical mucus
• recently stopped hormone-based contraception (like the pill, the injection or the IUS)
• drink a lot of alcohol
• recently miscarried
• recently terminated a pregnancy
• regularly travel through different time zones
• have used the emergency contraceptive pill in the last 2 months.

You also need to make sure you’ve had proper guidance from a medical professional – a fertility awareness teacher – before you start.

How can you get it? It’s not something you get, it’s something you do. Don’t do this without consulting your GP first, and seek guidance from them on how to learn the techniques from a professional. You can also talk to your local GUM/sexual health clinic for further advice.

What our MadeForMums community members say: "I have been doing this I have an ovulation calendar that tells me when I am fertile and when I am not, just the same as you would have if you were trying. I have been doing this for 7 months now and it has been working.

"I did this as the pill didn't seem to work with me and I did not like the coil. I will be honest, you have got to be very strict with it and very controlled.

"It sounds funny but you always seem to want [sex] on the bad days so you have to be quite strong not to. I had a couple of times after coming home from a drink and really wanting it but knowing I couldn't due to ovulation period.

"A lot of people may laugh at these methods and they are definitely not guaranteed to work, but the pill didn't work for me.

"I know that it is still a risk doing it this way, but I have been doing it for 8 months now since my youngest was born and it gets easier each month, and if I was to fall [pregnant] it would not necessarily be a problem" – Laura.

Pics: Getty Images

Read more:

• Mum pregnant with twins 6 weeks after giving birth
• When do your periods start again after having a baby?
• Is it possible to get pregnant while breastfeeding? Erm, yes!