Making choices about birth control isn’t easy. There are many factors that come into play: your overall health, how often you have sex, the number of sexual partners you have and possible side effects.


Birth control, also known as contraception, is a collection of methods used to prevent pregnancy. The different types of contraception can be classified as natural methods, barrier methods, hormonal contraception or intrauterine devices. Most birth control methods are quite effective if used properly. However, contraceptives can fail for a number of reasons, including incorrect use and failure of the medication, device, or method itself. Let’s go through the different options:

Natural methods

Abstinence generally means not having vaginal sex. There are many ways of being sexual without having vaginal sex. The benefits of abstinence are that it’s cheap, readily available and protects against HIV and other STIs. But it takes discipline.

100% effective

Side Effects: none

Withdrawal (coitus interruptus) is a form of birth control that some people call “pulling out”. The man pulls his penis out of his partner before sperm comes out.

97% effective

Side Effects: none

The “safe” period/fertility awareness method. When using this method, you track when you are “fertile” or most likely to fall pregnant. Fertilisation only occurs when intercourse takes place around the time of ovulation. Ovulation usually occurs 14 days before the next menstruation. If you avoid having unprotected sex while you are fertile, you are less likely to get pregnant.

95% effective

Side Effects: none

Lactational amenorrhea. Breastfeeding can be used as an effective form of birth control. In the breast feeding woman, suppression of ovulation occurs because of high prolactin levels. You can use this method for the first 6 months after giving birth by only nursing your baby from the breast (no pumping!).

99% effective

Side Effects: none

Barrier methods

Male condoms are one of the most commonly used methods of contraception. Apart from preventing pregnancy, the condom protects against HIV and other STIs. Like all birth control methods, condoms work better when used correctly. So, read the instructions!

98% effective with perfect use
82% effective with typical use
Side Effects: have to use it every time

Female condoms are made from thin, soft plastic called polyurethane. It is a sac with a wide ring that fits over the outside of the vagina, and with a looser inner ring that fits over the cervix. When used correctly during vaginal sex, they help to protect against pregnancy and STIs.

95% effective with perfect use
79% effective with typical use
Side Effects: have to use it every time

Diaphragm with spermicidal jelly. The diaphragm is a flexible rubber cup that’s inserted into the vagina and fits over the cervix. A spermicidal agent consisting of sperm-killing chemicals are added to enhance the efficacy. Unfortunately the spermicidal agent does not protect against STIs.

94% effective with perfect use
88% effective with typical use
Side Effects: can cause irritation

Hormonal methods

Hormonal contraceptives prevent pregnancy by inhibiting ovulation, thus fertilisation. There are a number of different forms of hormonal methods, each with its own pros and cons.

The Pill, or oral contraception is medication you take every day to prevent pregnancy. There is the combined oral contraception pill (containing estrogen and progesterone) and the progesterone only pill, also known as the Mini Pill. Benefits of the pill include protection against benign breast growths, ovarian cancer and endometrial cancer, and your periods will also become lighter and less painful.

The pill is not suitable for all women. You should not take the pill if you are smoker, older than 35, overweight, have a history of blood clots, heart problems or liver disease. This may increase your risk for blood clots. It’s best to speak to your doctor to find out if the pill is safe for you.

99% effective with perfect use
91% effective with typical use
Side Effects: nausea, mood swings, low libido and spotting

The injection contains progesterone. This hormone will prevent ovulation and increase the thickness of the cervical mucus to block the sperm from getting to the uterus. There are two contraceptive injections – Depo Provera (lasts for 12 weeks) and Nur Isterate (lasts 8 weeks). The main advantages of the injection are: it’s very effective and it lasts 8 to 12 weeks, so you don’t have to remember taking the pill.

99% effective with perfect use
94% effective with typical use
Side Effects: irregular bleeding, low libido, bone thinning

Implant (Implanon NXT). Implanon is a small, flexible contraceptive implant that you doctor places under the skin of you inner, upper arm, providing three years of protection. It contains progesterone, working the same way as the injection.

99% effective

Side Effects: irregular bleeding

Vaginal ring. NuvaRing is a small plastic ring that you place inside your vagina. After it’s inserted it stays in place for 3 weeks. Then it is removed for a 1-week break during which you’ll have your period. The ring releases estrogen and progesterone, working the same way as the pill. The advantages and disadvantages are similar to the pill – the  only difference is not having to remember to take a pill every day.

99% effective with perfect use
91% effective with typical use
Side Effects: irregular bleeding, nausea

The Patch (Evra) is as small sticky patch, similar to a nicotine patch. It is placed on the skin once a week for three continuous weeks, delivering estrogen and progesterone. This is followed by a week without a patch to allow menstruation.

99% effective with perfect use
91% effective with typical use
Side Effects: skin irritation and can be visible to others

Intrauterine device and system

An Intrauterine device (IUD) is a small T-shaped copper device that is inserted into the uterus. It releases a small amount of copper, which prevents the sperm from reaching the egg. The IUD is a long acting reversible contraceptive, lasting for 5 to 10 years. Complications associated with the IUD include perforation of the uterus, infection, expulsion (the IUD falls out) or irregular bleeding. Luckily these complications are rare.

99% effective

Side Effects: irregular, heavy bleeding

An Intrauterine system (IUS), or hormonal IUD goes by the brand name Mirena. It releases progesterone into the uterus. The lining of the uterus becomes thinner and the cervical mucus becomes thicker which makes it harder for sperm to enter the uterus. The Mirena contains no estrogen, so it can be used by women who can’t use the pill. Unlike the IUD, the IUS decreases the amount of menstrual bleeding and works for 5 years.

99% effective

Side Effects: spotting

I hope this makes the choice a bit easier! If you are still not sure about which method is right for you, please make an appointment to discuss the various options available to you.