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Natural contraception

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Natural family planning (or ‘fertility awareness’) is a way for women to work out when they are fertile by using natural signs shown by their bodies. You have to monitor and measure the signs carefully every day for this to work.

How effective is it?

When carried out carefully and correctly, natural family planning can be up to 98% effective in preventing pregnancy. You need to be precise and committed to the method.

How does it work?

Natural contraception works by tracking 3 main fertility indicators in your menstrual cycle.

You must:

  1. take and record your temperature every morning
  2. check what your cervical mucous looks like every day
  3. record the length of your menstrual cycle every month.

It can take 3 to 6 months to get a clear idea of how your menstrual cycle works and what days of the month you are fertile.

Advantages of natural contraception:

  • no side effects
  • great way to learn more about the menstrual cycle and fertility
  • can be used to help plan a pregnancy if you’re thinking about having a baby.

Disadvantages of natural contraception:

  • needs a lot of dedication and commitment - it works best if you learn it from a specially trained nurse or doctor, or other healthcare professional
  • monitoring needs to take place every day, so it’s not something that you can dip in and out of
  • during fertile periods you can’t have unprotected sex - this can make sex less spontaneous or mean that you need to use a barrier method, such as condoms.

Most importantly, natural family planning does not provide any protection against sexually transmitted infections (STIs), including HIV, like a condom does.

Where can I get it from and how much does it cost?

It is important to be taught well and get good instructions if you want to use natural family planning as a method of contraception. So, if you’re thinking of using this method you should speak to a specially trained doctor or nurse.

You’ll need a special mercury fertility thermometer or a digital thermometer to take your temperature every day.

You can buy fertility monitoring kits in pharmacies. There are also mobile fertility apps.

Female sterilisation

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Female sterilisation is also known as tubal ligation or ‘getting your tubes tied’.

How effective is it?

Sterilisation is over 99% effective in preventing pregnancy and is considered permanent.

How does it work?

Female sterilisation involves cutting, blocking or sealing the fallopian tubes, which carry eggs from the ovaries to the uterus (womb), where they might be fertilised by sperm.

This is a fairly minor operation and is done under general or local anaesthetic. Many women go home on the same day.

Women who have been sterilised still ovulate and have periods. Because the egg cannot travel past the fallopian tubes, it is absorbed by the body and dissolves naturally.

Advantages of sterilisation:

It is designed to be permanent, so you won’t need to think about contraception again after this procedure.

Disadvantages of sterilisation:

It’s not 100% effective as in a very small number of cases the fallopian tubes rejoin and the woman becomes fertile again. This happens for approximately one in 200 women. It can happen immediately or a few years after the operation.

Reversing a sterilisation is difficult and not always successful. Reversal is rarely available on the NHS and so will probably be expensive. So, it’s important to be absolutely certain that being sterilised is the right decision.

Things to bear in mind:

Counselling is usually recommended before going ahead. Sterilisation is not usually offered to young, childless women.

Being sterilised doesn’t provide any protection against STIs, including HIV, like a condom does.

Where can I get it from and how much does it cost?

You can be referred for free sterilisation on the NHS by a doctor. This can be your GP, another GP who you are registered with for family planning services, or a doctor at a family planning or sexual health clinic.

The NHS waiting list may be quite long. You can also pay for private treatment, which usually costs more than £2,000.

Vasectomy

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Vasectomy (male sterilisation) is also known as ‘the snip’.

How effective is it?

Having a vasectomy is over 99% effective in preventing pregnancy.

How does it work?

Vasectomy involves cutting, blocking or sealing the vas deferens, the tubes which carry sperm from the testicles to the penis.

This is done under local anaesthetic, takes about 15 minutes, and doesn’t require a stay in hospital.

Advantages of male sterilisation:

A vasectomy is designed to be permanent, so you won’t need to think about contraception again after having one.

Disadvantages of male sterilisation:

It’s not 100% effective – in a very small number of cases the vas deferens may rejoin, meaning the man becomes fertile again.

Reversing a vasectomy is possible but not always successful. Reversal is rarely available on the NHS and so will probably be expensive. So, it’s important to be absolutely certain that having the snip the right decision.

Things to bear in mind:

Having a vasectomy is a big decision to make, and counselling is often recommended before going ahead. It’s not usually offered to young, childless men.

Vasectomies are not immediately effective because there can still be some sperm left in the tubes leading to the penis. Use contraception until you have a test to confirm there is no leftover sperm. You can only be certain the vasectomy has been successful when you’ve had a negative sperm test.

Having a vasectomy doesn’t provide any protection against STIs, including HIV, like a condom does.

Where can I get it from and how much does it cost?

You can be referred for a free vasectomy on the NHS by a doctor. This can be your GP, another GP who you have registered with for family planning services, or a doctor at a sexual health clinic.

You can also pay for private treatment, which costs from around £465.