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Non-hormonal contraceptionPublished by Bupa's health information team, November 2007. This factsheet is for people who would like information about non-hormonal contraception. Non-hormonal contraception works by either preventing sperm fertilising an egg or preventing the implantation of a fertilised egg into the lining of the womb, both of which can lead to pregnancy. Between eight and nine in every 10 women can become pregnant if contraception isn't used. Non-hormonal contraception prevents pregnancy without using hormonal treatments such as the contraceptive pill. For information about hormonal methods of contraception, see Related topics.
Types of non-hormonal contraceptionThe main methods are:
Barrier methodsThese are physical barriers that stop the sperm coming into contact with the egg, preventing fertilisation. CondomsCondoms can help protect both partners against many sexually transmitted infections such as chlamydia, genital warts, gonorrhoea and HIV. Try to not use spermicidal condoms (containing nonoxinol 9) as they offer no additional benefits and may be less effective against sexually transmitted infections. For further information see Related topics. Ask your family planning doctor or nurse, or a pharmacist if you are using creams or pessaries (dissolvable tablets, inserted into the vagina) in your genital area that could affect a condom. You shouldn't use condoms with oil-based lubricants, such as petroleum jelly (eg Vaseline) or baby oil, because this can also cause the latex to break down. They will be able to advise you on other water-based lubricants (eg KY Jelly, Sylk) that won't affect condoms. Male condomA condom is a thin sheath, usually made out of latex, which is rolled onto an erect penis before sexual contact. If you are allergic to latex condoms, you can buy non-latex condoms instead (such as polyurethane). After sex, you should check the condom for leaks and tears before throwing it away - don't flush condoms down the toilet. Emergency contraception (the "morning after" pill) is available if you think the condom hasn't worked. For more information see Related topics. If you follow the instructions in the information leaflet contained in packs, condoms are about 99 percent effective at preventing pregnancy. This means that one in every 100 women per year could get pregnant using condoms. Female condomA female condom is a thin, soft polyurethane pouch, which is fitted inside the vagina before sex. It has an inner ring that goes into the upper part of the vagina, and an outer one, which should be visible. If you follow the instructions, the female condom is 95 percent effective. This means five in every 100 women per year could get pregnant using female condoms. If it's not used correctly, the failure rate is much higher. The diaphragm and cap with spermicideThe diaphragm and cap are devices made of thin, soft rubber or silicone that are inserted into the upper part of the vagina to cover the cervix (neck of the womb). They act as a barrier to sperm to prevent pregnancy but this doesn't protect against most sexually transmitted infections. Caps are smaller than diaphragms and both are available in several types and sizes. In the first instance, the cap or diaphragm needs to be fitted by a doctor or family planning nurse, to make sure it's the right size and is positioned correctly. After the initial fitting, they can be put in place a few hours before sex. A spermicidal cream or pessary should be used with the cap or diaphragm, and should be left in place for at least six hours after sex. After any pregnancy or significant weight change (more than 3kg) you should contact your family planning doctor or nurse to check if the cap or diaphragm need to be re-adjusted. Diaphragms and caps are made of latex or silicone. They can deteriorate and fail in the presence of certain lubricants and medicated creams or gels. Ask your family planning doctor or nurse, or a pharmacist for advice when using creams, lubricants or gels in the genital area which may affect your cap or diaphragm. If used correctly, with spermicide, caps and diaphragms are effective at preventing pregnancy in 92 to 96 percent of women using this method for a year. This means that between four and eight in every 100 women could get pregnant each year using the diaphragm. During the first year of using the cap this increases to nine to 26 in every 100 women per year. SpermicidesThese are creams, gels, sponges or pessaries that contain a chemical that kills sperm. They can increase the effectiveness of certain barrier methods of contraception such as a diaphragm. However, they don't provide reliable contraception when used alone and don't protect you against sexually transmitted infections. You can buy spermicides from a chemist without a prescription. The IUD or coilThe intra-uterine device (IUD) or coil is a small plastic and copper device, which is fitted into the womb (uterus) by a doctor or nurse. It's designed to prevent sperm meeting the egg and stop an egg settling in the womb. The main advantage of a coil is that, once fitted, and as long as the coil remains in place, it can be left for three to ten years. Coils are about 99 percent effective. This means that about one in every 100 women per year could get pregnant using this method. There are, however, some disadvantages. Copper coils can make a woman's periods heavier, longer or more painful. This may improve after a few months. If your periods are heavy prior to fitting an IUD, your GP may advise a different type of coil called the levonorgestrel intra-uterine system which releases a hormone to thin the lining of the womb. For more information see Related topics. There's a small chance of getting an infection during the first 20 days after a coil is fitted. Many GPs will advise a check-up for any existing infection before they fit a coil. Rarely, a coil might go through (perforate) the womb or cervix when it's fitted. This may cause pain but often there are no other symptoms. You should see your GP if this occurs. If you do get pregnant while using a coil, there is a small risk of an ectopic pregnancy. This is when the pregnancy develops outside the womb, usually in one of the fallopian tubes. Although this is rare, it is dangerous, so, if you miss a period, see your GP. An IUD doesn't protect against sexually transmitted infections (STIs). There is also an increased risk of pelvic infection from STIs. Natural family planning (NFP)This involves reducing the chance of becoming pregnant by planning sex around the most fertile times during the woman's monthly cycle. To be as effective as possible, natural family planning (NFP) should be taught by an experienced NFP teacher. The key is to keep a diary to work out ovulation dates, which is the point of the cycle where sex is most likely to result in pregnancy. It involves a woman recording the dates of her periods for three to six months. Ovulation occurs around 12 to 16 days before the start of the next period. The fertile period lasts for eight or nine days around ovulation because, although an egg only lives for 24 hours, sperm can survive in the woman's body for up to seven days. Measuring and recording body temperature with an accurate thermometer each morning can help determine when ovulation is occurring. After ovulation, body temperature can rise by between 0.2 and 0.6°C. However, a higher temperature can happen for other reasons, such as illness, so it's not a fail-safe indicator. Cervical secretions also change during the monthly cycle, so the woman can monitor vaginal discharge to establish when ovulation has occurred. There are devices available (eg Persona) that measure hormone levels in the urine. If used according to the instructions, they can be 94 percent effective. This means that up to six in every 100 women can get pregnant each year using the natural planning method. It may not work well in women who have short or long cycles, or in women using certain medicines such as tetracycline (an antibiotic) or women who have certain medical conditions. This method of contraception doesn't protect against sexually transmitted infections. Ask your pharmacist for advice. WithdrawalThis involves withdrawing the penis before ejaculation. It's not a method of contraception because it's not reliable as some sperm can leak out of the penis before ejaculation and cause pregnancy. This also doesn't prevent sexually transmitted infections. SterilisationThere are operations to permanently prevent fertilisation. This is only recommended for people who are sure they don't want to have any or more children. This doesn't prevent sexually transmitted infections. For information see Related topics. Further information
Related topicsSources
This information was published by Bupa's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by Dr James Quekett, Bsc.MB Ch.B MRCGP DRCOG DFFP, partner/principal general practitioner at Rowcroft Medical Centre; and Bupa doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional. Publication date: November 2007
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