Skip to main content
GynoTalksM.D., F.A.C.O.G.

Patient Education

Contraception

Hormonal and non-hormonal options, how each one works, and why a doctor might recommend one over another for you.

There are over thirteen contraceptive options on the market and the list keeps growing. It is genuinely difficult to know what to ask for when no one has ever explained how the methods differ — some suppress ovulation, some thicken cervical mucus, some work locally in the uterus, and some are entirely non-hormonal.

The best method is rarely the same for two women. Your age, your medical history, whether you smoke, whether you have heavy or painful periods, how soon you might want to conceive, and how much you want to think about it day to day all point in different directions.

Signs your current method may not be the right one

  • Breakthrough bleeding or spotting that has not settled after the first few months
  • Mood changes, low libido, or headaches that began with the method
  • Periods that remain heavy or painful despite hormonal contraception
  • Difficulty remembering a daily pill, or repeated missed doses
  • Nausea, breast tenderness, or weight changes you find hard to live with
  • Ongoing anxiety about whether the method is actually working

Factors that affect which method is right for you

  • Smoking, particularly over the age of 35, which makes estrogen-containing methods riskier
  • A history of blood clots, stroke, or certain cardiovascular conditions
  • Migraine with aura
  • Heavy or painful periods, which some methods actively improve
  • How soon you might want to become pregnant
  • Breastfeeding, which favors progesterone-only methods
  • A history of breast cancer or certain hormone-sensitive conditions
  • How much day-to-day attention you want the method to need

What the evaluation involves

  • A full medical and family history, which is what rules methods in or out
  • Blood pressure and a general examination
  • A pelvic examination when an IUD or diaphragm is being considered
  • A pregnancy test before starting a method, where appropriate
  • STI screening, since contraception and infection prevention are separate problems
  • A review of any medications that could interact with hormonal contraception

The available options

Broadly, methods fall into long-acting reversible options, shorter-acting hormonal options, barrier methods, and permanent options.

  • Combined oral contraceptive pill, containing both estrogen and progesterone
  • Progesterone-only pill, often called the mini-pill, suitable when estrogen is not
  • Hormonal IUD, which releases progesterone locally and often lightens periods considerably
  • Copper IUD, which is entirely non-hormonal and lasts many years
  • Contraceptive implant placed under the skin of the upper arm
  • Contraceptive injection given every few months
  • Vaginal ring and transdermal patch
  • Barrier methods — condoms, diaphragm, cervical cap — which also address infection risk
  • Fertility awareness methods, for women who prefer to avoid hormones and devices
  • Emergency contraception, for after unprotected sex
  • Permanent options, including tubal ligation and vasectomy for a partner

Dr. V's overview of contraception

Four more videos cover the pill, the progesterone-only pill, the copper IUD, and the progesterone IUD individually.

Watch on its own page

When to book an appointment

  • You are unhappy with your current method and want to change.
  • You are approaching the point of becoming sexually active, or your daughter is.
  • You want a long-acting method and want to understand the IUD properly first.
  • You are coming off contraception because you would like to conceive.

Frequently Asked Questions

1When exactly can I get pregnant in relation to my period?
Conception is possible in the days leading up to and just after ovulation, which for many women falls near the middle of the cycle. But cycles vary a great deal between women and from month to month, and sperm can survive for several days, so the fertile window is wider and less predictable than most people assume.
2How does the IUD work, and is it dangerous?
The hormonal IUD releases a small amount of progesterone directly into the uterus, thickening cervical mucus and thinning the uterine lining. The copper IUD works without hormones, by creating an environment inhospitable to sperm. Both are among the most effective methods available, and modern IUDs have a strong safety record — the reputation problem dates to a device withdrawn in the 1970s.
3Are there any good non-hormonal options?
Yes. The copper IUD is highly effective and lasts for years without any hormones. Barrier methods and fertility awareness methods are also entirely non-hormonal, though they depend more on consistent use.
4Can the pill affect my fertility if I have been on it too long?
No. Fertility returns after stopping the pill regardless of how long it was taken. Some women take a cycle or two to return to a regular pattern, but long-term use does not reduce your ability to conceive.
5Will contraception protect me from STIs?
Only barrier methods do. Pills, IUDs, implants, and injections prevent pregnancy but offer no protection against infection, which is why condoms often have a place alongside another method.

Explore

Related Conditions

The right method is the one that fits your life.

Book a consultation to talk through the options properly — including the ones no one has explained to you before. Dr. Varkey also runs a free Contraceptives 101 seminar.

Request an Appointment

Medical Disclaimer

The information on this site is for general educational purposes only and is not medical advice, diagnosis, or treatment. Reading this site does not create a doctor–patient relationship. Always consult a qualified healthcare professional for personal guidance. If this is an emergency, call 911. Mentions of medications, devices, or procedures are informational and not endorsements. Full medical disclaimer.