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The topic of contraception refers to methods used to prevent pregnancy. Some methods may feel easier to fit into your lifestyle than others, while other devices or methods can feel invasive or difficult. That's the beauty of having so many to choose from - you can find one that works well for you, your body, and your lifestyle. 


Most people know less about contraceptives than they think. So, here is a Q & A of the most-asked questions.

General Questions
Mirena Coil Questions

General Questions

How Does Contraception Work? 

Precisely how each method or device works will vary, but contraceptives generally aim at preventing pregnancy. 


They do this in one of three primary ways:


  • They block sperm

  • They disable sperm 

  • They suppress ovulation 


Some may also prevent you from contracting an STI (sexually transmitted infection), but most are strictly focused on preventing conception. 

How Does Hormonal Contraception Work?

Hormonal contraceptives use estrogen and progesterone to suppress ovulation. They do this by stopping your eggs from leaving your ovaries, causing the lining of the uterus to thin, or by causing the mucus lining of your cervix to thicken as a barrier to the sperm. An example of a hormonal contraceptive is the pill. 

How Does Non-Hormonal Contraception Work?

While non-hormonal contraception works by changing a woman's body, non-hormonal contraception works by blocking the sperm from getting to the egg. Examples of non-hormonal contraceptives are the sponge and the male or female condom. 

Why is Contraception Important?

Contraception is an essential part of responsible family planning. It's important because:


  • You can have children when you are ready for them

  • You can space out your children

  • You can protect your health if pregnancy compromises it

  • You can stop having children when your family is complete


Are you looking for expert care in your family planning? That's what we're all about. Visit our website to learn more about our services and how we can help you. Dr. Lisa Chavda is a GP with specialist expertise in Family Planning (contraception). 

Can You Get Contraception from the GP?

Yes, the NHS provides contraception free through your GP, sexual health clinic, and some pharmacies. Unfortunately, the challenges faced by the NHS mean long wait times for the things you need. We recommend going to a private GP to obtain your contraceptives more quickly.

Can You Use Contraception When Breastfeeding?

Yes, there are some contraceptives you can use while breastfeeding. After giving birth (when you are ready to have sex again), you can use male or female condoms, the injection, the implant, and progestogen-only birth control. These won't affect your breastmilk supply and are safe for your baby. 

Can Contraception Stop Periods?

Yes, some contraception methods can stop your period. Some birth control pills are designed to stop your bleeding for three months or up to one year. You can even stop having a period at all by continually using monophasic birth control pills. 

Can Contraception Cause Infertility?

The short answer is no. Hormonal contraceptives won't cause infertility, no matter how long you've been taking them. But because they're designed to hinder your fertility, you may face a delay in getting pregnant when you stop. Hormonal contraceptives won't harm your future fertility. 

Can Contraception Cause Weight Gain?

You are unlikely to gain weight by taking contraceptives like skin patches, birth control pills, vaginal rings, etc. In studies, some women have reported minor weight gain when they begin birth control pills. This weight (if it occurs) is not fat; it is fluid retention. The weight gain will be temporary, disappearing in just a couple of months. 

Can Contraception Cause Weight Loss?

Weight loss is not a usual effect of beginning birth control. Hormonal birth control is not designed to cause weight loss. However, a contraceptive that has a diuretic effect can cause you to lose some water weight.  

Which Contraceptive has the Least Side Effects?

Non-hormonal forms of contraceptives have the fewest side effects. Examples of non-hormonal contraceptives include barrier methods like:


  • Diaphragm - small silicone cup put inside the vagina to cover the cervix

  • Male and female condoms - cheap and easy to use, and will also protect against STIs

  • Spermicides - gels, creams, and suppositories used before sex to stop the sperm from reaching the egg

  • The Sponge - plastic foam that holds spermicide

  • Cervical Cap - similar to the diaphragm but smaller

What Contraception Has No Hormones?

You may choose to use a contraceptive with no hormones because of health concerns, side effects, breastfeeding, etc. These are usually barrier methods, meaning they work to keep the sperm from fertilizing your egg. 


These include:

  • Male  condoms - these protect against STIs as well as pregnancy

  • Diaphragm - a small silicone cup inserted in the vagina to cover your cervix, with application of spermicide gel

  • IUD (Intrauterine Device) - plastic and copper T-shaped device inserted into the uterus, releasing copper to prevent pregnancy. It can last for  5 to 10 years 

  • Surgical methods like sterilization - tubal ligation (for women) or vasectomy (for men)

What Contraception Works Straight Away?

There are a couple of ways to interpret this question, so we'll give a couple of answers. 


The combined pill is effective from the first day you take it as long as you take it on the first day of your period. You won't need any backup protection. 


If you didn't already have any contraception onboard before sex and you're looking for something that will still prevent pregnancy, you may try Levonelle or ellaOne. Levonelle may be taken within three days of sex, and ellaOne can be taken five days after sex. Both of these will stop your egg from being released. 

What are birth controls without Estrogen?


Many hormonal birth control methods contain both estrogen and progesterone. Some women may be unable to use birth control methods that use estrogen due to health problems. The contraceptive implant is an effective alternative. It works by steadily releasing the hormone progestogen into the bloodstream, preventing ovulation each month. It doesn’t contain estrogen. Because of the relative ease of using the method and its long-lasting protection, many women find the contraceptive implant the best birth control without estrogen for them.


Can contraception help with menopause?


Some contraceptive methods may reduce the symptoms associated with perimenopause, to help manage irregular periods, night sweats and hot flashes. The contraceptive implant is sometimes used as a part of treatment for menopausal symptoms. Even though the chances of becoming pregnant during perimenopause and menopause are reduced, contraception during menopause is still required.


Can birth control help with acne?


Birth control pills that contain the hormones estrogen and progestogen reduce functional androgen levels, thereby reducing sebum production and acne. However, contraception that uses only progesterone can worsen acne in some cases. If you have acne before getting the implant fitted, you may find that it gets worse over time and this will require management.


Is contraception used when on HRT?


Contraception when on HRT is still important. HRT is not a method of contraception and if your periods have not stopped before beginning HRT, then it is still possible to become pregnant. A contraceptive implant can be an effective contraceptive method in such circumstances.

Mirena Questions

Does the Mirena coil have hormones?


The Mirena coil is a hormonal intrauterine device. It contains 52 mg of levonorgestrel which is a progestin-based hormonal medication. The device releases around 20 mcg of the hormone every day. Over time, this amount will reduce, which means that eventually it will need to be replaced to carry on providing contraceptive protection. Mirena offers effective, long-term contraception for premenopausal women of all ages, including teenagers.


Does Mirena coil have fewer hormones than the pill?


Mirena releases a very low dose of the hormone progestin, which is also used in birth control pills. Unlike birth control pills, it does not contain estrogen. Progestin prevents pregnancy by thickening cervical mucus, creating a barrier to sperm entry. In some women, it may also prevent ovulation. Because it doesn’t contain estrogen it is considered lower risk. As progestin is delivered locally, it doesn’t pass through your body reducing the potential for side effects.


Does the Mirena coil stop working after 5 years?


The Mirena coil has been shown to be most effective for up to five years for all women whatever their age. Some studies have indicated that it may remain effective for longer, particularly in women over the age of 35. However, the Mirena coil is recommended for 5-year use and most women will choose to have the IUD replaced as they approach the five year mark.


Does the Mirena coil affect weight?


Hormonal IUDs are associated with weight gain due to the hormone, progestin. This occurs in around 5% of women who use the Mirena coil and is not reported to be significant in itself. The weight increase is not a result of an increase in body fat, but because of water retention. Progestin may increase the water retention that leads to bloating, with typical weight gain reported as being around 5lbs. The amount of weight any woman may gain will vary depending on their overall health, diet and lifestyle. Water retention-related weight gain usually reduces around three months after the IUD was inserted.


Do you still have periods on the Mirena coil?


Around 20% of women who use Mirena report that their periods stop altogether after a year of having the IUD inserted. In most cases, bleeding will decrease around three or more months after placement and the duration of periods will also decrease. For this reason, the Mirena coil is frequently used as a treatment for heavy periods. It can also reduce menstrual pain. In some cases, periods may become heavier and longer for the first few months before decreasing in the weeks and months that follow.

How long does the Mirena coil last?

The Mirena coil can last for up to 5 years. After this time, it should be removed and replaced if you wish to continue using it as a contraceptive method. However, some women may have their Mirena coil removed earlier if they experience complications or wish to stop using it for other reasons.

How does the Mirena coil work?

The Mirena coil works by releasing a small amount of levonorgestrel into the uterus. This hormone thickens the cervical mucus, which makes it difficult for sperm to reach and fertilize an egg. The hormone also thins the lining of the uterus, which can make it harder for a fertilized egg to implant.

Does the Mirena coil cause bleeding?

The Mirena coil may cause irregular bleeding or spotting, especially during the first few months after insertion. However, for many women, bleeding decreases over time, and some may even stop having periods altogether. If you are concerned about bleeding or have heavy bleeding after hysteroscopy Mirena coil insertion, be sure to talk to your doctor.

How long can a Mirena coil stay in?

The Mirena coil can stay in place for up to 5 years. After this time, it should be removed and replaced if you wish to continue using it as a contraceptive method. In some cases, however, Mirena coils may have to be removed earlier if complications occur or women wish to stop using copper Mirena.

Can you have a Mirena coil fited on your period?

Yes, you can have a Mirena coil fitted during your period. However, some healthcare professionals may prefer to schedule the insertion for a time when the cervix is more open, which can be during menstruation.

What are the negative side effects of the Mirena coil?

The most common bad side effect of the Mirena coil is irregular bleeding or spotting, especially in the first few months after insertion. Other common side effects of Mirena coil include cramps, headaches, nausea, or acne. Rare but serious complications may occur, such as uterine perforation or infection.

Can you keep the Mirena coil for longer than 5 years?

No, the Mirena coil should not be kept in for longer than 5 years. After this time, the effectiveness of the device may decrease, and there may be an increased risk of complications such as perforation or infection.

Does the Mirena coil cause endometriosis?

No, the Mirena coil does not cause endometriosis. In fact, the Mirena coil may actually help to alleviate the symptoms of endometriosis, such as heavy or painful periods, by thinning the lining of the uterus and reducing the growth of endometrial tissue. However, the Mirena coil is not a treatment for endometriosis itself and should be used in combination with other forms of treatment as recommended by a healthcare professional.

Implant Questions

What is the contraceptive implant insertion procedure?


The contraceptive implant is a matchstick-sized flexible plastic rod that is placed under the skin of the upper arm. As long as you are not pregnant, the implant can be fitted at any time during your menstrual cycle. Insertion is a simple procedure and will only take a few minutes. It feels similar to having an injection and no stitches are required after the implant has been fitted. The implant works for 3 years before needing to be replaced. It can be safely used until you reach menopause.


Does having the implant inserted hurt?


Most women will experience minimal pain when having the contraceptive implant inserted.  You should not be able to feel the implant being inserted and may just feel a slight pinch or stinging.


Should I feel pain after the contraceptive implant insertion?


You may have a stiff arm where the implant was inserted after the pain medication has worn off. This should ease quickly.

Copper Coil Questions

Do you bleed after copper coil insertion?


Bleeding after copper coil insertion is quite normal for the first few months after the insertion. In some cases, irregular bleeding and spotting may continue for up to 6 months. Moreover, during the first few days after the copper coil insertion, you may experience cramps, similar to period pain. But the pain should go away after a few days.

Do you lose weight after copper coil removal?


Unlike hormonal IUDs, copper coil IUDs do not cause any hormonal change. Copper IUDs are non-hormonal, and they do not contain estrogen, the hormone responsible for birth-control-related weight gain. Therefore, you have no reason to worry about weight loss after copper coil removal.


Can you do copper coil removal at home?


Coil removal at home by yourself is not recommended at all. When you are having a copper coil removed at your doctor’s office, you’ll have professional care that can manage to deal with any potential problem. 


Are there any risks of the copper coil?


The copper IUD does not contain any hormones. So, there are no risks and side effects to worry about due to hormonal fluctuations. The only issue associated with the insertion of copper coil is bleeding, spotting, and cramps, especially in the first 3-6 months. 


How long does the copper coil last?


The copper coil prevents pregnancy for between 5 and 10 years. Some studies indicated that women who continued using the same device beyond the completion of 10 years experienced no pregnancies through the end of 15 years, even up to 20 years. But the effectiveness of the device will certainly decrease. 


What is the difference between Mirena and copper coil?


The copper coil (IUD) is a contraception device made of plastic and copper that can protect against unwanted pregnancy for up to 10 years. Mirena is also made of plastic that contains a reservoir of the hormone levonorgestrel. Mirena’s effectiveness is estimated to be up to 8 years.

What are the benefits of non-hormonal birth control?


Firstly, non-hormonal birth control has fewer side effects compared to hormonal birth control devices. This is especially significant for women with certain health conditions. Moreover, non-hormonal birth control is a safer option for people who smoke. 

But overall, the choice between a hormonal and nonhormonal birth control option depends on your personal preferences, unique health considerations, and lifestyle. 

What are the side effects of the non-hormonal copper coil?


The non-hormonal copper coil may cause heavier periods, especially in the first 3-6 months. You may also have cramps or back pain for a few days. In some cases, women who have used the copper IUD have reported spotting between periods and irregular periods.


Can copper coil cause irregular periods?


Bleeding between periods is quite common with copper IUDs. Your body is simply adjusting to the insertion and removal of the device and will soon return to its natural course. 


Does the copper coil work straight away?

The copper IUD works right after insertion and stops sperm from surviving in the cervix or womb. This means that the sperm is unable to travel to fertilise an egg in the fallopian tubes.

Implant Questions
Copper Coil Questions
Dr Lisa Briscoe Chavda BSc MBBS MRCP DFSRH MRCGP
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