{"id":3041,"date":"2025-09-23T10:00:00","date_gmt":"2025-09-23T08:00:00","guid":{"rendered":"https:\/\/equilibriumpsychotherapy.net\/contraception-101\/"},"modified":"2026-11-02T15:02:50","modified_gmt":"2026-11-02T14:02:50","slug":"contraception-101","status":"publish","type":"post","link":"https:\/\/equilibriumpsychotherapy.net\/hr\/contraception-101\/","title":{"rendered":"Contraception 101"},"content":{"rendered":"\n<style>\n\/* The accent is a light-background device. 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the list\"] button{font-size:13.5px;line-height:1.25;padding:8px 10px;border-radius:12px;text-wrap:balance}}\n.ra-fig button:focus-visible,.ra-fig input:focus-visible{outline:2px solid #3d2874;outline-offset:2px}\n\n\/* ---- her asides: her own voice, in brackets, italic and muted ---- *\/\n.eqp .ra-aside{font-style:italic;color:#6b6259}\n\n\/* ---- fun fact ---- *\/\n.ra-ff{display:grid;grid-template-columns:auto minmax(0,1fr);gap:4px 16px;align-items:start;background:#fff;border:1.5px dashed #d5cbf0;\n  border-radius:18px;padding:20px 24px}\n.ra-ff .mk{grid-row:1\/3;width:40px;height:40px;border-radius:50%;background:#efecfb;color:#553a9c;display:flex;align-items:center;justify-content:center}\n.ra-ff .mk svg{width:22px;height:22px}\n.ra-ff .k{font-size:12px;font-weight:700;letter-spacing:.16em;text-transform:uppercase;color:#553a9c;margin:2px 0 4px}\n.ra-ff .t{font-size:clamp(14px,calc(10.2px + 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#3d2874;outline-offset:-4px;border-radius:18px}\n.ra-faq .qb{position:relative;display:block;width:46px;height:42px;transform-origin:30% 90%}\n.ra-faq .qb svg{position:absolute;inset:0;width:100%;height:100%;overflow:visible}\n.ra-faq .qb path{fill:#efecfb;stroke:#d5cbf0;stroke-width:1.6;transition:fill .25s ease,stroke .25s ease}\n.ra-faq .qb i{position:absolute;left:0;right:0;top:3px;text-align:center;font-style:normal;font-family:\"Playfair Display\",Georgia,serif;\n  font-size:23px;font-weight:800;line-height:1.3;color:#553a9c;transform:rotate(-9deg)}\n.ra-faq .qb .x{display:none;color:#3d2874;transform:rotate(6deg)}\n.ra-faq details[open] .qb path{fill:#fbf1d3;stroke:#e8cf94}\n.ra-faq details[open] .qb .q{display:none}\n.ra-faq details[open] .qb .x{display:block}\n.ra-faq summary:hover .qb{animation:raWig .55s ease}\n@keyframes raWig{0%,100%{transform:rotate(0)}30%{transform:rotate(-9deg)}65%{transform:rotate(6deg)}}\n@media(prefers-reduced-motion:reduce){.ra-faq summary:hover .qb{animation:none}}\n.ra-faq summary .pl{width:30px;height:30px;border-radius:50%;border:1.5px solid #e8cf94;color:#3d2874;display:flex;align-items:center;justify-content:center;transition:transform .2s ease,background .2s ease}\n.ra-faq summary .pl svg{width:12px;height:12px}\n.ra-faq details[open] summary .pl{transform:rotate(45deg);background:#fbf1d3}\n.ra-faq .an{background:#faf8f3;border-top:1.5px solid #e8e1d5;padding:18px 24px 20px 74px}\n.ra-faq .an p{font-size:18.5px;line-height:1.66;color:#2a2622;margin:0 0 12px}\n.ra-faq .an p:last-child{margin-bottom:0}\n@media(max-width:560px){.ra-faq summary{gap:12px;padding:16px}.ra-faq .qb{width:38px;height:35px}.ra-faq .qb i{font-size:19px;top:2px}.ra-faq .an{padding:16px}.ra-faq .an p{font-size:17.5px}}\n.ra-faq .all{display:flex;justify-content:flex-end;margin:0 0 2px}\n.ra-faq .all button{font:600 14.5px\/1.2 \"Work Sans\",sans-serif;border:0;background:none;color:#3d2874;cursor:pointer;text-decoration:underline;text-underline-offset:3px;padding:6px 4px}\n\n\/* ---- when to talk to a doctor: tiles, one small icon each ---- *\/\n.ra-dr{background:#faf8f3;border:1.5px solid #e8e1d5;border-radius:22px;padding:26px 28px;margin:4px 0 32px}\n.ra-dr .k{font-size:12px;font-weight:700;letter-spacing:.16em;text-transform:uppercase;color:#3d2874;margin:0 0 16px}\n.ra-dr ul{list-style:none;margin:0;padding:0;display:grid;grid-template-columns:repeat(2,minmax(0,1fr));gap:10px}\n@media(max-width:640px){.ra-dr ul{grid-template-columns:minmax(0,1fr)}.ra-dr{padding:20px 16px}}\n.ra-dr li{display:grid;grid-template-columns:auto minmax(0,1fr);gap:12px;align-items:center;background:#fff;border:1.5px solid #e8e1d5;border-radius:14px;\n  padding:14px 16px;margin:0;font-size:17px;line-height:1.45;color:#2a2622}\n.ra-dr li{grid-template-columns:minmax(0,1fr)}\n\n\n\n\/* ---- figure 1: the effectiveness ladder ---- *\/\n.ra-lad .sw{margin:0 0 20px}\n.ra-lad ul{list-style:none;margin:0;padding:0;display:flex;flex-direction:column;gap:2px}\n.ra-lad li{display:block;margin:0}\n.ra-lad .rw{display:grid;grid-template-columns:minmax(120px,1.45fr) minmax(0,3fr) auto;gap:0 14px;align-items:center;\n  width:100%;text-align:left;background:none;border:0;border-radius:12px;padding:9px 10px;cursor:pointer;font:inherit;transition:background .18s ease}\n.ra-lad .rw:hover{background:#faf8f3}\n.ra-lad li.open .rw{background:#efecfb}\n.ra-lad .nm{font-size:16px;font-weight:600;line-height:1.3;color:#2a2622}\n.ra-lad .tr{position:relative;height:16px}\n.ra-lad .tr::before{content:\"\";position:absolute;left:0;right:0;top:7px;height:2px;background:#e8e1d5}\n.ra-lad .gap{position:absolute;top:6px;height:4px;border-radius:2px;background:#f1dea5;transition:left .45s cubic-bezier(.4,0,.2,1),width .45s cubic-bezier(.4,0,.2,1)}\n.ra-lad .pt{position:absolute;border-radius:50%;transition:left .45s cubic-bezier(.4,0,.2,1)}\n.ra-lad .pp{top:0;width:16px;height:16px;margin-left:-8px;background:#bd8700}\n.ra-lad .tp{top:4px;width:8px;height:8px;margin-left:-4px;background:#553a9c}\n.ra-lad .axw{display:grid;grid-template-columns:minmax(120px,1.45fr) minmax(0,3fr) auto;gap:0 14px;margin:2px 0 0;padding:0 10px}\n.ra-lad .ax{position:relative;height:20px}\n.ra-lad .ax span{position:absolute;top:6px;transform:translateX(-50%);font-size:12.5px;color:#6b6259}\n.ra-lad .ax i{position:absolute;top:0;width:1px;height:5px;background:#e8e1d5}\n.ra-lad .vl{font-size:14.5px;font-weight:600;color:#6b6259;font-variant-numeric:tabular-nums;white-space:nowrap}\n.ra-lad .vl b{color:#553a9c;font-weight:700}\n.ra-lad li.none .tr::after{content:\"\";position:absolute;right:-2px;top:0;bottom:0;width:16px;\n  background:linear-gradient(105deg,transparent 46%,#fff 46%,#fff 54%,transparent 54%),linear-gradient(105deg,transparent 46%,#e8e1d5 46%,#e8e1d5 47.5%,transparent 47.5%)}\n.ra-lad li.none .nm{color:#a4561f}\n.ra-lad li.none .gap{background:#a4561f;opacity:.22}\n.ra-lad .dt{display:none;font-size:16px;line-height:1.6;color:#2a2622;margin:0 10px 10px;padding:12px 16px;background:#faf8f3;border-radius:12px;border-left:3px solid #6647ab}\n.ra-lad li.open .dt{display:block}\n.ra-lad .key{display:flex;flex-wrap:wrap;gap:8px 22px;margin:18px 0 0;font-size:14.5px;color:#6b6259}\n.ra-lad .key span{display:flex;align-items:center;gap:8px}\n.ra-lad .key i{display:block;width:12px;height:12px;border-radius:50%}\n@media(max-width:560px){.ra-lad .rw{grid-template-columns:minmax(0,1fr) auto;gap:4px 10px;padding:8px 6px}\n  .ra-lad .tr{grid-column:1\/3;order:3}.ra-lad .vl{font-size:13.5px}.ra-lad .nm{font-size:15px}\n  .ra-lad .axw{grid-template-columns:minmax(0,1fr);padding:0 6px}}\n\n\/* ---- figure 2: the three gates, as three drawn vignettes ---- *\/\n.ra-gt .panels{display:grid;grid-template-columns:repeat(3,minmax(0,1fr));gap:12px;margin:0 0 20px}\n.ra-gt .pn{background:#faf8f3;border:1.5px solid #e8e1d5;border-radius:16px;padding:16px 14px 18px;text-align:center;\n  transition:border-color .3s ease,background .3s ease}\n.ra-gt .pn.on{border-color:#553a9c;background:#efecfb}\n.ra-gt .pn svg{display:block;width:100%;max-width:172px;height:auto;margin:0 auto}\n.ra-gt .pn .tk{fill:#fff;stroke:#e8e1d5;transition:stroke .3s ease}\n.ra-gt .pn .rt{stroke:#e8e1d5;transition:stroke .3s ease}\n.ra-gt .pn.on .tk,.ra-gt .pn.on .rt{stroke:#553a9c}\n.ra-gt .pn .gx line{stroke:#553a9c;opacity:0;transform-origin:center;transition:opacity .3s ease,transform .35s cubic-bezier(.4,0,.2,1)}\n.ra-gt .pn .gx.h line{transform:scaleX(.2)}\n.ra-gt .pn .gx.v line{transform:scaleY(.2)}\n.ra-gt .pn.on .gx line{opacity:1;transform:none}\n.ra-gt .pn .lt{margin:12px 0 0}\n.ra-gt .pn .lt span{display:inline-flex;align-items:center;justify-content:center;width:24px;height:24px;border-radius:50%;\n  background:#e8e1d5;color:#6b6259;font-size:13px;font-weight:700;transition:background .3s ease,color .3s ease}\n.ra-gt .pn.on .lt span{background:#553a9c;color:#fff}\n.ra-gt .pn .cap{font-size:15px;line-height:1.4;color:#6b6259;margin:8px 0 0;transition:color .3s ease}\n.ra-gt .pn.on .cap{color:#2a2622;font-weight:600}\n.ra-gt .chips{display:flex;flex-wrap:wrap;gap:8px;margin:0 0 18px}\n.ra-gt .chips button{font:600 15px\/1.2 \"Work Sans\",sans-serif;border:1.5px solid #e8e1d5;background:#fff;color:#2a2622;\n  border-radius:999px;padding:9px 15px;cursor:pointer;transition:border-color .18s ease,background .18s ease,color .18s ease}\n.ra-gt .chips button:hover{border-color:#d5cbf0}\n.ra-gt .chips button[aria-pressed=true]{background:#553a9c;border-color:#553a9c;color:#fff}\n.ra-gt .out{background:#faf8f3;border-radius:14px;padding:18px 20px;border-left:3px solid #6647ab}\n.ra-gt .out .h{font-size:12px;font-weight:700;letter-spacing:.14em;text-transform:uppercase;color:#553a9c;margin:0 0 8px}\n.ra-gt .out .t{font-size:17px;line-height:1.6;color:#2a2622;margin:0}\n@media(max-width:620px){.ra-gt .panels{grid-template-columns:minmax(0,1fr);gap:10px}\n  .ra-gt .pn{display:grid;grid-template-columns:auto minmax(0,1fr);gap:0 16px;text-align:left;align-items:center;padding:12px 16px}\n  .ra-gt .pn svg{width:104px;grid-row:1\/3}\n  .ra-gt .pn .lt{margin:0 0 4px}.ra-gt .pn .cap{margin:0}}\n\/* phone only: one drop-down in place of the fourteen chips; both drive the same buttons *\/\n.ra-gt .gt-mob{display:none}\n.ra-gt .gt-lab{display:block;font:700 12px\/1.3 \"Work Sans\",sans-serif;letter-spacing:.14em;text-transform:uppercase;color:#553a9c;margin:0 0 8px}\n.ra-gt .gt-sel{display:block;width:100%;max-width:none;height:auto;box-sizing:border-box;min-height:52px;font:600 16px\/1.3 \"Work Sans\",sans-serif;color:#2a2622;background-color:#fff;border:1.5px solid #553a9c;border-radius:14px;padding:12px 44px 12px 16px;margin:0 0 18px;cursor:pointer;box-shadow:none;-webkit-appearance:none;appearance:none;background-image:linear-gradient(45deg,transparent 50%,#553a9c 50%),linear-gradient(135deg,#553a9c 50%,transparent 50%);background-position:calc(100% - 22px) 50%,calc(100% - 16px) 50%;background-size:6px 6px,6px 6px;background-repeat:no-repeat}\n.ra-gt .gt-sel:focus-visible{outline:2px solid #3d2874;outline-offset:2px}\n@media(max-width:640px){.ra-gt .chips{display:none}.ra-gt .gt-mob{display:block}}\n\n\/* ---- figure 3: ten thousand ---- *\/\n.ra-tt .sw{margin:0 0 20px}\n.ra-tt .grid{background:#faf8f3;border:1.5px solid #e8e1d5;border-radius:18px;padding:16px}\n.ra-tt svg{display:block;width:100%;height:auto}\n.ra-tt .hi{fill:#553a9c;transition:opacity .35s ease}\n.ra-tt .hi.mb{fill:#fff;stroke:#553a9c;stroke-width:2px;vector-effect:non-scaling-stroke}\n.ra-tt .rd{font-size:clamp(17px,1.9vw,19px);line-height:1.55;color:#2a2622;margin:20px 0 0}\n.ra-tt .rd b{color:#553a9c}\n\n\/* ---- figure 4: the emergency clock ---- *\/\n.ra-ec .bars{position:relative;display:grid;gap:12px;margin:0 0 6px}\n.ra-ec .bar{display:grid;grid-template-columns:minmax(96px,1fr) minmax(0,3.2fr);gap:0 14px;align-items:center}\n.ra-ec .bar .nm{font-size:15.5px;font-weight:600;color:#2a2622;line-height:1.25}\n.ra-ec .tr{position:relative;height:30px;background:#faf8f3;border-radius:8px;overflow:hidden}\n.ra-ec .fill{position:absolute;top:0;bottom:0;left:0;background:#f1dea5}\n.ra-ec .fade{position:absolute;top:0;bottom:0;background:repeating-linear-gradient(115deg,#f1dea5 0 5px,transparent 5px 10px)}\n.ra-ec .now{position:absolute;top:-6px;bottom:-6px;width:2px;background:#553a9c;transition:left .12s linear}\n.ra-ec .now::after{content:\"\";position:absolute;left:-4px;top:-4px;width:10px;height:10px;border-radius:50%;background:#553a9c}\n.ra-ec .ax{position:relative;height:22px;margin:4px 0 0}\n.ra-ec .ax span{position:absolute;top:0;transform:translateX(-50%);font-size:13px;color:#6b6259;white-space:nowrap}\n.ra-ec .axw{display:grid;grid-template-columns:minmax(96px,1fr) minmax(0,3.2fr);gap:0 14px}\n.ra-ec .sl{display:grid;gap:8px;margin:20px 0 0}\n.ra-ec .sl label{font-size:12px;font-weight:700;letter-spacing:.14em;text-transform:uppercase;color:#6b6259}\n.ra-ec .sl label b{color:#553a9c;font-size:14px;letter-spacing:0}\n.ra-ec input[type=range]{width:100%;accent-color:#553a9c}\n.ra-ec .out{margin:16px 0 0;padding:18px 20px;background:#efecfb;border-radius:14px;font-size:17.5px;line-height:1.6;color:#2a2622}\n.ra-ec .out b{color:#3d2874}\n@media(max-width:560px){.ra-ec .bar,.ra-ec .axw{grid-template-columns:minmax(0,1fr);gap:4px}.ra-ec .bar .nm{font-size:14.5px}}\n\n\/* ---- figure 5: what bleeding becomes ---- *\/\n.ra-bl .sw{margin:0 0 20px}\n.ra-bl .grp{margin:0 0 22px}\n.ra-bl .grp:last-of-type{margin-bottom:0}\n.ra-bl .mh{font-size:17.5px;font-weight:700;color:#2a2622;margin:0 0 12px}\n.ra-bl .row{display:grid;grid-template-columns:minmax(0,1.5fr) auto auto;gap:0 14px;align-items:center;padding:8px 0;border-top:1px solid #e8e1d5}\n.ra-bl .row .l{font-size:16px;line-height:1.35;color:#2a2622}\n.ra-bl .dots{display:flex;gap:4px}\n.ra-bl .dots i{display:block;width:12px;height:12px;border-radius:50%;background:#e8e1d5}\n.ra-bl .dots i.f{background:#553a9c}\n.ra-bl .row .n{font-size:14.5px;font-weight:600;color:#6b6259;font-variant-numeric:tabular-nums;white-space:nowrap}\n@media(max-width:560px){.ra-bl .row{grid-template-columns:minmax(0,1fr) auto;gap:4px 10px}.ra-bl .dots{grid-column:1\/3;order:3}}\n\/* ---- the short version (23 Sep 2026): panel()'s own mist ground, line,\n   radius, padding and eyebrow, set in the reading column under the lede.\n   The findings are a set, one sentence each, so no theme bullet: each is\n   marked with the bleeding figure's filled violet dot ---- *\/\n.eqp ul.ra-short{list-style:none;margin:0;padding:0}\n.eqp ul.ra-short li{position:relative;margin:0 0 12px;padding:0 0 0 26px}\n.eqp ul.ra-short li:last-child{margin-bottom:0}\n.eqp ul.ra-short li::before{content:\"\";position:absolute;left:1px;top:.6em;width:10px;height:10px;border-radius:50%;background:#553a9c}\n@media(max-width:560px){.eqp ul.ra-short{font-size:17.5px!important;line-height:1.62!important}.eqp ul.ra-short li{padding-left:20px}.eqp ul.ra-short li::before{width:8px;height:8px;top:.58em}}\n\/* the reading column is only 252px on a 360px phone, so the panel's own 18px\n   side padding plus the marker indent left 194px of text; this box alone\n   gives back 4px a side and 4px of indent to keep it over 200. No child\n   combinator: no other has-background group encloses this list, and a child\n   combinator in a style block is one more thing for the render\n   filters to touch *\/\n@media(max-width:420px){.eqp .wp-block-group.has-background:has(ul.ra-short){padding:22px 14px!important}\n  .eqp ul.ra-short li{padding-left:16px}.eqp ul.ra-short li::before{width:7px;height:7px;top:.61em;left:0}}\n\/* measuring gate, 23 Sep: 44px for any tap target below 900px *\/\n@media(max-width:899px){.eqp [id^=\"ra-\"] button{min-height:44px}.eqp [id^=\"ra-\"] input[type=range]{height:44px;background:transparent}}\n\/* Gutenberg padding is inline at one value, so on a phone the panels left 159px of measure *\/\n@media(max-width:620px){.eqp .wp-block-group.has-background{padding:26px 22px!important}}\n@media(max-width:420px){.eqp .wp-block-group.has-background{padding:22px 18px!important}}\n\n@media(max-width:520px){.ra-fig{padding:20px 14px;border-radius:16px;margin:0 -12px!important}}\n@media(prefers-reduced-motion:reduce){.ra-fig *,.ra-faq *{transition:none!important}}\n@media print{.ra-seg,.ra-lad .sw,.ra-ec .sl,.ra-faq .all{display:none!important}.ra-faq details{display:block}}\n@media(max-width:480px){.eqp ol.wp-block-list{padding-left:18px}.eqp ol.wp-block-list li{overflow-wrap:anywhere}}\n<\/style><style>\n\/* ---- glossary popups ---- *\/\n\n\/* THE PAGE MUST NOT SCROLL SIDEWAYS BECAUSE OF A CARD NOBODY CAN SEE. A hidden\n   absolutely positioned box still extends the scrollable width, and a card\n   centred on a word near the right edge hangs off it until the script nudges it\n   back. The script does that on load, but \"on load\" is a moving target: web\n   fonts reflow the line after it, and the sleep article was still scrolling\n   41px sideways at 720px on some loads and not others.\n\n   overflow-x:clip settles it without depending on timing at all. Not hidden:\n   clip does not make this a scroll container, so anything sticky inside keeps\n   sticking and overflow-y stays visible. The clip edge is the page box, and a\n   320px card centred on a word inside the measure column has a couple of\n   hundred pixels of slack before it can reach that edge, so on a desktop it\n   never clips anything; on a narrow screen the clip edge is the viewport, which\n   is where the script is putting the card anyway. *\/\n.eqp{overflow-x:clip}\n\n\/* A dotted underline under a term that is usually already italic: quiet enough\n   to ignore, and different enough from a link to never be mistaken for one. *\/\n.eqp .gl{position:relative;display:inline;border-bottom:1.5px dotted #d5cbf0;\n  cursor:help;outline:none}\n.eqp .gl:focus-visible{outline:2px solid var(--eqp-accent);outline-offset:3px;\n  border-radius:3px}\n\n.eqp .gd{position:absolute;left:50%;bottom:calc(100% + 12px);z-index:40;\n  width:min(320px,78vw);box-sizing:border-box;\n  \/* THE NUDGE IS A MARGIN, NOT PART OF THE TRANSFORM. It used to ride inside\n     translateX as calc(-50% + var(--sx)), and the variable never took effect:\n     the script set --sx correctly, the sheet shipped correctly, and the\n     computed transform stayed at a flat -50% regardless. Measured on the live\n     page with the compositor running and a control element proving transform\n     itself worked, cards still sat 54 to 61px off the left edge of a 390px\n     screen. margin-left is a layout property, it resolves the variable, and it\n     put every card exactly where the script had calculated. *\/\n  transform:translateX(-50%) translateY(4px);margin-left:var(--sx,0px);\n  opacity:0;visibility:hidden;pointer-events:none;\n  background:#fff;border:1.5px solid var(--eqp-line2);border-radius:12px;\n  box-shadow:0 10px 30px rgba(20,30,40,.14);padding:14px 16px;\n  font-family:\"Work Sans\",sans-serif;font-size:14.5px;line-height:1.55;\n  font-style:normal;font-weight:400;color:var(--eqp-body);text-align:left;\n  transition:opacity .16s ease,transform .16s ease}\n.eqp .gd b{display:block;font-family:\"Work Sans\",sans-serif;font-size:11px;\n  font-weight:700;letter-spacing:.13em;text-transform:uppercase;\n  color:var(--eqp-muted);margin:0 0 6px}\n\/* The pointer, a rotated square sitting half outside the card. It carries the\n   nudge in reverse so it stays under the term when the card has moved. *\/\n.eqp .gd::after{content:\"\";position:absolute;left:calc(50% - 6px - var(--sx,0px));\n  bottom:-7px;width:12px;height:12px;background:#fff;\n  border-right:1.5px solid var(--eqp-line2);border-bottom:1.5px solid var(--eqp-line2);\n  transform:rotate(45deg)}\n.eqp .gl:hover .gd,.eqp .gl:focus .gd,.eqp .gl:focus-within .gd{\n  opacity:1;visibility:visible;pointer-events:auto;\n  transform:translateX(-50%) translateY(0)}\n@media(prefers-reduced-motion:reduce){\n  .eqp .gd{transition:none;transform:translateX(-50%)}\n}\n\/* A popup means nothing on paper, and nothing is lost: every glossed term keeps\n   the author's own sentence around it. *\/\n@media print{.eqp .gd{display:none}.eqp .gl{border-bottom:0}}\n<\/style><style>\n.eqp .gl{color:#553a9c}\n.eqp .gl:hover{background:#efecfb}\n.eqp .eqb .gl{color:inherit}\n.eqp .gd{border-left:3px solid #6647ab}\n.eqp .gd b{color:#3d2874;background:#efecfb;margin:-14px -16px 12px;padding:10px 16px 9px;border-bottom:1px solid #d5cbf0}\n.eqp .gd::after{border-right-color:#d5cbf0;border-bottom-color:#d5cbf0}\n<\/style><script>\n(function(){\n  \/* The sheet is the first block on the page, so at parse time not one .gl\n     exists yet and binding straight away binds to nothing. 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aria-hidden=\"true\"><i><\/i><\/div><nav id=\"eqp-parts\" aria-hidden=\"true\"><a href=\"#part-1\" data-i=\"1\" tabindex=\"-1\"><span class=\"dot\"><\/span><span class=\"lbl\">How well it works<\/span><\/a><a href=\"#part-2\" data-i=\"2\" tabindex=\"-1\"><span class=\"dot\"><\/span><span class=\"lbl\">Where each method intervenes<\/span><\/a><a href=\"#part-3\" data-i=\"3\" tabindex=\"-1\"><span class=\"dot\"><\/span><span class=\"lbl\">What it does to the rest of you<\/span><\/a><a href=\"#part-4\" data-i=\"4\" tabindex=\"-1\"><span class=\"dot\"><\/span><span class=\"lbl\">The risks, as numbers<\/span><\/a><a href=\"#part-5\" data-i=\"5\" tabindex=\"-1\"><span class=\"dot\"><\/span><span class=\"lbl\">Emergency contraception<\/span><\/a><a href=\"#part-6\" data-i=\"6\" tabindex=\"-1\"><span class=\"dot\"><\/span><span class=\"lbl\">Everything you were too afraid to ask<\/span><\/a><a href=\"#part-7\" data-i=\"7\" tabindex=\"-1\"><span class=\"dot\"><\/span><span class=\"lbl\">Men and 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.cpw-pl-k::after{left:14px;background:#3d2874}\n@media(prefers-reduced-motion:reduce){.cpw-pill,.cpw-pill.cpw-pill-on,.cpw-segb{transition:none!important}}\n@media print{.cpw-seg,.cpw-hint,.cpw-pill{display:none!important}}\n\/* the back to top button (house chrome) sits one pill higher so the two never overlap *\/\n#eqp-top{right:max(16px,env(safe-area-inset-right))!important;bottom:calc(max(16px,env(safe-area-inset-bottom)) + 54px)!important}\n\/*>*\/<\/style>\n\n\n\n<div class=\"wp-block-group alignfull eqp cpw-post has-global-padding is-layout-constrained wp-container-core-group-is-layout-69fa9525 wp-block-group-is-layout-constrained\" style=\"margin-top:0;margin-bottom:0;padding:0px 22px\">\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n<div style=\"color:#6b6259;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.455), 18px);font-style:normal;font-weight:400;margin-top:54px;margin-bottom:0\" class=\"has-link-color wp-elements-1 wp-block-post-date has-text-color has-work-sans-regular-font-family\"><time datetime=\"2025-09-23T10:00:00+02:00\">23 rujna, 2025<\/time><\/div>\n\n<div style=\"color:#6b6259;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.455), 18px);font-style:normal;font-weight:700;text-transform:uppercase;margin-top:0;margin-bottom:0\" class=\"taxonomy-category has-link-color wp-elements-2 wp-block-post-terms has-text-color has-work-sans-regular-font-family\"><a href=\"https:\/\/equilibriumpsychotherapy.net\/hr\/category\/too-afraid-to-ask\/\" rel=\"tag\">Everything You Were Too Afraid to Ask<\/a><span class=\"wp-block-post-terms__separator\">, <\/span><a href=\"https:\/\/equilibriumpsychotherapy.net\/hr\/category\/mens-health\/\" rel=\"tag\">Men&#8217;s Health<\/a><span class=\"wp-block-post-terms__separator\">, <\/span><a href=\"https:\/\/equilibriumpsychotherapy.net\/hr\/category\/womens-health\/\" rel=\"tag\">Women&#8217;s Health<\/a><\/div>\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family ra-series wp-block-paragraph\" style=\"color:#3d2874;margin-top:24px;margin-bottom:0;font-size:12.5px;font-weight:700;letter-spacing:0.2em;line-height:1.4\">Everything you were too afraid to ask<\/p>\n\n\n\n<h1 class=\"wp-block-heading has-text-color has-playfair-display-font-family\" id=\"top\" style=\"color:#2a2622;margin-top:8px;margin-bottom:16px;font-size:clamp(26.944px, 1.684rem + ((1vw - 3.2px) * 2.165), 46px);font-style:normal;font-weight:800;line-height:1.12\">Contraception 101<\/h1>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#524a42;margin-top:0;margin-bottom:22px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.55\">How well each method really works, where in the body each one intervenes, what it does to bleeding, mood, weight and desire, the risks, what emergency contraception can and cannot do, plain answers to the questions people rarely ask out loud, where men come into it, and how to have the conversation<\/p>\n\n\n\n<p class=\"eq-credit\" style=\"--eq-credit-ac:#3d2874\">Written by <a href=\"\/our-team-ivana\/\" rel=\"author\">Ivana<\/a>, psychologist and psychotherapist<\/p>\n\n\n\n<div style=\"margin-top:0px;margin-bottom:0px\"><div class=\"cpw-swbox cpw-keep\" id=\"cpw-swbox\"><div class=\"cpw-metarow\"><p class=\"has-text-color has-work-sans-regular-font-family cpw-metat\" style=\"color:#6b6259;margin-top:0;margin-bottom:0;font-size:15px;line-height:1.5\"><span class=\"cpw-mtw\"><span class=\"cpw-mt-f\"><strong style=\"color:#3d2874\">44 minute read<\/strong> &nbsp;&middot;&nbsp; 9,914 words<\/span><span class=\"cpw-mt-p\"><strong style=\"color:#3d2874\">40 minute read<\/strong> &nbsp;&middot;&nbsp; 8,979 words<\/span><\/span><\/p><div class=\"cpw-seg\" id=\"cpw-seg\" role=\"radiogroup\" aria-label=\"Reading version\" aria-describedby=\"cpw-sw-h\"><button type=\"button\" class=\"cpw-segb\" id=\"cpw-seg-full\" role=\"radio\" aria-checked=\"true\" tabindex=\"0\">Detailed<\/button><button type=\"button\" class=\"cpw-segb\" id=\"cpw-seg-plain\" role=\"radio\" aria-checked=\"false\" tabindex=\"-1\">Plain words<\/button><\/div><\/div><p class=\"cpw-hint\" id=\"cpw-sw-h\">Detailed explains the research and the reasons behind each point. Plain words gives the same main points in short, everyday language. Safety advice and emergency steps are the same in both.<\/p><button type=\"button\" class=\"cpw-pill\" id=\"cpw-pill\" role=\"switch\" aria-checked=\"false\"><span class=\"cpw-pl-t\">Plain words<\/span><span class=\"cpw-pl-k\" aria-hidden=\"true\"><\/span><\/button><\/div><!-- eq-post-top -->\n<div class=\"pt-on\" hidden data-src=\"https:\/\/equilibriumpsychotherapy.net\/wp-content\/uploads\/2026\/10\/contraception-101-post-top.jpg\" data-w=\"433\" data-aspect=\"0.925\" data-side=\"right\" data-bleed=\"\"><\/div>\n<script>\n\/* Post tops: turns the post's masthead group into the cream band and adds the\n   drawing beside the words. It runs as soon as the masthead's words are in, before\n   the post's own scripts measure anything (the Plain words switch keeps its place on\n   screen, so a band built later scrolled the page). 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It never changes the mode. *\/function fromHash(){if(!root.classList.contains(\"cpw-plain\")){return;}var id=window.location.hash;if(2>id.length){return;}try{id=decodeURIComponent(id.slice(1));}catch(e4){id=id.slice(1);}var t=document.getElementById(id);if(!t){return;}if(t.getClientRects().length>0){return;}var n=t;while(n.parentElement){if(n.parentElement===root){break;}n=n.parentElement;}var h2=null;while(n){h2=n.querySelector('h2[id^=\"part-\"]');if(h2){break;}n=n.previousElementSibling;}if(h2){h2.scrollIntoView({block:\"start\",behavior:\"instant\"});}}window.addEventListener(\"hashchange\",fromHash);window.addEventListener(\"load\",fromHash);\/* the floating pill: shown only once the masthead control has scrolled up out of view, and never over the ending (the closing panel and the footer, which are parsed after this script, so they are looked up on first use). The observer says when the control leaves the screen; a passive scroll listener recomputes from the real positions as well, because a jump (a contents link, the End key) can skip an observer entirely. *\/var ends=[null,null],busy=false;function update(){busy=false;var h=window.innerHeight,show=false,hide=false,k,r;if(!ends[0]){ends[0]=document.querySelector(\".cpw-end\");}if(!ends[1]){ends[1]=document.querySelector(\"footer\");}r=seg.getBoundingClientRect();if(0>=r.bottom){show=true;}for(k=0;ends.length>k;k+=1){if(ends[k]){r=ends[k].getBoundingClientRect();if(h-72>r.top){if(r.bottom>0){hide=true;}}}}var sf=document.querySelectorAll(\".cpw-nopill\"),m;for(m=0;sf.length>m;m+=1){r=sf[m].getBoundingClientRect();if(h>r.top){if(r.bottom>0){hide=true;}}}if(show){if(!hide){pill.classList.add(\"cpw-pill-on\");return;}}pill.classList.remove(\"cpw-pill-on\");}function soon(){if(!busy){busy=true;window.requestAnimationFrame(update);}}window.addEventListener(\"scroll\",soon,{passive:true});window.addEventListener(\"resize\",soon);if(window.IntersectionObserver){new IntersectionObserver(soon).observe(seg);}window.addEventListener(\"load\",soon);update();})();\/*>*\/<\/script><\/div>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group cpw-keep has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family eq-drop wp-block-paragraph\" style=\"color:#35302a;margin-top:46px;margin-bottom:26px;font-size:clamp(14.642px, 0.915rem + ((1vw - 3.2px) * 0.836), 22px);line-height:1.62\">Most people choose contraception the way they choose a phone plan: a short conversation, a leaflet, and then years of living with the choice. Maybe that&#8217;s how it went for you, or maybe you&#8217;re about to choose and you&#8217;re wondering what it will do to your mood, your weight or your chances of having a baby later. It makes sense to want better answers than a leaflet gives. What nobody hands over is the part that would actually help: how well each method works in real life, what it&#8217;s doing inside your body, and which of the things people say about it are true.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">This article hands that over. It starts with how well each method works, because the gap between how well it works on paper and how well it works in everyday life is bigger than almost anyone expects, and it explains why. Then it looks at what each method does in your body, what it changes, and what the risks are when they&#8217;re written as numbers instead of warnings. It also takes on the questions people tend not to ask out loud. If you&#8217;d like everything in plainer words, choose Plain words above.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Nothing here can tell you what to use. That depends on your body, your history and what you can live with, and it&#8217;s a conversation to have with a doctor or a sexual health clinic. What this can do is make that conversation shorter and a lot less awkward, because you&#8217;ll already know what the words mean.<\/p>\n\n\n\n<div style=\"margin-top:10px;margin-bottom:0px\"><aside class=\"ra-anyway\"><span class=\"mk\" aria-hidden=\"true\"><svg viewBox=\"0 0 24 24\" fill=\"none\" stroke=\"currentColor\" stroke-width=\"1.6\" stroke-linecap=\"round\" stroke-linejoin=\"round\"><path d=\"M4 5.5h6.5a2.5 2.5 0 0 1 2.5 2.5v11a2 2 0 0 0-2-2H4zM20 5.5h-6.5A2.5 2.5 0 0 0 11 8v11a2 2 0 0 1 2-2h7z\"\/><\/svg><\/span><p class=\"h\">This one assumes a little.<\/p><p class=\"t\">If any of the words below are unfamiliar, the first two articles in this series start from zero: <a href=\"\/womens-health-101\/\" style=\"color:#3d2874;font-weight:600;text-decoration:underline;text-underline-offset:3px;text-decoration-color:#d5cbf0\">Women&#8217;s Health 101<\/a> and <a href=\"\/mens-health-101\/\" style=\"color:#3d2874;font-weight:600;text-decoration:underline;text-underline-offset:3px;text-decoration-color:#d5cbf0\">Men&#8217;s Health 101<\/a>. Neither is required reading. Both make this one shorter.<\/p><\/aside><\/div>\n\n\n\n<div class=\"wp-block-group has-background has-global-padding is-layout-constrained wp-container-core-group-is-layout-83938ec0 wp-block-group-is-layout-constrained\" style=\"background-color:#f5f2ec;border-color:#e6e0d4;border-width:1.5px;border-style:solid;border-radius:20px;margin-top:40px;margin-bottom:0;padding:34px 38px\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2b1a60;margin-top:0;margin-bottom:12px;font-size:12px;font-weight:700;letter-spacing:0.16em;line-height:1.4\">THE SHORT VERSION<\/p>\n\n\n\n<ul class=\"wp-block-list ra-short has-text-color has-work-sans-regular-font-family\" style=\"color:#2a2622;margin-top:0;margin-bottom:0;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.568), 19px);line-height:1.7\">\n<li><a href=\"#part-1\"><span class=\"cpw-nrm\"><strong class=\"eqb\">How well a method works depends mostly on how easy it is to use correctly<\/strong>: methods you have to remember, like the pill or condoms, fail more often in real life than in studies, while the implant and the coils almost never do.<\/span><span class=\"cpw-pln\"><strong class=\"eqb\">How well a method works depends mostly on how easy it is to use correctly.<\/strong> Methods you have to remember, like the pill or condoms, fail more often in real life than in studies. The implant and the coils almost never do.<\/span><\/a><\/li>\n\n\n\n<li><a href=\"#part-2\"><span class=\"cpw-nrm\">Every method prevents pregnancy in one of three ways: it stops an egg being released, stops sperm from reaching it, or makes it much harder for a pregnancy to begin.<\/span><span class=\"cpw-pln\">Every method works in one of three ways. It stops an egg being released, it stops sperm from reaching it, or it makes it much harder for a pregnancy to begin.<\/span><\/a><\/li>\n\n\n\n<li><a href=\"#part-3\"><span class=\"cpw-nrm\">Hormonal methods usually change your periods and some people notice a change in mood or desire, but the evidence that they cause weight gain is weak, and fertility comes back after you stop.<\/span><span class=\"cpw-pln\">Hormonal methods usually change your periods, and some people notice a change in mood or desire. The evidence that they cause weight gain is weak, and fertility comes back after you stop.<\/span><\/a><\/li>\n\n\n\n<li><a href=\"#part-4\"><span class=\"cpw-nrm\">The combined pill does raise the risk of a blood clot, but the risk stays very small, and it is lower than the risk during pregnancy.<\/span><span class=\"cpw-pln\">The combined pill does raise the risk of a blood clot, but the risk stays very small, and it is lower than the risk during pregnancy.<\/span><\/a><\/li>\n\n\n\n<li><a href=\"#part-5\"><span class=\"cpw-nrm\">After unprotected sex, act quickly: the copper coil is the most effective option and the only one that still works after an egg has been released.<\/span><span class=\"cpw-pln\">After unprotected sex, act quickly: the copper coil is the most effective option and the only one that still works after an egg has been released.<\/span><\/a><\/li>\n\n\n\n<li><a href=\"#part-6\"><span class=\"cpw-nrm\">The worries people keep to themselves mostly have simple answers: most antibiotics do not affect the pill, the morning after pill is not an abortion pill, and only condoms protect against infections.<\/span><span class=\"cpw-pln\">Most of the worries people keep to themselves have simple answers. Most antibiotics don&#8217;t affect the pill, the morning after pill isn&#8217;t an abortion pill, and only condoms protect against infections.<\/span><\/a><\/li>\n\n\n\n<li><a href=\"#part-7\"><span class=\"cpw-nrm\">Men still have only condoms and vasectomy, and a vasectomy is very reliable, but only once a test confirms there are no sperm left.<\/span><span class=\"cpw-pln\">Men still have only condoms and vasectomy, and a vasectomy is very reliable, but only once a test confirms there are no sperm left.<\/span><\/a><\/li>\n\n\n\n<li><a href=\"#part-8\"><span class=\"cpw-nrm\">If one method is ruled out for you, most of the others usually are not, so ask which option fits your life, and go back if something does not suit you.<\/span><span class=\"cpw-pln\">If one method is ruled out for you, most of the others usually are not, so ask which option fits your life, and go back if something does not suit you.<\/span><\/a><\/li>\n<\/ul>\n\n\n<\/div>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group cpw-keep has-global-padding is-layout-constrained wp-container-core-group-is-layout-d2a766d4 wp-block-group-is-layout-constrained\">\n\n\n<div class=\"wp-block-group has-background has-global-padding is-layout-constrained wp-container-core-group-is-layout-4ccedd2e wp-block-group-is-layout-constrained\" style=\"border-color:#e8e1d5;border-width:1.5px;border-style:solid;border-radius:22px;background-color:#faf8f3;margin-top:56px;margin-bottom:20px;padding:30px 34px\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#6b6259;margin-top:0;margin-bottom:22px;font-size:12px;font-weight:700;letter-spacing:0.16em;line-height:1.4\">WHAT THIS ARTICLE COVERS &middot; EIGHT PARTS<\/p>\n\n\n\n<div class=\"wp-block-rank-math-toc-block\">\n<div class=\"eq-toc\"><details><summary><svg class=\"chev\" viewBox=\"0 0 12 12\" aria-hidden=\"true\" focusable=\"false\"><path d=\"M4 2l4 4-4 4\" fill=\"none\" stroke=\"currentColor\" stroke-width=\"1.7\" stroke-linecap=\"round\" stroke-linejoin=\"round\"\/><\/svg><p hidden><\/p><span class=\"num\">PART 1<\/span><a class=\"ttl\" href=\"#part-1\">How well it works<\/a><span class=\"cnt\"><span class=\"cpw-n2\"><span class=\"sec\">4 sections<\/span><span class=\"sep\"> &middot; <\/span>3 min<\/span><span class=\"cpw-p2\">3 min<\/span><\/span><\/summary><ul><li><a href=\"#every-method-has-two-numbers\">Every method has two numbers<\/a><\/li><li><a href=\"#the-gap-is-the-whole-story\">The gap is the whole story<\/a><\/li><li><a href=\"#circumstance-matters-more-than-the-method\">Circumstance matters more than the method<\/a><\/li><li><a href=\"#the-methods-with-nothing-to-get-wrong\">The methods with nothing to get wrong<\/a><\/li><\/ul><\/details><details><summary><svg class=\"chev\" viewBox=\"0 0 12 12\" aria-hidden=\"true\" focusable=\"false\"><path d=\"M4 2l4 4-4 4\" fill=\"none\" stroke=\"currentColor\" stroke-width=\"1.7\" stroke-linecap=\"round\" stroke-linejoin=\"round\"\/><\/svg><p hidden><\/p><span class=\"num\">PART 2<\/span><a class=\"ttl\" href=\"#part-2\">Where each method intervenes<\/a><span class=\"cnt\"><span class=\"cpw-n2\"><span class=\"sec\">5 sections<\/span><span class=\"sep\"> &middot; <\/span>4 min<\/span><span class=\"cpw-p2\">4 min<\/span><\/span><\/summary><ul><li><a href=\"#three-places-to-interrupt\">Three places to interrupt<\/a><\/li><li><a href=\"#the-methods-that-stop-ovulation\">The methods that stop ovulation<\/a><\/li><li><a href=\"#mucus-is-doing-more-work-than-anyone-mentions\">Mucus is doing more work than anyone mentions<\/a><\/li><li><a href=\"#the-two-coils-are-not-the-same-device\">The two coils are not the same device<\/a><\/li><li><a href=\"#barriers-withdrawal-and-timing\">Barriers, withdrawal and timing<\/a><\/li><\/ul><\/details><details><summary><svg class=\"chev\" viewBox=\"0 0 12 12\" aria-hidden=\"true\" focusable=\"false\"><path d=\"M4 2l4 4-4 4\" fill=\"none\" stroke=\"currentColor\" stroke-width=\"1.7\" stroke-linecap=\"round\" stroke-linejoin=\"round\"\/><\/svg><p hidden><\/p><span class=\"num\">PART 3<\/span><a class=\"ttl\" href=\"#part-3\">What it does to the rest of you<\/a><span class=\"cnt\"><span class=\"cpw-n2\"><span class=\"sec\">6 sections<\/span><span class=\"sep\"> &middot; <\/span>10 min<\/span><span class=\"cpw-p2\">8 min<\/span><\/span><\/summary><ul><li><a href=\"#bleeding-changes-and-it-is-a-common-reason-people-stop\">Bleeding changes, and it is a common reason people stop<\/a><\/li><li><a href=\"#mood-is-the-question-people-most-want-answered\">Mood is the question people most want answered<\/a><\/li><li><a href=\"#what-dose-does-and-what-to-do-about-it\">What dose does, and what to do about it<\/a><\/li><li><a href=\"#weight-gain-is-the-most-believed-and-the-least-supported\">Weight gain is the most believed and the least supported<\/a><\/li><li><a href=\"#desire-is-more-mixed-than-either-side-claims\">Desire is more mixed than either side claims<\/a><\/li><li><a href=\"#what-happens-when-you-stop\">What happens when you stop<\/a><\/li><\/ul><\/details><details><summary><svg class=\"chev\" viewBox=\"0 0 12 12\" aria-hidden=\"true\" focusable=\"false\"><path d=\"M4 2l4 4-4 4\" fill=\"none\" stroke=\"currentColor\" stroke-width=\"1.7\" stroke-linecap=\"round\" stroke-linejoin=\"round\"\/><\/svg><p hidden><\/p><span class=\"num\">PART 4<\/span><a class=\"ttl\" href=\"#part-4\">The risks, as numbers<\/a><span class=\"cnt\"><span class=\"cpw-n2\"><span class=\"sec\">3 sections<\/span><span class=\"sep\"> &middot; <\/span>4 min<\/span><span class=\"cpw-p2\">4 min<\/span><\/span><\/summary><ul><li><a href=\"#clots-written-out\">Clots, written out<\/a><\/li><li><a href=\"#which-is-exactly-why-breaks-are-a-bad-idea\">Which is exactly why breaks are a bad idea<\/a><\/li><li><a href=\"#cancer-over-a-lifetime-rather-than-a-year\">Cancer, over a lifetime rather than a year<\/a><\/li><\/ul><\/details><details><summary><svg class=\"chev\" viewBox=\"0 0 12 12\" aria-hidden=\"true\" focusable=\"false\"><path d=\"M4 2l4 4-4 4\" fill=\"none\" stroke=\"currentColor\" stroke-width=\"1.7\" stroke-linecap=\"round\" stroke-linejoin=\"round\"\/><\/svg><p hidden><\/p><span class=\"num\">PART 5<\/span><a class=\"ttl\" href=\"#part-5\">Emergency contraception<\/a><span class=\"cnt\"><span class=\"cpw-n2\"><span class=\"sec\">6 sections<\/span><span class=\"sep\"> &middot; <\/span>5 min<\/span><span class=\"cpw-p2\">5 min<\/span><\/span><\/summary><ul><li><a href=\"#three-options-and-most-people-are-offered-one\">Three options, and most people are offered one<\/a><\/li><li><a href=\"#the-copper-coil-is-the-most-effective-and-the-least-asked-\">The copper coil is the most effective, and the least asked for<\/a><\/li><li><a href=\"#the-two-pills-are-not-the-same-pill\">The two pills are not the same pill<\/a><\/li><li><a href=\"#weight-can-change-the-answer\">Weight can change the answer<\/a><\/li><li><a href=\"#it-is-not-an-abortion-pill\">It is not an abortion pill<\/a><\/li><li><a href=\"#the-day-matters-more-than-the-hour\">The day matters more than the hour<\/a><\/li><\/ul><\/details><div class=\"flat\"><svg class=\"chev hide\" viewBox=\"0 0 12 12\" aria-hidden=\"true\" focusable=\"false\"><path d=\"M4 2l4 4-4 4\" fill=\"none\" stroke=\"currentColor\" stroke-width=\"1.7\" stroke-linecap=\"round\" stroke-linejoin=\"round\"\/><\/svg><p hidden><\/p><span class=\"num\">PART 6<\/span><a class=\"ttl\" href=\"#part-6\">Everything you were too afraid to ask<\/a><span class=\"cnt\"><span class=\"cpw-n2\">6 min<\/span><span class=\"cpw-p2\">6 min<\/span><\/span><\/div><details><summary><svg class=\"chev\" viewBox=\"0 0 12 12\" aria-hidden=\"true\" focusable=\"false\"><path d=\"M4 2l4 4-4 4\" fill=\"none\" stroke=\"currentColor\" stroke-width=\"1.7\" stroke-linecap=\"round\" stroke-linejoin=\"round\"\/><\/svg><p hidden><\/p><span class=\"num\">PART 7<\/span><a class=\"ttl\" href=\"#part-7\">Men and contraception<\/a><span class=\"cnt\"><span class=\"cpw-n2\"><span class=\"sec\">3 sections<\/span><span class=\"sep\"> &middot; <\/span>4 min<\/span><span class=\"cpw-p2\">3 min<\/span><\/span><\/summary><ul><li><a href=\"#two-methods-and-one-of-them-is-permanent\">Two methods, and one of them is permanent<\/a><\/li><li><a href=\"#vasectomy-is-more-effective-and-less-risky-than-the-female\">Vasectomy is more effective and less risky than the female equivalent<\/a><\/li><li><a href=\"#why-there-is-still-no-male-pill\">Why there is still no male pill<\/a><\/li><\/ul><\/details><details><summary><svg class=\"chev\" viewBox=\"0 0 12 12\" aria-hidden=\"true\" focusable=\"false\"><path d=\"M4 2l4 4-4 4\" fill=\"none\" stroke=\"currentColor\" stroke-width=\"1.7\" stroke-linecap=\"round\" stroke-linejoin=\"round\"\/><\/svg><p hidden><\/p><span class=\"num\">PART 8<\/span><a class=\"ttl\" href=\"#part-8\">Choosing, and talking about it<\/a><span class=\"cnt\"><span class=\"cpw-n2\"><span class=\"sec\">4 sections<\/span><span class=\"sep\"> &middot; <\/span>5 min<\/span><span class=\"cpw-p2\">4 min<\/span><\/span><\/summary><ul><li><a href=\"#how-doctors-actually-decide\">How doctors actually decide<\/a><\/li><li><a href=\"#what-to-take-to-the-appointment\">What to take to the appointment<\/a><\/li><li><a href=\"#when-to-go-back\">When to go back<\/a><\/li><li><a href=\"#and-when-not-to-wait\">And when not to wait<\/a><\/li><\/ul><\/details><\/div>\n<\/div>\n\n\n<\/div>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group cpw-keep has-global-padding is-layout-constrained wp-container-core-group-is-layout-d2a766d4 wp-block-group-is-layout-constrained\">\n\n\n<div style=\"margin-top:92px;margin-bottom:34px\"><div class=\"ra-part\"><div class=\"wm\" aria-hidden=\"true\">01<\/div><div class=\"ic\" aria-hidden=\"true\"><svg viewBox=\"0 0 24 24\" fill=\"none\" stroke=\"currentColor\" stroke-width=\"1.5\" stroke-linecap=\"round\" stroke-linejoin=\"round\"><path d=\"M3 20h18M6.5 20v-6M12 20V5.5M17.5 20v-9\"\/><\/svg><\/div><div class=\"tx\"><div class=\"meta\"><p class=\"lb\">Part one of eight<\/p><span class=\"tk\" aria-hidden=\"true\"><i class=\"now\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><\/span><\/div><h2 id=\"part-1\">How well it works<\/h2><p class=\"sb\">The two numbers every method has, and why they are so far apart<\/p><\/div><\/div><\/div>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group cpw-pl has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family cpw-plk wp-block-paragraph\" style=\"color:#3d2874;margin-top:38px;margin-bottom:14px;font-size:12px;font-weight:700;letter-spacing:0.16em;line-height:1.4\">In plain words<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Every method has two numbers for how well it works. <em class=\"eqi\">Perfect use<\/em> is what happens when you use a method exactly as intended, every single time, with nothing forgotten and nothing rushed. <em class=\"eqi\">Typical use<\/em> is what happens to real people over a year, including the missed pill, the late appointment and the condom that went on halfway through.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\"><strong class=\"eqb\">Both numbers show how many people out of 100 become pregnant over a year of using the method.<\/strong> For the combined pill (the pill with two hormones in it), it&#8217;s 0.3 with perfect use and 7 with typical use. For the external condom, it&#8217;s 2 and 13. For withdrawal (pulling out), it&#8217;s 4 and 20. To put those in context, the number for using nothing at all is 85.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Open any row in the figure below to see its two numbers in a sentence, and switch the order to see how the ranking changes.<\/p>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group cpw-n has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"every-method-has-two-numbers\" style=\"color:#3d2874;margin-top:72px;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">Every method has two numbers<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Every method comes with two numbers for how well it works, and it isn&#8217;t obvious why there are two. The first is <em class=\"eqi\">perfect use<\/em>: what happens when a method is used exactly as intended, every single time, with nothing forgotten and nothing rushed. The second is <em class=\"eqi\">typical use<\/em>: what happens to real people over a year, including the missed pill, the late appointment and the condom that went on halfway through.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\"><strong class=\"eqb\">Both numbers are counted the same way: out of 100 people using the method for a year, how many become pregnant<\/strong>. For the combined pill, the perfect-use figure is 0.3 and the typical-use figure is 7. For the external condom, it&#8217;s 2 and 13. For withdrawal, it&#8217;s 4 and 20.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">To put those in context, the number for using nothing at all is 85.<\/p>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group cpw-keep has-global-padding is-layout-constrained wp-container-core-group-is-layout-d2a766d4 wp-block-group-is-layout-constrained\">\n\n\n<div style=\"margin-top:40px;margin-bottom:48px\"><figure class=\"ra-fig ra-lad\" id=\"ra-lad\"><div class=\"hd\"><p class=\"ti\">Perfect use against real life<\/p><p class=\"q\">Out of 100 people using it for a year, how many become pregnant<\/p><\/div><div class=\"sw\"><div class=\"ra-seg\" role=\"group\" aria-label=\"Sort the list\"><button type=\"button\" data-s=\"t\" aria-pressed=\"true\">Order by real life<\/button><button type=\"button\" data-s=\"p\" aria-pressed=\"false\">Order by perfect use<\/button><\/div><\/div><ul><li id=\"ra-ld0\" class=\"\"><button type=\"button\" class=\"rw\" data-i=\"0\" aria-expanded=\"false\" aria-controls=\"ra-ldd0\"><span class=\"nm\">Implant<\/span><span class=\"tr\"><span class=\"gap\" style=\"left:0.45%;width:calc(0.45% &#45; 0.45%)\"><\/span><span class=\"pt pp\" style=\"left:0.45%\"><\/span><span class=\"pt tp\" style=\"left:0.45%\"><\/span><\/span><span class=\"vl\">0.1 <b>0.1<\/b><\/span><\/button><p class=\"dt\" id=\"ra-ldd0\">Out of 1,000 people using implant for a year, about 1 become pregnant when it is used perfectly, and about 1 as people actually use it.<\/p><\/li><li id=\"ra-ld1\" class=\"\"><button type=\"button\" class=\"rw\" data-i=\"1\" aria-expanded=\"false\" aria-controls=\"ra-ldd1\"><span class=\"nm\">Vasectomy<\/span><span class=\"tr\"><span class=\"gap\" style=\"left:0.45%;width:calc(0.68% &#45; 0.45%)\"><\/span><span class=\"pt pp\" style=\"left:0.45%\"><\/span><span class=\"pt tp\" style=\"left:0.68%\"><\/span><\/span><span class=\"vl\">0.1 <b>0.15<\/b><\/span><\/button><p class=\"dt\" id=\"ra-ldd1\">Out of 1,000 people using vasectomy for a year, about 1 become pregnant when it is used perfectly, and about 2 as people actually use it.<\/p><\/li><li id=\"ra-ld2\" class=\"\"><button type=\"button\" class=\"rw\" data-i=\"2\" aria-expanded=\"false\" aria-controls=\"ra-ldd2\"><span class=\"nm\">Hormonal coil<\/span><span class=\"tr\"><span class=\"gap\" style=\"left:1.36%;width:calc(1.82% &#45; 1.36%)\"><\/span><span class=\"pt pp\" style=\"left:1.36%\"><\/span><span class=\"pt tp\" style=\"left:1.82%\"><\/span><\/span><span class=\"vl\">0.3 <b>0.4<\/b><\/span><\/button><p class=\"dt\" id=\"ra-ldd2\">Out of 1,000 people using hormonal coil for a year, about 3 become pregnant when it is used perfectly, and about 4 as people actually use it.<\/p><\/li><li id=\"ra-ld3\" class=\"\"><button type=\"button\" class=\"rw\" data-i=\"3\" aria-expanded=\"false\" aria-controls=\"ra-ldd3\"><span class=\"nm\">Tubal surgery<span class=\"cpw-pln\"> (tubes closed)<\/span><\/span><span class=\"tr\"><span class=\"gap\" style=\"left:2.27%;width:calc(2.27% &#45; 2.27%)\"><\/span><span class=\"pt pp\" style=\"left:2.27%\"><\/span><span class=\"pt tp\" style=\"left:2.27%\"><\/span><\/span><span class=\"vl\">0.5 <b>0.5<\/b><\/span><\/button><p class=\"dt\" id=\"ra-ldd3\">Out of 1,000 people using tubal surgery for a year, about 5 become pregnant when it is used perfectly, and about 5 as people actually use it.<\/p><\/li><li id=\"ra-ld4\" class=\"\"><button type=\"button\" class=\"rw\" data-i=\"4\" aria-expanded=\"false\" aria-controls=\"ra-ldd4\"><span class=\"nm\">Copper coil<\/span><span class=\"tr\"><span class=\"gap\" style=\"left:2.73%;width:calc(3.64% &#45; 2.73%)\"><\/span><span class=\"pt pp\" style=\"left:2.73%\"><\/span><span class=\"pt tp\" style=\"left:3.64%\"><\/span><\/span><span class=\"vl\">0.6 <b>0.8<\/b><\/span><\/button><p class=\"dt\" id=\"ra-ldd4\">Out of 1,000 people using copper coil for a year, about 6 become pregnant when it is used perfectly, and about 8 as people actually use it.<\/p><\/li><li id=\"ra-ld5\" class=\"\"><button type=\"button\" class=\"rw\" data-i=\"5\" aria-expanded=\"false\" aria-controls=\"ra-ldd5\"><span class=\"nm\">Injection<\/span><span class=\"tr\"><span class=\"gap\" style=\"left:0.91%;width:calc(18.18% &#45; 0.91%)\"><\/span><span class=\"pt pp\" style=\"left:0.91%\"><\/span><span class=\"pt tp\" style=\"left:18.18%\"><\/span><\/span><span class=\"vl\">0.2 <b>4<\/b><\/span><\/button><p class=\"dt\" id=\"ra-ldd5\">Out of 1,000 people using injection for a year, about 2 become pregnant when it is used perfectly, and about 40 as people actually use it.<\/p><\/li><li id=\"ra-ld6\" class=\"\"><button type=\"button\" class=\"rw\" data-i=\"6\" aria-expanded=\"false\" aria-controls=\"ra-ldd6\"><span class=\"nm\">Combined pill<\/span><span class=\"tr\"><span class=\"gap\" style=\"left:1.36%;width:calc(31.82% &#45; 1.36%)\"><\/span><span class=\"pt pp\" style=\"left:1.36%\"><\/span><span class=\"pt tp\" style=\"left:31.82%\"><\/span><\/span><span class=\"vl\">0.3 <b>7<\/b><\/span><\/button><p class=\"dt\" id=\"ra-ldd6\">Out of 1,000 people using combined pill for a year, about 3 become pregnant when it is used perfectly, and about 70 as people actually use it.<\/p><\/li><li id=\"ra-ld7\" class=\"\"><button type=\"button\" class=\"rw\" data-i=\"7\" aria-expanded=\"false\" aria-controls=\"ra-ldd7\"><span class=\"nm\">Patch<\/span><span class=\"tr\"><span class=\"gap\" style=\"left:1.36%;width:calc(31.82% &#45; 1.36%)\"><\/span><span class=\"pt pp\" style=\"left:1.36%\"><\/span><span class=\"pt tp\" style=\"left:31.82%\"><\/span><\/span><span class=\"vl\">0.3 <b>7<\/b><\/span><\/button><p class=\"dt\" id=\"ra-ldd7\">Out of 1,000 people using patch for a year, about 3 become pregnant when it is used perfectly, and about 70 as people actually use it.<\/p><\/li><li id=\"ra-ld8\" class=\"\"><button type=\"button\" class=\"rw\" data-i=\"8\" aria-expanded=\"false\" aria-controls=\"ra-ldd8\"><span class=\"nm\">Vaginal ring<\/span><span class=\"tr\"><span class=\"gap\" style=\"left:1.36%;width:calc(31.82% &#45; 1.36%)\"><\/span><span class=\"pt pp\" style=\"left:1.36%\"><\/span><span class=\"pt tp\" style=\"left:31.82%\"><\/span><\/span><span class=\"vl\">0.3 <b>7<\/b><\/span><\/button><p class=\"dt\" id=\"ra-ldd8\">Out of 1,000 people using vaginal ring for a year, about 3 become pregnant when it is used perfectly, and about 70 as people actually use it.<\/p><\/li><li id=\"ra-ld9\" class=\"\"><button type=\"button\" class=\"rw\" data-i=\"9\" aria-expanded=\"false\" aria-controls=\"ra-ldd9\"><span class=\"nm\">External condom<\/span><span class=\"tr\"><span class=\"gap\" style=\"left:9.09%;width:calc(59.09% &#45; 9.09%)\"><\/span><span class=\"pt pp\" style=\"left:9.09%\"><\/span><span class=\"pt tp\" style=\"left:59.09%\"><\/span><\/span><span class=\"vl\">2 <b>13<\/b><\/span><\/button><p class=\"dt\" id=\"ra-ldd9\">Out of 1,000 people using external condom for a year, about 20 become pregnant when it is used perfectly, and about 130 as people actually use it.<\/p><\/li><li id=\"ra-ld10\" class=\"\"><button type=\"button\" class=\"rw\" data-i=\"10\" aria-expanded=\"false\" aria-controls=\"ra-ldd10\"><span class=\"nm\">Diaphragm<span class=\"cpw-pln\"> (a cap over the cervix)<\/span><\/span><span class=\"tr\"><span class=\"gap\" style=\"left:72.73%;width:calc(77.27% &#45; 72.73%)\"><\/span><span class=\"pt pp\" style=\"left:72.73%\"><\/span><span class=\"pt tp\" style=\"left:77.27%\"><\/span><\/span><span class=\"vl\">16 <b>17<\/b><\/span><\/button><p class=\"dt\" id=\"ra-ldd10\">Out of 1,000 people using diaphragm for a year, about 160 become pregnant when it is used perfectly, and about 170 as people actually use it.<\/p><\/li><li id=\"ra-ld11\" class=\"\"><button type=\"button\" class=\"rw\" data-i=\"11\" aria-expanded=\"false\" aria-controls=\"ra-ldd11\"><span class=\"nm\">Withdrawal<span class=\"cpw-pln\"> (pulling out)<\/span><\/span><span class=\"tr\"><span class=\"gap\" style=\"left:18.18%;width:calc(90.91% &#45; 18.18%)\"><\/span><span class=\"pt pp\" style=\"left:18.18%\"><\/span><span class=\"pt tp\" style=\"left:90.91%\"><\/span><\/span><span class=\"vl\">4 <b>20<\/b><\/span><\/button><p class=\"dt\" id=\"ra-ldd11\">Out of 1,000 people using withdrawal for a year, about 40 become pregnant when it is used perfectly, and about 200 as people actually use it.<\/p><\/li><li id=\"ra-ld12\" class=\"\"><button type=\"button\" class=\"rw\" data-i=\"12\" aria-expanded=\"false\" aria-controls=\"ra-ldd12\"><span class=\"nm\">Internal condom<\/span><span class=\"tr\"><span class=\"gap\" style=\"left:22.73%;width:calc(95.45% &#45; 22.73%)\"><\/span><span class=\"pt pp\" style=\"left:22.73%\"><\/span><span class=\"pt tp\" style=\"left:95.45%\"><\/span><\/span><span class=\"vl\">5 <b>21<\/b><\/span><\/button><p class=\"dt\" id=\"ra-ldd12\">Out of 1,000 people using internal condom for a year, about 50 become pregnant when it is used perfectly, and about 210 as people actually use it.<\/p><\/li><li id=\"ra-ld13\" class=\"\"><button type=\"button\" class=\"rw\" data-i=\"13\" aria-expanded=\"false\" aria-controls=\"ra-ldd13\"><span class=\"nm\">Spermicide<span class=\"cpw-pln\"> (a gel, foam or film)<\/span><\/span><span class=\"tr\"><span class=\"gap\" style=\"left:72.73%;width:calc(95.45% &#45; 72.73%)\"><\/span><span class=\"pt pp\" style=\"left:72.73%\"><\/span><span class=\"pt tp\" style=\"left:95.45%\"><\/span><\/span><span class=\"vl\">16 <b>21<\/b><\/span><\/button><p class=\"dt\" id=\"ra-ldd13\">Out of 1,000 people using spermicide for a year, about 160 become pregnant when it is used perfectly, and about 210 as people actually use it.<\/p><\/li><li id=\"ra-ld14\" class=\"none\"><button type=\"button\" class=\"rw\" data-i=\"14\" aria-expanded=\"false\" aria-controls=\"ra-ldd14\"><span class=\"nm\">No method<\/span><span class=\"tr\"><span class=\"gap\" style=\"left:0;width:100%\"><\/span><\/span><span class=\"vl\"><b>85<\/b><\/span><\/button><p class=\"dt\" id=\"ra-ldd14\">Out of 1,000 people using nothing for a year, about 850 become pregnant. Every number above is a reduction from that one.<\/p><\/li><\/ul><div class=\"axw\"><span><\/span><div class=\"ax\"><i style=\"left:0.00%\"><\/i><span style=\"left:0.00%\">0<\/span><i style=\"left:22.73%\"><\/i><span style=\"left:22.73%\">5<\/span><i style=\"left:45.45%\"><\/i><span style=\"left:45.45%\">10<\/span><i style=\"left:68.18%\"><\/i><span style=\"left:68.18%\">15<\/span><i style=\"left:90.91%\"><\/i><span style=\"left:90.91%\">20<\/span><\/div><span><\/span><\/div><div class=\"key\"><span><i style=\"background:#bd8700\"><\/i>Used perfectly<\/span><span><i style=\"background:#553a9c\"><\/i>As people actually use it<\/span><span>Pregnancies per 100 people in a year<\/span><\/div><figcaption><span class=\"cpw-nrm\">The two dots on each row are the same method measured twice. Where they sit on top of each other, there is nothing left to remember; where they are far apart, the method depends on somebody doing something correctly. <b>Reorder the list and the ranking changes.<\/b> Figures from the World Health Organization, 2025, which reprints estimates made in the United States.<\/span><span class=\"cpw-pln\">Each row has two dots, which are the same method measured twice. Where they sit on top of each other, there is nothing left to remember. Where they are far apart, the method depends on somebody doing something correctly. <b>Reorder the list and the ranking changes.<\/b> The figures come from the World Health Organization (2025), which reprints estimates made in the United States.<\/span><\/figcaption><script>(function(){\n  var f=document.getElementById(\"ra-lad\"); if(!f){return;}\n  var data=[[0.1,0.1],[0.1,0.15],[0.3,0.4],[0.5,0.5],[0.6,0.8],[0.2,4],[0.3,7],[0.3,7],[0.3,7],[2,13],[16,17],[4,20],[5,21],[16,21]];\n  var items=f.querySelectorAll(\"ul li\");\n  function sort(key){\n    var idx=[]; var i;\n    for(i=0;i<data.length;i++){ idx.push(i); }\n    idx.sort(function(a,b){ return data[a][key]-data[b][key]; });\n    for(i=0;i<idx.length;i++){ items[idx[i]].style.order=i; }\n    items[items.length-1].style.order=999;\n  }\n  var segs=f.querySelectorAll(\".ra-seg button\");\n  for(var s=0;s<segs.length;s++){\n    segs[s].addEventListener(\"click\",function(){\n      for(var j=0;j<segs.length;j++){ segs[j].setAttribute(\"aria-pressed\",\"false\"); }\n      this.setAttribute(\"aria-pressed\",\"true\");\n      sort(this.getAttribute(\"data-s\")===\"p\"?0:1);\n    });\n  }\n  var btns=f.querySelectorAll(\".rw\");\n  for(var b=0;b<btns.length;b++){\n    btns[b].addEventListener(\"click\",function(){\n      var li=this.parentNode;\n      var open=li.classList.contains(\"open\");\n      for(var k=0;k<items.length;k++){ items[k].classList.remove(\"open\"); items[k].querySelector(\".rw\").setAttribute(\"aria-expanded\",\"false\"); }\n      if(!open){ li.classList.add(\"open\"); this.setAttribute(\"aria-expanded\",\"true\"); }\n    });\n  }\n  sort(1);\n})();\/*>*\/<\/script><\/figure><\/div>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group cpw-pl has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family cpw-plk wp-block-paragraph\" style=\"color:#3d2874;margin-top:38px;margin-bottom:14px;font-size:12px;font-weight:700;letter-spacing:0.16em;line-height:1.4\">In plain words<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">The perfect-use numbers are the ones on packaging and in conversation, and they describe a life almost nobody lives. The most careful estimate of what happens in real life comes from a large survey in the United States. It put the pill at about 7 pregnancies per 100 people over a year and the condom at about 13. The World Health Organization&#8217;s international figures differ a little, but the shape holds everywhere: <strong class=\"eqb\">the gap is widest for the methods that ask the most of you<\/strong>.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">If a method has ever failed you, the gap measures how much that method asks of you, every day or every time. It says nothing about carelessness.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">If you&#8217;ve missed a pill, a condom has failed or an injection is late, go to part five now. <strong class=\"eqb\">Emergency contraception works better the sooner it&#8217;s used<\/strong>, and every one of the three options has a window measured in days, not weeks.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">The same method fails at very different rates depending on the life it&#8217;s used in, and that almost never makes it into the appointment. In that survey, the condom failed about four times as often for women living with a partner they weren&#8217;t married to as for married women. The pill failed more than three times as often for women with two or more children as for women who had never given birth.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Across all the reversible methods (everything except sterilization), failure was almost three times as common for women in households below the poverty line as for women in households well above it. None of that is chemistry. It comes down to how much room a life leaves for doing something correctly every day. <strong class=\"eqb\">The useful question when choosing isn&#8217;t which method is best, but which one asks the least of you<\/strong>.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">The implant (a small rod under the skin of the arm), the hormonal coil and the copper coil (two small devices fitted through the cervix, the neck of the uterus, which is also called the womb) each have two numbers that are almost the same, all under 1 in 100. <strong class=\"eqb\">Once they&#8217;re in place, there&#8217;s nothing left for anyone to remember<\/strong>.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">The injection shows what happens when a little remembering is added back: 0.2 in 100 with perfect use, 4 with typical use, a twentyfold difference that comes entirely from appointments that slip. In the survey, the pill failed about five times as often as the implant and the coils together. It isn&#8217;t that they&#8217;re cleverer. It&#8217;s that they don&#8217;t depend on you!<\/p>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group cpw-n has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"the-gap-is-the-whole-story\" style=\"color:#3d2874;margin-top:72px;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">The gap is the whole story<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">The perfect-use figures are the ones that end up on packaging and in conversation, and they describe a life almost nobody lives. The most careful estimate of what actually happens, from a large survey in the United States, put the pill at about 7 pregnancies per 100 people over a year and the condom at about 13.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">The World Health Organization also publishes international figures, and they differ a little, lower for some methods and higher for others. Some of that difference is real, and some of it is how differently countries report these things. The shape holds everywhere, which is the part that matters: <strong class=\"eqb\">the gap is widest for the methods that ask the most of you<\/strong>.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">If a method has ever failed you, know this: what the gap measures isn&#8217;t carelessness. It&#8217;s the distance between a method that asks something of you every day, or every time, and one that doesn&#8217;t.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">One more thing belongs here rather than later, because this article is written as though the decision happens calmly in advance. If you&#8217;ve missed a pill, a condom has failed or an injection is late, go to part five now. <strong class=\"eqb\">Emergency contraception works better the sooner it&#8217;s used<\/strong>, and every one of the three options has a window measured in days, not weeks.<\/p>\n\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"circumstance-matters-more-than-the-method\" style=\"color:#3d2874;margin-top:72px;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">Circumstance matters more than the method<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">This is the finding that almost never makes it into the appointment, and it changes how you read the whole table. The same method fails at very different rates depending on the life it&#8217;s used in.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">In that US survey, the condom failed about four times as often for women living with a partner they weren&#8217;t married to as for married women. The pill failed more than three times as often for women with two or more children as for women who had never given birth. And across all the reversible methods, failure was almost three times as common for women in households below the poverty line as for women in households well above it.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">None of that is about chemistry. It&#8217;s about how much room a life leaves for doing something correctly every day, and a full life leaves less of that room. <strong class=\"eqb\">The useful question when choosing isn&#8217;t which method is best, but which one asks the least of you<\/strong>.<\/p>\n\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"the-methods-with-nothing-to-get-wrong\" style=\"color:#3d2874;margin-top:72px;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">The methods with nothing to get wrong<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Look down the table and a pattern appears. The implant, the hormonal coil and the copper coil each have two numbers that are almost identical, all under 1 in 100. <strong class=\"eqb\">Once they&#8217;re in place, there&#8217;s nothing left for anyone to remember<\/strong>.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">The injection shows what happens when a little remembering is added back in. Used perfectly, it&#8217;s 0.2 in 100. As people actually use it, it&#8217;s 4, a twentyfold difference that comes entirely from appointments that slip.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">That&#8217;s why these long-acting methods sit in a category of their own. In the US survey, the pill failed about five times as often as the implant and the coils together. It isn&#8217;t that they&#8217;re cleverer. It&#8217;s that they don&#8217;t depend on you!<\/p>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group cpw-keep has-global-padding is-layout-constrained wp-container-core-group-is-layout-d2a766d4 wp-block-group-is-layout-constrained\">\n\n\n<div style=\"margin-top:92px;margin-bottom:34px\"><div class=\"ra-part\"><div class=\"wm\" aria-hidden=\"true\">02<\/div><div class=\"ic\" aria-hidden=\"true\"><svg viewBox=\"0 0 24 24\" fill=\"none\" stroke=\"currentColor\" stroke-width=\"1.5\" stroke-linecap=\"round\" stroke-linejoin=\"round\"><path d=\"M4 7.5h16M5.5 7.5V20M18.5 7.5V20M9 7.5V20M12 7.5V20M15 7.5V20M3 20h18M12 3.2l7 4.3H5z\"\/><\/svg><\/div><div class=\"tx\"><div class=\"meta\"><p class=\"lb\">Part two of eight<\/p><span class=\"tk\" aria-hidden=\"true\"><i class=\"past\"><\/i><i class=\"now\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><\/span><\/div><h2 id=\"part-2\">Where each method intervenes<\/h2><p class=\"sb\">The three places in the process that contraception can interrupt<\/p><\/div><\/div><\/div>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group cpw-pl has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family cpw-plk wp-block-paragraph\" style=\"color:#3d2874;margin-top:38px;margin-bottom:14px;font-size:12px;font-weight:700;letter-spacing:0.16em;line-height:1.4\">In plain words<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">If you&#8217;ve ever wondered what your contraception is actually doing, it helps to start with what has to happen for a pregnancy to begin. An egg has to be released. That&#8217;s called ovulation. Sperm have to reach it. The two have to meet, and what results has to settle into the lining of the uterus. <strong class=\"eqb\">Every method interrupts one or more of those steps<\/strong>, and knowing which one explains most of what a method feels like to use.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">There are three ways in: stop the egg being released, stop the sperm getting through, or make the meeting and the settling far less likely. Most methods do more than one. Pick a method in the figure below to see which of the three it uses.<\/p>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group cpw-n has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"three-places-to-interrupt\" style=\"color:#3d2874;margin-top:72px;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">Three places to interrupt<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">If you&#8217;ve ever wondered what your contraception is actually doing, it helps to start with what has to happen for a pregnancy to begin. An egg has to be released. Sperm have to reach it. The two have to meet, and what results has to settle into the lining of the uterus. <strong class=\"eqb\">Every method interrupts one or more of those steps<\/strong>, and knowing which one explains most of what a method feels like to use.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">There are three ways in: stop the egg being released, stop the sperm getting through, or make the meeting and the settling far less likely. Most methods do more than one.<\/p>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group cpw-keep has-global-padding is-layout-constrained wp-container-core-group-is-layout-d2a766d4 wp-block-group-is-layout-constrained\">\n\n\n<div style=\"margin-top:40px;margin-bottom:48px\"><figure class=\"ra-fig ra-gt\" id=\"ra-gt\"><div class=\"hd\"><p class=\"ti\">Where it interrupts<\/p><p class=\"q\">Where in the sequence each method interrupts<\/p><\/div><div class=\"panels\"><div class=\"pn\" id=\"ra-gp0\"><svg viewBox=\"0 0 140 140\" aria-hidden=\"true\"><path d=\"M10 96C10 74 32 60 62 59c16-.5 30 4 39 12 9 7 14 15 14 25 0 22-21 38-51 38S10 118 10 96z\" fill=\"#f0d7bd\" stroke=\"#d5a877\" stroke-width=\"2.6\" stroke-linejoin=\"round\"\/><ellipse cx=\"60\" cy=\"102\" rx=\"29\" ry=\"16\" fill=\"#fff\" fill-opacity=\".38\"\/><circle cx=\"24\" cy=\"88\" r=\"2.6\" fill=\"#fff\" stroke=\"#d5a877\" stroke-width=\"1.3\"\/><circle cx=\"30\" cy=\"112\" r=\"3.2\" fill=\"#fff\" stroke=\"#d5a877\" stroke-width=\"1.3\"\/><circle cx=\"52\" cy=\"124\" r=\"4\" fill=\"#fff\" stroke=\"#d5a877\" stroke-width=\"1.4\"\/><circle cx=\"82\" cy=\"119\" r=\"5.5\" fill=\"#fff\" stroke=\"#d5a877\" stroke-width=\"1.5\"\/><circle cx=\"42\" cy=\"99\" r=\"8.5\" fill=\"#fff\" stroke=\"#d5a877\" stroke-width=\"1.7\"\/><circle cx=\"42\" cy=\"102\" r=\"2.3\" fill=\"#d5a877\"\/><circle cx=\"96\" cy=\"64\" r=\"17.5\" fill=\"#fff\" stroke=\"#d5a877\" stroke-width=\"2.4\"\/><path d=\"M85 58a11.5 11.5 0 0 1 20 3\" fill=\"none\" stroke=\"#d5a877\" stroke-width=\"1.4\" stroke-linecap=\"round\"\/><circle cx=\"97\" cy=\"69\" r=\"4.2\" fill=\"#f0d7bd\" stroke=\"#d5a877\" stroke-width=\"1.4\"\/><path class=\"rt\" d=\"M103 49C110 41 114 34 116 27\" fill=\"none\" stroke-width=\"2.2\" stroke-linecap=\"round\" stroke-dasharray=\"4 5\"\/><circle class=\"rt\" cx=\"126.5\" cy=\"22.0\" r=\"2.7\" fill=\"#fff\" stroke-width=\"1.5\"\/><circle class=\"rt\" cx=\"124.7\" cy=\"27.6\" r=\"2.7\" fill=\"#fff\" stroke-width=\"1.5\"\/><circle class=\"rt\" cx=\"119.9\" cy=\"31.0\" r=\"2.7\" fill=\"#fff\" stroke-width=\"1.5\"\/><circle class=\"rt\" cx=\"114.1\" cy=\"31.0\" r=\"2.7\" fill=\"#fff\" stroke-width=\"1.5\"\/><circle class=\"rt\" cx=\"109.3\" cy=\"27.6\" r=\"2.7\" fill=\"#fff\" stroke-width=\"1.5\"\/><circle class=\"rt\" cx=\"107.5\" cy=\"22.0\" r=\"2.7\" fill=\"#fff\" stroke-width=\"1.5\"\/><circle class=\"rt\" cx=\"109.3\" cy=\"16.4\" r=\"2.7\" fill=\"#fff\" stroke-width=\"1.5\"\/><circle class=\"rt\" cx=\"114.1\" cy=\"13.0\" r=\"2.7\" fill=\"#fff\" stroke-width=\"1.5\"\/><circle class=\"rt\" cx=\"119.9\" cy=\"13.0\" r=\"2.7\" fill=\"#fff\" stroke-width=\"1.5\"\/><circle class=\"rt\" cx=\"124.7\" cy=\"16.4\" r=\"2.7\" fill=\"#fff\" stroke-width=\"1.5\"\/><circle class=\"tk\" cx=\"117\" cy=\"22\" r=\"7\" stroke-width=\"2.3\"\/><g class=\"gx h\"><line x1=\"76\" y1=\"42\" x2=\"138\" y2=\"42\" stroke-width=\"5.5\" stroke-linecap=\"round\"\/><\/g><\/svg><p class=\"lt\"><span>A<\/span><\/p><p class=\"cap\">The egg is never released<\/p><\/div><div class=\"pn\" id=\"ra-gp1\"><svg viewBox=\"0 0 140 140\" aria-hidden=\"true\"><circle class=\"rt\" cx=\"69.0\" cy=\"70.0\" r=\"4.2\" fill=\"#fff\" stroke-width=\"1.5\"\/><circle class=\"rt\" cx=\"66.3\" cy=\"81.7\" r=\"4.2\" fill=\"#fff\" stroke-width=\"1.5\"\/><circle class=\"rt\" cx=\"58.8\" cy=\"91.1\" r=\"4.2\" fill=\"#fff\" stroke-width=\"1.5\"\/><circle class=\"rt\" cx=\"48.0\" cy=\"96.3\" r=\"4.2\" fill=\"#fff\" stroke-width=\"1.5\"\/><circle class=\"rt\" cx=\"36.0\" cy=\"96.3\" r=\"4.2\" fill=\"#fff\" stroke-width=\"1.5\"\/><circle class=\"rt\" cx=\"25.2\" cy=\"91.1\" r=\"4.2\" fill=\"#fff\" stroke-width=\"1.5\"\/><circle class=\"rt\" cx=\"17.7\" cy=\"81.7\" r=\"4.2\" fill=\"#fff\" stroke-width=\"1.5\"\/><circle class=\"rt\" cx=\"15.0\" cy=\"70.0\" r=\"4.2\" fill=\"#fff\" stroke-width=\"1.5\"\/><circle class=\"rt\" cx=\"17.7\" cy=\"58.3\" r=\"4.2\" fill=\"#fff\" stroke-width=\"1.5\"\/><circle class=\"rt\" cx=\"25.2\" cy=\"48.9\" r=\"4.2\" fill=\"#fff\" stroke-width=\"1.5\"\/><circle class=\"rt\" cx=\"36.0\" cy=\"43.7\" r=\"4.2\" fill=\"#fff\" stroke-width=\"1.5\"\/><circle class=\"rt\" cx=\"48.0\" cy=\"43.7\" r=\"4.2\" fill=\"#fff\" stroke-width=\"1.5\"\/><circle class=\"rt\" cx=\"58.8\" cy=\"48.9\" r=\"4.2\" fill=\"#fff\" stroke-width=\"1.5\"\/><circle class=\"rt\" cx=\"66.3\" cy=\"58.3\" r=\"4.2\" fill=\"#fff\" stroke-width=\"1.5\"\/><circle class=\"tk\" cx=\"42\" cy=\"70\" r=\"20\" stroke-width=\"2.6\"\/><circle class=\"rt\" cx=\"42\" cy=\"70\" r=\"13\" fill=\"none\" stroke-width=\"1.6\"\/><circle class=\"rt\" cx=\"38\" cy=\"66\" r=\"3.4\" fill=\"none\" stroke-width=\"1.4\"\/><ellipse class=\"tk\" cx=\"104\" cy=\"44\" rx=\"7.5\" ry=\"5.4\" stroke-width=\"2.2\"\/><line class=\"rt\" x1=\"111\" y1=\"44\" x2=\"116\" y2=\"44\" stroke-width=\"3\" stroke-linecap=\"round\"\/><path class=\"rt\" d=\"M116 44q7.5 -7 15 0q7.5 7 15 0\" fill=\"none\" stroke-width=\"2\" stroke-linecap=\"round\"\/><ellipse class=\"tk\" cx=\"112\" cy=\"70\" rx=\"7.5\" ry=\"5.4\" stroke-width=\"2.2\"\/><line class=\"rt\" x1=\"119\" y1=\"70\" x2=\"124\" y2=\"70\" stroke-width=\"3\" stroke-linecap=\"round\"\/><path class=\"rt\" d=\"M124 70q6.75 -7 13.5 0q6.75 7 13.5 0\" fill=\"none\" stroke-width=\"2\" stroke-linecap=\"round\"\/><ellipse class=\"tk\" cx=\"102\" cy=\"96\" rx=\"7.5\" ry=\"5.4\" stroke-width=\"2.2\"\/><line class=\"rt\" x1=\"109\" y1=\"96\" x2=\"114\" y2=\"96\" stroke-width=\"3\" stroke-linecap=\"round\"\/><path class=\"rt\" d=\"M114 96q7.5 -7 15 0q7.5 7 15 0\" fill=\"none\" stroke-width=\"2\" stroke-linecap=\"round\"\/><g class=\"gx v\"><line x1=\"80\" y1=\"26\" x2=\"80\" y2=\"114\" stroke-width=\"5.5\" stroke-linecap=\"round\"\/><\/g><\/svg><p class=\"lt\"><span>B<\/span><\/p><p class=\"cap\">They cannot reach each other<\/p><\/div><div class=\"pn\" id=\"ra-gp2\"><svg viewBox=\"0 0 140 140\" aria-hidden=\"true\"><path d=\"M8 96c9-6 15 5 24 0s15 5 24 0 15 5 24 0 15 5 24 0 15 5 24 0v34H8z\" fill=\"#f2dcd9\" stroke=\"#c9948d\" stroke-width=\"2.4\" stroke-linejoin=\"round\"\/><path d=\"M26 99c-3 6 1 9 0 14c-1 6 4 7 5 1\" fill=\"none\" stroke=\"#c9948d\" stroke-width=\"1.7\" stroke-linecap=\"round\"\/><path d=\"M58 99c-3 6 1 9 0 21c-1 6 4 7 5 1\" fill=\"none\" stroke=\"#c9948d\" stroke-width=\"1.7\" stroke-linecap=\"round\"\/><path d=\"M90 99c-3 6 1 9 0 14c-1 6 4 7 5 1\" fill=\"none\" stroke=\"#c9948d\" stroke-width=\"1.7\" stroke-linecap=\"round\"\/><path d=\"M118 99c-3 6 1 9 0 21c-1 6 4 7 5 1\" fill=\"none\" stroke=\"#c9948d\" stroke-width=\"1.7\" stroke-linecap=\"round\"\/><path d=\"M42 128c4-4-4-7 0-11s-4-7 0-11\" fill=\"none\" stroke=\"#c9948d\" stroke-width=\"1.9\" stroke-linecap=\"round\"\/><path d=\"M104 128c4-4-4-7 0-11s-4-7 0-11\" fill=\"none\" stroke=\"#c9948d\" stroke-width=\"1.9\" stroke-linecap=\"round\"\/><path d=\"M8 124h132\" stroke=\"#c9948d\" stroke-width=\"1.6\" stroke-dasharray=\"3 4\" opacity=\".75\"\/><circle class=\"tk\" cx=\"70\" cy=\"46\" r=\"21\" stroke-width=\"2.6\"\/><circle class=\"rt\" cx=\"70\" cy=\"46\" r=\"15.5\" fill=\"none\" stroke-width=\"1.5\" stroke-dasharray=\"2.5 3.5\"\/><circle class=\"rt\" cx=\"62\" cy=\"40\" r=\"4.4\" fill=\"#fff\" stroke-width=\"1.5\"\/><circle class=\"rt\" cx=\"71\" cy=\"37\" r=\"4.4\" fill=\"#fff\" stroke-width=\"1.5\"\/><circle class=\"rt\" cx=\"66\" cy=\"47\" r=\"4.4\" fill=\"#fff\" stroke-width=\"1.5\"\/><circle class=\"rt\" cx=\"75\" cy=\"44\" r=\"4\" fill=\"#fff\" stroke-width=\"1.5\"\/><path class=\"rt\" d=\"M70 70v10\" fill=\"none\" stroke-width=\"2.2\" stroke-linecap=\"round\" stroke-dasharray=\"4 5\"\/><path class=\"rt\" d=\"M65 76l5 6 5-6\" fill=\"none\" stroke-width=\"2.2\" stroke-linecap=\"round\" stroke-linejoin=\"round\"\/><g class=\"gx h\"><line x1=\"22\" y1=\"88\" x2=\"118\" y2=\"88\" stroke-width=\"5.5\" stroke-linecap=\"round\"\/><\/g><\/svg><p class=\"lt\"><span>C<\/span><\/p><p class=\"cap\">Settling is made less likely<\/p><\/div><\/div><div class=\"chips\" role=\"group\" aria-label=\"Choose a method\"><button type=\"button\" data-i=\"0\" aria-pressed=\"true\">combined pill<\/button><button type=\"button\" data-i=\"1\" aria-pressed=\"false\">patch or ring<\/button><button type=\"button\" data-i=\"2\" aria-pressed=\"false\">injection<\/button><button type=\"button\" data-i=\"3\" aria-pressed=\"false\">implant<\/button><button type=\"button\" data-i=\"4\" aria-pressed=\"false\">newer mini pill<span class=\"cpw-pln\"> (desogestrel or drospirenone)<\/span><\/button><button type=\"button\" data-i=\"5\" aria-pressed=\"false\">older mini pill<span class=\"cpw-pln\"> (levonorgestrel or norethisterone)<\/span><\/button><button type=\"button\" data-i=\"6\" aria-pressed=\"false\">hormonal coil<\/button><button type=\"button\" data-i=\"7\" aria-pressed=\"false\">copper coil<\/button><button type=\"button\" data-i=\"8\" aria-pressed=\"false\">condom<\/button><button type=\"button\" data-i=\"9\" aria-pressed=\"false\">diaphragm or cap<\/button><button type=\"button\" data-i=\"10\" aria-pressed=\"false\">withdrawal<\/button><button type=\"button\" data-i=\"11\" aria-pressed=\"false\">vasectomy<\/button><button type=\"button\" data-i=\"12\" aria-pressed=\"false\">tubal surgery<span class=\"cpw-pln\"> (tubes closed)<\/span><\/button><button type=\"button\" data-i=\"13\" aria-pressed=\"false\">fertility awareness<span class=\"cpw-pln\"> (tracking fertile days)<\/span><\/button><\/div><div class=\"gt-mob\"><label class=\"gt-lab\" for=\"ra-gt-sel\">Choose a method<\/label><select class=\"gt-sel\" id=\"ra-gt-sel\"><option value=\"0\" selected>combined pill<\/option><option value=\"1\">patch or ring<\/option><option value=\"2\">injection<\/option><option value=\"3\">implant<\/option><option value=\"4\" data-pn=\"newer mini pill (desogestrel or drospirenone)\">newer mini pill<\/option><option value=\"5\" data-pn=\"older mini pill (levonorgestrel or norethisterone)\">older mini pill<\/option><option value=\"6\">hormonal coil<\/option><option value=\"7\">copper coil<\/option><option value=\"8\">condom<\/option><option value=\"9\">diaphragm or cap<\/option><option value=\"10\">withdrawal<\/option><option value=\"11\">vasectomy<\/option><option value=\"12\" data-pn=\"tubal surgery (tubes closed)\">tubal surgery<\/option><option value=\"13\" data-pn=\"fertility awareness (tracking fertile days)\">fertility awareness<\/option><\/select><\/div><div class=\"out\"><p class=\"h\" id=\"ra-gtn\">combined pill<\/p><p class=\"t\" id=\"ra-gtt\">Suppresses the hormones that trigger ovulation, so no egg is released. Changes to cervical mucus and to the lining contribute as well.<\/p><\/div><figcaption>Pick a method and the gates it closes light up. Most methods close more than one at once, which is part of why they keep working when one of them is imperfect. <b>Only condoms do anything about infections.<\/b> Descriptions follow the wording of the World Health Organization, UK and US guidance.<\/figcaption><script>(function(){\n  var f=document.getElementById(\"ra-gt\"); if(!f){return;}\n  var M=[[\"combined pill\",[1,1,1],\"Suppresses the hormones that trigger ovulation, so no egg is released. Changes to cervical mucus and to the lining contribute as well.\"],[\"patch or ring\",[1,1,1],\"The same hormones by a different route, and the same primary effect: ovulation is prevented, with the same secondary effects on mucus and lining.\"],[\"injection\",[1,1,0],\"A progestogen alone, inhibiting ovulation and thickening cervical mucus.\"],[\"implant\",[1,1,0],\"Works in the same way as the injection, from a small rod under the skin of the arm.\"],[\"newer mini pill\",[1,1,1],\"Desogestrel and drospirenone pills do reliably inhibit ovulation, with effects on mucus, lining and tubes as well.\"],[\"older mini pill\",[0,1,1],\"Levonorgestrel and norethisterone pills affect the hormones but do not reliably stop ovulation. Their effect rests on the mucus, a thinned lining and tubal movement.\"],[\"hormonal coil\",[0,1,1],\"The cervical mucus, which stops sperm passing into the uterus, and the lining, where the effect may prevent implantation. It does not reliably prevent ovulation, which is why the mucus matters so much.\"],[\"copper coil\",[0,1,1],\"Copper is toxic to sperm and to eggs, and copper in the mucus stops sperm getting through. A second, smaller effect on the lining could make implantation harder.\"],[\"condom\",[0,1,0],\"A physical barrier, and the only method here that also reduces the risk of sexually transmitted infections.\"],[\"diaphragm or cap\",[0,1,0],\"Covers the cervix, used with spermicide.\"],[\"withdrawal\",[0,1,0],\"Prevents sperm entering at all, which works far better in theory than in practice.\"],[\"vasectomy\",[0,1,0],\"The tubes carrying sperm are cut or blocked, so there are no sperm in the ejaculate at all.\"],[\"tubal surgery\",[0,1,0],\"The fallopian tubes are closed, so sperm and egg cannot meet.\"],[\"fertility awareness\",[0,1,0],\"Nothing is blocked. The fertile days are identified and avoided, so the two are never in the same place at the same time.\"]];\n  var P=[\"Turns down the hormones that make an egg be released, so no egg is released. It also changes the mucus at the cervix and the lining of the uterus, which helps.\",\"The same hormones, taken a different way. Ovulation is prevented, and the mucus and the lining change in the same way.\",\"A progestogen, a man-made hormone related to progesterone, on its own. It stops ovulation and thickens the mucus at the cervix.\",\"Works the same way as the injection, from a small rod under the skin of the arm.\",\"Desogestrel and drospirenone pills reliably stop ovulation. They also affect the mucus, the lining and the fallopian tubes.\",\"Levonorgestrel and norethisterone pills affect the hormones but don\u2019t reliably stop ovulation. They rely on the mucus, a thinner lining and the movement of the fallopian tubes.\",\"It works on the mucus at the cervix, which stops sperm getting into the uterus, and on the lining, where it may prevent an egg settling in. It doesn\u2019t reliably stop ovulation, which is why the mucus matters so much.\",\"Copper is toxic to sperm and to eggs, and copper in the mucus stops sperm getting through. A second, smaller effect on the lining could make it harder for an egg to settle in.\",\"A barrier. It\u2019s the only method here that also lowers the risk of sexually transmitted infections.\",\"Covers the cervix, and is used with spermicide, a gel, foam or film that kills sperm.\",\"Stops sperm entering the vagina at all. It works far better in theory than in practice.\",\"The tubes that carry sperm are cut or blocked, so there are no sperm in the semen at all.\",\"The fallopian tubes are closed, so sperm and egg can\u2019t meet.\",\"Nothing is blocked. The fertile days are worked out and avoided, so sperm and egg are never in the same place at the same time.\"];var cur=0;var P_ON=function(){var r=document.querySelector(\".cpw-post\");if(r){return r.classList.contains(\"cpw-plain\");}return false;};\n  function show(i){\n    var m=M[i], k;cur=i;\n    for(k=0;k<3;k++){\n      var pn=document.getElementById(\"ra-gp\"+k);\n      if(m[1][k]===1){ pn.classList.add(\"on\"); }\n      if(m[1][k]!==1){ pn.classList.remove(\"on\"); }\n    }\n    document.getElementById(\"ra-gtn\").textContent=m[0];\n    var tx=m[2];if(P_ON()){tx=P[i];}document.getElementById(\"ra-gtt\").textContent=tx;\n  }\n  var b=f.querySelectorAll(\".chips button\");\n  var sel=document.getElementById(\"ra-gt-sel\");\n  for(var i=0;i<b.length;i++){\n    b[i].addEventListener(\"click\",function(){\n      for(var j=0;j<b.length;j++){ b[j].setAttribute(\"aria-pressed\",\"false\"); }\n      this.setAttribute(\"aria-pressed\",\"true\");\n      if(sel){ sel.value=this.getAttribute(\"data-i\"); }\n      show(parseInt(this.getAttribute(\"data-i\"),10));\n    });\n  }\n  if(sel){\n    sel.addEventListener(\"change\",function(){\n      var x=b[parseInt(sel.value,10)];\n      if(x){ x.click(); }\n    });\n  }\n  function names(){if(!sel){return;}var on=P_ON(),os=sel.options,i,t;for(i=0;os.length>i;i+=1){if(os[i].getAttribute(\"data-n\")===null){os[i].setAttribute(\"data-n\",os[i].textContent);}t=os[i].getAttribute(\"data-pn\");if(on){if(t){os[i].textContent=t;continue;}}os[i].textContent=os[i].getAttribute(\"data-n\");}}\n  document.addEventListener(\"cpw-plain-change\",function(){names();show(cur);});\n  names();show(0);\n})();\/*>*\/<\/script><\/figure><\/div>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group cpw-pl has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family cpw-plk wp-block-paragraph\" style=\"color:#3d2874;margin-top:38px;margin-bottom:14px;font-size:12px;font-weight:700;letter-spacing:0.16em;line-height:1.4\">In plain words<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">The combined pill, the patch and the vaginal ring all work the same way. They turn down the two hormones that make an egg grow and be released, so no egg is released at all. Changes to the mucus at the cervix, the lining of the uterus and the fallopian tubes add to it.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">The injection and the implant do the same thing a different way, using a progestogen on its own. Progestogen is the general name for the man-made hormones related to progesterone that are used in contraception. Different ones behave differently, which is why two pills that look alike can carry different risks.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">The progestogen-only pill, also called the mini pill, comes in two kinds, and they don&#8217;t work the same way. The newer kind, with desogestrel or drospirenone in it, reliably stops ovulation. The older kind, with levonorgestrel or norethisterone, affects the hormones but doesn&#8217;t reliably stop ovulation at all. It relies on the mucus, a thinner lining and the movement of the fallopian tubes instead.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">That makes a real, practical difference to your day. Under UK guidance, a traditional progestogen-only pill still protects you if you take it within about three hours of your usual time. A desogestrel pill allows twelve hours, and a drospirenone pill allows twenty-four. <strong class=\"eqb\">They&#8217;re the same kind of medicine, with an eightfold difference in how much margin you have<\/strong>. The exact window is set for each product and can differ between countries, so the leaflet in your own packet is the one that counts.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Mucus does more work than anyone mentions. Progestogens make the mucus at the cervix much thicker, and there&#8217;s less of it, so sperm struggle to get through. <strong class=\"eqb\">Thicker mucus is part of how almost every hormonal method works<\/strong>. The older progestogen-only pill relies on it almost entirely, and the hormonal coil relies on it most.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">The two coils are both small, both fitted through the cervix, and both last for years, which is about where the similarity ends. The hormonal coil releases a progestogen right where it&#8217;s needed. It works on the mucus and on the lining, where it may prevent implantation, which means a fertilized egg settling into the lining. It starts working seven days after it&#8217;s fitted. The copper coil has no hormones at all, and it works straight away. Copper is toxic to sperm and to eggs, and it also stops sperm getting through the mucus. A second effect on the lining could make implantation harder.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">You might be wondering whether a coil works by ending a pregnancy. The UK guidelines answer that carefully in both directions. The copper coil has effects both before and after fertilization, which is the moment sperm meets egg, but <strong class=\"eqb\">the main way both coils work is by acting before fertilization<\/strong>. A review of the biological evidence put it more bluntly: the common belief that coils work by destroying embryos in the uterus isn&#8217;t supported by the evidence. The evidence can&#8217;t say exactly how the two effects divide up, and the UK guideline says anyone who raises it should be told what is known and what is uncertain.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">The rest of the methods work in the simplest way there is: they keep sperm and egg apart, or they avoid the days when the two could meet. Condoms, internal and external, stop sperm getting in. A diaphragm or cap covers the cervix and is used with spermicide, a gel, foam or film that kills or immobilizes sperm. Withdrawal stops sperm entering the vagina at all. It works better than its reputation when it&#8217;s done perfectly, at 4 in 100, and much worse in everyday life, at 20.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Fertility awareness methods find the fertile days, either by watching the body&#8217;s own signs or by counting the days of the cycle. <strong class=\"eqb\">Of all the kinds of method, fertility awareness varies the most<\/strong>, from under 1 in 100 for the most careful sign-based method used perfectly, to more than 20 in 100 in everyday use for one of the mucus-based ones. If you track your cycle to avoid pregnancy, <a href=\"\/womens-health-101\/#the-fertile-window-is-about-six-days\" style=\"color:#553a9c;text-decoration:underline;text-underline-offset:3px;text-decoration-thickness:1.5px;text-decoration-color:#d5cbf0\">the fertile window moves when ovulation moves<\/a>, and ovulation moves more than most people were taught.<\/p>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group cpw-n has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"the-methods-that-stop-ovulation\" style=\"color:#3d2874;margin-top:72px;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">The methods that stop ovulation<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">The combined pill, the patch and the vaginal ring all work the same way. They act on the signals between the brain and the ovaries, turning down the two hormones that make an egg grow and be released, so no egg is released at all. Stopping ovulation is the main way they work, and changes to the cervical mucus, the lining of the uterus and the fallopian tubes add to it.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">The injection and the implant do the same thing by a different route, using a <span class=\"gl\" tabindex=\"0\" aria-describedby=\"gd-1\"><em class=\"eqi\">progestogen<\/em><span class=\"gd\" role=\"tooltip\" id=\"gd-1\"><b>progestogen<\/b>The general name for the synthetic hormones related to progesterone that are used in contraception. Different ones behave differently, which is why two pills that look alike can carry different risks.<\/span><\/span> alone to stop ovulation and thicken the cervical mucus.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">The progestogen-only pill is where it gets interesting, because there are two kinds, and they don&#8217;t work the same way. The newer ones, containing desogestrel or drospirenone, reliably stop ovulation. The older ones, containing levonorgestrel or norethisterone, affect the hormones but don&#8217;t reliably stop ovulation at all. They rely instead on the cervical mucus, a thinner lining and the movement of the fallopian tubes.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">That makes a real, practical difference to your day. Under UK guidance, a traditional progestogen-only pill still protects you if you take it within about three hours of your usual time. A desogestrel pill allows twelve hours, and a drospirenone pill allows twenty-four. <strong class=\"eqb\">They&#8217;re the same kind of medicine, with an eightfold difference in how much margin you have<\/strong>. The exact window is set for each product and can differ between countries, so the leaflet in your own packet is the one that counts.<\/p>\n\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"mucus-is-doing-more-work-than-anyone-mentions\" style=\"color:#3d2874;margin-top:72px;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">Mucus is doing more work than anyone mentions<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">The mucus made by the cervix changes across a normal cycle, becoming clear and stretchy around ovulation so that sperm can pass. Progestogens turn it into something else entirely: there&#8217;s less of it, it&#8217;s much thicker, and its structure changes so that sperm struggle to get through to the uterus and beyond.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\"><strong class=\"eqb\">Thicker mucus is the quiet backbone of most hormonal contraception<\/strong>. It&#8217;s what the older progestogen-only pill relies on almost entirely, what the hormonal coil relies on most, and what&#8217;s still working in the background of every method that also stops ovulation.<\/p>\n\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"the-two-coils-are-not-the-same-device\" style=\"color:#3d2874;margin-top:72px;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">The two coils are not the same device<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">They&#8217;re both small, both fitted through the cervix, and both last for years, which is about where the similarity ends.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">The hormonal coil releases a progestogen right where it&#8217;s needed. It works on the cervical mucus, which stops sperm getting into the uterus, and on the lining, where it may prevent implantation. Having a device in the uterus may help too, and in some people it stops ovulation, although it isn&#8217;t relied on for that. It starts working seven days after it&#8217;s fitted.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">The copper coil has no hormones at all, and it works straight away. Copper is toxic to sperm and to eggs, and copper in the cervical mucus also stops sperm getting through. It has a second effect too: an inflammatory response in the lining that could make implantation harder.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">You might be wondering whether a coil works by ending a pregnancy. That&#8217;s the question people actually want answered, and the UK guidelines answer it carefully in both directions. The copper coil has effects both before and after fertilization, but <strong class=\"eqb\">the main way both coils work is by acting before fertilization<\/strong>. A review of the biological evidence put it more bluntly: the common belief that coils work by destroying embryos in the uterus isn&#8217;t supported by the evidence.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">What the evidence can&#8217;t do is say exactly how the two effects divide up. If this matters to you for reasons that aren&#8217;t medical, that&#8217;s where the evidence stands, and the UK guideline says anyone who raises it should be told what is known and what is uncertain.<\/p>\n\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"barriers-withdrawal-and-timing\" style=\"color:#3d2874;margin-top:72px;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">Barriers, withdrawal and timing<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">The rest of the methods work in the simplest way there is: they keep sperm and egg apart, or they avoid the days when the two could meet.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Condoms, internal and external, stop sperm getting in. A diaphragm or cap covers the cervix and is used with <span class=\"gl\" tabindex=\"0\" aria-describedby=\"gd-2\"><em class=\"eqi\">spermicide<\/em><span class=\"gd\" role=\"tooltip\" id=\"gd-2\"><b>spermicide<\/b>A gel, foam or film that kills or immobilizes sperm. Used on its own it is one of the least effective methods; it is also used together with a diaphragm or cap.<\/span><\/span>. Withdrawal stops sperm entering the vagina at all, and it works better than its reputation when it&#8217;s done perfectly, at 4 in 100, and much worse in everyday life, at 20.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Fertility awareness methods find the fertile days, either by watching the body&#8217;s own signs or by counting the days of the cycle. <strong class=\"eqb\">Of all the kinds of method, fertility awareness varies the most<\/strong>. It runs from under 1 in 100 when the most careful sign-based method is used perfectly, to more than 20 in 100 in everyday use for one of the mucus-based ones.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">If you track your cycle to avoid pregnancy, this is the part to know. The reason is in the first article in this series: <a href=\"\/womens-health-101\/#the-fertile-window-is-about-six-days\" style=\"color:#553a9c;text-decoration:underline;text-underline-offset:3px;text-decoration-thickness:1.5px;text-decoration-color:#d5cbf0\">the fertile window moves when ovulation moves<\/a>, and ovulation moves more than most people were taught.<\/p>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group cpw-keep has-global-padding is-layout-constrained wp-container-core-group-is-layout-d2a766d4 wp-block-group-is-layout-constrained\">\n\n\n<div style=\"margin-top:92px;margin-bottom:34px\"><div class=\"ra-part\"><div class=\"wm\" aria-hidden=\"true\">03<\/div><div class=\"ic\" aria-hidden=\"true\"><svg viewBox=\"0 0 24 24\" fill=\"none\" stroke=\"currentColor\" stroke-width=\"1.5\" stroke-linecap=\"round\" stroke-linejoin=\"round\"><path d=\"M12 3.5c3.2 4 5.5 7.3 5.5 10.2a5.5 5.5 0 0 1-11 0C6.5 10.8 8.8 7.5 12 3.5zM9.5 14.5c.3 1.5 1.3 2.3 2.7 2.4\"\/><\/svg><\/div><div class=\"tx\"><div class=\"meta\"><p class=\"lb\">Part three of eight<\/p><span class=\"tk\" aria-hidden=\"true\"><i class=\"past\"><\/i><i class=\"past\"><\/i><i class=\"now\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><\/span><\/div><h2 id=\"part-3\">What it does to the rest of you<\/h2><p class=\"sb\">Bleeding, mood, weight, desire, and what happens when you stop<\/p><\/div><\/div><\/div>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group cpw-pl has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family cpw-plk wp-block-paragraph\" style=\"color:#3d2874;margin-top:38px;margin-bottom:14px;font-size:12px;font-weight:700;letter-spacing:0.16em;line-height:1.4\">In plain words<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">If your periods changed after you started a method and nobody warned you, you&#8217;re far from the only one. <strong class=\"eqb\">Almost every hormonal method changes bleeding, and what it changes it into depends on the method<\/strong>. It&#8217;s worth knowing before you start rather than after, because a change you were told about is a very different experience from one you weren&#8217;t.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">With the combined pill, patch or ring, up to one in five people have irregular bleeding in the first three months, and it usually settles. With the progestogen-only pill, bleeding is unpredictable and may not settle with time. By the end of the first year, around half of the people on the injection have no periods at all. The implant varies a lot: roughly two in ten have no bleeding, and others bleed often or for long stretches, at unpredictable times.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\"><strong class=\"eqb\">The hormonal coil reduces bleeding the most<\/strong>, by up to 90% over a year. That&#8217;s why it&#8217;s more than a contraceptive: if your periods are heavy, UK guidance treats it as the first thing to try, ahead of the combined pill. The copper coil goes the other way. Periods can be heavier, longer or more painful than before, and there can be bleeding between them. The heavier bleeding often settles with time, but the bleeding in between is less likely to.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">The figure below has two views: the pattern for each method, and who has no periods at all.<\/p>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group cpw-n has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"bleeding-changes-and-it-is-a-common-reason-people-stop\" style=\"color:#3d2874;margin-top:72px;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">Bleeding changes, and it is a common reason people stop<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">If your periods changed after you started a method and nobody warned you, you&#8217;re far from the only one. <strong class=\"eqb\">Almost every hormonal method changes bleeding, and what it changes it into depends on the method<\/strong>. It&#8217;s worth knowing before you start rather than after, because a change you were told about is a very different experience from one you weren&#8217;t.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">On the combined pill, patch or ring, up to one in five people have irregular bleeding in the first three months, and it usually settles. The UK guideline also notes that bleeding between periods on the combined pill isn&#8217;t very different from what women who aren&#8217;t using it report anyway.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">On the progestogen-only pill, bleeding is unpredictable and may not settle with time. After a year on the desogestrel kind, about half of people have no bleeding or only occasional bleeding, around four in ten have a regular pattern, and a smaller number bleed often or for more than two weeks at a time.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">On the injection, around half or more have no periods at all by the end of the first year.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">On the implant, the first three months are broadly a preview of what follows. The pattern varies a lot: roughly two in ten have no bleeding, some bleed only now and then, and others bleed often or for long stretches, at unpredictable times.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\"><strong class=\"eqb\">The hormonal coil reduces bleeding the most<\/strong>, by up to 90% over a year. By three years, about a quarter of people using the larger device have no periods at all, and about one in eight using the smaller, lower-dose version.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">That&#8217;s worth pausing on, because it&#8217;s why the hormonal coil is more than a contraceptive. If your periods are heavy, UK guidance treats it as the first thing to try, ahead of the combined pill.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">The copper coil goes the other way. Periods can be heavier, longer or more painful than before, and there can be bleeding between them. The heavier bleeding often settles with time, but the bleeding in between is less likely to.<\/p>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group cpw-keep has-global-padding is-layout-constrained wp-container-core-group-is-layout-d2a766d4 wp-block-group-is-layout-constrained\">\n\n\n<div style=\"margin-top:40px;margin-bottom:48px\"><figure class=\"ra-fig ra-bl\" id=\"ra-bl\"><div class=\"hd\"><p class=\"ti\">What bleeding becomes<\/p><p class=\"q\">What bleeding usually becomes, by method<\/p><\/div><div class=\"sw\"><div class=\"ra-seg\" role=\"group\" aria-label=\"Choose a view\"><button type=\"button\" data-v=\"0\" aria-pressed=\"true\">The pattern<\/button><button type=\"button\" data-v=\"1\" aria-pressed=\"false\">No periods at all<\/button><\/div><\/div><div id=\"ra-blv0\"><div class=\"grp\"><p class=\"mh\">The newer mini pill, after a year<\/p><div class=\"row\"><span class=\"l\">No bleeding, or only infrequent bleeding<\/span><span class=\"dots\" aria-hidden=\"true\"><i class=\"f\"><\/i><i class=\"f\"><\/i><i class=\"f\"><\/i><i class=\"f\"><\/i><i class=\"f\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><\/span><span class=\"n\">5 in 10<\/span><\/div><div class=\"row\"><span class=\"l\"><span class=\"cpw-nrm\">A regular pattern, three to five episodes<\/span><span class=\"cpw-pln\">A regular pattern, three to five bleeding episodes<\/span><\/span><span class=\"dots\" aria-hidden=\"true\"><i class=\"f\"><\/i><i class=\"f\"><\/i><i class=\"f\"><\/i><i class=\"f\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><\/span><span class=\"n\">4 in 10<\/span><\/div><div class=\"row\"><span class=\"l\"><span class=\"cpw-nrm\">Frequent bleeding, six episodes or more<\/span><span class=\"cpw-pln\">Frequent bleeding, six or more bleeding episodes<\/span><\/span><span class=\"dots\" aria-hidden=\"true\"><i class=\"f\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><\/span><span class=\"n\">1 in 10<\/span><\/div><div class=\"row\"><span class=\"l\"><span class=\"cpw-nrm\">Episodes lasting more than two weeks<\/span><span class=\"cpw-pln\">Bleeding episodes lasting more than two weeks<\/span><\/span><span class=\"dots\" aria-hidden=\"true\"><i class=\"f\"><\/i><i class=\"f\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><\/span><span class=\"n\">2 in 10<\/span><\/div><\/div><div class=\"grp\"><p class=\"mh\">The implant, as a guide<\/p><div class=\"row\"><span class=\"l\">No bleeding at all<\/span><span class=\"dots\" aria-hidden=\"true\"><i class=\"f\"><\/i><i class=\"f\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><\/span><span class=\"n\">2 in 10<\/span><\/div><div class=\"row\"><span class=\"l\">Infrequent bleeding<\/span><span class=\"dots\" aria-hidden=\"true\"><i class=\"f\"><\/i><i class=\"f\"><\/i><i class=\"f\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><\/span><span class=\"n\">3 in 10<\/span><\/div><div class=\"row\"><span class=\"l\">Frequent bleeding<\/span><span class=\"dots\" aria-hidden=\"true\"><i class=\"f\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><\/span><span class=\"n\">fewer than 1 in 10<\/span><\/div><div class=\"row\"><span class=\"l\">Prolonged bleeding<\/span><span class=\"dots\" aria-hidden=\"true\"><i class=\"f\"><\/i><i class=\"f\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><\/span><span class=\"n\">2 in 10<\/span><\/div><\/div><\/div><div id=\"ra-blv1\" hidden><div class=\"grp\"><div class=\"row\"><span class=\"l\">The injection, at twelve months<br><span style=\"font-size:14.5px;color:#6b6259\">Around half or more have no periods at all.<\/span><\/span><span class=\"dots\" aria-hidden=\"true\"><i class=\"f\"><\/i><i class=\"f\"><\/i><i class=\"f\"><\/i><i class=\"f\"><\/i><i class=\"f\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><\/span><span class=\"n\">50%<\/span><\/div><div class=\"row\"><span class=\"l\"><span class=\"cpw-nrm\">The 52 mg hormonal coil, at three years<\/span><span class=\"cpw-pln\">The larger hormonal coil (52 mg), at three years<\/span><br><span style=\"font-size:14.5px;color:#6b6259\">Bleeding falls by up to 90% over the first year.<\/span><\/span><span class=\"dots\" aria-hidden=\"true\"><i class=\"f\"><\/i><i class=\"f\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><\/span><span class=\"n\">24%<\/span><\/div><div class=\"row\"><span class=\"l\"><span class=\"cpw-nrm\">The 13.5 mg hormonal coil, at three years<\/span><span class=\"cpw-pln\">The smaller, lower-dose hormonal coil (13.5 mg), at three years<\/span><br><span style=\"font-size:14.5px;color:#6b6259\">The lower dose does this for fewer people.<\/span><\/span><span class=\"dots\" aria-hidden=\"true\"><i class=\"f\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><\/span><span class=\"n\">13%<\/span><\/div><div class=\"row\"><span class=\"l\">The copper coil<br><span style=\"font-size:14.5px;color:#6b6259\">No hormones, and periods are often heavier, longer or more painful than before.<\/span><\/span><span class=\"dots\" aria-hidden=\"true\"><i class=\"\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><\/span><span class=\"n\">none<\/span><\/div><\/div><\/div><figcaption><span class=\"cpw-nrm\">The four rows in each group are not four slices of the same ten people: prolonged bleeding can happen to someone who bleeds infrequently, so the rows overlap and do not add to ten. <b>Every one of these is a reason people stop, and every one of them is easier to live with when it has been described in advance.<\/b> Figures from the UK guideline on problematic bleeding, 2015.<\/span><span class=\"cpw-pln\">The rows in each group are not slices of the same ten people. Prolonged bleeding can happen to someone who bleeds infrequently, so the rows overlap and don&#8217;t add up to ten. <b>Every one of these is a reason people stop, and every one of them is easier to live with when it has been described in advance.<\/b> The figures come from the UK guideline on problematic bleeding (2015).<\/span><\/figcaption><script>(function(){\n  var f=document.getElementById(\"ra-bl\"); if(!f){return;}\n  var b=f.querySelectorAll(\".ra-seg button\");\n  for(var i=0;i<b.length;i++){\n    b[i].addEventListener(\"click\",function(){\n      for(var j=0;j<b.length;j++){ b[j].setAttribute(\"aria-pressed\",\"false\"); }\n      this.setAttribute(\"aria-pressed\",\"true\");\n      var v=this.getAttribute(\"data-v\");\n      document.getElementById(\"ra-blv0\").hidden=(v!==\"0\");\n      document.getElementById(\"ra-blv1\").hidden=(v!==\"1\");\n    });\n  }\n})();\/*>*\/<\/script><\/figure><\/div>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group cpw-pl has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family cpw-plk wp-block-paragraph\" style=\"color:#3d2874;margin-top:38px;margin-bottom:14px;font-size:12px;font-weight:700;letter-spacing:0.16em;line-height:1.4\">In plain words<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">If you&#8217;ve ever felt low after starting a method and wondered whether it was the pill or just life, you probably want a clear answer. This is also where the gap between what people believe, what studies show and what it means for any one person is widest, so it&#8217;s worth going slowly.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">The study most people have heard about followed over a million women for several years. Those using hormonal contraception were more likely to start an antidepressant for the first time, and for girls aged 15 to 19 the increase was considerably higher. The authors were careful to call depression a potential side effect.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Then come the qualifiers, and they matter. A second large study, of more than 800,000 women, found the same link overall, and then split it by age. In teenage girls it was strong. In adult women it was, in the authors&#8217; words, non-existent. It also reported the absolute risk, which is the actual share of people affected: about 4% of people using hormonal contraception, at any age, were prescribed a medicine for their mental health over the year. Knowing who used hormonal contraception barely predicted who was prescribed one, so the researchers concluded that we need to look for other explanations for the poor mental health of young girls.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Four large studies that used depression questionnaires, and a randomized trial in which people were assigned by chance to a combined pill or a placebo (a dummy pill), found no increase in depression, although the trial did find a modest drop in general well-being. A review of progestogen-only methods found very little link at all. The UK guideline&#8217;s summary is the fairest one there is: <strong class=\"eqb\">some people may experience negative mood changes on combined hormonal contraception, but there isn&#8217;t clear, consistent evidence that it causes depression<\/strong>.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">One more study asked whether the amount of hormone matters. In women having a hormonal coil fitted for the first time, the lower the dose of the coil, the fewer new antidepressant prescriptions there were. It&#8217;s one study, in women aged 15 to 34 who hadn&#8217;t given birth, so it&#8217;s narrower than it sounds. So there&#8217;s no single answer for hormonal contraception and mood, and <strong class=\"eqb\">which method you&#8217;re on may matter more than whether it contains hormones at all<\/strong>.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">None of this is a reason to avoid hormonal contraception altogether. <strong class=\"eqb\">If you already live with depression, no method of contraception is closed to you<\/strong>. The World Health Organization places the combined pill, the patch, the ring and both coils in its least restrictive category for depression, noting that the combined pill didn&#8217;t increase depressive symptoms in women who already had depression.<\/p>\n\n\n\n<div class=\"wp-block-group has-background has-global-padding is-layout-constrained wp-container-core-group-is-layout-bd3116f4 wp-block-group-is-layout-constrained\" style=\"background-color:#efecfb;border-radius:18px;margin-top:4px;margin-bottom:30px;padding:24px 28px\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#3d2874;margin-top:0;margin-bottom:12.5px;font-size:12px;font-weight:700;letter-spacing:0.16em;line-height:1.4\">WHAT HELPS<\/p>\n\n\n\n<ul class=\"wp-block-list has-text-color has-work-sans-regular-font-family\" style=\"color:#2a2622;margin-top:0;margin-bottom:0;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.568), 19px);line-height:1.7\">\n<li>If your mood changes after starting a method, take it seriously and say it out loud to whoever prescribed it.<\/li>\n\n\n\n<li>Ask about a different formulation, dose or route if one doesn&#8217;t suit you, because another can be tried.<\/li>\n\n\n\n<li>If you take an antidepressant, name it at the appointment, because some antidepressants and some hormonal contraceptives can interact.<\/li>\n<\/ul>\n\n\n<\/div>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">The most alarming figure in this research comes from the same group behind the first study. They reported that current and recent users were about twice as likely to attempt suicide. For suicide itself, their estimate was about three times as likely, but it rested on a fairly small number of deaths, and the possible range ran from about one and a third times to about seven times, which means the data can&#8217;t pin the number down.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Other researchers have formally challenged the methods in print, and of the earlier studies, one found a link and four found none. It deserves to be known, and it doesn&#8217;t deserve to be quoted as a settled fact.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">A newer and larger study, from Sweden in late 2025, fits that cautious reading. It followed more than two million women and found no extra overall risk of suicidal behavior for pills or for combined methods that are not swallowed. It did find a small rise, about 17% in relative terms, for progestogen-only methods that are not swallowed.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">It also found a rise among 15 to 18 year olds using pills or combined methods that are not swallowed, which adults did not show. That comes from watching what happened rather than testing anything. It is still observational, so it can&#8217;t show that the hormones caused it.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">What it does deserve is a plain response. If you are having <a href=\"\/suicidal-thoughts\/\" style=\"color:#553a9c;text-decoration:underline;text-underline-offset:3px;text-decoration-thickness:1.5px;text-decoration-color:#d5cbf0\">thoughts of harming yourself<\/a>, that is not something to sit with until the next appointment, whatever set it off. Almost every country has a free, confidential line. <strong class=\"eqb\">The first thing to do is tell someone, not stop your contraception<\/strong>.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">If you&#8217;ve been told the pill will make you put on weight, that&#8217;s what almost everyone expects. The evidence has looked hard for it and hasn&#8217;t found a general effect. Reviews found no large effect from combined methods, and the few trials that had a placebo or no-treatment group found no sign that they cause weight gain. For progestogen-only methods, average gain at six or twelve months was usually under 2 kilograms.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">The exception is the injection, where a real difference keeps appearing: around 2 to 3 kilograms more than with the copper coil. But more than half of those studies were rated low quality, and they weren&#8217;t randomized, so they can&#8217;t separate the method from the people who choose it. In the few studies that ran for several years, the average gain was roughly double the one-year figure, although the groups still generally didn&#8217;t differ from each other.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Put together, the evidence says this. <strong class=\"eqb\">When researchers have gone looking for a general effect, they haven&#8217;t found one<\/strong>. The one place a signal keeps appearing is the injection. And if you&#8217;ve gained weight over several years on a method, nothing here says you&#8217;re imagining it.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">And a fun fact. Of the 49 trials Cochrane (a group that reviews medical research) found on whether combined contraception causes weight gain, only four compared it with a placebo or with no treatment at all. Most of the evidence on the most widely believed side effect has nobody in it who was not taking anything.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">If your sex drive has changed since you started the pill, it&#8217;s natural to wonder whether the two are connected. The evidence is more mixed than a simple yes or no. A large review found that <strong class=\"eqb\">among combined pill users, 85% reported an increase or no change in desire and 15% reported a decrease<\/strong>. A steady decline showed up only with the lowest-dose pills. A tidy explanation often offered is that the pill lowers free testosterone, but it&#8217;s less tidy than it sounds.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">A woman&#8217;s own testosterone level has a moderate link with her desire, and the link is the same whether or not she uses hormonal contraception. The UK guideline calls the evidence mixed and limited, and it also records findings that point the other way, such as lower desire on pills below 20 micrograms. The UK&#8217;s national health service puts it more flatly, saying there&#8217;s no evidence that the pill changes your sex drive. All of that fits with about 15 in 100 people noticing a drop, which is the number worth carrying. If you&#8217;re one of them, it&#8217;s worth raising with whoever prescribed it.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">If you might want a baby one day, this is probably the question underneath all the others. About 83 out of 100 women became pregnant within twelve months of stopping contraception, with no significant difference between hormonal methods and the coil, and no difference by how long someone had used the pill.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">A wider review found similar rates after the pill, the coils and the implant, and no increase in pregnancy complications or other problems after stopping any reversible method. The World Health Organization puts it most clearly: of all contraceptive methods, <strong class=\"eqb\">only sterilization is permanent, and no other method causes permanent infertility<\/strong>. Sterilization means surgery such as a vasectomy or tubal surgery.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">There&#8217;s one real exception to how quickly things return, and it&#8217;s the injection. It can take up to a year for ovulation to come back after stopping it. That&#8217;s an outer limit rather than a typical wait, and it&#8217;s a delay in ovulation returning, not a loss of fertility afterward. If you want to be pregnant within the year, it&#8217;s a reason to choose something else.<\/p>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group cpw-n has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"mood-is-the-question-people-most-want-answered\" style=\"color:#3d2874;margin-top:72px;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">Mood is the question people most want answered<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">If you&#8217;ve ever felt low after starting a method and wondered whether it was the pill or just life, you probably want a clear answer. This is also where the gap between what people believe, what studies show and what it means for any one person is widest, so it&#8217;s worth going slowly.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">The study most people have heard about followed over a million women for several years. Compared with women who weren&#8217;t using hormonal contraception, those who were using it were more likely to start an antidepressant for the first time. The increase ranged from about a quarter for the combined pill to double for the patch, and for girls aged 15 to 19 it was considerably higher. The risk peaked about six months after starting, and the authors&#8217; own conclusion was careful to call depression a potential side effect.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Then come the qualifiers, and they matter.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">A second large study, of more than 800,000 women, found the same link overall, and then split it by age. In teenage girls it was strong. In adult women it was, in the authors&#8217; words, non-existent.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">That study also reported the absolute risk, which the first one didn&#8217;t. About 4% of people using hormonal contraception, at any age, were prescribed a medicine for their mental health over the year. And when the researchers tested how well knowing that someone used hormonal contraception predicted whether they&#8217;d be prescribed one, the answer was barely at all. They concluded that we need to look for other explanations for the poor mental health of young girls, because this one doesn&#8217;t carry the weight.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Meanwhile, four large studies that used depression questionnaires rather than prescription records found no increase in depression on combined methods. A <span class=\"gl\" tabindex=\"0\" aria-describedby=\"gd-3\"><em class=\"eqi\">randomized trial<\/em><span class=\"gd\" role=\"tooltip\" id=\"gd-3\"><b>randomized trial<\/b>A study in which people are assigned to one treatment or another by chance, so that the groups differ only in what they were given. It is the design that can show cause rather than association.<\/span><\/span> that gave women either a standard combined pill or a placebo for three months found a modest drop in general well-being and no difference in depressive symptoms.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">A <span class=\"gl\" tabindex=\"0\" aria-describedby=\"gd-4\"><em class=\"eqi\">systematic review<\/em><span class=\"gd\" role=\"tooltip\" id=\"gd-4\"><b>systematic review<\/b>A study that searches for every piece of research on a question, using set rules, and weighs up what it shows as a whole.<\/span><\/span> of progestogen-only methods found very little link at all.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">The UK guideline&#8217;s summary is the fairest one there is: <strong class=\"eqb\">some people may experience negative mood changes on combined hormonal contraception, but there isn&#8217;t clear, consistent evidence that it causes depression<\/strong>.<\/p>\n\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"what-dose-does-and-what-to-do-about-it\" style=\"color:#3d2874;margin-top:72px;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">What dose does, and what to do about it<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">One more study is worth knowing, because it asks a better question than most. Instead of asking whether hormones affect mood, it asked whether the amount matters.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">It looked at women having a hormonal coil fitted for the first time, and at how many of them started an antidepressant afterwards. The study compared three coils with different doses, and the lower the dose, the fewer new antidepressant prescriptions there were. Once the comparison was adjusted, the two lower doses came out about 15 to 23% below the highest. It was the same hormone, by the same route, in a different amount, and there was a measurable difference.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">It&#8217;s one study, in women aged 15 to 34 who hadn&#8217;t given birth and didn&#8217;t have the conditions a coil is often fitted for, so it&#8217;s narrower than it sounds. It&#8217;s still the best answer there is to a question the public conversation rarely thinks to ask.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">So hormonal contraception isn&#8217;t simply safe or simply risky for your mood. <strong class=\"eqb\">Which method you&#8217;re on may matter more than whether it contains hormones at all<\/strong>.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">None of this is a reason to avoid hormonal contraception altogether. <strong class=\"eqb\">If you already live with depression, no method of contraception is closed to you<\/strong>. The World Health Organization places the combined pill, the patch, the ring and both coils in its least restrictive category for depression, noting that the combined pill didn&#8217;t increase depressive symptoms in women who already had depression.<\/p>\n\n\n\n<div class=\"wp-block-group has-background has-global-padding is-layout-constrained wp-container-core-group-is-layout-bd3116f4 wp-block-group-is-layout-constrained\" style=\"background-color:#efecfb;border-radius:18px;margin-top:4px;margin-bottom:30px;padding:24px 28px\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#3d2874;margin-top:0;margin-bottom:12.5px;font-size:12px;font-weight:700;letter-spacing:0.16em;line-height:1.4\">WHAT HELPS<\/p>\n\n\n\n<ul class=\"wp-block-list has-text-color has-work-sans-regular-font-family\" style=\"color:#2a2622;margin-top:0;margin-bottom:0;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.568), 19px);line-height:1.7\">\n<li>If your mood changes after starting a method, take it seriously and say it out loud to whoever prescribed it.<\/li>\n\n\n\n<li>Ask about a different formulation, dose or route if one doesn&#8217;t suit you, because another can be tried.<\/li>\n\n\n\n<li>If you take an antidepressant, name it at the appointment, because some antidepressants and some hormonal contraceptives can interact.<\/li>\n<\/ul>\n\n\n<\/div>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">The most alarming figure in this research comes from the same group behind the first study. They reported that current and recent users were about twice as likely to attempt suicide. For suicide itself, their estimate was about three times as likely, but it rested on a fairly small number of deaths, and the possible range ran from about one and a third times to about seven times, which means the data can&#8217;t pin the number down. Other researchers have formally challenged the methods in print, and of the earlier studies, one found a link and four found none. It deserves to be known, and it doesn&#8217;t deserve to be quoted as a settled fact.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">A newer and larger study, from Sweden in late 2025, fits that cautious reading. It followed more than two million women and found no extra overall risk of suicidal behavior for pills or for combined methods that are not swallowed. It did find a small rise, about 17% in relative terms, for progestogen-only methods that are not swallowed. It also found a rise among 15 to 18 year olds using pills or combined methods that are not swallowed, which adults did not show. It is still observational, so it can&#8217;t show that the hormones caused it.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">What it does deserve is a plain response. If you are having <a href=\"\/suicidal-thoughts\/\" style=\"color:#553a9c;text-decoration:underline;text-underline-offset:3px;text-decoration-thickness:1.5px;text-decoration-color:#d5cbf0\">thoughts of harming yourself<\/a>, that is not something to sit with until the next appointment, whatever set it off. Almost every country has a free, confidential line. <strong class=\"eqb\">The first thing to do is tell someone, not stop your contraception<\/strong>.<\/p>\n\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"weight-gain-is-the-most-believed-and-the-least-supported\" style=\"color:#3d2874;margin-top:72px;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">Weight gain is the most believed and the least supported<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">If you&#8217;ve been told the pill will make you put on weight, that&#8217;s what almost everyone expects. The evidence has looked hard for it and hasn&#8217;t found a general effect.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">A Cochrane review of trials of combined methods concluded that the evidence wasn&#8217;t enough to determine whether there&#8217;s an effect, but that no large effect was evident, and the few trials that compared the method with a placebo or no treatment found no sign that it caused weight gain. A second review, of progestogen-only methods, found that in most studies the groups didn&#8217;t differ significantly, and that average weight gain at six or twelve months was usually under 2 kilograms.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">The exception is the injection, where a real difference keeps appearing. In one study, people using it gained around 2 to 3 kilograms more than people using the copper coil, at one, two and three years. But the reviewers rated more than half the studies as low quality, and the studies showing this weren&#8217;t randomized, so they can&#8217;t separate the method from the people who choose it.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Two more things belong with that. Most of these figures come from six or twelve months. In the studies that ran for several years, the average gain by two to four years was roughly double the one-year figure, although the groups still generally didn&#8217;t differ from each other. And the reviewers who found no general effect still recommend that people be told what weight gain is typical.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">So the accurate answer isn&#8217;t that hormonal contraception never affects weight. It&#8217;s that <strong class=\"eqb\">when researchers have gone looking for a general effect, they haven&#8217;t found one<\/strong>, that the one place a signal keeps appearing is the injection, and that if you&#8217;ve gained weight over several years on a method, nothing here says you&#8217;re imagining it.<\/p>\n\n\n\n<div style=\"margin-top:6px;margin-bottom:34px\"><aside class=\"ra-ff\"><span class=\"mk\" aria-hidden=\"true\"><svg viewBox=\"0 0 24 24\" fill=\"none\" stroke=\"currentColor\" stroke-width=\"1.6\" stroke-linecap=\"round\" stroke-linejoin=\"round\"><path d=\"M12 3.5l1.9 5.1 5.1 1.9-5.1 1.9L12 17.5l-1.9-5.1-5.1-1.9 5.1-1.9zM18.5 15.5l.8 2 2 .8-2 .8-.8 2-.8-2-2-.8 2-.8z\"\/><\/svg><\/span><p class=\"k\">Fun fact<\/p><p class=\"t\">Of the 49 trials Cochrane found on whether combined contraception causes weight gain, only four compared it with a placebo or with no treatment at all. Most of the evidence on the most widely believed side effect has nobody in it who was not taking anything.<\/p><\/aside><\/div>\n\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"desire-is-more-mixed-than-either-side-claims\" style=\"color:#3d2874;margin-top:72px;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">Desire is more mixed than either side claims<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">If your sex drive has changed since you started the pill, it&#8217;s natural to wonder whether the two are connected. The evidence is more mixed than a simple yes or no.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">A large systematic review found that <strong class=\"eqb\">among combined pill users, 85% reported an increase or no change in desire and 15% reported a decrease<\/strong>. A steady decline showed up only with the lowest-dose pills, those containing 15 micrograms of <span class=\"gl\" tabindex=\"0\" aria-describedby=\"gd-5\"><em class=\"eqi\">ethinylestradiol<\/em><span class=\"gd\" role=\"tooltip\" id=\"gd-5\"><b>ethinylestradiol<\/b>The synthetic estrogen in most combined pills. The figure in micrograms is the dose, and it is the number that changes between one combined pill and another.<\/span><\/span>.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">There&#8217;s a tidy explanation often offered for this, which is that the pill lowers free testosterone. It&#8217;s less tidy than it sounds. A <span class=\"gl\" tabindex=\"0\" aria-describedby=\"gd-6\"><em class=\"eqi\">meta-analysis<\/em><span class=\"gd\" role=\"tooltip\" id=\"gd-6\"><b>meta-analysis<\/b>A study of studies: it pools the results of many studies on the same question to estimate how large an effect usually is, rather than relying on any single result.<\/span><\/span> that looked at whether a woman&#8217;s own testosterone level predicts her desire found a moderate link overall, and the link was the same whether or not the women were using hormonal contraception.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">The UK guideline calls the evidence mixed and limited, notes that most studies had no placebo group, and says there&#8217;s no clear evidence of a link with the standard 20 microgram pill. It also records the findings that point the other way: desire may be lower on pills below 20 micrograms than on those at 20, and one small trial found lower desire and arousal scores in women randomly given the pill than in women given barrier methods. The UK&#8217;s national health service puts it more flatly, saying there&#8217;s no evidence that the pill changes your sex drive.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">All of that fits with about 15 in 100 people noticing a drop, which is the number worth carrying. If you&#8217;re one of them, it&#8217;s worth raising with whoever prescribed it.<\/p>\n\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"what-happens-when-you-stop\" style=\"color:#3d2874;margin-top:72px;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">What happens when you stop<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">If you might want a baby one day, this is probably the question underneath all the others. A meta-analysis found that about 83 out of 100 women became pregnant within twelve months of stopping contraception, with no significant difference between hormonal methods and the coil. Neither the type of progestogen nor how long someone had used the pill made a significant difference.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">A wider review found similar rates after the pill, the coils and the implant, and no increase in pregnancy complications or other problems after stopping any reversible method.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">The World Health Organization puts it most clearly: of all contraceptive methods, <strong class=\"eqb\">only sterilization is permanent, and no other method causes permanent infertility<\/strong>.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">There&#8217;s one real exception to how quickly things return, and it&#8217;s the injection. It can take up to a year for ovulation to come back after stopping it. That&#8217;s an outer limit rather than a typical wait, and it&#8217;s a delay in ovulation returning, not a loss of fertility afterwards. If you want to be pregnant within the year, it&#8217;s a reason to choose something else.<\/p>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group cpw-keep has-global-padding is-layout-constrained wp-container-core-group-is-layout-d2a766d4 wp-block-group-is-layout-constrained\">\n\n\n<div style=\"margin-top:92px;margin-bottom:34px\"><div class=\"ra-part\"><div class=\"wm\" aria-hidden=\"true\">04<\/div><div class=\"ic\" aria-hidden=\"true\"><svg viewBox=\"0 0 24 24\" fill=\"none\" stroke=\"currentColor\" stroke-width=\"1.5\" stroke-linecap=\"round\" stroke-linejoin=\"round\"><path d=\"M6 6h.01M12 6h.01M18 6h.01M6 12h.01M12 12h.01M18 12h.01M6 18h.01M12 18h.01M18 18h.01\"\/><\/svg><\/div><div class=\"tx\"><div class=\"meta\"><p class=\"lb\">Part four of eight<\/p><span class=\"tk\" aria-hidden=\"true\"><i class=\"past\"><\/i><i class=\"past\"><\/i><i class=\"past\"><\/i><i class=\"now\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><\/span><\/div><h2 id=\"part-4\">The risks, as numbers<\/h2><p class=\"sb\">Clots and cancer, written out rather than implied<\/p><\/div><\/div><\/div>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group cpw-pl has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family cpw-plk wp-block-paragraph\" style=\"color:#3d2874;margin-top:38px;margin-bottom:14px;font-size:12px;font-weight:700;letter-spacing:0.16em;line-height:1.4\">In plain words<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Clots are the risk of the combined pill that you&#8217;ve most likely heard about. The medical name is <em class=\"eqi\">venous thromboembolism<\/em>, a blood clot forming in a vein. On its own, the relative figure sounds alarming: the combined pill roughly triples the risk. The actual numbers are what turn that into something you can weigh.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">In a year, among 10,000 women who aren&#8217;t pregnant and aren&#8217;t using combined hormonal contraception, about 2 will have a clot. That starting figure is itself uncertain, and the UK guideline says so, because other estimates put it higher, between about 4 and 10 in 10,000. The comparisons use the lowest figure, which makes them the least flattering version. Among 10,000 women using a pill containing levonorgestrel, norethisterone or norgestimate, about 5 to 7 will have a clot. With etonogestrel or norelgestromin, it&#8217;s about 6 to 12. With drospirenone, gestodene or desogestrel, it&#8217;s about 9 to 12. Choose a group in the figure below to see it as dots.<\/p>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group cpw-n has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"clots-written-out\" style=\"color:#3d2874;margin-top:72px;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">Clots, written out<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Of all the risks of the combined pill, clots are the one you&#8217;ve most likely heard about. The medical name is <em class=\"eqi\">venous thromboembolism<\/em>, a blood clot forming in a vein. On its own, the relative figure sounds alarming: the combined pill roughly triples the risk. The actual numbers are what turn that into something you can weigh.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">In a year, among 10,000 women who aren&#8217;t pregnant and aren&#8217;t using combined hormonal contraception, about 2 will have a clot.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">That starting figure is itself uncertain, and the UK guideline says so. Other estimates put it higher, somewhere between about 4 and 10 in 10,000. The comparisons below use the lowest figure, which makes them the least flattering version.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Among 10,000 women using a pill containing levonorgestrel, norethisterone or norgestimate, about 5 to 7 will have a clot. With etonogestrel or norelgestromin, it&#8217;s about 6 to 12. With drospirenone, gestodene or desogestrel, it&#8217;s about 9 to 12.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Two things follow from those numbers. The first is that <strong class=\"eqb\">which pill you&#8217;re on genuinely matters, and it&#8217;s a reasonable thing to ask about<\/strong>. The second is that the difference between the highest and lowest rows is about five clots per 10,000 women a year, which is a real difference and a small one.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Of the clots that do happen during use, around 1% are fatal. The guideline&#8217;s own summary is the right one: <strong class=\"eqb\">the risk is increased, and the absolute risk for any individual remains very small<\/strong>. It&#8217;s also lower on the pill than during pregnancy and the weeks after giving birth, which is the comparison that most often gets left out.<\/p>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group cpw-keep has-global-padding is-layout-constrained wp-container-core-group-is-layout-d2a766d4 wp-block-group-is-layout-constrained\">\n\n\n<div style=\"margin-top:40px;margin-bottom:48px\"><figure class=\"ra-fig ra-tt\" id=\"ra-tt\"><div class=\"hd\"><p class=\"ti\">Ten thousand women<\/p><p class=\"q\">Out of 10,000 women in a year, how many have a blood clot<\/p><\/div><div class=\"sw\"><div class=\"ra-seg\" role=\"group\" aria-label=\"Choose a group\"><button type=\"button\" data-i=\"0\" aria-pressed=\"true\">Not using it<\/button><button type=\"button\" data-i=\"1\" aria-pressed=\"false\">Levonorgestrel<\/button><button type=\"button\" data-i=\"2\" aria-pressed=\"false\">Patch or ring<\/button><button type=\"button\" data-i=\"3\" aria-pressed=\"false\">Drospirenone<\/button><\/div><\/div><div class=\"grid\"><svg viewBox=\"0 0 1200 300\" role=\"img\" aria-label=\"A grid of ten thousand dots, with the affected number marked\"><defs><pattern id=\"ra-tp\" width=\"6\" height=\"6\" patternUnits=\"userSpaceOnUse\"><circle cx=\"3\" cy=\"3\" r=\"1.3\" fill=\"#c9bda8\"\/><\/pattern><\/defs><rect width=\"1200\" height=\"300\" fill=\"url(#ra-tp)\"\/><circle class=\"hi\" id=\"ra-td0\" cx=\"279\" cy=\"105\" r=\"2.6\" opacity=\"0\"\/><circle class=\"hi\" id=\"ra-td1\" cx=\"849\" cy=\"201\" r=\"2.6\" opacity=\"0\"\/><circle class=\"hi\" id=\"ra-td2\" cx=\"585\" cy=\"51\" r=\"2.6\" opacity=\"0\"\/><circle class=\"hi\" id=\"ra-td3\" cx=\"129\" cy=\"243\" r=\"2.6\" opacity=\"0\"\/><circle class=\"hi\" id=\"ra-td4\" cx=\"1035\" cy=\"75\" r=\"2.6\" opacity=\"0\"\/><circle class=\"hi\" id=\"ra-td5\" cx=\"435\" cy=\"183\" r=\"2.6\" opacity=\"0\"\/><circle class=\"hi\" id=\"ra-td6\" cx=\"711\" cy=\"267\" r=\"2.6\" opacity=\"0\"\/><circle class=\"hi\" id=\"ra-td7\" cx=\"1113\" cy=\"231\" r=\"2.6\" opacity=\"0\"\/><circle class=\"hi\" id=\"ra-td8\" cx=\"207\" cy=\"33\" r=\"2.6\" opacity=\"0\"\/><circle class=\"hi\" id=\"ra-td9\" cx=\"945\" cy=\"147\" r=\"2.6\" opacity=\"0\"\/><circle class=\"hi\" id=\"ra-td10\" cx=\"57\" cy=\"135\" r=\"2.6\" opacity=\"0\"\/><circle class=\"hi\" id=\"ra-td11\" cx=\"627\" cy=\"165\" r=\"2.6\" opacity=\"0\"\/><\/svg><\/div><p class=\"rd\" id=\"ra-ttr\"><b>About 2 in 10,000.<\/b> Women who are not pregnant and not using combined hormonal contraception.<\/p><figcaption><span class=\"cpw-nrm\">Every dot is one woman, and there are ten thousand of them. The relative figure, that the combined pill roughly triples the risk, describes the distance between the first row and the others. <b>The distance between the safest and the riskiest pill is about five women in ten thousand.<\/b> Ranges from the European Medicines Agency, as published in the UK guideline.<\/span><span class=\"cpw-pln\">Every dot is one woman, and there are ten thousand of them. &#8220;Roughly triples the risk&#8221; is the distance between the first row and the others. <b>The distance between the safest and the riskiest pill is about five women in ten thousand.<\/b> The ranges come from the European Medicines Agency, as published in the UK guideline.<\/span><\/figcaption><script>(function(){\n  var f=document.getElementById(\"ra-tt\"); if(!f){return;}\n  var R=[[\"Not using it\",2,2,\"Women who are not pregnant and not using combined hormonal contraception.\"],[\"Levonorgestrel, norethisterone or norgestimate\",5,7,\"The older progestogens, and the lowest of the combined rows.\"],[\"Etonogestrel or norelgestromin\",6,12,\"The progestogens in the ring and the patch.\"],[\"Drospirenone, gestodene or desogestrel\",9,12,\"The newer progestogens, and the highest of the rows.\"]];\n  var RP=[\"Women who aren\u2019t pregnant and aren\u2019t using combined hormonal contraception.\",\"The older progestogens, and the lowest of the pill groups.\",\"The progestogens in the ring and the patch.\",\"The newer progestogens, and the highest of the groups.\"];var cur=0;var P_ON=function(){var r=document.querySelector(\".cpw-post\");if(r){return r.classList.contains(\"cpw-plain\");}return false;};\n  function show(i){\n    var r=R[i], k;cur=i;\n    for(k=0;k<12;k++){\n      var d=document.getElementById(\"ra-td\"+k);\n      if(k<r[1]){ d.setAttribute(\"opacity\",\"1\"); d.classList.remove(\"mb\"); }\n      if(k>=r[1]){\n        if(k<r[2]){ d.setAttribute(\"opacity\",\"1\"); d.classList.add(\"mb\"); }\n        if(k>=r[2]){ d.setAttribute(\"opacity\",\"0\"); d.classList.remove(\"mb\"); }\n      }\n    }\n    var txt=\"About \"+r[1];\n    if(r[2]!==r[1]){ txt=\"About \"+r[1]+\" to \"+r[2]; }\n    document.getElementById(\"ra-ttr\").innerHTML=\"<b>\"+txt+\" in 10,000.<\/b> \"+(P_ON()?RP[i]:r[3]);\n  }\n  function fit(){var s=f.querySelector(\".grid svg\"); var w=s?s.getBoundingClientRect().width:0; if(!w){return;} var rr=Math.max(2.6,4.6*1200\/w); for(var k=0;k<12;k++){document.getElementById(\"ra-td\"+k).setAttribute(\"r\",rr.toFixed(2));}}\n  fit(); window.addEventListener(\"resize\",fit);\n  var b=f.querySelectorAll(\".ra-seg button\");\n  for(var i=0;i<b.length;i++){\n    b[i].addEventListener(\"click\",function(){\n      for(var j=0;j<b.length;j++){ b[j].setAttribute(\"aria-pressed\",\"false\"); }\n      this.setAttribute(\"aria-pressed\",\"true\");\n      show(parseInt(this.getAttribute(\"data-i\"),10));\n    });\n  }\n  document.addEventListener(\"cpw-plain-change\",function(){show(cur);});\n  show(0);\n})();\/*>*\/<\/script><\/figure><\/div>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group cpw-pl has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family cpw-plk wp-block-paragraph\" style=\"color:#3d2874;margin-top:38px;margin-bottom:14px;font-size:12px;font-weight:700;letter-spacing:0.16em;line-height:1.4\">In plain words<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Two things follow from those numbers. The first is that <strong class=\"eqb\">which pill you&#8217;re on genuinely matters, and it&#8217;s a reasonable thing to ask about<\/strong>. The second is that the difference between the highest and lowest rows is about five clots per 10,000 women a year, which is a real difference and a small one.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Of the clots that do happen during use, around 1% are fatal. The guideline&#8217;s own summary is the right one: <strong class=\"eqb\">the risk is increased, and the absolute risk for any individual remains very small<\/strong>. It&#8217;s also lower on the pill than during pregnancy and the weeks after giving birth, which is the comparison that most often gets left out.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">You may have heard that it&#8217;s good to give your body a break from the pill now and then. The risk of a clot isn&#8217;t spread evenly across the years, though. It&#8217;s highest in the first months after starting, and after restarting following a break of a month or more. It falls across the first year and then stays flat. <strong class=\"eqb\">A break doesn&#8217;t let your body recover from a risk that builds up; it re-runs the riskiest part<\/strong>. The guideline puts it plainly: for eligible women under 50 there&#8217;s no arbitrary limit on how long the combined pill can be used, and repeated starting and stopping should be discouraged.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Cancer is the risk people worry about most and understand least, because the answer goes in both directions. A British study that followed some of its tens of thousands of women for more than 40 years found that having ever used the pill was linked with lower rates of bowel cancer, cancer of the lining of the uterus, ovarian cancer, and cancers of the lymph and blood-forming systems. It was also linked with higher rates of breast and cervical cancer, but only in current and recent users, and that increase seemed to disappear within about five years of stopping.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">The UK&#8217;s health service is more cautious, saying the risk returns to normal within ten years. A raised rate of lung cancer showed up only in women who were smokers when they joined the study. The researchers concluded that <strong class=\"eqb\">for past users, the overall balance of cancer risk was neutral<\/strong>, and for ovarian cancer the protection was still there 30 years after stopping. The study began when pills contained far more hormone than they do now, which is worth remembering in both directions.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">One newer finding is about the progestogens in hormonal birth control. A meningioma is an uncommon brain tumor. It&#8217;s usually benign (not cancer) and slow growing, but it can press on the brain and sometimes needs surgery. Studies from France (2024 and 2025) and Denmark (published July 2026) found a higher chance of meningioma among women using some progestogens. It was clearest for the injection. The French studies also found it for the desogestrel mini pill after long use. The Danish study added several combined pills and the 52 mg hormonal coil, but found no clear rise for pills with norethisterone or norgestimate, the norethisterone mini pill or the lower-dose coils.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">The absolute risk, the actual chance for one woman, is still low, and it rises with age. For women aged 45 to 49, the Danish figures work out at roughly one extra case a year for every 20,000 to 40,000 women using one of those pills or the 52 mg coil, and for about every 4,300 using the injection. The studies don&#8217;t all agree: the French ones found no rise for the 52 mg coil or for levonorgestrel pills. The link was strongest in current or recent users and, for most methods, no longer apparent after about five years.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\"><strong class=\"eqb\">If you have, or have ever had, a meningioma, tell whoever prescribes your method.<\/strong> The UK&#8217;s College of Sexual and Reproductive Healthcare advises against the injection and desogestrel pills in that case, and says the implant may not be appropriate. For everyone else, it advises weighing the small extra risk against the benefits of contraception, including preventing an unplanned pregnancy.<\/p>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group cpw-n has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"which-is-exactly-why-breaks-are-a-bad-idea\" style=\"color:#3d2874;margin-top:72px;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">Which is exactly why breaks are a bad idea<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">You may have heard that it&#8217;s good to give your body a break from the pill now and then. The risk of a clot isn&#8217;t spread evenly across the years, though. It&#8217;s highest in the first months after starting, and after restarting following a break of a month or more. It falls across the first year and then stays flat.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">That one fact undoes a very common piece of advice. <strong class=\"eqb\">A break doesn&#8217;t let your body recover from a risk that builds up; it re-runs the riskiest part<\/strong>. The guideline puts it plainly: for eligible women under 50 there&#8217;s no arbitrary limit on how long the combined pill can be used, and repeated starting and stopping should be discouraged.<\/p>\n\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"cancer-over-a-lifetime-rather-than-a-year\" style=\"color:#3d2874;margin-top:72px;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">Cancer, over a lifetime rather than a year<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">This is the risk people worry about most and understand least, partly because the answer genuinely goes in both directions.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">The best evidence comes from a British study that recruited tens of thousands of women and followed some of them for more than 40 years. Having ever used the pill was linked with lower rates of bowel cancer, cancer of the lining of the uterus, ovarian cancer, and cancers of the lymph and blood-forming systems.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">It was also linked with higher rates of breast and cervical cancer, but only in current and recent users, and that increase seemed to disappear within about five years of stopping. The UK&#8217;s health service is more cautious, saying the risk returns to normal within ten years. A raised rate of lung cancer showed up too, but only in women who were smokers when they joined the study.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">The researchers&#8217; conclusion was that <strong class=\"eqb\">for past users, the overall balance of cancer risk was neutral<\/strong>, with the increases balanced out by reductions that last for at least 30 years.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">For ovarian cancer in particular, a large pooled analysis found that the longer the pill was used, the lower the risk, and the protection faded only slowly, still present 30 years after stopping. In high-income countries, ten years of use was estimated to lower the chance of ovarian cancer before the age of 75 from 1.2 in 100 women to 0.8.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">The British study began when pills contained far more hormone than they do now, which is worth remembering in both directions.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">One newer finding concerns the progestogens in hormonal birth control. Meningioma is an uncommon brain tumor, usually benign and slow growing, though it can press on the brain and sometimes needs surgery. Studies from France (2024 and 2025) and Denmark (published July 2026) found a higher chance of meningioma among women using some progestogens. It was clearest for the injection. The French studies also found it for the desogestrel mini pill after long use. The Danish study added several combined pills and the 52 mg hormonal coil, but found no clear rise for pills with norethisterone or norgestimate, the norethisterone mini pill or the lower-dose coils.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">The absolute risk is still low, and it rises with age. For women aged 45 to 49, the Danish figures work out at roughly one extra case a year for every 20,000 to 40,000 women using one of those pills or the 52 mg coil, and for about every 4,300 using the injection. The studies do not all agree: the French ones found no rise for the 52 mg coil or for levonorgestrel pills. The link was strongest in current or recent users and, for most methods, no longer apparent after about five years.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\"><strong class=\"eqb\">If you have, or have ever had, a meningioma, tell whoever prescribes your method.<\/strong> The UK&#8217;s College of Sexual and Reproductive Healthcare advises against the injection and desogestrel pills in that case, and says the implant may not be appropriate. For everyone else, it advises weighing the small extra risk against the benefits of contraception, including preventing an unplanned pregnancy.<\/p>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group cpw-keep has-global-padding is-layout-constrained wp-container-core-group-is-layout-d2a766d4 wp-block-group-is-layout-constrained\">\n\n\n<div style=\"margin-top:92px;margin-bottom:34px\"><div class=\"ra-part\"><div class=\"wm\" aria-hidden=\"true\">05<\/div><div class=\"ic\" aria-hidden=\"true\"><svg viewBox=\"0 0 24 24\" fill=\"none\" stroke=\"currentColor\" stroke-width=\"1.5\" stroke-linecap=\"round\" stroke-linejoin=\"round\"><path d=\"M12 21a8.5 8.5 0 1 0 0-17 8.5 8.5 0 0 0 0 17zM12 8v4.5l3 2\"\/><\/svg><\/div><div class=\"tx\"><div class=\"meta\"><p class=\"lb\">Part five of eight<\/p><span class=\"tk\" aria-hidden=\"true\"><i class=\"past\"><\/i><i class=\"past\"><\/i><i class=\"past\"><\/i><i class=\"past\"><\/i><i class=\"now\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><\/span><\/div><h2 id=\"part-5\">Emergency contraception<\/h2><p class=\"sb\">The three options, and the one the guideline puts first<\/p><\/div><\/div><\/div>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group cpw-pl has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family cpw-plk wp-block-paragraph\" style=\"color:#3d2874;margin-top:38px;margin-bottom:14px;font-size:12px;font-weight:700;letter-spacing:0.16em;line-height:1.4\">In plain words<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">If you&#8217;re reading this the morning after a condom split or a pill was missed, it makes sense to feel panicky. You have more options than most people are offered, and the sooner you act, the better they work.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">There are three things that work after sex: a copper coil, and two different pills, levonorgestrel (sold as Plan B in the US and Levonelle in the UK, among other names) and ulipristal (ellaOne, or ella in the US). They aren&#8217;t interchangeable, they don&#8217;t work for the same length of time, and the one the UK guideline ranks first is the one people are least likely to ask for by name.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">The two pills share a limit that&#8217;s rarely explained. They work by delaying or preventing ovulation. <strong class=\"eqb\">Once ovulation has happened, the pills don&#8217;t work at all<\/strong>. The copper coil is the exception. Move the slider in the figure below to see how long each option keeps working.<\/p>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group cpw-n has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"three-options-and-most-people-are-offered-one\" style=\"color:#3d2874;margin-top:72px;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">Three options, and most people are offered one<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">If you&#8217;re reading this the morning after a condom split or a pill was missed, it makes sense to feel panicky. You have more options than most people are offered, and the sooner you act, the better they work.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">There are three things that work after sex: a copper coil, and two different pills, levonorgestrel (sold as Plan B in the US and Levonelle in the UK, among other names) and ulipristal (ellaOne, or ella in the US). They aren&#8217;t interchangeable, they don&#8217;t work for the same length of time, and the one the UK guideline ranks first is the one people are least likely to ask for by name.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">The two pills share a limit that&#8217;s rarely explained. They work by delaying or preventing ovulation. <strong class=\"eqb\">Once ovulation has happened, the pills don&#8217;t work at all<\/strong>. The copper coil is the exception, and that&#8217;s why the order of this section matters.<\/p>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group cpw-keep cpw-nopill has-global-padding is-layout-constrained wp-container-core-group-is-layout-d2a766d4 wp-block-group-is-layout-constrained\">\n\n\n<div style=\"margin-top:40px;margin-bottom:48px\"><figure class=\"ra-fig ra-ec\" id=\"ra-ec\"><div class=\"hd\"><p class=\"ti\">The five-day window<\/p><p class=\"q\">How long each option keeps working after sex<\/p><\/div><div class=\"bars\"><div class=\"bar\"><span class=\"nm\">Copper coil<\/span><span class=\"tr\"><span class=\"fill\" style=\"width:90.91%\"><\/span><\/span><\/div><div class=\"bar\"><span class=\"nm\">Ulipristal pill<\/span><span class=\"tr\"><span class=\"fill\" style=\"width:90.91%\"><\/span><\/span><\/div><div class=\"bar\"><span class=\"nm\">Levonorgestrel pill<\/span><span class=\"tr\"><span class=\"fill\" style=\"width:54.55%\"><\/span><span class=\"fade\" style=\"left:54.55%;width:calc(72.73% &#45; 54.55%)\"><\/span><\/span><\/div><div class=\"now\" id=\"ra-ecn\" style=\"left:0\"><\/div><\/div><div class=\"axw\"><span><\/span><div class=\"ax\"><span style=\"left:0.00%\">0<\/span><span style=\"left:18.18%\">24h<\/span><span style=\"left:36.36%\">48h<\/span><span style=\"left:54.55%\">72h<\/span><span style=\"left:72.73%\">96h<\/span><span style=\"left:90.91%\">120h<\/span><\/div><\/div><div class=\"sl\"><label for=\"ra-ecs\">Hours since sex <b id=\"ra-ech\">12<\/b><\/label><input type=\"range\" id=\"ra-ecs\" min=\"0\" max=\"132\" step=\"1\" value=\"12\"><\/div><p class=\"out\" id=\"ra-eco\"><\/p><figcaption>The hatched stretch on the bottom bar is the gap between what levonorgestrel is licensed for, 72 hours, and the point at which the evidence says it has stopped working, 96. <b>Both pills depend on ovulation not having happened yet; the copper coil does not.<\/b> Windows from the UK guideline, 2017, amended 2026.<\/figcaption><script>(function(){\n  var f=document.getElementById(\"ra-ec\"); if(!f){return;}\n  var s=document.getElementById(\"ra-ecs\"), o=document.getElementById(\"ra-eco\"), n=document.getElementById(\"ra-ecn\");\n  var bars=f.querySelector(\".bars\");\n  function upd(){\n    var h=parseInt(s.value,10);\n    document.getElementById(\"ra-ech\").textContent=h;\n    var w=bars.querySelector(\".tr\");\n    var left=w.offsetLeft+(h\/132)*w.offsetWidth;\n    n.style.left=left+\"px\";\n    var t=\"\";\n    if(h<=72){ t=\"<b>All three still work.<\/b> The copper coil is the most effective of them, and it carries on working as contraception afterwards.\"; }\n    if(h>72){\n      if(h<=96){ t=\"<b>The copper coil and the ulipristal pill still work.<\/b> Levonorgestrel is past the 72 hours it is licensed for, and the evidence suggests it stops working at 96.\"; }\n      if(h>96){\n        if(h<=120){ t=\"<b>The copper coil and the ulipristal pill still work.<\/b> Levonorgestrel no longer does.\"; }\n        if(h>120){ t=\"<b>Past five days, only the copper coil may still be an option<\/b>, and only if it is within five days of the earliest likely date of ovulation. This is a conversation to have today rather than tomorrow.\"; }\n      }\n    }\n    o.innerHTML=t;\n  }\n  s.addEventListener(\"input\",upd);\n  window.addEventListener(\"resize\",upd);\n  upd();\n  setTimeout(upd,300);\n})();\/*>*\/<\/script><\/figure><\/div>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group cpw-pl has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family cpw-plk wp-block-paragraph\" style=\"color:#3d2874;margin-top:38px;margin-bottom:14px;font-size:12px;font-weight:700;letter-spacing:0.16em;line-height:1.4\">In plain words<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">The copper coil is the most effective, and the least asked for. Fitted as emergency contraception, it has a pregnancy rate below 1 in 1,000, far lower than either pill. <strong class=\"eqb\">It&#8217;s the only option that still works after ovulation has happened<\/strong>. It can be fitted within five days of the first unprotected sex in a cycle, or within five days of the earliest likely day of ovulation, whichever is later. In a regular 28-day cycle, that means up to about day 19.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Your weight isn&#8217;t known to affect it, although a higher body mass index does raise the chance of the device being pushed out afterwards, which is worth knowing so you can check. Body mass index, or BMI, is a number worked out from your height and weight. The copper coil also carries on working as contraception, so one appointment covers both the emergency and the next several years. The guideline says it should be considered by all women who have had unprotected sex and don&#8217;t want to become pregnant. It&#8217;s something you can ask for!<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\"><strong class=\"eqb\">Whichever pill you take, take it as soon as you can<\/strong>. Nothing below changes that, and the time limits are outer limits, not deadlines to use up.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Ulipristal delays ovulation for at least five days. It works for up to 120 hours, or five days, after sex, and its overall pregnancy rate is reported at about 1 to 2%. Levonorgestrel is licensed for up to 72 hours, or three days, and the evidence suggests it doesn&#8217;t work after 96. It delays ovulation only if it&#8217;s taken before the hormone surge that triggers ovulation has started, which ulipristal doesn&#8217;t depend on. Its reported pregnancy rates run from 0.6 to 2.6%.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">In the trial that compared the two directly, ulipristal had fewer pregnancies among women treated within three days. The difference only became statistically significant, which means unlikely to be down to chance, when the results were pooled with earlier data, in an analysis funded by the company that makes ulipristal.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">What stood out more was the later window: among the women treated between three and five days after sex, three became pregnant, and all three had taken levonorgestrel. As for how many pregnancies each one prevents, ulipristal is estimated at around 60 to 80%. The older claim that levonorgestrel prevents about 85% hasn&#8217;t held up well, and a more recent estimate puts it at 69%.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Two practical notes rarely get said out loud. If you take ulipristal, guidelines advise waiting five days before starting or restarting hormonal contraception, because starting sooner works against the ulipristal you&#8217;ve just taken. And if you&#8217;re breastfeeding, either pill is fine: UK guidance changed in 2025, and there&#8217;s no longer any need to pause breastfeeding after a single dose of ulipristal.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Your weight can change which emergency pill works best.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">The UK guideline is explicit: levonorgestrel could work less well above a body mass index of 26, or a weight over 70 kilograms, and in that situation either ulipristal or a larger dose of levonorgestrel should be given. It adds that it isn&#8217;t known which of those two is better. The threshold you&#8217;re given depends on where you are.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">The World Health Organization and US guidance use a body mass index of 30 rather than 26, so the same person can be told two different things in two countries. Ulipristal isn&#8217;t exempt either. A meta-analysis found it less effective above a body mass index of 30 than below it. A standard single dose of levonorgestrel is the easiest thing for a pharmacy to hand over, and none of this comes with it unless somebody asks. <strong class=\"eqb\">If you&#8217;re near either line, say so and ask<\/strong>.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">If you&#8217;re worried that taking emergency contraception means having an abortion, it doesn&#8217;t. The World Health Organization states it directly: <strong class=\"eqb\">emergency contraceptive pills work by preventing or delaying ovulation, and they don&#8217;t work if a woman is already pregnant<\/strong>. If they&#8217;re taken during a pregnancy nobody knew about, there&#8217;s no known harm to the woman, to the pregnancy or to the fetus. The copper coil, fitted for emergency use, goes in well before the earliest point at which a pregnancy could implant, which is six days after ovulation at the very soonest, and usually eight to ten.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">The effectiveness figures you&#8217;ll see for emergency contraception are strange numbers, and the guideline says so. If a study gives a pill to everyone who came within three days and 1% become pregnant, that 1% includes a great many women who were nowhere near ovulating and were never going to conceive that time.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">As the guideline puts it, for a woman who had unprotected sex just before she was likely to ovulate, it would be inappropriate to tell her she has only a 1% chance of pregnancy. Her risk is higher, and the choice of method matters more. That&#8217;s the practical takeaway. <strong class=\"eqb\">Where you are in your cycle changes what to ask for<\/strong>, and it&#8217;s the first thing worth saying when you ask.<\/p>\n\n\n\n<div class=\"wp-block-group has-background has-global-padding is-layout-constrained wp-container-core-group-is-layout-bd3116f4 wp-block-group-is-layout-constrained\" style=\"background-color:#efecfb;border-radius:18px;margin-top:4px;margin-bottom:30px;padding:24px 28px\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#3d2874;margin-top:0;margin-bottom:12.5px;font-size:12px;font-weight:700;letter-spacing:0.16em;line-height:1.4\">WHAT HELPS<\/p>\n\n\n\n<ul class=\"wp-block-list has-text-color has-work-sans-regular-font-family\" style=\"color:#2a2622;margin-top:0;margin-bottom:0;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.568), 19px);line-height:1.7\">\n<li>Go as soon as you can, because every option works better the sooner it&#8217;s used.<\/li>\n\n\n\n<li>Say where you are in your cycle, if you know, because it changes which option makes most sense.<\/li>\n\n\n\n<li>Ask about the copper coil, because it&#8217;s the most effective option and the only one that still works after ovulation.<\/li>\n<\/ul>\n\n\n<\/div>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group cpw-n has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"the-copper-coil-is-the-most-effective-and-the-least-asked-\" style=\"color:#3d2874;margin-top:72px;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">The copper coil is the most effective, and the least asked for<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Fitted as emergency contraception, the copper coil has a pregnancy rate below 1 in 1,000, far lower than either pill. <strong class=\"eqb\">It&#8217;s the only option that still works after ovulation has happened<\/strong>. It can be fitted within five days of the first unprotected sex in a cycle, or within five days of the earliest likely day of ovulation, whichever is later. In a regular 28-day cycle, that means up to about day 19.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Your weight isn&#8217;t known to affect it, although a higher body mass index does raise the chance of the device being pushed out afterwards, which is worth knowing so you can check. And it carries on working as contraception, so one appointment covers both the emergency and the next several years.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">The guideline&#8217;s recommendation could hardly be stronger: it says the copper coil should be considered by all women who have had unprotected sex and don&#8217;t want to become pregnant. It&#8217;s worth knowing that, because it&#8217;s something you can ask for!<\/p>\n\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"the-two-pills-are-not-the-same-pill\" style=\"color:#3d2874;margin-top:72px;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">The two pills are not the same pill<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\"><strong class=\"eqb\">Whichever pill you take, take it as soon as you can<\/strong>. Nothing below changes that, and the time limits are outer limits, not deadlines to use up.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Ulipristal acetate delays ovulation for at least five days, which is long enough for sperm from that time to stop being able to fertilize an egg. It works for up to 120 hours, or five days, after sex, and its overall pregnancy rate is reported at about 1 to 2%.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Levonorgestrel is licensed for up to 72 hours, or three days, and the evidence suggests it doesn&#8217;t work after 96. It delays ovulation only if it&#8217;s taken before the hormone surge that triggers ovulation has started, which ulipristal doesn&#8217;t depend on. Its reported pregnancy rates run from 0.6 to 2.6%.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">In the trial that compared the two directly, ulipristal had fewer pregnancies among women treated within three days, but the difference only became statistically significant when pooled with earlier data, in an analysis funded by the company that makes ulipristal. What stood out more was the later window: among the women treated between three and five days after sex, three became pregnant, and all three had taken levonorgestrel.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">As for how many pregnancies each one prevents, ulipristal is estimated at around 60 to 80%. The older claim that levonorgestrel prevents about 85% hasn&#8217;t held up well, and a more recent estimate puts it at 69%.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Two practical notes rarely get said out loud. If you take ulipristal, guidelines advise waiting five days before starting or restarting hormonal contraception, because starting sooner works against the ulipristal you&#8217;ve just taken. And if you&#8217;re breastfeeding, either pill is fine: UK guidance changed in 2025, and there&#8217;s no longer any need to pause breastfeeding after a single dose of ulipristal.<\/p>\n\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"weight-can-change-the-answer\" style=\"color:#3d2874;margin-top:72px;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">Weight can change the answer<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Your weight can change which emergency pill works best.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">The UK guideline is explicit: levonorgestrel could work less well above a body mass index of 26, or a weight over 70 kilograms, and in that situation either ulipristal or a double dose of levonorgestrel should be given. It adds that it isn&#8217;t known which of those two is better. The threshold you&#8217;re given depends on where you are. The World Health Organization and US guidance use a body mass index of 30 rather than 26, so the same person can be told two different things in two countries.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Ulipristal isn&#8217;t exempt either. A meta-analysis found it less effective above a body mass index of 30 than below it.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">A standard single dose of levonorgestrel is the easiest thing for a pharmacy to hand over, and none of this comes with it unless somebody asks. <strong class=\"eqb\">If you&#8217;re near either line, say so and ask<\/strong>.<\/p>\n\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"it-is-not-an-abortion-pill\" style=\"color:#3d2874;margin-top:72px;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">It is not an abortion pill<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">If you&#8217;re worried that taking emergency contraception means having an abortion, it doesn&#8217;t. The World Health Organization states it directly: <strong class=\"eqb\">emergency contraceptive pills work by preventing or delaying ovulation, and they don&#8217;t work if a woman is already pregnant<\/strong>. If they&#8217;re taken during a pregnancy nobody knew about, there&#8217;s no known harm to the woman, to the pregnancy or to the fetus.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">The copper coil, fitted for emergency use, goes in well before the earliest point at which a pregnancy could implant, which is six days after ovulation at the very soonest, and usually eight to ten.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">The UK guideline also says something worth repeating: if this matters to you, you can ask, and you should be told what is known and what is uncertain.<\/p>\n\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"the-day-matters-more-than-the-hour\" style=\"color:#3d2874;margin-top:72px;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">The day matters more than the hour<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">The effectiveness figures you&#8217;ll see for emergency contraception are strange numbers, and the guideline says so. If a study gives a pill to everyone who came within three days and 1% become pregnant, that 1% includes a great many women who were nowhere near ovulating and were never going to conceive that time.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">As the guideline puts it, for a woman who had unprotected sex just before she was likely to ovulate, it would be inappropriate to tell her she has only a 1% chance of pregnancy. Her risk is higher, and the choice of method matters more, precisely because she&#8217;s in the part of the cycle where it counts.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">That&#8217;s the practical takeaway. <strong class=\"eqb\">Where you are in your cycle changes what to ask for<\/strong>, and it&#8217;s the first thing worth saying when you ask.<\/p>\n\n\n\n<div class=\"wp-block-group has-background has-global-padding is-layout-constrained wp-container-core-group-is-layout-bd3116f4 wp-block-group-is-layout-constrained\" style=\"background-color:#efecfb;border-radius:18px;margin-top:4px;margin-bottom:30px;padding:24px 28px\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#3d2874;margin-top:0;margin-bottom:12.5px;font-size:12px;font-weight:700;letter-spacing:0.16em;line-height:1.4\">WHAT HELPS<\/p>\n\n\n\n<ul class=\"wp-block-list has-text-color has-work-sans-regular-font-family\" style=\"color:#2a2622;margin-top:0;margin-bottom:0;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.568), 19px);line-height:1.7\">\n<li>Go as soon as you can, because every option works better the sooner it&#8217;s used.<\/li>\n\n\n\n<li>Say where you are in your cycle, if you know, because it changes which option makes most sense.<\/li>\n\n\n\n<li>Ask about the copper coil, because it&#8217;s the most effective option and the only one that still works after ovulation.<\/li>\n<\/ul>\n\n\n<\/div>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group cpw-keep has-global-padding is-layout-constrained wp-container-core-group-is-layout-d2a766d4 wp-block-group-is-layout-constrained\">\n\n\n<div style=\"margin-top:92px;margin-bottom:34px\"><div class=\"ra-part\"><div class=\"wm\" aria-hidden=\"true\">06<\/div><div class=\"ic\" aria-hidden=\"true\"><svg viewBox=\"0 0 24 24\" fill=\"none\" stroke=\"currentColor\" stroke-width=\"1.5\" stroke-linecap=\"round\" stroke-linejoin=\"round\"><path d=\"M4 4.5h16v11.5H9.5L4 20.3zM9.8 8.6a2.2 2.2 0 1 1 3.3 1.9c-.7.4-1.1.9-1.1 1.7M12 13.8v.3\"\/><\/svg><\/div><div class=\"tx\"><div class=\"meta\"><p class=\"lb\">Part six of eight<\/p><span class=\"tk\" aria-hidden=\"true\"><i class=\"past\"><\/i><i class=\"past\"><\/i><i class=\"past\"><\/i><i class=\"past\"><\/i><i class=\"past\"><\/i><i class=\"now\"><\/i><i class=\"\"><\/i><i class=\"\"><\/i><\/span><\/div><h2 id=\"part-6\">Everything you were too afraid to ask<\/h2><p class=\"sb\">Plain answers to the questions people rarely say out loud<\/p><\/div><\/div><\/div>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group cpw-keep has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">These are the questions people most often keep to themselves, or only ever ask a friend. Every one of them is a fair thing to wonder about, and each has a short answer below.<\/p>\n\n\n<\/div>\n\n\n\n<div class=\"cpw-keep\" style=\"margin-top:10px;margin-bottom:20px\"><div class=\"ra-faq\" id=\"ra-faq\"><div class=\"all\"><button type=\"button\" id=\"ra-fa\">Open all<\/button><\/div><details id=\"q-1\"><summary><span class=\"qb\" aria-hidden=\"true\"><svg viewBox=\"0 0 46 42\"><path d=\"M23 3C11.4 3 4 9.8 4 18.2c0 4.8 2.5 9 6.5 11.7L8.6 38l8.8-4.4c1.8.4 3.6.6 5.6.6 11.6 0 19-6.8 19-15.2S34.6 3 23 3z\"\/><\/svg><i class=\"q\">?<\/i><i class=\"x\">!<\/i><\/span><p hidden><\/p><span>Does the pill make you gain weight?<\/span><span class=\"pl\" aria-hidden=\"true\"><svg viewBox=\"0 0 12 12\"><path d=\"M6 1.5v9M1.5 6h9\" fill=\"none\" stroke=\"currentColor\" stroke-width=\"1.8\" stroke-linecap=\"round\"\/><\/svg><\/span><p hidden><\/p><\/summary><div class=\"an\"><div class=\"cpw-nrm\"><p><strong class=\"eqb\">The evidence finds no large effect, even though almost everyone expects one<\/strong>. Reviews found no large effect from combined methods, and on progestogen-only methods average gain was under 2 kilograms at six to twelve months, with no significant difference between groups in most studies.<\/p><p>The UK&#8217;s health service says flatly that there&#8217;s no evidence the pill makes you put on weight. The one method where a real difference keeps appearing is the injection, and even there the studies are low quality.<\/p><\/div><div class=\"cpw-pln\"><p><strong class=\"eqb\">The evidence finds no large effect, even though almost everyone expects one<\/strong>. Reviews found no large effect from combined methods. For progestogen-only methods, average gain was under 2 kilograms at six to twelve months, with no significant difference between groups in most studies.<\/p><p>The UK&#8217;s health service says flatly that there&#8217;s no evidence the pill makes you put on weight. The one method where a real difference keeps appearing is the injection, and even there the studies are low quality.<\/p><\/div><\/div><\/details><details id=\"q-2\"><summary><span class=\"qb\" aria-hidden=\"true\"><svg viewBox=\"0 0 46 42\"><path d=\"M23 3C11.4 3 4 9.8 4 18.2c0 4.8 2.5 9 6.5 11.7L8.6 38l8.8-4.4c1.8.4 3.6.6 5.6.6 11.6 0 19-6.8 19-15.2S34.6 3 23 3z\"\/><\/svg><i class=\"q\">?<\/i><i class=\"x\">!<\/i><\/span><p hidden><\/p><span>Do you need to take breaks from the pill?<\/span><span class=\"pl\" aria-hidden=\"true\"><svg viewBox=\"0 0 12 12\"><path d=\"M6 1.5v9M1.5 6h9\" fill=\"none\" stroke=\"currentColor\" stroke-width=\"1.8\" stroke-linecap=\"round\"\/><\/svg><\/span><p hidden><\/p><\/summary><div class=\"an\"><p>No, and the reason is the opposite of what you might expect. The risk of a blood clot is highest in the first months of use and after restarting following a break of a month or more, so <strong class=\"eqb\">a break re-runs the riskiest stretch rather than avoiding it<\/strong>. The UK guideline says there&#8217;s no arbitrary limit on how long eligible women under 50 can use the combined pill, and that repeated starting and stopping should be discouraged.<\/p><\/div><\/details><details id=\"q-3\"><summary><span class=\"qb\" aria-hidden=\"true\"><svg viewBox=\"0 0 46 42\"><path d=\"M23 3C11.4 3 4 9.8 4 18.2c0 4.8 2.5 9 6.5 11.7L8.6 38l8.8-4.4c1.8.4 3.6.6 5.6.6 11.6 0 19-6.8 19-15.2S34.6 3 23 3z\"\/><\/svg><i class=\"q\">?<\/i><i class=\"x\">!<\/i><\/span><p hidden><\/p><span>Will antibiotics stop it working?<\/span><span class=\"pl\" aria-hidden=\"true\"><svg viewBox=\"0 0 12 12\"><path d=\"M6 1.5v9M1.5 6h9\" fill=\"none\" stroke=\"currentColor\" stroke-width=\"1.8\" stroke-linecap=\"round\"\/><\/svg><\/span><p hidden><\/p><\/summary><div class=\"an\"><p>Usually not. The UK guideline is clear that no extra precautions are needed with antibiotics that aren&#8217;t <em class=\"eqi\">enzyme inducers<\/em>, which is the vast majority of them. Enzyme inducers are a small number of medicines that speed up how fast your body clears the hormones, and their effect can last for 28 days after you stop taking them.<\/p><p>The guideline doesn&#8217;t say to check and carry on; it says anyone taking one should be offered a method they don&#8217;t affect. So <strong class=\"eqb\">if you&#8217;re prescribed something new, mention your contraception before you leave<\/strong>. Being ill matters separately from the medicine: vomiting or severe diarrhea can reduce how much of a pill your body absorbs. The diabetes and weight-loss injection tirzepatide (Mounjaro) can do the same: if you take a pill, add a barrier method such as condoms, or switch to a method you don&#8217;t swallow, for four weeks after starting it and for four weeks after each dose increase. Semaglutide (Ozempic, Wegovy) doesn&#8217;t appear to have this effect.<\/p><\/div><\/details><details id=\"q-4\"><summary><span class=\"qb\" aria-hidden=\"true\"><svg viewBox=\"0 0 46 42\"><path d=\"M23 3C11.4 3 4 9.8 4 18.2c0 4.8 2.5 9 6.5 11.7L8.6 38l8.8-4.4c1.8.4 3.6.6 5.6.6 11.6 0 19-6.8 19-15.2S34.6 3 23 3z\"\/><\/svg><i class=\"q\">?<\/i><i class=\"x\">!<\/i><\/span><p hidden><\/p><span>Can I have a coil if I have never had a baby?<\/span><span class=\"pl\" aria-hidden=\"true\"><svg viewBox=\"0 0 12 12\"><path d=\"M6 1.5v9M1.5 6h9\" fill=\"none\" stroke=\"currentColor\" stroke-width=\"1.8\" stroke-linecap=\"round\"\/><\/svg><\/span><p hidden><\/p><\/summary><div class=\"an\"><div class=\"cpw-nrm\"><p>Yes. <strong class=\"eqb\">Never having had a baby doesn&#8217;t rule out a coil<\/strong>, and the idea that it does is one of the most persistent myths in the field. The UK criteria place both coils in their least restrictive category for women who have never given birth, noting that the risks of the coil coming out, perforation, pregnancy and infection are low for everyone. The World Health Organization is very slightly more cautious and puts it in its second category rather than its first. Both of those mean yes!<\/p><\/div><div class=\"cpw-pln\"><p>Yes. <strong class=\"eqb\">Never having had a baby doesn&#8217;t rule out a coil<\/strong>, and the idea that it does is one of the most persistent myths in the field. The UK criteria place both coils in their least restrictive category (category 1, no restriction) for women who have never given birth, noting that the risks of the coil coming out, of it going through the wall of the uterus, of pregnancy and of infection are low for everyone. The World Health Organization is very slightly more cautious and puts them in its second category, which means a coil can generally be used. Both of those mean yes!<\/p><\/div><\/div><\/details><details id=\"q-5\"><summary><span class=\"qb\" aria-hidden=\"true\"><svg viewBox=\"0 0 46 42\"><path d=\"M23 3C11.4 3 4 9.8 4 18.2c0 4.8 2.5 9 6.5 11.7L8.6 38l8.8-4.4c1.8.4 3.6.6 5.6.6 11.6 0 19-6.8 19-15.2S34.6 3 23 3z\"\/><\/svg><i class=\"q\">?<\/i><i class=\"x\">!<\/i><\/span><p hidden><\/p><span>Is the morning after pill an abortion pill?<\/span><span class=\"pl\" aria-hidden=\"true\"><svg viewBox=\"0 0 12 12\"><path d=\"M6 1.5v9M1.5 6h9\" fill=\"none\" stroke=\"currentColor\" stroke-width=\"1.8\" stroke-linecap=\"round\"\/><\/svg><\/span><p hidden><\/p><\/summary><div class=\"an\"><div class=\"cpw-nrm\"><p>No. <strong class=\"eqb\">Emergency contraceptive pills work by preventing or delaying ovulation, and they don&#8217;t work if a pregnancy has already begun<\/strong>. If one is taken during a pregnancy nobody knew about, there&#8217;s no known harm to the pregnancy. The copper coil fitted for emergency use goes in well before the earliest point at which implantation could happen.<\/p><\/div><div class=\"cpw-pln\"><p>No. <strong class=\"eqb\">Emergency contraceptive pills work by preventing or delaying ovulation, and they don&#8217;t work if a pregnancy has already begun<\/strong>. If one is taken during a pregnancy nobody knew about, there&#8217;s no known harm to the pregnancy. The copper coil fitted for emergency use goes in well before the earliest point at which a pregnancy could implant (settle into the lining of the uterus).<\/p><\/div><\/div><\/details><details id=\"q-6\"><summary><span class=\"qb\" aria-hidden=\"true\"><svg viewBox=\"0 0 46 42\"><path d=\"M23 3C11.4 3 4 9.8 4 18.2c0 4.8 2.5 9 6.5 11.7L8.6 38l8.8-4.4c1.8.4 3.6.6 5.6.6 11.6 0 19-6.8 19-15.2S34.6 3 23 3z\"\/><\/svg><i class=\"q\">?<\/i><i class=\"x\">!<\/i><\/span><p hidden><\/p><span>Does the copper coil work by causing a very early abortion?<\/span><span class=\"pl\" aria-hidden=\"true\"><svg viewBox=\"0 0 12 12\"><path d=\"M6 1.5v9M1.5 6h9\" fill=\"none\" stroke=\"currentColor\" stroke-width=\"1.8\" stroke-linecap=\"round\"\/><\/svg><\/span><p hidden><\/p><\/summary><div class=\"an\"><div class=\"cpw-nrm\"><p>No. <strong class=\"eqb\">Copper&#8217;s main effect is to stop sperm and egg meeting at all<\/strong>: it&#8217;s toxic to both, and it also stops sperm getting through the cervical mucus. There&#8217;s a second effect on the lining that could make implantation harder, and the guidelines acknowledge it. But they&#8217;re equally clear that the effects before fertilization are the main way it works, and a review of the biological evidence concluded that the common belief that coils work by destroying embryos isn&#8217;t supported by the evidence.<\/p><\/div><div class=\"cpw-pln\"><p>No. <strong class=\"eqb\">Copper&#8217;s main effect is to stop sperm and egg meeting at all<\/strong>. It&#8217;s toxic to both, and it also stops sperm getting through the mucus at the cervix. There&#8217;s a second effect on the lining that could make it harder for an egg to settle in, and the guidelines acknowledge it. But they&#8217;re equally clear that the effects before fertilization are the main way it works. A review of the biological evidence concluded that the common belief that coils work by destroying embryos isn&#8217;t supported by the evidence.<\/p><\/div><\/div><\/details><details id=\"q-7\"><summary><span class=\"qb\" aria-hidden=\"true\"><svg viewBox=\"0 0 46 42\"><path d=\"M23 3C11.4 3 4 9.8 4 18.2c0 4.8 2.5 9 6.5 11.7L8.6 38l8.8-4.4c1.8.4 3.6.6 5.6.6 11.6 0 19-6.8 19-15.2S34.6 3 23 3z\"\/><\/svg><i class=\"q\">?<\/i><i class=\"x\">!<\/i><\/span><p hidden><\/p><span>Will it be harder to get pregnant after stopping?<\/span><span class=\"pl\" aria-hidden=\"true\"><svg viewBox=\"0 0 12 12\"><path d=\"M6 1.5v9M1.5 6h9\" fill=\"none\" stroke=\"currentColor\" stroke-width=\"1.8\" stroke-linecap=\"round\"\/><\/svg><\/span><p hidden><\/p><\/summary><div class=\"an\"><div class=\"cpw-nrm\"><p>No. A large analysis found that 83% of women were pregnant within a year of stopping, with no significant difference between hormonal methods and the coil, and no effect of how long the pill had been used. Guidelines hold that <strong class=\"eqb\">no method except sterilization causes lasting infertility<\/strong>. That&#8217;s what the evidence rules out. It can&#8217;t rule out a small delay after any method, and there&#8217;s one real exception to the speed: after the injection, ovulation can take up to a year to come back.<\/p><\/div><div class=\"cpw-pln\"><p>No. A large analysis found that 83% of women were pregnant within a year of stopping, with no significant difference between hormonal methods and the coil, and no effect of how long the pill had been used. Guidelines hold that <strong class=\"eqb\">no method except sterilization causes lasting infertility<\/strong>. That&#8217;s what the evidence rules out. It can&#8217;t rule out a small delay after any method, and there&#8217;s one real exception to the speed: after the injection, ovulation can take up to a year to come back.<\/p><\/div><\/div><\/details><details id=\"q-8\"><summary><span class=\"qb\" aria-hidden=\"true\"><svg viewBox=\"0 0 46 42\"><path d=\"M23 3C11.4 3 4 9.8 4 18.2c0 4.8 2.5 9 6.5 11.7L8.6 38l8.8-4.4c1.8.4 3.6.6 5.6.6 11.6 0 19-6.8 19-15.2S34.6 3 23 3z\"\/><\/svg><i class=\"q\">?<\/i><i class=\"x\">!<\/i><\/span><p hidden><\/p><span>Does it change your sex drive?<\/span><span class=\"pl\" aria-hidden=\"true\"><svg viewBox=\"0 0 12 12\"><path d=\"M6 1.5v9M1.5 6h9\" fill=\"none\" stroke=\"currentColor\" stroke-width=\"1.8\" stroke-linecap=\"round\"\/><\/svg><\/span><p hidden><\/p><\/summary><div class=\"an\"><p>For most people, no. In a large review, 85% of combined pill users reported an increase or no change, and 15% reported a decrease. A steady decline showed up only with the lowest-dose pills. That also means that <strong class=\"eqb\">if you&#8217;re one of the 15%, you&#8217;re not imagining it<\/strong>, and it&#8217;s a reasonable thing to take back to whoever prescribed it.<\/p><\/div><\/details><details id=\"q-9\"><summary><span class=\"qb\" aria-hidden=\"true\"><svg viewBox=\"0 0 46 42\"><path d=\"M23 3C11.4 3 4 9.8 4 18.2c0 4.8 2.5 9 6.5 11.7L8.6 38l8.8-4.4c1.8.4 3.6.6 5.6.6 11.6 0 19-6.8 19-15.2S34.6 3 23 3z\"\/><\/svg><i class=\"q\">?<\/i><i class=\"x\">!<\/i><\/span><p hidden><\/p><span>Can I skip a period on the pill?<\/span><span class=\"pl\" aria-hidden=\"true\"><svg viewBox=\"0 0 12 12\"><path d=\"M6 1.5v9M1.5 6h9\" fill=\"none\" stroke=\"currentColor\" stroke-width=\"1.8\" stroke-linecap=\"round\"\/><\/svg><\/span><p hidden><\/p><\/summary><div class=\"an\"><div class=\"cpw-nrm\"><p><strong class=\"eqb\">For many people, yes, and it&#8217;s a recognized option rather than a trick<\/strong>. The bleed on a combined pill is a <em class=\"eqi\">withdrawal bleed<\/em> caused by the break, not a period, and the UK guideline discusses regimes with shorter breaks or none. If period pain is the problem, taking the pill continuously may help with it more than the standard pattern. It&#8217;s worth asking about rather than improvising.<\/p><\/div><div class=\"cpw-pln\"><p><strong class=\"eqb\">For many people, yes, and it&#8217;s a recognized option rather than a trick<\/strong>. The bleed you get on a combined pill is a <em class=\"eqi\">withdrawal bleed<\/em>, caused by the break in taking the pill, and it isn&#8217;t a period. The UK guideline discusses ways of taking the pill with shorter breaks or none. If period pain is the problem, taking the pill continuously may help with it more than the standard pattern. It&#8217;s worth asking about rather than improvising.<\/p><\/div><\/div><\/details><details id=\"q-10\"><summary><span class=\"qb\" aria-hidden=\"true\"><svg viewBox=\"0 0 46 42\"><path d=\"M23 3C11.4 3 4 9.8 4 18.2c0 4.8 2.5 9 6.5 11.7L8.6 38l8.8-4.4c1.8.4 3.6.6 5.6.6 11.6 0 19-6.8 19-15.2S34.6 3 23 3z\"\/><\/svg><i class=\"q\">?<\/i><i class=\"x\">!<\/i><\/span><p hidden><\/p><span>Does the coil hurt?<\/span><span class=\"pl\" aria-hidden=\"true\"><svg viewBox=\"0 0 12 12\"><path d=\"M6 1.5v9M1.5 6h9\" fill=\"none\" stroke=\"currentColor\" stroke-width=\"1.8\" stroke-linecap=\"round\"\/><\/svg><\/span><p hidden><\/p><\/summary><div class=\"an\"><div class=\"cpw-nrm\"><p>The guidelines don&#8217;t answer this well. They cover safety and who can have a coil in detail, and say very little about what it feels like. What is documented is that the coil goes through the wall of the uterus in about 1 to 2 of every 1,000 fittings, and that younger people have a higher chance of the device coming out. Pain during fitting differs widely from one person to the next. <strong class=\"eqb\">You&#8217;re allowed to ask what pain relief is available beforehand, and to say if it hurts<\/strong>. Afterwards, if you can&#8217;t feel the threads, get it checked rather than ignoring it, because a coil that has moved may not be protecting you.<\/p><\/div><div class=\"cpw-pln\"><p>The guidelines don&#8217;t answer this well. They cover safety and who can have a coil in detail, and say very little about what it feels like. Pain during fitting differs widely from one person to the next. <strong class=\"eqb\">You&#8217;re allowed to ask what pain relief is available beforehand, and to say if it hurts<\/strong>.<\/p><p>What is documented is that the coil goes through the wall of the uterus in about 1 to 2 of every 1,000 fittings, and that younger people have a higher chance of the device coming out. Afterwards, if you can&#8217;t feel the threads, get it checked rather than ignoring it, because a coil that has moved may not be protecting you.<\/p><\/div><\/div><\/details><details id=\"q-11\"><summary><span class=\"qb\" aria-hidden=\"true\"><svg viewBox=\"0 0 46 42\"><path d=\"M23 3C11.4 3 4 9.8 4 18.2c0 4.8 2.5 9 6.5 11.7L8.6 38l8.8-4.4c1.8.4 3.6.6 5.6.6 11.6 0 19-6.8 19-15.2S34.6 3 23 3z\"\/><\/svg><i class=\"q\">?<\/i><i class=\"x\">!<\/i><\/span><p hidden><\/p><span>Does any of this protect against infections?<\/span><span class=\"pl\" aria-hidden=\"true\"><svg viewBox=\"0 0 12 12\"><path d=\"M6 1.5v9M1.5 6h9\" fill=\"none\" stroke=\"currentColor\" stroke-width=\"1.8\" stroke-linecap=\"round\"\/><\/svg><\/span><p hidden><\/p><\/summary><div class=\"an\"><p>Only condoms do. Using condoms consistently is estimated to cut the risk of catching HIV from a partner who has it by about 80%, and condoms protect well against infections carried in fluids, such as chlamydia and gonorrhea. They don&#8217;t protect against infections spread by skin-to-skin contact, such as herpes and syphilis, because they don&#8217;t cover all the skin involved. Correct use lowers the risk of infection, but it doesn&#8217;t remove it. <strong class=\"eqb\">No hormonal method and no coil offers any protection against infections<\/strong>.<\/p><\/div><\/details><details id=\"q-12\"><summary><span class=\"qb\" aria-hidden=\"true\"><svg viewBox=\"0 0 46 42\"><path d=\"M23 3C11.4 3 4 9.8 4 18.2c0 4.8 2.5 9 6.5 11.7L8.6 38l8.8-4.4c1.8.4 3.6.6 5.6.6 11.6 0 19-6.8 19-15.2S34.6 3 23 3z\"\/><\/svg><i class=\"q\">?<\/i><i class=\"x\">!<\/i><\/span><p hidden><\/p><span>Is it true the pill helps period pain and acne?<\/span><span class=\"pl\" aria-hidden=\"true\"><svg viewBox=\"0 0 12 12\"><path d=\"M6 1.5v9M1.5 6h9\" fill=\"none\" stroke=\"currentColor\" stroke-width=\"1.8\" stroke-linecap=\"round\"\/><\/svg><\/span><p hidden><\/p><\/summary><div class=\"an\"><div class=\"cpw-nrm\"><p>Yes to both, although the evidence is much stronger for one of them. <strong class=\"eqb\">For period pain, a Cochrane review found the combined pill works better than a placebo<\/strong>, and rated that finding high quality: improvement went from about 28 in 100 women on the placebo to between 37 and 60 in 100 on the pill. The same review rated the main downside just as highly. Irregular bleeding went from about 18 in 100 on the placebo to between 39 and 60 in 100 on the pill, and headaches and nausea were somewhat more likely as well. Both belong in the same sentence.<\/p><p>For acne, a review of trials found that combined pills reduced the number of spots compared with a placebo, with little consistent difference between types. That review is more than a decade old, though, and it couldn&#8217;t say how the pill compares with the treatments a dermatologist would reach for first.<\/p><\/div><div class=\"cpw-pln\"><p>Yes to both, although the evidence is much stronger for one of them. <strong class=\"eqb\">For period pain, a Cochrane review found the combined pill works better than a placebo<\/strong> (a dummy pill), and rated that finding high quality. Improvement went from about 28 in 100 women on the placebo to between 37 and 60 in 100 on the pill. The same review rated the main downside just as highly: irregular bleeding went from about 18 in 100 on the placebo to between 39 and 60 in 100 on the pill, and headaches and nausea were somewhat more likely as well. Both belong in the same sentence.<\/p><p>For acne, a review of trials found that combined pills reduced the number of spots compared with a placebo. That review is more than a decade old, and it couldn&#8217;t say how the pill compares with the treatments a dermatologist would reach for first.<\/p><\/div><\/div><\/details><script>(function(){var b=document.getElementById(\"ra-fa\");if(!b){return;}var d=document.querySelectorAll(\"#ra-faq details\");b.addEventListener(\"click\",function(){var open=b.textContent===\"Open all\";for(var i=0;i<d.length;i++){d[i].open=open;}b.textContent=open?\"Close all\":\"Open all\";});})();\/*>*\/<\/script><\/div><\/div>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n<\/div>\n\n\n\n<div class=\"wp-block-group cpw-keep has-global-padding is-layout-constrained wp-container-core-group-is-layout-d2a766d4 wp-block-group-is-layout-constrained\">\n\n\n<div style=\"margin-top:92px;margin-bottom:34px\"><div class=\"ra-part\"><div class=\"wm\" aria-hidden=\"true\">07<\/div><div class=\"ic\" aria-hidden=\"true\"><svg viewBox=\"0 0 24 24\" fill=\"none\" stroke=\"currentColor\" stroke-width=\"1.5\" stroke-linecap=\"round\" stroke-linejoin=\"round\"><path d=\"M9.5 20.5a5.5 5.5 0 1 0 0-11 5.5 5.5 0 0 0 0 11zM13.6 12.4L20 6M15 5.5h5.2v5.2\"\/><\/svg><\/div><div class=\"tx\"><div class=\"meta\"><p class=\"lb\">Part seven of eight<\/p><span class=\"tk\" aria-hidden=\"true\"><i class=\"past\"><\/i><i class=\"past\"><\/i><i class=\"past\"><\/i><i class=\"past\"><\/i><i class=\"past\"><\/i><i class=\"past\"><\/i><i class=\"now\"><\/i><i class=\"\"><\/i><\/span><\/div><h2 id=\"part-7\">Men and contraception<\/h2><p class=\"sb\">Condoms, vasectomy, and the male pill that keeps not arriving<\/p><\/div><\/div><\/div>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group cpw-pl has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family cpw-plk wp-block-paragraph\" style=\"color:#3d2874;margin-top:38px;margin-bottom:14px;font-size:12px;font-weight:700;letter-spacing:0.16em;line-height:1.4\">In plain words<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">If you&#8217;re a man reading this, you might have noticed how little of it has been about you. Half of the people involved in any pregnancy are men, and apart from withdrawal, the options available to them are a barrier and an operation. That&#8217;s the whole list, and it has been the whole list for a long time.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Condoms have a perfect-use figure of 2 in 100 and a typical-use figure of 13. <strong class=\"eqb\">For infections, condoms are the only thing on this page that does anything<\/strong>. Using them consistently is estimated to cut HIV transmission from a partner who has it by around 80% in heterosexual couples, and the US Centers for Disease Control and Prevention notes that this is probably an underestimate, because it depends on people reporting their own use accurately.<\/p>\n\n\n\n<div class=\"wp-block-group has-background has-global-padding is-layout-constrained wp-container-core-group-is-layout-bd3116f4 wp-block-group-is-layout-constrained\" style=\"background-color:#efecfb;border-radius:18px;margin-top:4px;margin-bottom:30px;padding:24px 28px\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#3d2874;margin-top:0;margin-bottom:12.5px;font-size:12px;font-weight:700;letter-spacing:0.16em;line-height:1.4\">WHAT HELPS<\/p>\n\n\n\n<ul class=\"wp-block-list has-text-color has-work-sans-regular-font-family\" style=\"color:#2a2622;margin-top:0;margin-bottom:0;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.568), 19px);line-height:1.7\">\n<li>Put the condom on from the start, not halfway through.<\/li>\n\n\n\n<li>Avoid oil-based lubricants with latex condoms, because they weaken latex and can cause a condom to break.<\/li>\n\n\n\n<li>If a condom breaks, remember that emergency contraception works better the sooner it&#8217;s used.<\/li>\n<\/ul>\n\n\n<\/div>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">And a fun fact. Under US quality standards, samples of condoms are filled with water and checked for leaks, and at least 996 out of every 1,000 tested have to hold.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">The UK guideline states that vasectomy has a lower failure rate and less risk than female sterilization done by keyhole or open surgery. Once a semen test has confirmed the operation worked, about 1 in 2,000 vasectomies fail, against about 1 in 200 for tubal sterilization by keyhole surgery. Those figures differ from the table in part one because the table counts the whole first year, including pregnancies before a semen test has confirmed anything.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">The part that&#8217;s easy to get wrong is the waiting. <strong class=\"eqb\">A vasectomy doesn&#8217;t work straight away, and you&#8217;ll need another method until a semen test confirms that it has<\/strong>. Sperm already past the point of the operation take time to clear, and the guideline puts the best time for the first semen test at twelve weeks. Pregnancies have happened years later, which is rare, and it does happen. The guideline also names a risk of pain in the testicles, scrotum, penis or lower abdomen after the operation, which is rarely severe and in some men is long-lasting.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">If you&#8217;ve wondered why there&#8217;s still no pill for men, it isn&#8217;t for lack of trying. The most advanced trial gave men an injection combining a progestogen and testosterone every eight weeks. It worked: in almost all of the men who kept going, sperm counts fell to the target level, the pregnancy rate among their partners was about 1.6 per 100, and nearly all of them had normal sperm production back a year after stopping.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">That is relatively good compared with the other reversible methods available to men, though about five times the pill&#8217;s perfect-use figure. The trial was stopped early, on the advice of an outside safety committee, because of side effects. The most common were acne, pain where the injection went in, increased libido, and mood changes, which is the same side effect part three looked at for women, where the evidence is still debated.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Work continues. A hormonal gel combining segesterone acetate and testosterone has been tested in a large phase two trial, which is the middle stage of testing a drug, and another compound is in trials too. But as of now, <strong class=\"eqb\">no reversible hormonal method for men is on sale anywhere<\/strong>, and no full results from that gel trial have yet appeared in a medical journal. There&#8217;s also a practical obstacle: in 5 to 10% of men, the hormonal approach doesn&#8217;t bring sperm production down enough.<\/p>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group cpw-n has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"two-methods-and-one-of-them-is-permanent\" style=\"color:#3d2874;margin-top:72px;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">Two methods, and one of them is permanent<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">If you&#8217;re a man reading this, you might have noticed how little of it has been about you. Half of the people involved in any pregnancy are men, and apart from withdrawal, the options available to them are a barrier and an operation. That&#8217;s the whole list, and it has been the whole list for a long time.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Condoms have a perfect-use figure of 2 in 100 and a typical-use figure of 13. The gap is the same story as everywhere else: something that has to be done correctly every time, by someone, in the moment.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\"><strong class=\"eqb\">For infections, condoms are the only thing on this page that does anything<\/strong>. Using them consistently is estimated to cut HIV transmission from a partner who has it by around 80% in heterosexual couples, and the US Centers for Disease Control and Prevention notes that this is probably an underestimate, because it depends on people reporting their own use accurately.<\/p>\n\n\n\n<div class=\"wp-block-group has-background has-global-padding is-layout-constrained wp-container-core-group-is-layout-bd3116f4 wp-block-group-is-layout-constrained\" style=\"background-color:#efecfb;border-radius:18px;margin-top:4px;margin-bottom:30px;padding:24px 28px\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#3d2874;margin-top:0;margin-bottom:12.5px;font-size:12px;font-weight:700;letter-spacing:0.16em;line-height:1.4\">WHAT HELPS<\/p>\n\n\n\n<ul class=\"wp-block-list has-text-color has-work-sans-regular-font-family\" style=\"color:#2a2622;margin-top:0;margin-bottom:0;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.568), 19px);line-height:1.7\">\n<li>Put the condom on from the start, not halfway through.<\/li>\n\n\n\n<li>Avoid oil-based lubricants with latex condoms, because they weaken latex and can cause a condom to break.<\/li>\n\n\n\n<li>If a condom breaks, remember that emergency contraception works better the sooner it&#8217;s used.<\/li>\n<\/ul>\n\n\n<\/div>\n\n\n\n<div style=\"margin-top:6px;margin-bottom:34px\"><aside class=\"ra-ff\"><span class=\"mk\" aria-hidden=\"true\"><svg viewBox=\"0 0 24 24\" fill=\"none\" stroke=\"currentColor\" stroke-width=\"1.6\" stroke-linecap=\"round\" stroke-linejoin=\"round\"><path d=\"M12 3.5l1.9 5.1 5.1 1.9-5.1 1.9L12 17.5l-1.9-5.1-5.1-1.9 5.1-1.9zM18.5 15.5l.8 2 2 .8-2 .8-.8 2-.8-2-2-.8 2-.8z\"\/><\/svg><\/span><p class=\"k\">Fun fact<\/p><p class=\"t\">Under US quality standards, samples of condoms are filled with water and checked for leaks, and at least 996 out of every 1,000 tested have to hold.<\/p><\/aside><\/div>\n\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"vasectomy-is-more-effective-and-less-risky-than-the-female\" style=\"color:#3d2874;margin-top:72px;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">Vasectomy is more effective and less risky than the female equivalent<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">This comparison isn&#8217;t widely known, and it&#8217;s a striking one. The UK guideline states that vasectomy has a lower failure rate and less risk than female sterilization done by keyhole or open surgery.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Once a semen test has confirmed the operation worked, about 1 in 2,000 vasectomies fail. For tubal sterilization by keyhole surgery, the lifetime failure rate is estimated at about 1 in 200.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Those aren&#8217;t the same numbers as the ones in the table in part one, which put vasectomy at 0.15% and tubal surgery at 0.5% over the first year. They don&#8217;t conflict. The table counts everything that happens in the first twelve months, including pregnancies before a semen test has confirmed anything, while the guideline&#8217;s figure is the long-run risk once it has.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">The part that&#8217;s easy to get wrong is the waiting. <strong class=\"eqb\">A vasectomy doesn&#8217;t work straight away, and you&#8217;ll need another method until a semen test confirms that it has<\/strong>. Sperm already past the point of the operation take time to clear, and the guideline puts the best time for the first semen test at twelve weeks. Pregnancies have happened years afterwards, which is rare, and it does happen.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">It isn&#8217;t free of consequences either. The guideline names a risk of pain in the testicles, scrotum, penis or lower abdomen afterwards, which is rarely severe and in some men is long-lasting.<\/p>\n\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"why-there-is-still-no-male-pill\" style=\"color:#3d2874;margin-top:72px;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">Why there is still no male pill<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">If you&#8217;ve wondered why there&#8217;s still no pill for men, it isn&#8217;t for lack of trying, and the most advanced trial was stopped early for a reason that connects directly to part three.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">In that trial, men were given an injection combining a progestogen and testosterone every eight weeks. It worked. In almost all of the men who kept going, sperm counts fell to the target level, the pregnancy rate among their partners was about 1.6 per 100, and nearly all of them had normal sperm production back a year after stopping.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">The authors called that relatively good compared with the other reversible methods available to men, which is the right comparison and a lower bar than the table in part one. About 1.6 per 100 is better than the pill as people actually use it, but it&#8217;s about five times the pill&#8217;s perfect-use figure and many times the implant&#8217;s.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">The trial was stopped early, on the advice of an outside safety committee, because of side effects. The most common were acne, pain where the injection went in, increased libido, and mood changes. The authors noted that mild to moderate mood changes were relatively common, and that is the same side effect part three looked at for women, where the evidence is still debated.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Work continues. A hormonal gel combining segesterone acetate and testosterone has been tested in a large <span class=\"gl\" tabindex=\"0\" aria-describedby=\"gd-7\"><em class=\"eqi\">phase two trial<\/em><span class=\"gd\" role=\"tooltip\" id=\"gd-7\"><b>phase two trial<\/b>The middle stage of testing a drug: a few hundred people, enough to show whether it works and at what dose, before the much larger trials that decide whether it is approved.<\/span><\/span>, and another compound is in trials too. But as of now, <strong class=\"eqb\">no reversible hormonal method for men is on sale anywhere<\/strong>, and no full results from that gel trial have yet appeared in a medical journal.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">There&#8217;s also a practical obstacle that rarely gets mentioned: in 5 to 10% of men, the hormonal approach doesn&#8217;t bring sperm production down enough.<\/p>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group cpw-keep has-global-padding is-layout-constrained wp-container-core-group-is-layout-d2a766d4 wp-block-group-is-layout-constrained\">\n\n\n<div style=\"margin-top:92px;margin-bottom:34px\"><div class=\"ra-part\"><div class=\"wm\" aria-hidden=\"true\">08<\/div><div class=\"ic\" aria-hidden=\"true\"><svg viewBox=\"0 0 24 24\" fill=\"none\" stroke=\"currentColor\" stroke-width=\"1.5\" stroke-linecap=\"round\" stroke-linejoin=\"round\"><path d=\"M6.5 3v5.5a3.5 3.5 0 0 0 7 0V3M10 12v2.5a4.5 4.5 0 0 0 9 0V12M19 12a2 2 0 1 0 0-4 2 2 0 0 0 0 4z\"\/><\/svg><\/div><div class=\"tx\"><div class=\"meta\"><p class=\"lb\">Part eight of eight<\/p><span class=\"tk\" aria-hidden=\"true\"><i class=\"past\"><\/i><i class=\"past\"><\/i><i class=\"past\"><\/i><i class=\"past\"><\/i><i class=\"past\"><\/i><i class=\"past\"><\/i><i class=\"past\"><\/i><i class=\"now\"><\/i><\/span><\/div><h2 id=\"part-8\">Choosing, and talking about it<\/h2><p class=\"sb\">How doctors decide what is safe, and what to bring to the appointment<\/p><\/div><\/div><\/div>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group cpw-pl has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family cpw-plk wp-block-paragraph\" style=\"color:#3d2874;margin-top:38px;margin-bottom:14px;font-size:12px;font-weight:700;letter-spacing:0.16em;line-height:1.4\">In plain words<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">If you&#8217;ve ever been told a method isn&#8217;t safe for you and didn&#8217;t really understand why, there&#8217;s a system behind that answer, and knowing it helps. The World Health Organization publishes medical eligibility criteria, now in a sixth edition, as a reference that countries adapt into their own. All of them sort every method against every relevant health condition into four categories.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Category 1 means no restriction. Category 2 means the method can generally be used, but follow-up may be needed, and more thought is called for when several category 2s stack up in the same person. Category 3 means it isn&#8217;t usually recommended unless nothing else is available or acceptable. Category 4 means an unacceptable health risk.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Two examples show how much the answer depends on the specific method rather than on hormones in general. If you&#8217;re 35 or over and smoke fifteen or more cigarettes a day, the combined pill is category 4, an unacceptable risk, but every progestogen-only method and both coils stay at category 1. If you get migraine with aura, where visual changes or other warning signs usually come before the headache, the combined pill is again category 4 at any age, while in the UK criteria the copper coil is category 1 and every progestogen-only method is category 2.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Two more rows are worth knowing. Having stopped smoking counts: at 35 and over, the UK criteria put the combined pill at category 3 if you stopped less than a year ago and category 2 if you stopped more than a year ago, rather than leaving you at 4 forever. And migraine without aura isn&#8217;t the same row as migraine with it. In the UK criteria the combined pill is category 2 to start and 3 to continue, which makes it a conversation rather than a closed door.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">In other words, &#8220;the pill is not safe for me&#8221; almost never means &#8220;hormonal contraception is not safe for me&#8221;. <strong class=\"eqb\">It usually means one specific route is ruled out and the rest of the list is open<\/strong>. The criteria also treat starting a method differently from continuing one, which matters if a condition appears while you&#8217;re already using something, such as migraine with aura that starts for the first time on the combined pill.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Appointments about contraception are short, and they tend to open with a method rather than a question. It helps to arrive with the question. Do you want something you never have to think about? How would you feel about having no periods at all, or about unpredictable bleeding? Might you want to be pregnant within the next year? Have you ever had a bad time with a hormonal method, and if so, which one? And do you need protection from infections as well as from pregnancy? Only one method on the list does both.<\/p>\n\n\n\n<div class=\"wp-block-group has-background has-global-padding is-layout-constrained wp-container-core-group-is-layout-bd3116f4 wp-block-group-is-layout-constrained\" style=\"background-color:#efecfb;border-radius:18px;margin-top:4px;margin-bottom:30px;padding:24px 28px\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#3d2874;margin-top:0;margin-bottom:12.5px;font-size:12px;font-weight:700;letter-spacing:0.16em;line-height:1.4\">WORTH WRITING DOWN BEFORE YOU GO<\/p>\n\n\n\n<ul class=\"wp-block-list has-text-color has-work-sans-regular-font-family\" style=\"color:#2a2622;margin-top:0;margin-bottom:0;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.568), 19px);line-height:1.7\">\n<li>Note any migraines, and whether they come with visual changes.<\/li>\n\n\n\n<li>Note any history of blood clots, in you or a close relative.<\/li>\n\n\n\n<li>Note whether you smoke, and how much.<\/li>\n\n\n\n<li>List any medicines you take regularly.<\/li>\n\n\n\n<li>Describe what your periods are normally like.<\/li>\n<\/ul>\n\n\n<\/div>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">And there&#8217;s one question worth asking out loud, because this whole article is built around it: <strong class=\"eqb\">which of these asks the least of me?<\/strong><\/p>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family cpw-n\" id=\"how-doctors-actually-decide\" style=\"color:#3d2874;margin-top:72px;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">How doctors actually decide<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family cpw-n wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">If you&#8217;ve ever been told a method isn&#8217;t safe for you and didn&#8217;t really understand why, there&#8217;s a system behind that answer, and knowing it helps. The World Health Organization publishes medical eligibility criteria, now in a sixth edition, as a reference that countries adapt into their own. All of them sort every method against every relevant health condition into four categories.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family cpw-n wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Category 1 means no restriction. Category 2 means the method can generally be used, but follow-up may be needed, and more thought is called for when several category 2s stack up in the same person. Category 3 means it isn&#8217;t usually recommended unless nothing else is available or acceptable. Category 4 means an unacceptable health risk.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family cpw-n wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Two examples show how much the answer depends on the specific method rather than on hormones in general. If you&#8217;re 35 or over and smoke fifteen or more cigarettes a day, the combined pill is category 4, an unacceptable risk, but every progestogen-only method and both coils stay at category 1. If you get migraine with aura, where visual changes or other warning signs usually come before the headache, the combined pill is again category 4 at any age, while in the UK criteria the copper coil is category 1 and every progestogen-only method is category 2.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family cpw-n wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Two more rows are worth knowing, because part of what makes this conversation hard is not knowing which question you&#8217;re in. Having stopped smoking counts: at 35 and over, the UK criteria put the combined pill at category 3 if you stopped less than a year ago and category 2 if you stopped more than a year ago, rather than leaving you at 4 forever. And migraine without aura isn&#8217;t the same row as migraine with it. In the UK criteria the combined pill is category 2 to start and 3 to continue, which makes it a conversation rather than a closed door.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family cpw-n wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">In other words, &#8220;the pill is not safe for me&#8221; almost never means &#8220;hormonal contraception is not safe for me&#8221;. <strong class=\"eqb\">It usually means one specific route is ruled out and the rest of the list is open<\/strong>.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family cpw-n wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">The criteria also treat starting a method differently from continuing one, which matters if a condition appears while you&#8217;re already using something, such as migraine with aura that starts for the first time on the combined pill.<\/p>\n\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family cpw-n\" id=\"what-to-take-to-the-appointment\" style=\"color:#3d2874;margin-top:72px;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">What to take to the appointment<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family cpw-n wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Appointments about contraception are short, and they tend to open with a method rather than a question. It helps to arrive with the question.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family cpw-n wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Before you go, it&#8217;s worth thinking about a few things. Do you want something you never have to think about? How would you feel about having no periods at all, or about unpredictable bleeding? Might you want to be pregnant within the next year? Have you ever had a bad time with a hormonal method, and if so, which one? And do you need protection from infections as well as from pregnancy? Only one method on the list does both.<\/p>\n\n\n\n<div class=\"wp-block-group has-background cpw-n has-global-padding is-layout-constrained wp-container-core-group-is-layout-bd3116f4 wp-block-group-is-layout-constrained\" style=\"background-color:#efecfb;border-radius:18px;margin-top:4px;margin-bottom:30px;padding:24px 28px\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#3d2874;margin-top:0;margin-bottom:12.5px;font-size:12px;font-weight:700;letter-spacing:0.16em;line-height:1.4\">WORTH WRITING DOWN BEFORE YOU GO<\/p>\n\n\n\n<ul class=\"wp-block-list has-text-color has-work-sans-regular-font-family\" style=\"color:#2a2622;margin-top:0;margin-bottom:0;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.568), 19px);line-height:1.7\">\n<li>Note any migraines, and whether they come with visual changes.<\/li>\n\n\n\n<li>Note any history of blood clots, in you or a close relative.<\/li>\n\n\n\n<li>Note whether you smoke, and how much.<\/li>\n\n\n\n<li>List any medicines you take regularly.<\/li>\n\n\n\n<li>Describe what your periods are normally like.<\/li>\n<\/ul>\n\n\n<\/div>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family cpw-n wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">And there&#8217;s one question worth asking out loud, because this whole article is built around it: <strong class=\"eqb\">which of these asks the least of me?<\/strong><\/p>\n\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family cpw-keep cpw-nopill\" id=\"when-to-go-back\" style=\"color:#3d2874;margin-top:72px;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">When to go back<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family cpw-keep cpw-nopill wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">You don&#8217;t have to wait for a routine appointment if something isn&#8217;t right. None of the following means something has gone wrong, but <strong class=\"eqb\">each is a reason to speak to a doctor, pharmacist or clinic rather than to wait and see<\/strong>:<\/p>\n\n\n\n<div class=\"cpw-keep cpw-nopill\" style=\"margin-top:4px;margin-bottom:32px\"><div class=\"ra-dr\"><p class=\"k\">Worth going back about<\/p><ul><li><span>Side effects that are still a problem after three months<\/span><\/li><li><span>Bleeding that has not settled, or that is affecting your life<\/span><\/li><li><span>Feeling persistently low or unlike yourself since starting a method<\/span><\/li><li><span>Migraine with aura starting for the first time<\/span><\/li><li><span>Turning 35 while smoking and using a combined method<\/span><\/li><li><span>Coil threads you cannot feel, or that feel different<\/span><\/li><li><span>Needing emergency contraception more than occasionally<\/span><\/li><li><span>Wanting to stop, and not knowing what to do instead<\/span><\/li><\/ul><\/div><\/div>\n\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family cpw-keep cpw-nopill\" id=\"and-when-not-to-wait\" style=\"color:#3d2874;margin-top:72px;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">And when not to wait<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family cpw-keep cpw-nopill wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">One situation is different from everything on that list. If you have pain or swelling in one leg, usually in the calf or thigh, or the skin there looks red, blue or darker than usual, <strong class=\"eqb\">get seen the same day rather than the same week, because it can be a clot<\/strong>. If that comes with breathlessness or chest pain, it&#8217;s no longer an appointment. It&#8217;s an emergency, so <strong class=\"eqb\">call your local emergency number or go to an emergency department, rather than phoning and waiting<\/strong>.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family cpw-keep cpw-nopill wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">This is rare, and the whole of part four shows how rare. It&#8217;s worth knowing anyway, because it&#8217;s one of the few things on this page where the difference between today and next week is what matters.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family cpw-keep cpw-nopill wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">The other one isn&#8217;t physical. If you&#8217;ve been feeling persistently low since starting a method, or you&#8217;re having thoughts of harming yourself, <strong class=\"eqb\">that&#8217;s also a today conversation, not a wait-three-months one<\/strong>. It doesn&#8217;t matter whether the method caused it. If you don&#8217;t know where to start, you can find the crisis lines and emergency numbers for your country on <a href=\"\/crisis-helplines\/\" style=\"color:#553a9c;text-decoration:underline;text-underline-offset:3px;text-decoration-thickness:1.5px;text-decoration-color:#d5cbf0\">our helplines page<\/a>.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family cpw-keep cpw-nopill wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">If you&#8217;re young, or a partner or family would react badly to you asking, a family planning or sexual health clinic is often the safer place to start, and in many places they&#8217;ll see young people in confidence. A pharmacist can help too, including with emergency contraception in many countries, and it&#8217;s fine to ask how they keep your information before you share it.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family cpw-keep cpw-nopill wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">There&#8217;s no best method on this page, and that isn&#8217;t a failure of the research: the right answer depends on your body, your history and your life more than on any number. What the evidence can do is narrow the field and take the myths off the table.<\/p>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n<\/div>\n\n\n\n<div class=\"wp-block-group cpw-keep has-global-padding is-layout-constrained wp-container-core-group-is-layout-d2a766d4 wp-block-group-is-layout-constrained\">\n\n\n<div class=\"wp-block-group has-background has-global-padding is-layout-constrained wp-container-core-group-is-layout-f86ed65e wp-block-group-is-layout-constrained\" style=\"background-color:#fbf4e6;border-color:#eedcb9;border-width:1.5px;border-style:solid;border-radius:20px;margin-top:46px;margin-bottom:46px;padding:34px 38px\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2b1a60;margin-top:0;margin-bottom:12px;font-size:12px;font-weight:700;letter-spacing:0.16em;line-height:1.4\">WORTH BEING CLEAR ABOUT<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">This article draws on the World Health Organization wherever it can, because its guidance is written for everywhere. Much of the detail underneath is national: the effectiveness figures are American, the clot ranges European, and several of the clearest statements come from UK guidelines, because that&#8217;s where they&#8217;re written most plainly.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:0;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">The reference list below names every source. Schedules, thresholds and what&#8217;s available free differ from country to country, and the large effectiveness studies are surveys in which people report their own use. Much of the evidence on mood comes from national prescription records, which show what was prescribed rather than what was diagnosed, and can&#8217;t separate a medicine&#8217;s effect from the reasons people start and stop taking it. The long-term cancer data come from a study that began in the 1960s, when pills contained far more hormone than they do now.<\/p>\n\n\n<\/div>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group cpw-keep has-global-padding is-layout-constrained wp-container-core-group-is-layout-d2a766d4 wp-block-group-is-layout-constrained\">\n\n\n<div class=\"wp-block-group has-background has-global-padding is-layout-constrained wp-container-core-group-is-layout-69c879e7 wp-block-group-is-layout-constrained\" style=\"background-color:#faf8f3;border-color:#e8e1d5;border-width:1.5px;border-style:solid;border-radius:18px;margin-top:0;margin-bottom:44px;padding:30px 34px\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#6b6259;margin-top:0;margin-bottom:14px;font-size:12px;font-weight:700;letter-spacing:0.16em;line-height:1.4\">REFERENCES<\/p>\n\n\n\n<ol class=\"wp-block-list has-text-color has-work-sans-regular-font-family\" style=\"color:#524a42;margin-top:0;margin-bottom:0;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.17), 15.5px);line-height:1.7\">\n<li><a href=\"https:\/\/doi.org\/10.1136\/bmjopen-2025-105694\" target=\"_blank\" rel=\"noopener\" style=\"color:inherit;text-decoration:underline;text-underline-offset:3px;text-decoration-thickness:1px;text-decoration-color:#cfc4ea\">Aleknaviciute, J., Lu, D., Gotby, V., Frans, E. M., Kuja-Halkola, R., Engberg, H., Tiemeier, H., Lichtenstein, P., Fang, F., Kushner, S. A., &amp; Chang, Z. (2025). Hormonal contraception and the risk of suicidal behaviour: A Swedish nationwide register-based study. <em>BMJ Open, 15<\/em>(11), Article e105694.<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/22786490\/\" target=\"_blank\" rel=\"noopener\" style=\"color:inherit;text-decoration:underline;text-underline-offset:3px;text-decoration-thickness:1px;text-decoration-color:#cfc4ea\">Arowojolu, A. O., Gallo, M. F., Lopez, L. M., &amp; Grimes, D. A. (2012). Combined oral contraceptive pills for treatment of acne. <em>Cochrane Database of Systematic Reviews, 2012<\/em>(7), Article CD004425.<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/doi.org\/10.1210\/jc.2016-2141\" target=\"_blank\" rel=\"noopener\" style=\"color:inherit;text-decoration:underline;text-underline-offset:3px;text-decoration-thickness:1px;text-decoration-color:#cfc4ea\">Behre, H. M., Zitzmann, M., Anderson, R. A., Handelsman, D. J., Lestari, S. W., McLachlan, R. I., Meriggiola, M. C., Misro, M. M., Noe, G., Wu, F. C., Festin, M. P. R., Habib, N. A., Vogelsong, K. M., Callahan, M. M., Linton, K. A., &amp; Colvard, D. S. (2016). Efficacy and safety of an injectable combination hormonal contraceptive for men. <em>The Journal of Clinical Endocrinology &amp; Metabolism, 101<\/em>(12), 4779-4788.<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/www.cdc.gov\/condom-use\/index.html\" target=\"_blank\" rel=\"noopener\" style=\"color:inherit;text-decoration:underline;text-underline-offset:3px;text-decoration-thickness:1px;text-decoration-color:#cfc4ea\">Centers for Disease Control and Prevention. (2024). <em>Condom use: An overview<\/em>.<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/www.cdc.gov\/contraception\/about\/index.html\" target=\"_blank\" rel=\"noopener\" style=\"color:inherit;text-decoration:underline;text-underline-offset:3px;text-decoration-thickness:1px;text-decoration-color:#cfc4ea\">Centers for Disease Control and Prevention. (2024). <em>Contraception and birth control methods<\/em>.<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/www.cdc.gov\/hivpartners\/php\/riskandprevention\/index.html\" target=\"_blank\" rel=\"noopener\" style=\"color:inherit;text-decoration:underline;text-underline-offset:3px;text-decoration-thickness:1px;text-decoration-color:#cfc4ea\">Centers for Disease Control and Prevention. (2024). <em>HIV risk and prevention estimates<\/em>.<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/www.cdc.gov\/contraception\/hcp\/usmec\/index.html\" target=\"_blank\" rel=\"noopener\" style=\"color:inherit;text-decoration:underline;text-underline-offset:3px;text-decoration-thickness:1px;text-decoration-color:#cfc4ea\">Centers for Disease Control and Prevention. (2024). <em>U.S. medical eligibility criteria for contraceptive use, 2024<\/em>.<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/doi.org\/10.1016\/S0140-6736(08)60167-1\" target=\"_blank\" rel=\"noopener\" style=\"color:inherit;text-decoration:underline;text-underline-offset:3px;text-decoration-thickness:1px;text-decoration-color:#cfc4ea\">Collaborative Group on Epidemiological Studies of Ovarian Cancer. (2008). Ovarian cancer and oral contraceptives: Collaborative reanalysis of data from 45 epidemiological studies including 23,257 women with ovarian cancer and 87,303 controls. <em>The Lancet, 371<\/em>(9609), 303-314.<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/www.cosrh.org\/Common\/Uploaded%20files\/documents\/UKMEC_2025.pdf\" target=\"_blank\" rel=\"noopener\" style=\"color:inherit;text-decoration:underline;text-underline-offset:3px;text-decoration-thickness:1px;text-decoration-color:#cfc4ea\">College of Sexual and Reproductive Healthcare. (2025). <em>UK medical eligibility criteria for contraceptive use (UKMEC 2025)<\/em>.<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/www.cosrh.org\/Common\/Uploaded%20files\/documents\/Statement%20Response%20Lundstrom%20et%20al%20Progestogens%20and%20meningioma%20study%20(July%202026).pdf\" target=\"_blank\" rel=\"noopener\" style=\"color:inherit;text-decoration:underline;text-underline-offset:3px;text-decoration-thickness:1px;text-decoration-color:#cfc4ea\">College of Sexual and Reproductive Healthcare. (2026a). <em>CoSRH CEU statement: Response to new study by Lundstr&#248;m et al. (2026), Contraceptive progestogens and incident meningioma<\/em>.<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/www.cosrh.org\/Common\/Uploaded%20files\/documents\/Statement%20on%20Meningioma%20and%20Contraception.pdf\" target=\"_blank\" rel=\"noopener\" style=\"color:inherit;text-decoration:underline;text-underline-offset:3px;text-decoration-thickness:1px;text-decoration-color:#cfc4ea\">College of Sexual and Reproductive Healthcare. (2026b). <em>CoSRH statement: Meningioma and progestogens<\/em>.<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/www.cosrh.org\/Common\/Uploaded%20files\/documents\/cec-ceu-guidance-sterilisation-summary-sep-2014.pdf\" target=\"_blank\" rel=\"noopener\" style=\"color:inherit;text-decoration:underline;text-underline-offset:3px;text-decoration-thickness:1px;text-decoration-color:#cfc4ea\">Faculty of Sexual &amp; Reproductive Healthcare. (2014). <em>Male and female sterilisation: Summary of recommendations<\/em>.<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/www.cosrh.org\/Common\/Uploaded%20files\/documents\/ceuguidanceproblematicbleedinghormonalcontraception.pdf\" target=\"_blank\" rel=\"noopener\" style=\"color:inherit;text-decoration:underline;text-underline-offset:3px;text-decoration-thickness:1px;text-decoration-color:#cfc4ea\">Faculty of Sexual &amp; Reproductive Healthcare. (2015). <em>Problematic bleeding with hormonal contraception<\/em>.<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/www.cosrh.org\/Public\/Documents\/ceu-clinical-guidance-emergency-contraception-march-2017.aspx\" target=\"_blank\" rel=\"noopener\" style=\"color:inherit;text-decoration:underline;text-underline-offset:3px;text-decoration-thickness:1px;text-decoration-color:#cfc4ea\">Faculty of Sexual &amp; Reproductive Healthcare. (2017, amended 2026). <em>FSRH guideline: Emergency contraception<\/em>. College of Sexual and Reproductive Healthcare.<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/www.cosrh.org\/Common\/Uploaded%20files\/documents\/fsrh-guideline-combined-hormonal-contraception-october-2023.pdf\" target=\"_blank\" rel=\"noopener\" style=\"color:inherit;text-decoration:underline;text-underline-offset:3px;text-decoration-thickness:1px;text-decoration-color:#cfc4ea\">Faculty of Sexual &amp; Reproductive Healthcare. (2019, amended 2023). <em>FSRH guideline: Combined hormonal contraception<\/em>.<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/www.cosrh.org\/Public\/Documents\/ceu-guideline-progestogen-only-pills.aspx\" target=\"_blank\" rel=\"noopener\" style=\"color:inherit;text-decoration:underline;text-underline-offset:3px;text-decoration-thickness:1px;text-decoration-color:#cfc4ea\">Faculty of Sexual &amp; Reproductive Healthcare. (2022, amended 2026). <em>FSRH guideline: Progestogen-only pills<\/em>. College of Sexual and Reproductive Healthcare.<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/www.cosrh.org\/Common\/Uploaded%20files\/documents\/fsrh-clinical-guideline-intrauterine-contraception-mar-23-amended.pdf\" target=\"_blank\" rel=\"noopener\" style=\"color:inherit;text-decoration:underline;text-underline-offset:3px;text-decoration-thickness:1px;text-decoration-color:#cfc4ea\">Faculty of Sexual &amp; Reproductive Healthcare. (2023, amended 2025). <em>FSRH clinical guideline: Intrauterine contraception<\/em>.<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/www.cosrh.org\/Common\/Uploaded%20files\/documents\/CEU-statement-GLP-1-agonists-and-contraception.pdf\" target=\"_blank\" rel=\"noopener\" style=\"color:inherit;text-decoration:underline;text-underline-offset:3px;text-decoration-thickness:1px;text-decoration-color:#cfc4ea\">Faculty of Sexual &amp; Reproductive Healthcare. (2025). <em>FSRH statement: Glucagon-like peptide-1 (GLP-1) agonists and oral contraception<\/em>.<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/doi.org\/10.1002\/14651858.CD003987.pub5\" target=\"_blank\" rel=\"noopener\" style=\"color:inherit;text-decoration:underline;text-underline-offset:3px;text-decoration-thickness:1px;text-decoration-color:#cfc4ea\">Gallo, M. F., Lopez, L. M., Grimes, D. A., Carayon, F., Schulz, K. F., &amp; Helmerhorst, F. M. (2014). Combination contraceptives: Effects on weight. <em>Cochrane Database of Systematic Reviews, 2014<\/em>(1), Article CD003987.<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/doi.org\/10.1186\/s40834-018-0064-y\" target=\"_blank\" rel=\"noopener\" style=\"color:inherit;text-decoration:underline;text-underline-offset:3px;text-decoration-thickness:1px;text-decoration-color:#cfc4ea\">Girum, T., &amp; Wasie, A. (2018). Return of fertility after discontinuation of contraception: A systematic review and meta-analysis. <em>Contraception and Reproductive Medicine, 3<\/em>(1), Article 9. (Correction published 2023, 8(1), 29.)<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/doi.org\/10.1016\/S0140-6736(10)60101-8\" target=\"_blank\" rel=\"noopener\" style=\"color:inherit;text-decoration:underline;text-underline-offset:3px;text-decoration-thickness:1px;text-decoration-color:#cfc4ea\">Glasier, A. F., Cameron, S. T., Fine, P. M., Logan, S. J. S., Casale, W., Van Horn, J., Sogor, L., Blithe, D. L., Scherrer, B., Mathe, H., Jaspart, A., Ulmann, A., &amp; Gainer, E. (2010). Ulipristal acetate versus levonorgestrel for emergency contraception: A randomised non-inferiority trial and meta-analysis. <em>The Lancet, 375<\/em>(9714), 555-562.<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/doi.org\/10.1016\/j.ajog.2017.02.002\" target=\"_blank\" rel=\"noopener\" style=\"color:inherit;text-decoration:underline;text-underline-offset:3px;text-decoration-thickness:1px;text-decoration-color:#cfc4ea\">Iversen, L., Sivasubramaniam, S., Lee, A. J., Fielding, S., &amp; Hannaford, P. C. (2017). Lifetime cancer risk and combined oral contraceptives: The Royal College of General Practitioners&#8217; Oral Contraception Study. <em>American Journal of Obstetrics and Gynecology, 216<\/em>(6), 580.e1-580.e9.<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/doi.org\/10.1002\/14651858.CD008815.pub4\" target=\"_blank\" rel=\"noopener\" style=\"color:inherit;text-decoration:underline;text-underline-offset:3px;text-decoration-thickness:1px;text-decoration-color:#cfc4ea\">Lopez, L. M., Ramesh, S., Chen, M., Edelman, A., Otterness, C., Trussell, J., &amp; Helmerhorst, F. M. (2016). Progestin-only contraceptives: Effects on weight. <em>Cochrane Database of Systematic Reviews, 2016<\/em>(8), Article CD008815.<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/doi.org\/10.1186\/s12610-023-00204-z\" target=\"_blank\" rel=\"noopener\" style=\"color:inherit;text-decoration:underline;text-underline-offset:3px;text-decoration-thickness:1px;text-decoration-color:#cfc4ea\">Louwagie, E. J., Quinn, G. F. L., Pond, K. L., &amp; Hansen, K. A. (2023). Male contraception: Narrative review of ongoing research. <em>Basic and Clinical Andrology, 33<\/em>(1), Article 30.<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/doi.org\/10.1001\/jamanetworkopen.2026.22603\" target=\"_blank\" rel=\"noopener\" style=\"color:inherit;text-decoration:underline;text-underline-offset:3px;text-decoration-thickness:1px;text-decoration-color:#cfc4ea\">Lundstr&#248;m, N. H., Knudgaard, M. H., Pedersen, M. S., Christiansen, M. L. S., &amp; Skovlund, C. W. (2026). Contraceptive progestogens and incident meningioma. <em>JAMA Network Open, 9<\/em>(7), Article e2622603.<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/doi.org\/10.1016\/j.contraception.2011.04.002\" target=\"_blank\" rel=\"noopener\" style=\"color:inherit;text-decoration:underline;text-underline-offset:3px;text-decoration-thickness:1px;text-decoration-color:#cfc4ea\">Mansour, D., Gemzell-Danielsson, K., Inki, P., &amp; Jensen, J. T. (2011). Fertility after discontinuation of contraception: A comprehensive review of the literature. <em>Contraception, 84<\/em>(5), 465-477.<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/doi.org\/10.1016\/j.jsxm.2022.01.515\" target=\"_blank\" rel=\"noopener\" style=\"color:inherit;text-decoration:underline;text-underline-offset:3px;text-decoration-thickness:1px;text-decoration-color:#cfc4ea\">Maseroli, E., &amp; Vignozzi, L. (2022). Are endogenous androgens linked to female sexual function? A systemic review and meta-analysis. <em>The Journal of Sexual Medicine, 19<\/em>(4), 553-568.<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/www.nhs.uk\/contraception\/methods-of-contraception\/progestogen-only-pill\/how-to-take-it\/\" target=\"_blank\" rel=\"noopener\" style=\"color:inherit;text-decoration:underline;text-underline-offset:3px;text-decoration-thickness:1px;text-decoration-color:#cfc4ea\">NHS. (2024). <em>How to take the progestogen-only pill<\/em>.<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/www.nhs.uk\/contraception\/methods-of-contraception\/combined-pill\/side-effects\/\" target=\"_blank\" rel=\"noopener\" style=\"color:inherit;text-decoration:underline;text-underline-offset:3px;text-decoration-thickness:1px;text-decoration-color:#cfc4ea\">NHS. (2024). <em>Side effects and risks of the combined pill<\/em>.<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/www.nhs.uk\/conditions\/deep-vein-thrombosis-dvt\/\" target=\"_blank\" rel=\"noopener\" style=\"color:inherit;text-decoration:underline;text-underline-offset:3px;text-decoration-thickness:1px;text-decoration-color:#cfc4ea\">NHS. (2026). <em>DVT (deep vein thrombosis)<\/em>.<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/doi.org\/10.1016\/j.contraception.2007.01.020\" target=\"_blank\" rel=\"noopener\" style=\"color:inherit;text-decoration:underline;text-underline-offset:3px;text-decoration-thickness:1px;text-decoration-color:#cfc4ea\">Ortiz, M. E., &amp; Croxatto, H. B. (2007). Copper-T intrauterine device and levonorgestrel intrauterine system: Biological bases of their mechanism of action. <em>Contraception, 75<\/em>(6 Suppl), S16-S30.<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/doi.org\/10.3109\/13625187.2012.728643\" target=\"_blank\" rel=\"noopener\" style=\"color:inherit;text-decoration:underline;text-underline-offset:3px;text-decoration-thickness:1px;text-decoration-color:#cfc4ea\">Pastor, Z., Holla, K., &amp; Chmel, R. (2013). The influence of combined oral contraceptives on female sexual desire: A systematic review. <em>The European Journal of Contraception &amp; Reproductive Health Care, 18<\/em>(1), 27-43.<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/doi.org\/10.1136\/bmj-2024-083981\" target=\"_blank\" rel=\"noopener\" style=\"color:inherit;text-decoration:underline;text-underline-offset:3px;text-decoration-thickness:1px;text-decoration-color:#cfc4ea\">Roland, N., Kolla, E., Baricault, B., Dayani, P., Duranteau, L., Froelich, S., Zureik, M., &amp; Weill, A. (2025). Oral contraceptives with progestogens desogestrel or levonorgestrel and risk of intracranial meningioma: National case-control study. <em>BMJ, 389<\/em>, Article e083981.<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/doi.org\/10.1136\/bmj-2023-078078\" target=\"_blank\" rel=\"noopener\" style=\"color:inherit;text-decoration:underline;text-underline-offset:3px;text-decoration-thickness:1px;text-decoration-color:#cfc4ea\">Roland, N., Neumann, A., Hoisnard, L., Duranteau, L., Froelich, S., Zureik, M., &amp; Weill, A. (2024). Use of progestogens and the risk of intracranial meningioma: National case-control study. <em>BMJ, 384<\/em>, Article e078078.<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/doi.org\/10.1002\/14651858.CD002120.pub4\" target=\"_blank\" rel=\"noopener\" style=\"color:inherit;text-decoration:underline;text-underline-offset:3px;text-decoration-thickness:1px;text-decoration-color:#cfc4ea\">Schroll, J. B., Black, A. Y., Farquhar, C., &amp; Chen, I. (2023). Combined oral contraceptive pill for primary dysmenorrhoea. <em>Cochrane Database of Systematic Reviews, 2023<\/em>(7), Article CD002120.<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/doi.org\/10.1016\/j.lanepe.2023.100813\" target=\"_blank\" rel=\"noopener\" style=\"color:inherit;text-decoration:underline;text-underline-offset:3px;text-decoration-thickness:1px;text-decoration-color:#cfc4ea\">Skovlund, C. W., M&#248;ller, A. L., Torp-Pedersen, C., M&#248;rch, L. S., &amp; Meaidi, A. (2024). Depression risk in users of different doses of levonorgestrel intrauterine systems: A nationwide prospective cohort study. <em>The Lancet Regional Health-Europe, 38<\/em>, Article 100813.<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/doi.org\/10.1176\/appi.ajp.2017.17060616\" target=\"_blank\" rel=\"noopener\" style=\"color:inherit;text-decoration:underline;text-underline-offset:3px;text-decoration-thickness:1px;text-decoration-color:#cfc4ea\">Skovlund, C. W., M&#248;rch, L. S., Kessing, L. V., Lange, T., &amp; Lidegaard, &#216;. (2018). Association of hormonal contraception with suicide attempts and suicides. <em>American Journal of Psychiatry, 175<\/em>(4), 336-342.<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/doi.org\/10.1001\/jamapsychiatry.2016.2387\" target=\"_blank\" rel=\"noopener\" style=\"color:inherit;text-decoration:underline;text-underline-offset:3px;text-decoration-thickness:1px;text-decoration-color:#cfc4ea\">Skovlund, C. W., M&#248;rch, L. S., Kessing, L. V., &amp; Lidegaard, &#216;. (2016). Association of hormonal contraception with depression. <em>JAMA Psychiatry, 73<\/em>(11), 1154-1162.<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/doi.org\/10.1363\/psrh.12017\" target=\"_blank\" rel=\"noopener\" style=\"color:inherit;text-decoration:underline;text-underline-offset:3px;text-decoration-thickness:1px;text-decoration-color:#cfc4ea\">Sundaram, A., Vaughan, B., Kost, K., Bankole, A., Finer, L., Singh, S., &amp; Trussell, J. (2017). Contraceptive failure in the United States: Estimates from the 2006-2010 National Survey of Family Growth. <em>Perspectives on Sexual and Reproductive Health, 49<\/em>(1), 7-16.<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/doi.org\/10.1016\/j.fertnstert.2021.03.047\" target=\"_blank\" rel=\"noopener\" style=\"color:inherit;text-decoration:underline;text-underline-offset:3px;text-decoration-thickness:1px;text-decoration-color:#cfc4ea\">Thirumalai, A., &amp; Amory, J. K. (2021). Emerging approaches to male contraception. <em>Fertility and Sterility, 115<\/em>(6), 1369-1376.<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/doi.org\/10.1097\/MED.0000000000000880\" target=\"_blank\" rel=\"noopener\" style=\"color:inherit;text-decoration:underline;text-underline-offset:3px;text-decoration-thickness:1px;text-decoration-color:#cfc4ea\">Thirumalai, A., &amp; Page, S. T. (2024). Testosterone and male contraception. <em>Current Opinion in Endocrinology, Diabetes and Obesity, 31<\/em>(6), 236-242.<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/doi.org\/10.1002\/14651858.CD003255\" target=\"_blank\" rel=\"noopener\" style=\"color:inherit;text-decoration:underline;text-underline-offset:3px;text-decoration-thickness:1px;text-decoration-color:#cfc4ea\">Weller, S. C., &amp; Davis-Beaty, K. (2002). Condom effectiveness in reducing heterosexual HIV transmission. <em>Cochrane Database of Systematic Reviews, 2002<\/em>(1), Article CD003255.<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/www.who.int\/publications\/i\/item\/9789240115583\" target=\"_blank\" rel=\"noopener\" style=\"color:inherit;text-decoration:underline;text-underline-offset:3px;text-decoration-thickness:1px;text-decoration-color:#cfc4ea\">World Health Organization. (2025). <em>Medical eligibility criteria for contraceptive use<\/em> (6th ed.).<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/doi.org\/10.1016\/j.contraception.2018.01.010\" target=\"_blank\" rel=\"noopener\" style=\"color:inherit;text-decoration:underline;text-underline-offset:3px;text-decoration-thickness:1px;text-decoration-color:#cfc4ea\">Worly, B. L., Gur, T. L., &amp; Schaffir, J. (2018). The relationship between progestin hormonal contraception and depression: A systematic review. <em>Contraception, 97<\/em>(6), 478-489.<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/doi.org\/10.1371\/journal.pone.0194773\" target=\"_blank\" rel=\"noopener\" style=\"color:inherit;text-decoration:underline;text-underline-offset:3px;text-decoration-thickness:1px;text-decoration-color:#cfc4ea\">Zettermark, S., Perez Vicente, R., &amp; Merlo, J. (2018). Hormonal contraception increases the risk of psychotropic drug use in adolescent girls but not in adults: A pharmacoepidemiological study on 800 000 Swedish women. <em>PLOS ONE, 13<\/em>(3), Article e0194773.<\/a><\/li>\n<\/ol>\n\n\n\n<p class=\"eq-lastrev\" style=\"margin:34px 0 0;font-family:&quot;Work Sans&quot;,sans-serif;font-size:12px;font-weight:700;letter-spacing:.15em;text-transform:uppercase;line-height:1.5;color:#6b6259\">Last reviewed October 2026<\/p>\n\n\n<\/div>\n\n\n\n<style>.eqp{--rc-accent:#553a9c;--rc-band:#eeeaf8;--rc-hover:#e2daf4;--rc-bg:#faf8f3}.eqp .eq-rc-btn{display:none}.eqp .eq-rc{position:relative}.eqp .eq-rc li[hidden]{display:block;margin:0;padding:0;height:0;line-height:0;font-size:0}.eqp .eq-rc li.rc-off{display:none}.eqp .eq-rc.is-collapsed::after{content:\"\";position:absolute;left:0;right:0;bottom:0;height:76px;background:linear-gradient(to bottom,transparent,var(--rc-bg) 94%);pointer-events:none}.eqp .eq-rc ~ .eq-rc-btn{display:inline-flex;align-items:center;justify-content:center;gap:8px;box-sizing:border-box;min-width:260px;min-height:48px;margin:22px 0 0;padding:12px 26px;background:var(--rc-band);color:var(--rc-accent);border:1.5px solid var(--rc-accent);border-radius:9px;font-family:\"Work Sans\",system-ui,sans-serif;font-size:15px;font-weight:600;line-height:1.3;letter-spacing:normal;text-transform:none;text-decoration:none;text-align:center;box-shadow:none;cursor:pointer;-webkit-appearance:none;appearance:none;-webkit-tap-highlight-color:transparent}.eqp .eq-rc ~ .eq-rc-btn:hover{background:var(--rc-hover);color:var(--rc-accent)}.eqp .eq-rc ~ .eq-rc-btn:focus-visible{outline:3px solid var(--rc-accent);outline-offset:3px}.eqp .eq-rc-chev{flex:0 0 auto;width:8px;height:8px;margin-top:-4px;border-right:2px solid currentColor;border-bottom:2px solid currentColor;transform:rotate(45deg);transition:transform .2s ease}.eqp .eq-rc-btn[aria-expanded=\"true\"] .eq-rc-chev{margin-top:4px;transform:rotate(-135deg)}@media (max-width:640px){.eqp .eq-rc ~ .eq-rc-btn{display:flex;width:100%;min-width:0;margin:18px 0 0;padding:12px 10px}}@media (prefers-reduced-motion:reduce){.eqp .eq-rc-chev{transition:none}}@media print{.eqp .eq-rc-btn{display:none!important}.eqp .eq-rc::after{display:none!important}.eqp .eq-rc li[hidden]{display:list-item!important;content-visibility:visible!important;height:auto!important;font-size:inherit!important;line-height:inherit!important}.eqp .eq-rc li.rc-off{display:list-item!important}}<\/style><style>\/* eq-sweep-3041 (build, 17 Oct 2026). 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Do not start, stop or change a method on the strength of anything written here. Psychological support is intended to work alongside appropriate medical care, never to replace it.<\/p>\n\n\n<\/div>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group cpw-keep has-global-padding is-layout-constrained wp-container-core-group-is-layout-d2a766d4 wp-block-group-is-layout-constrained\">\n\n\n<div style=\"margin-top:0px;margin-bottom:44px\"><a class=\"ra-next\" href=\"\/mens-health-101\/\"><span class=\"eyb\">Read next<\/span><span class=\"ti\">Everything You Were Too Afraid to Ask: Men\u2019s Health 101<\/span><span class=\"wy\">What is normal, what is worth checking, and why half the people involved in any pregnancy are so rarely part of this conversation.<\/span><\/a><\/div>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group cpw-keep cpw-end has-global-padding is-layout-constrained wp-container-core-group-is-layout-d2a766d4 wp-block-group-is-layout-constrained\">\n\n\n<div style=\"margin-top:0px;margin-bottom:0px\"><img loading=\"lazy\" decoding=\"async\" width=\"2560\" height=\"1708\" src=\"https:\/\/equilibriumpsychotherapy.net\/wp-content\/uploads\/2024\/06\/mid-shot-woman-therapist-taking-notes-clipboard-scaled.jpg\" alt=\"A therapist taking notes on a clipboard during a session\" class=\"wp-image-230\" style=\"width:100%;height:340px;object-fit:cover;object-position:center 40%;border-radius:22px 22px 0 0;display:block\" srcset=\"https:\/\/equilibriumpsychotherapy.net\/wp-content\/uploads\/2024\/06\/mid-shot-woman-therapist-taking-notes-clipboard-scaled.jpg 2560w, https:\/\/equilibriumpsychotherapy.net\/wp-content\/uploads\/2024\/06\/mid-shot-woman-therapist-taking-notes-clipboard-300x200.jpg 300w, https:\/\/equilibriumpsychotherapy.net\/wp-content\/uploads\/2024\/06\/mid-shot-woman-therapist-taking-notes-clipboard-1024x683.jpg 1024w, https:\/\/equilibriumpsychotherapy.net\/wp-content\/uploads\/2024\/06\/mid-shot-woman-therapist-taking-notes-clipboard-768x512.jpg 768w, https:\/\/equilibriumpsychotherapy.net\/wp-content\/uploads\/2024\/06\/mid-shot-woman-therapist-taking-notes-clipboard-1536x1025.jpg 1536w\" sizes=\"auto, (max-width: 2560px) 100vw, 2560px\" \/><\/div>\n<div hidden data-eq-related=\"2981,3006,2792\"><\/div>\n\n\n\n<div class=\"wp-block-group has-background eq-ondark has-global-padding is-layout-constrained wp-container-core-group-is-layout-f761ea3b wp-block-group-is-layout-constrained\" style=\"background-color:#3d2874;border-radius:0px 0px 22px 22px;margin-top:0;margin-bottom:80px;padding:52px\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#e8cf94;margin-top:0;margin-bottom:14px;font-size:12px;font-weight:700;letter-spacing:0.16em;line-height:1.4\">WORKING WITH THIS<\/p>\n\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"when-the-decision-is-harder-than-the-facts\" style=\"color:#ffffff;margin-top:0;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">When the decision is harder than the facts<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#ffffff;margin-top:0;margin-bottom:30px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.455), 18px);line-height:1.7\">Choosing what to use, living with a side effect nobody warned you about, or deciding whether you want children at all can weigh far more than the medical part of it suggests. Talking it over with someone, with good medical care alongside, can help the decision feel like your own. That's the part we can help with.<\/p>\n\n\n\n<div class=\"wp-block-buttons is-layout-flex wp-block-buttons-is-layout-flex\">\n<div class=\"wp-block-button\"><a class=\"wp-block-button__link has-text-color has-background has-work-sans-regular-font-family wp-element-button\" href=\"\/individual-session\/\" style=\"border-radius:9px;color:#2a2622;background-color:#faf8f3;padding:15px 30px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.284), 16.5px);font-weight:700\">Book a session<\/a><\/div>\n\n\n\n<div class=\"wp-block-button footer_b\"><a class=\"wp-block-button__link has-text-color has-work-sans-regular-font-family wp-element-button\" href=\"\/contact\/\" style=\"border-color:#e8cf94;border-width:1.5px;border-style:solid;border-radius:9px;color:#ffffff;padding:15px 30px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.284), 16.5px);font-weight:600\">Get in touch<\/a><\/div>\n<\/div>\n\n\n<\/div>\n\n\n<\/div>\n\n\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>How well each method really works, where in the body each one intervenes, what it does to bleeding, mood, weight and desire, the risks, what emergency contraception can and cannot do, plain answers to the questions people rarely ask out loud, where men come into it, and how to have the conversation<\/p>","protected":false},"author":2,"featured_media":3088,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"iawp_total_views":1112,"footnotes":""},"categories":[18,19,17],"tags":[],"class_list":["post-3041","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-too-afraid-to-ask","category-mens-health","category-womens-health"],"_links":{"self":[{"href":"https:\/\/equilibriumpsychotherapy.net\/hr\/wp-json\/wp\/v2\/posts\/3041","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/equilibriumpsychotherapy.net\/hr\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/equilibriumpsychotherapy.net\/hr\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/equilibriumpsychotherapy.net\/hr\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/equilibriumpsychotherapy.net\/hr\/wp-json\/wp\/v2\/comments?post=3041"}],"version-history":[{"count":20,"href":"https:\/\/equilibriumpsychotherapy.net\/hr\/wp-json\/wp\/v2\/posts\/3041\/revisions"}],"predecessor-version":[{"id":4775,"href":"https:\/\/equilibriumpsychotherapy.net\/hr\/wp-json\/wp\/v2\/posts\/3041\/revisions\/4775"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/equilibriumpsychotherapy.net\/hr\/wp-json\/wp\/v2\/media\/3088"}],"wp:attachment":[{"href":"https:\/\/equilibriumpsychotherapy.net\/hr\/wp-json\/wp\/v2\/media?parent=3041"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/equilibriumpsychotherapy.net\/hr\/wp-json\/wp\/v2\/categories?post=3041"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/equilibriumpsychotherapy.net\/hr\/wp-json\/wp\/v2\/tags?post=3041"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}