All Contraceptive Methods – Which to Choose?

A few words about effectiveness

So is it possible to measure it somehow?

In determining which contraceptive method is most effective, it seems essential to familiarize yourself with statistics. Remember, however, that even they can be unreliable, so the key is to choose a contraceptive method that will make you certain that you are using it properly and correctly.

What is the Pearl Index?

It is also called the Pearl Index . It was created in 1932! It is used to determine the effectiveness of a given contraceptive method.

The Pearl Index is determined by multiplying the ratio of the number of unwanted pregnancies to the number of menstrual cycles by 1200 (i.e. the annual number of fertilizations per 100 people using the same contraceptive method). The lower the index, the greater its effectiveness and the lower the risk of pregnancy.

It should be noted, however, that all of this mathematical operation applies to a given group from a specific population. The Pearl Index is influenced by, among other things, the culture being studied, demographics, and instructional technology, which is why it arouses much controversy.

In publications we usually deal with two types of Pearl Index:

• the first includes all pregnancies and cycles taken into account when calculating the effectiveness of the method;
• the second concerns those pregnancies that occurred despite perfect use of a given contraceptive method (or those cycles during which this use was correct).

It is generally accepted that the most effective methods of contraception according to the Pearl Index are the contraceptive implant, the intrauterine coil and oral hormonal contraception. The less effective ones include, among others, natural methods of contraception. This is due to the many variables and rigid rules of their use, which are sometimes beyond our full control (for example, during an infection, in the case of lack of adequate sleep, and the like).

Remember that the only "method" that will give you 100% certainty that you will not get pregnant is... abstinence . For people without a regular partner, double protection may be valuable : for example, oral contraceptives + a condom, which protects against sexually transmitted diseases. It all depends on your needs - for many people, sex is an important and necessary part of life that gives a lot of pleasure and fulfillment, while others do not feel the need for intercourse. Both are okay! The most important thing is to listen to yourself and take care of your well-being and safety. And we are here to guide you a little in this strategy :)

Below I present to you all the contraceptive methods available in Poland. At the same time, I will encourage you to look at our other articles, in which we develop selected topics.

Mechanical methods of contraception

Mechanical methods aim to create a barrier that prevents sperm from reaching the egg.

Male condoms

In this text we focus more on female options, but it is impossible to mention what seems to me to be the most popular and most accessible one for men.

The popularity of condoms is pleasing – first, because they are relatively cheap, and second, because they are highly effective. In addition, in addition to protecting against unwanted pregnancy, condoms also protect against sexually transmitted diseases. The ease of using condoms and the lack of the need to “commit” yourself, as in methods that require good organization and meticulousness (pills), are also encouraging.

Female condoms

Female condoms are made of polyurethane, thin, loose and transparent.

In appearance, such a condom resembles a long bag (some even call it a second vagina ). Its application is facilitated by two rings (inner and outer), although the process of putting it on is rather uncomfortable. Remember that when choosing a female condom, you should not use its male counterpart at the same time. In such a situation, condoms can slip off or break!

Their undoubted advantage is the lack of interference with the body's hormonal balance and coagulation system. Like male condoms, they protect against sexually transmitted diseases.

You can learn more about female condoms in the article here .

Does the use of lubricants affect the effectiveness and durability of condoms?

Gels created on the basis of various types of oils can cause micro-damage to the latex, and as a further consequence – the rupture of the condom. When choosing a product, be sure to look at its composition!

With or without a condom, solo or in a duet – check out what our intimate gel can do!

Diaphragm

It is also called a cervical cap – it is a round dome made of soft, thin silicone. It is placed in the vagina before sexual intercourse. It covers the cervix, which cuts off the path of sperm and prevents fertilization of the egg.

Hormonal contraception

Contraceptive pills

Birth control pills contain synthetic hormone equivalents. Their purpose is of course to block ovulation (changes in the endometrium and cervical mucus).

When it comes to contraceptive pills, there are two types:

• Single-ingredient pills – also known as mini-pills. As the name suggests, they contain a low concentration of one hormone (progestogen, or synthetic progesterone). However, this does not mean that they are less effective than the two-ingredient preparations listed below. When taking them, you should expect a high time rigor and the need to take the medication at a specific time. Importantly, they can be taken by breastfeeding people!
• Two-component pills – they contain two synthetic equivalents of hormones (estrogen and progestogen).

Many people wonder what to do if they inadvertently miss a dose of the drug. In such a case, they should take the missed pill in the 12-hour window and swallow the next one at the standard time.

You can read more about this topic in the articles: Birth control pills and your period and Birth control pills and libido .

Contraceptive patches

They have been available in Poland since 2004 – I remember when I was a child wondering why the stars from covers and TV had wounds at the same time and in the same place on their arm ;)

Contrary to my childhood fantasy, the contraceptive patch is a form of safe, transdermal (transdermal) contraception. In Poland, there is currently one preparation available – Evra . Using contraceptive patches is safe for the body.

Contraceptive patches contain the same ingredients as combined contraceptive pills.

Contraceptive rings

You will also find it under other names: vaginal ring, contraceptive ring, contraceptive ring.

Vaginal rings contain two active ingredients (two synthetic hormones) that are released in the vagina and absorbed by its epithelium over a period of 3 weeks (after which the ring should be removed). It should be inserted on the first day of the cycle (i.e. the first day of menstruation). It is soft and flexible, and many people compare its application to placing a tampon inside the vagina .

Contraceptive injections

Contraceptive injections are administered intramuscularly (in the buttock or arm) once every 3 months. This is undoubtedly attractive to those who do not like the rigor and discipline necessary for taking the pill. However, there is a downside: in the event of poor tolerance of the injection, the contraceptive effect cannot be reversed for the aforementioned 3 months.

The contraceptive injection contains one hormone (progestogen), which makes it also suitable for breastfeeding women.

Hormonal contraception is described in all its breadth and glory in an article dedicated to it – drop by to learn all its secrets! 

Long-term contraception

That is, the so-called LARC – long-acting reversible contraception .

Intrauterine device

Also known as: contraceptive coil, hormonal device, intrauterine device.

This contraceptive method involves placing (by a specialist!) an insert (interchangeably called a spiral due to its shape ) inside the vagina. It is shaped like the letter T (for those curious: a round, non-hormonal version is also available on the market!). It has a thin wire or string attached to it, which, after insertion, is located at the level of the cervix.

There are several types of contraceptive coils:

• Hormonal – has the highest effectiveness among these contraceptive methods; it has a “reservoir” with a trace amount of progestogen, which is gradually released into the body. It can be used during breastfeeding , but after 6 weeks of postpartum.
• Copper - copper has a strong spermicidal effect, which is why this type of coil has such a coating. Does not contain hormones!
• Neutral – as the name suggests, these IUDs are made of materials that are neutral to the body (for example, polyvinyl chloride). They prevent the egg from implanting in the uterus, but they are considered the least effective of the IUDs.

Contraceptive implant

It is a small, plastic rod implanted directly under the skin, which gradually releases the progestogen contained in it. In addition to its long duration of action (depending on the type, even from 3 to 5 years), its undoubted advantage is its effectiveness, convenience of use and lack of numerous side effects (which is related to the lack of estrogens, to which most of the undesirable symptoms are attributed). However, this does not mean that contraceptive implants are a 100% ideal method - your body itself will give you a sign of what is optimal for it.

Once the contraceptive implant is removed, fertility returns with the next menstrual cycle.

Permanent methods

This is the so-called surgical sterilization.

Vasectomy

The permanent method of contraception available to people with penises is vasectomy , which is the cutting and tying of the spermatic cords (sperm is still produced, however). I put special emphasis on the word available – because unfortunately, the alternative for people with uteruses is currently illegal in Poland. Read our article on the legality of vasectomy and tubal ligation in Poland.

Tubal ligation

The goal is to block them so that the released egg cannot move to the uterus. There are various ways to stop the patency of the fallopian tubes (including inserting a coil into the fallopian tube, which over time becomes overgrown with muscle tissue, tying the fallopian tubes during a laparoscopic procedure, or cutting them out).

This type of contraception in Poland is controversial, mainly due to Polish law provisions suggesting that a doctor who performs a tubal ligation procedure may be detained by law enforcement agencies under Article 156 of the Penal Code. The exceptions are health implications and clinical indications for its performance.

Natural methods

Many people decide to use them, among other things, because of religious beliefs, aversion to taking pharmaceuticals or a feeling of discomfort when using condoms. As you can see – there are always options :) The ones I mention below require real meticulousness and are therefore among the most unreliable. I am presenting them to you in a telegraphic summary – you will find more information in the text by our friendly gynecologist Karolina .

Calendar

We observe cycles, identify the dayof ovulation and once or twice mark when the fertile days will fall, during which of course we refrain from intercourse. If only it were that simple... ;) People who menstruate know very well how unstable the menstrual cycle is. Even a trivial cold can disrupt its rhythm and lengthen or shorten it. For this reason, using only a calendar to control fertility may prove ineffective.

Thermal method

It involves daily monitoring of body temperature – as we wrote (for example) here, after ovulation it can increase by about half a degree Celsius. The measurement is taken orally or vaginally (always from the same place) immediately after waking up. It is important that such monitoring is preceded by at least 6 hours of sleep. The body must also be healthy – any kind of cold or taking certain medications can affect the temperature, which in the case of trying to “catch” ovulation can falsify the result.

The Billings Method…

…based on the observation of cervical mucus .

So we are trying to track ovulation again – during ovulation, the mucus is watery and stretchy and appears in greater quantity than usual (the aim is to create the best possible conditions for the traveling sperm). Later, we are dealing with white and thick “infertile” mucus, impossible for sperm to overcome. Sometimes it happens that on infertile days there is no cervical mucus at all, which can also be a clue.

I am a big advocate of observing your body in general, because it allows us to detect not only various natural processes, but also possible anomalies in the body, remember that!

Symptom-thermal method

This is an extension of the previous methods – the body temperature, mucus, general well-being and the cervix are monitored, which also changes during the cycle, which can be palpated during self-examination (on infertile days it is hard, on fertile days it is soft and located in the axis of the birth canal).

When choosing natural methods of contraception, the greatest effectiveness can be achieved by using them together. This is also a good method to implement the habit of observing the changes that occur in our body during the menstrual cycle.

Chemical methods of contraception…

…that is, those that use spermicides in their composition. Let's take a look at them!

The purpose of spermicides is to damage the cell membrane of sperm, preventing them from moving. Spermicides are a component of many products, such as selected condoms, gels or spermicidal foams. Some of the most popular (and at the same time the cheapest and most widely available - because on the pharmacy shelf) are:

Contraceptive pills

The suppository should be placed in the vagina a dozen or so minutes before planned intercourse so that it can dissolve completely (which takes a comparable amount of time). The spermicide retains its properties for about an hour, so if full ejaculation has not occurred during this time, another suppository should be inserted.

For greater protection, it is worth combining pills and mechanical methods of contraception (for example condoms).

Vaginal sponge

The contraceptive sponge is made of soft polyurethane foam. It basically combines two methods of contraception - mechanical (however, it does not protect against infection with sexually transmitted diseases) and chemical, because it has been soaked in spermicide. It is placed deep, so that it covers the cervix. The vaginal muscles hold the sponge in one place, so you should not be afraid of it moving, what's more - after correct insertion it is imperceptible to partners during intercourse. The sponge has a ribbon, which works on the same principle as the string in a tampon and allows it to be removed after intercourse.

Emergency contraception

Otherwise known as emergency contraception, it prevents pregnancy after unprotected sexual intercourse.

Morning-after pill

It is most effective when taken within 24 hours of unprotected intercourse, regardless of the day of the cycle – this is irrelevant in this case. The pill is designed to prevent the release of an egg into the fallopian tubes and its implantation in the endometrium – remember that sperm can survive in the reproductive tract for up to several days!

The following emergency contraceptive pills are available on the market:

• Escapelle – is used for up to 72 hours after unprotected sexual intercourse. It contains levonorgestel , which prevents the cells of the uterine lining from multiplying and prevents the embryo from implanting.
• EllaOne – its main ingredient is ulipristal acetate , which delays ovulation and thus makes fertilization more difficult. The pill should be taken within 120 hours (5 days) of intercourse.

Emergency contraception is safe – the hormones it contains do not stay in the body as long as standard pills. In Poland, emergency hormonal contraception requires a prescription, but like abortion, it is a subject of nationwide discourse.

You can read more about the effectiveness and availability of the morning-after pill here .

Which contraceptive method should I choose?

Contraception is not only a way to plan a family and prevent unwanted pregnancies. In the case of selected methods, it is also protection against sexually transmitted diseases. It is also sometimes used as a form of treatment for menstrual disorders. Therefore, a responsible approach to the subject is extremely important – full of openness, conversation and substantive information that can be obtained from a specialist.

A gynecologist is always happy to answer any questions you may have and present the pros and cons of each method of preventing pregnancy. Remember that when choosing, your general health and the results of check-ups, as well as your preferences and needs, are important. Talk to your partner, do some research and present any concerns to a specialist who will present you with both the benefits and possible side effects.

If you are worried about an unplanned pregnancy, using contraception should give you more freedom and mental ease, and therefore – have a positive impact on the quality of your sexual life. This is also important!

Myths about contraception

After reviewing the numerous fertility control methods available, it's time to deal with the most popular myths about them.

If you decide to use contraception, you must do it consciously, understanding the essence of the method. Uncle Google, with all due respect, unfortunately – does not know everything ;)

Withdrawal sex is NOT a method of contraception!

Most of these unwanted pregnancies result from the false belief in the correctness of this method.

Withdrawal coitus involves the partner withdrawing the penis from the vagina just before the semen ejaculates into the vagina. During intercourse, however, pre-ejaculate (a natural lubricant) is released, which contains sperm.

Does taking birth control pills cause weight gain?

You may come across this statement quite often – many people are skeptical about hormonal methods of preventing pregnancy, fearing the change in body appearance. But is there anything to be afraid of?

It happens that after starting to take birth control pills, your weight may increase by a few kilograms - however, this is related to water retention in the body, not fat storage. If this effect lasts longer - you simply need a change of hormones (i.e. another, replacement preparation).

Hormonal methods should not be used chronically.

Some people are convinced that it is right to stop taking pills for a while, for example, to check their cycles and the health of their body. However, this turns out to be unnecessary and groundless, and what's more - it disrupts the body even more. Even if a given form of hormonal contraception changes your cycles, you don't have to worry about problems with getting pregnant after stopping it. However, don't forget about check-ups every year!

Remember, we are here for you! In addition to the articles on YOU KNOW, we also have our own Facebook group #mensTRUEacja by Your KAYA . If you feel like you need support or have additional questions (not only about contraception methods!), feel free to share your concerns there. We stick together! <3