Sexual Health

Looking after your sexual health is just as important as looking after your physical and emotional health. Ensuring that you are in a safe and healthy relationship is one aspect of sexual health and the other is protecting yourself from any risks associated with unsafe sex, such as unplanned pregnancy or sexually transmitted infections (STIs). This section explores the different types of contraception available and information about STIs.

STIs

Information has been taken from the NHS Choices website. For more detailed information, please visit www.nhs.uk.

Chlamydia

What is it?

Chlamydia is a bacterial infection and one of the most common STIs in the UK, especially among teenagers. In 2013, almost 7 out of 10 people testing positive for chlamydia were under 25 years old. Chlamydia can sometimes present with no symptoms but if you suspect that you have it, get tested as soon as possible. If left untreated, the infection can spread to other parts of the body causing to health issues like pelvic inflammatory disease (PID), infertility and for males, inflammation of the testicles. Chlamydia can also be passed to the unborn baby during pregnancy. This could mean that the baby is born with conjunctivitis (an eye infection) or pneumonia (a lung infection). There is also a risk of premature birth (before 37 weeks), miscarriage or stillbirth.

How do you catch it?

You can contract chlamydia through unprotected vaginal, anal or oral sex. You can even catch the infection through close contact with your sexual partner's genitals or sharing sex toys.

What are the symptoms?

Some men/women will suffer with mild symptoms which disappear after several days; some people will get no symptoms at all. Even if you have no symptoms, you may still have the infection so it is always best to get tested if you suspect you might have chlamydia.

Men:

  • A white, cloudy or watery discharge from the penis
  • Pain when peeing
  • Pain in the testicles

Women:

  • A change in vaginal discharge
  • Pain when peeing
  • Abdominal pain
  • Pain during sex
  • Bleeding after sex
  • Bleeding in between periods
  • Heavy periods

What should I do if I have it?

If you suspect you might have chlamydia, get yourself tested and treated as soon as you can. You can get tested for chlamydia at a genitourinary medicine (GUM) clinic or GP surgery. If you are aged 15 - 24, you can go to www.areyougettingit.com and order a free chlamydia test. You will be sent the test kit in plain cardboard packaging and it is easy enough to do yourself at home. Just simply collect a urine sample, fill in your details and post back in the envelope provided. You can choose whether you want to receive your results by letter or by text. If you test positive, someone will contact you to arrange your treatment.

How is it treated?

Chlamydia is treated using antibiotics and you will either be given tablets to take in one day or a course of antibiotics to be taken over a week. It is advised that you inform any sexual partners from the past six months so that they can get tested too. You shouldn't have sex until the course of treatment is finished.

How can I prevent it?

  • Use a condom when having vaginal or anal sex
  • Do not share sex toys
  • Use protection whilst having oral sex; use a condom to cover the penis or a dam to cover female genitals

Gonorrhoea

What is it?

Also known as 'the clap', gonorrhoea is a bacterial infection. Similarly to chlamydia, gonorrhoea can present without any symptoms so there is a risk of not knowing that you have the infection. If left untreated, it can lead to infertility in both men and women or pelvic inflammatory disease in women.

How do you catch it?

Gonorrhoea is passed from person to person through their sexual fluid during vaginal, anal or oral sex. Anyone can contract the infection but people who don't use a condom or who change their sexual partners frequently are more at risk. It can also be passed to an unborn baby during pregnancy.

What are the symptoms?

Gonorrhoea can affect the cervix, urethra, rectum (the final section of the last intestine before the anus) and sometimes the throat and eyes. Symptoms include:

  • Pain when peeing
  • Bleeding between periods
  • A thick green / yellow discharge from the vagina or penis

However, some people will not have any symptoms at all.

What should I do if I have it?

If you suspect you might have gonorrhoea, get yourself tested and treated as soon as you can. You can get tested at a genitourinary medicine (GUM) clinic or GP surgery.

How is it treated?

Gonorrhoea is treated with an antibiotic injection and one antibiotic tablet. Symptoms should improve within a few days but it is important that you don't have sex while being treated. Another test will be offered one to two weeks later to make sure that the infection has gone.

How can I prevent it?

  • Use a condom when having vaginal or anal sex
  • Do not share sex toys
  • Use protection whilst having oral sex; use a condom to cover the penis or a dam to cover female genitals

Genital Herpes

What is it?

Genital herpes is a long term condition, caused by the herpes simplex virus. Once you have herpes, the virus lays dormant in the nerve cell and further outbreaks can occur. During the first two years it is likely that someone will suffer with four to five outbreaks, however, the outbreaks tend to become less frequent and less severe over time.

How do you catch it?

Herpes is highly contagious and easily passed from one person to another. The virus can be passed through direct genital contact but a person can also contract herpes if they receive oral sex from someone who has a cold sore in their mouth. Recurrent outbreaks can be brought on by a variety of factors such as stress, excessive drinking, being unwell, having a weakened immune system or after surgery.

What are the symptoms?

Symptoms can appear 4 - 7 days after becoming infected but some people might not realise they have the condition as symptoms can sometimes take months to come out. Symptoms will be at their worst during the first (primary) infection.

Symptoms for the primary infection:

  • Small blisters which burst and become open sores. These blisters appear around the genitals, anus and can spread over the surrounding skin on the bottom or thighs.
  • Blisters or ulcers on the cervix (women)
  • Pain when peeing
  • Flu like symptoms
  • Vaginal discharge (women)

Once the primary infection clears up, the virus lays dormant in the body but can flare up again. Symptoms for recurrent infections are:

  • Tingling, burning or itching sensation on genitals, or even in the leg, before an outbreak of blisters, which then become open sores again
  • Blisters and ulcers on the cervix

What should I do if I have it?

If you suspect that you have genital herpes you should see your GP or visit a GUM clinic as soon as possible. If you are pregnant, you will be referred for specialist treatment as the virus can be passed to your unborn baby. If you experience regular outbreaks of herpes, you may be tested for HIV. Recurrent episodes could be caused by a weakened immune system which could be a result of an HIV infection. This is not always the case but it may be worth being tested for peace of mind.

How is it treated?

The sores will eventually heal by themselves but antiviral medication can be prescribed to treat genital herpes. Five tablets are taken per day for a course of five days but can cause side effects such as vomiting and headaches. For mild episodes, self-soothing techniques are recommended such as wrapping an ice pack in a flannel and placing it on the blisters (do not share flannels or towels as this can spread the infection), cleaning the area with salt water, drinking lots of fluids or applying Vaseline to the affected area to ease the pain when urinating.

Someone who has six or less recurrent episodes per year can be prescribed antivirals in the initial stages of the outbreak, when the skin is tingling before the blisters appear. This is called episodic treatment and prevents the virus from progressing into a full-blown episode.

Someone who has more than six recurrent episodes per year will be offered antiviral medication as part of a long term plan to prevent further outbreaks. This is called suppressive treatment.

How can I prevent it?

The risk of contracting genital herpes can be reduced by using a condom during vaginal or anal sex, a condom during oral sex on a man and a dam for oral sex on a woman. It is also advised to use a condom, even when symptoms have disappeared to protect other people from getting the virus.

Genital Warts (HPV)

What is it?

Genital warts are caused by the spread of the human papilloma virus (HPV), and are very common in the UK.

How do you catch it?

The virus can be spread by skin to skin contact during vaginal or anal sex, genital to genital contact or by sharing sex toys. It is also possible for warts to spread to a baby at birth.

What are the symptoms?

Warts are small growths or bumps on the skin. They are not usually painful but can cause the person psychological distress if they have them. They can become itchy and may bleed due to scratching. If they appear inside or close to the urethra (the tube which passes urine out of the body) it can be painful to pee. It can sometimes take months or years for the warts to appear. Warts can appear on the genitals, around or inside the anus, around or inside the urethra or on the upper thighs.

What should I do if I have it?

If you suspect that you have genital warts, you should seek advice from a GUM clinic or GP. If you current or previous sexual partner develops warts, you should get yourself checked too and find out what to do if they appear in the future.

How is it treated?

Treatment for genital warts is entirely different to treating warts on hands, for example, so specialist treatment should be sought. You may also be offered an STI check. Treatment could come in the form of creams or lotions, or you may be offered cryotherapy to freeze the warts. It is important that you do not have sex while being treated for genital warts. Despite the warts being treated, they might still come back in the future.

How can I prevent it?

Condoms are the most effective protection against STIs but can't guarantee protection from genital warts. This is because the skin around the condom may be infected so could come onto contact with the other person's skin or genitals. Female condoms may provide added protection as the have a larger area which can be used to cover the outside of the genitals. Condoms are still the safest option and dams can be used to prevent contact with the female genitals or the anus.

HIV and AIDs

What is it?

HIV is a virus which attacks the immune system meaning that the person is less able to fight illness. AIDS is the final stage of HIV when the body is no longer able to fight infection and disease.

How do you catch it?

HIV is spread through oral, vaginal and anal sex and through sharing sex toys. HIV can be spread from a mother to her child during pregnancy, childbirth and breastfeeding. It can also be spread through sharing needles.

What are the symptoms?

Symptoms usually appear two to six weeks after contracting the infection. The first sign is usually a rash and flu-like symptoms:

  • Sore throat
  • Fever
  • Tiredness
  • Painful joints and muscles

These symptoms last from one to two weeks. After the initial symptoms, the person usually won't have any health issues for many years but during that time, the virus will attack and cause damage to the immune system. This can take about ten years and during this time, the person may fell completely well.

Once the immune system has become damaged, a person with HIV may suffer from the following symptoms:

  • Serious, life-threatening illnesses which will be difficult to recover from
  • Weight loss
  • Chronic diarrhoea
  • Night sweats
  • Skin problems

These symptoms can be prevented with an early diagnosis.

What should I do if I have it?

If you suspect that you have HIV or might have been in contact with the virus, you should see your GP or local GUM clinic and get tested. A blood test is required in order to diagnose HIV.

How is it treated?

There is no cure for HIV but there are treatments which enable people with the virus to live long and healthy lives.

Emergency HIV Treatment

Emergency treatment is a way of preventing the virus from infecting the person, if it is caught early enough. You can access emergency medication within 72 hours if you think you have been in contact with the virus. The earlier it's treated, the more effective the results. Treatment lasts one month and the side effects are serious. There is also no guarantee that the treatment will be successful in treating and killing the virus.

Combination Therapy / Antiretroviral Therapy

If a person has contracted HIV, they will be treated using a combination of antiretroviral drugs to try to prevent the virus from becoming resistant to a single type of drug. Antiretroviral drugs work by preventing the virus from replicating itself, giving the body a chance to repair the damage caused by HIV. Antiretroviral drugs can also prevent the virus from spreading to an unborn baby. A person will usually have to continue with drug treatment for the rest of their life.

How can I prevent it?

You can prevent HIV by using protection while having oral, vaginal or anal sex and not sharing sex toys. If injecting equipment is being used, needles and other equipment should be sterile and not shared with other people.

Syphillis

What is it?

Syphillis is a bacterial infection and has very serious consequences for health if it is not diagnosed and treated in time.

How do you catch it?

Syphillis can be passed from one person to another by having unprotected vaginal, oral and anal sex. It can also be spread by sharing needles. If syphilis is not treated, it can be passed onto an unborn baby causing health issues, miscarriage or causing the baby to be stillborn.

What are the symptoms?

There are three stages of the disease. If syphilis is untreated and reaches the third stage, it can cause severe damage to health and can lead to death. Fortunately this is rare in the UK and syphilis is generally treated before it becomes too severe.

Primary syphilis symptoms (first stage):

  • A highly infectious sore on the genitals or anus
  • Occasionally the sores can appear on the mouth, fingers or buttocks

The sore appears within ten days to three months of contracting the infection. It is not usually painful and will disappear within two to six weeks.

Secondary syphilis symptoms (second stage):

The secondary symptoms of syphilis last for a few weeks or may come and go over a period of a few months. Symptoms include:

  • Skin rash
  • Sore throat
  • Flu-like symptoms
  • Weight loss
  • Skin growths on the genitals or anus
  • Patchy hair loss

Between the secondary and tertiary stages of the infection, there is a latent phase where symptoms may disappear, sometimes for several years or even decades. The infection can still be passed on during this stage and there is the risk of the person assuming that the infection has cleared up and not being treated for it. However, the third stage of syphilis is dangerous to the body.

Tertiary syphilis symptoms (third stage):

Tertiary stage syphilis is rare in the UK but at this stage there is a risk of developing some serious health issues including:

  • Stroke
  • Dementia
  • Paralysis
  • Blindness
  • Deafness
  • Numbness
  • Rashes
  • Loss of co-ordination
  • Heart disease

Tertiary stage syphilis can also lead to death.

What should I do if I have it?

If you suspect that you have syphilis you should see your GP or GUM clinic as soon as possible. If the infection is diagnosed in the first or second stage, there is a greater chance of successful treatment before the infection causes damage to the body.

How is it treated?

If the infection is diagnosed in the primary or secondary stage, syphilis can be treated with a course of antibiotics. Treatment usually lasts two weeks. If diagnosed in the tertiary stage, longer courses of antibiotics are required and sometimes intravenous (IV) treatment (treatment directly into a vein). Damage to the body in the third stage, however, is irreversible.

How can I prevent it?

You can protect yourself from catching syphilis by not sharing sex toys and by using condoms during vaginal, oral or anal sex and dams for contact with female genitals or the anus.

Pubic Lice (crabs)

What is it?

Pubic lice are tiny insects, that look like crabs, who live on course body hair such as pubic hair. They can also live on underarm hair, chest hair, in beards and even on eyebrows and eyelashes. Pubic lice crawl from one person to another but can't jump, fly or swim. The lice can grow up to 2mm and are red or yellowy grey in colour. An infestation can spread quickly if left untreated. The lifespan of a louse is one to three months. A female can lay up to 300 eggs, which will hatch in six to ten days, and then reproduce again within three weeks of hatching.

How do you catch it?

Pubic lice can be spread through close physical contact, especially sexual contact. Lice can also be spread on clothing, towels and bed linen.

What are the symptoms?

Symptoms of pubic lice may not appear for several weeks. Symptoms include:

  • Itching leading to irritation where scratching occurs
  • Black powder in underwear
  • Blue spots on the skin caused by bites
  • Tiny blood spots on the skin or underwear, caused by bites

What should I do if I have it?

If you suspect you have pubic lice, you should visit the GUM clinic or GP surgery as soon as possible. You will also be offered an STI check up to ensure you have no other infections.

How is it treated?

Treatment for lice comes in the form of a specialist shampoo, lotion or cream but some lice can develop a resistance to certain treatments so another should be used if the infestation doesn't clear up. If the lice are in the eyelashes, an eye ointment will be prescribed. It is advised that current sexual partners should be checked, as well as other members of the household as the lice can spread on materials.

How can I prevent it?

Pubic lice can't be prevented by condoms. If someone in the household has pubic lice, bedding and towels should not be shared and should be washed on at least a 50 degree wash.

Trichomoniasis

What is it?

Trichomoniasis is caused by a tiny parasite which infects the vagina and urethra in women and the urethra, head of the penis and prostate gland in men.

How do you catch it?

Trichomoniasis is spread through unprotected sex, sharing sex toys and can also be spread from sharing towels and underwear.

What are the symptoms?

Symptoms develop within one month of becoming infected however, up to half of those infected will show no symptoms at all.

What should I do if I have it?

If you think you have Trichomoniasis you should see your GP or GUM clinic as soon as possible. If the infection is left untreated it can make someone more vulnerable to other STIs. It can also cause complications in pregnancy such as premature birth and a baby with a low birth weight.

How is it treated?

Trichomoniasis is treated with a course of antibiotics. You should avoid having sex during treatment to avoid infecting other people of becoming re-infected yourself.

How can I prevent it?

You can prevent Trichomoniasis by not sharing sex toys and by using condoms during vaginal and anal sex. For women having sex with other women, a dam should be used.

Bacterial Vaginosis

What is it?

Bacterial vaginosis is an imbalance of bacteria in the vagina. It is a condition which affects women and there is no evidence that it affects men although there is some debate as to whether men can be carriers of the infection. It is not generally serious for many women but it may cause issues in pregnancy if symptoms are present. BV may increase the risk of miscarriage or premature birth in women who have a history of these complications.

How do you catch it?

Bacterial vaginosis isn't strictly considered an STI as it doesn't get passed to men. However, some studies have shown that women can pass it to other women through sexual contact and studies have also found lower rates of BV in women who use condoms and higher rates in women who change their sexual partners frequently, indicating that it may be possible to be passed through sex and sexual contact.

What are the symptoms?

Symptoms of bacterial vaginosis are:

  • A thin, greyish discharge
  • Unpleasant, fishy smell from the vagina
  • An unpleasant smell after sex

What should I do if I have it?

If you think you have bacterial vaginosis, you should visit your GP or GUM clinic as soon as you can, especially if you are pregnant. You will be tested for other STIs to rule out other infections such as gonorrhoea and chlamydia, as they may have similar symptoms.

How is it treated?

BV is treated with antibiotics and/or a cream which is applied inside the vagina. This is known as vaginal pH correction treatment and will make it more difficult for harmful bacteria to survive there.

How can I prevent it?

It is difficult to recommend how to prevent BV as it's causes are largely unknown. However, it has been found that women are more at risk of contracting the infection if they do things which upset the balance of bacteria in the vagina such as:

  • Vaginal douching
  • Using scented soaps and bubble bath
  • Using strong washing detergents for underwear
  • Using vaginal deodorants
  • Having lots of sexual partners

If you need advice around sexually transmitted infections, visit your local pharmacy, GUM clinic or your GP. Always use protection with new sexual partners to prevent STIs and get yourself checked regularly. It is everyone's responsibility to carry protection, don't assume that the other person will.

Contraception

Male Condom

The male condom is a disposable sheath that covers the penis. It is made of latex (although latex-free condoms are available) and works to prevent sperm from reaching the sexual partner protecting against unplanned pregnancy and the transmission of STIs.

Pros:

  • If used correctly, male condoms are 98% effective
  • Condoms are effective in protecting against STIs
  • Easy to use
  • There are no serious health risks associated with condom use
  • They are easy to get hold of

Cons:

  • Applying a condom can interrupt sex
  • It's possible for a condom to slip off during sex
  • Condoms can sometimes become damaged, especially if oil-based lubricants are used
  • Some people might be allergic to the latex or spermicide on condoms

Female Condom

The female condom is made from soft, thin plastic called polyurethane and is worn inside the vagina to prevent sperm from getting to the womb. It can be inserted up to eight hours before sex. The penis should go into the condom and not slip down the side in between the condom and the vaginal wall.

Pros:

  • It doesn't always interrupt sex if the condom has been inserted beforehand
  • The female condom is 95% effective in protecting against unplanned pregnancy and transmission of STIs
  • There are no serious health risks associated with condom use

Cons:

  • Female condoms aren't as easily accessible and are more expensive than male condoms
  • There's a risk of unplanned pregnancy or contracting an STI if the penis enters between the condom and the vaginal wall
  • The condom can be damaged by sharp nails or jewellery
  • The condom can sometimes be pushed too far into the vagina, causing it to be less effective

Intrauterine System (IUS)

The IUS is a small T-shaped plastic device which is inserted into the womb by a professional. It releases a hormone called progestogen into the womb which thickens the mucus at the neck of the womb to prevent the sperm reaching an egg and also thins the womb lining so that, if an egg becomes fertilised, there is less chance of implantation. For some women, it might also stop the ovaries from ovulating (releasing an egg). The IUS can protect against pregnancy for three to five years, depending on the type used.

Pros:

  • It's more than 99% effective in protecting against pregnancy
  • It is long-lasting so you don't need to worry about it
  • The IUD can be removed at any time by a professional and fertility will quickly return to normal
  • Using this form of contraception doesn't interrupt sex
  • It might make your periods lighter or shorter or they might stop completely

Cons:

  • There's a risk of infection when the IUS is inserted
  • It does not protect against STIs
  • It can be uncomfortable when inserted
  • In rare cases it can cause damage to the womb
  • There is a risk that the womb might reject the IUD so it could move out of place, therefore, being less effective

Intrauterine Device (IUD)

The IUD is a small T-shaped device which made from plastic and copper. It is inserted into the womb by a professional and prevents the sperm and egg from surviving inside the fallopian tubes. It might also prevent an egg from implanting into the lining of the womb. Depending on which variety you use, the IUD can protect against pregnancy for five to ten years.

Pros:

  • It's more than 99% effective in protecting against pregnancy
  • It is long-lasting so you don't need to worry about it
  • The IUD can be removed at any time by a professional and fertility will quickly return to normal
  • Using this form of contraception doesn't interrupt sex
  • It is not affected by any medicines

Cons:

  • It can affect your periods by making them heavier, painful or longer but this is usually for the first three to six months
  • There is a risk of infection in the early stages when it is first inserted
  • It does not protect against STIs
  • It can be uncomfortable when inserted
  • In rare cases it can cause damage to the womb
  • There is a risk that the womb might reject the IUD so it could move out of place, therefore, being less effective

Contraceptive Injection

The contraceptive injection contains progestogen which thickens the mucus at the neck of the womb to prevent the sperm reaching an egg and also thins the womb lining so that, if an egg becomes fertilised, there is less chance of implantation. There are three types of injection, one which lasts eight weeks, one which lasts twelve weeks and one which lasts for thirteen weeks.

Pros:

  • You don't have to worry about it as the injection lasts for weeks at a time
  • Using this form of contraception doesn't interrupt sex
  • The injection isn't affected by any medication
  • It is safe to use when breastfeeding

Cons:

  • Periods can change becoming longer, irregular or by stopping completely
  • Once the protection wears off, it can take up to a year for fertility to return to normal
  • One of the varieties of injection can cause thinning of the bones
  • It does not protect against STIs
  • It could cause you to gain weight

Implant

The contraceptive implant is a small tube which is inserted under the skin on the upper arm and protects against pregnancy for three years. The implant slowly releases progestogen into the body which thickens the mucus at the neck of the womb to prevent the sperm reaching an egg and also thins the womb lining so that, if an egg becomes fertilised, there is less chance of implantation.

Pros:

  • The implant lasts for three years so you don't have to worry about it
  • It can be removed at any time and your fertility will quickly return to normal
  • If the implant has been inserted correctly by a professional, it more than 99% effective at preventing pregnancy
  • Periods can become lighter or sometimes stop completely
  • Using this form of contraception doesn't interrupt sex

Cons:

  • During the first year of having the implant in, periods can become lighter, heavier, irregular or more frequent
  • Some people might forget to have it removed after three years so there's a risk of becoming pregnant (usually you will be given a card to keep in your purse which will have the expiry date on it)
  • It does not protect against STIs

Female Sterilisation

Female sterilisation is a surgical procedure performed under general anaesthetic. It involves blocking or sealing the fallopian tubes meaning that eggs can't pass through the tube to become fertilised by sperm.

Pros:

  • You don't have to worry about using contraception
  • It can be more than 99% effective against pregnancy
  • Sterilisation will not affect your sex drive or hormone levels
  • It doesn't interrupt sex

Cons:

  • Female sterilisation is difficult to reverse so you have to be sure that you are happy with the decision that you won't become pregnant any time in the future (reversal is sometimes possible but will rarely be funded through the NHS)
  • There are risks associated with having surgery such as infection or internal bleeding
  • It doesn't protect against STIs
  • You will still have periods even after sterilisation

Male Sterilisation or Vasectomy

Male sterilisation involves cutting, blocking or sealing the tubes between the testicles and the penis, meaning that sperm will not reach the semen (the fluid ejaculated during sex). Therefore a woman's egg will not be fertilised. A vasectomy is a minor operation which takes about 15 minutes.

Pros:

  • Male sterilisation is more than 99% effective at preventing pregnancy
  • It is long-term and you don't have to worry about using contraception
  • It doesn't affect your sex drive or hormone levels
  • It doesn't interrupt sex

Cons:

  • There is a small risk of infection as a result of the surgery
  • It doesn't protect against STIs
  • Reversing male sterilisation is difficult and rarely funded by the NHS
  • There are some risks associated with male sterilisation such as haematoma (blood clot in the scrotum), sperm granulomas sperm leaking from the cut tubes into the surrounding tissue, forming hard and often painful lumps), llong-term testicle pain or testicles feeling full, particularly in the first few weeks of having the procedure done.
  • In rare cases, the tubes can reconnect over time, meaning fertility returns and there's a risk of pregnancy again
  • The decision not to have any more children is a very big decision to make and might be upsetting in the future if circumstances change and you regret your decision

Contraceptive Patch

The contraceptive patch is a small sticky patch which releases hormones through the skin. It contains oestrogen and progesterone which prevent a woman's ovaries from ovulating (releasing an egg) and thickens the mucus in the neck of the womb, making it difficult for a sperm to reach an egg. The patch lasts for one week. You use the patches for three weeks and then have one week without a patch when you will usually have your period.

Pros:

  • If used correctly, the patch is more than 99% effective at preventing pregnancy
  • You will know when your period is going to happen each month
  • Using this form of contraception doesn't interrupt sex
  • You can wear the patch anywhere, even in the bath or shower
  • It can help if you have heavy or painful periods
  • It is easy to use
  • Reduces risk of cancer of the womb, ovaries and colon

Cons:

  • It does not protect against STIs
  • Some women are not able to use the contraceptive patch if they have a family history of certain illnesses or have suffered themselves (such as heart disease, cancer, blood clot)
  • The patch may not be suitable for breastfeeding mothers as it can affect milk flow
  • It can cause skin irritation
  • It can be visible to other people

Vaginal Ring

The vaginal ring is a small soft ring which is inserted into the vagina and releases the hormones oestrogen and progestogen. The hormones prevent the woman from ovulating and thicken the mucus in the neck of the womb, making it difficult for a sperm to reach an egg. They also thin the womb lining so that if an egg becomes fertilised, there is less chance of implantation. The ring should be inserted for 21 days then removed for 7 days, during which time you might have a period-type bleed. You are protected from pregnancy even during the ring-free week.

Pros:

  • It doesn't interrupt sex
  • You don't need to worry about contraception as you are already protected
  • Periods may become lighter
  • The vaginal ring is easy to insert and remove
  • If used correctly it is more the 99% effective in preventing pregnancy
  • It may prevent certain cancers such as ovarian, uterus and colon cancer

Cons:

  • It does not protect against STIs
  • Sometimes the ring can be felt by the woman or her male partner during sex
  • It may not be suitable if you feel uncomfortable about inserting and removing the ring

Combined Pill

The combined pill contains hormones, oestrogen and progesterone, which prevent a woman's ovaries from ovulating (releasing an egg) and thickens the mucus in the neck of the womb, making it difficult for a sperm to reach an egg. It also thins the womb lining so that, if an egg becomes fertilised, there is less chance of implantation. You need to take one pill every day for 21 days then stop taking it for 7 days. During these seven days, you will have a period, then you continue taking the pill for another 21 days and so on.

Pros:

  • The combined pill can help if you tend to have heavy or painful periods
  • If used correctly, the combined pill is over 99% effective
  • There is a very low risk of negative side effects or complications
  • You will know when your period is going to happen each month
  • Using this form of contraception doesn't interrupt sex
  • Reduces risk of cancer of the womb, ovaries and colon

Cons:

  • The pill has to be taken at the same time every day or you could become pregnant
  • It does not protect against STIs
  • Some women are not able to use the combined pill if they have a family history of certain illnesses or have suffered themselves (such as heart disease, cancer, blood clot)
  • The combined pill may not be suitable for breastfeeding mothers as it can affect milk flow

Progestogen-Only Pill (mini pill)

The mini pill contains progestogen which, similarly to the combined pill, thickens the mucus at the neck of the womb to prevent the sperm reaching an egg. Some varieties of the pill also stop the ovaries from releasing eggs. The mini pill is taken every day without a break.

Pros:

  • If used correctly, the mini pill is over 99% effective
  • It is safe for women who have a history of illness such as high blood pressure or heart disease
  • Generally the mini pill should be taken at the same time but it is still effective if you take it up to three hours late (or twelve hours late for some varieties)
  • Using this form of contraception doesn't interrupt sex
  • It is safe to use while breastfeeding

Cons:

  • The mini pill can make periods lighter but can also make them irregular or more frequent
  • It does not protect against STIs
  • The mini pill is less effective if antibiotics are being taken at the same time

Diaphragm

The diaphragm is a reusable cap which is inserted before sex and covers the opening of the cervix. It must be used with spermicide and left in the vagina for six hours after sex to ensure that no sperm are able to enter the womb. The cap can then be removed and washed. The diaphragm is 92 - 96% effective in protecting against unplanned pregnancy.

Pros:

  • There are no serious health risks
  • You can insert the diaphragm several hours before sex
  • There is more control with this type of contraception

Cons:

  • The diaphragm is fairly effective but there is still a risk of pregnancy
  • There is a risk of developing cystitis with diaphragm use (a painful bladder infection)
  • It doesn't protect against STIs
  • Using a diaphragm can interrupt sex
  • It's not as easy to use at first, unlike some other forms of contraception

C-Card

If you are between 13 and 24 years old and living in Norfolk or Waveney, you can get access to sexual health information and free condoms and lubricant with a c-card. There are many youth workers registered to provide the c-card service and you can get them in most pharmacies too. For information on c-card providers in your area, go to www.areyougettingit.com and search using your town or postcode.

C-card is confidential and non-judgemental. The appointment will be in a private place so other people won't hear your conversation and the only information you need to give is your date of birth and the first part of your postcode. You should feel comfortable enough to ask the practitioner any questions you have or discuss any worries. On your first visit, you will have a discussion around sexual health and then the practitioner will go through a condom demonstration with you to ensure you can apply one correctly. A plastic condom demonstrator will be used for this. You will then be given a selection of condoms and some lubricant to take away with you. If you are under 16 years old, you can have three visits after the initial appointment and can have 12 condoms of your choice to take away with you. After your third visit, you will be required to have another chat around sexual health with the practitioner. If you are 16 years or over, you can have six visits before having another chat with the practitioner. This is just to ensure that you are keeping safe and to discuss any worries that might have cropped up.

How to Apply a Condom

Condoms protect against unwanted pregnancy and the transmission of sexually transmitted infections (STIs). However, if used without following the proper steps, condoms may not be effective.

Here are some steps you can take to ensure you use a condom properly.

What to Check Before Opening the Wrapper:

  1. Keep condoms in a cool dry place away from sunlight, avoiding wallets or purses as other items may damage the condom.
  2. Most condoms are made of latex. If you have a latex allergy, alternative condoms made out of a very thin plastic (polyurethane) are available.
  3. Check the unopened wrapper for damage such as holes or tears that may have damaged the condom. You can give the packet a squeeze to check that air is sealed inside.
  4. Check for the British Standards Institute (BSI) kitemark, or European CE symbol. This tells you that the condoms have been tested and meets safety standards. Non-latex and female condoms may not have a kitemark, but are better than nothing.

  5. Check the expiry date, usually found on the back of individual wrappers, or on the back of a box of condoms. A condom is more likely to tear if it is out of date.

Putting on the Condom:

  1. A condom should only be put on once the penis is erect.
  2. Put the condom on before there is any genital contact.
  3. Push the condom to one side inside the closed wrapper to prevent accidental tearing, then open foil wrapper and take the condom out, being careful not to damage it with jewellery or nails.
  4. Hold the rolled up edge and give the condom a little shake to make sure right way up. The condom will only roll down correctly if applied the right way up.
  5. Do not unroll the condom before use.
  6. Pinch the tip to push out trapped air and make room for semen. Excess air in the condom increases the risk of the condom splitting.
  7. Place the condom on the tip of the penis and roll it down all the way to the base. If the condom rolls down easily, it is likely to be the right way up.
  8. If you feel the condom slipping or stretching, check that it is not damaged.
  9. Make sure the condom is rolled down properly and not inside out.
  10. If it is inside out, start again with a new condom, do not reuse.

Other Tips:

  1. Never use two condoms together. The friction between two latex condoms increases the likelihood of splitting. It does not provide double the protection. Similarly, only one femidom OR one condom should be used. If both are used, the friction could cause them to break.
  2. Don't use oil based lubricants with latex condoms. Oil dissolves latex and will damage the condom. You can demonstrate this by blowing up latex condom or latex balloon and applying an oil based product.

After:

  1. Withdraw immediately after ejaculation, holding the condom at base of penis to prevent any spillage of semen.
  2. Check that the condom is intact. If the condom has split, you may wish to seek advice from a Family Planning and Sexual Health clinic.
  3. Remove the condom from penis whilst still erect, making sure there is no genital contact.
  4. Tie body of condom in a knot, wrap in tissue and throw away in bin. Never flush a condom down a toilet. Condoms are designed to not breakdown so may block the drain or float back to the surface, making for an interesting conversation with the next person to use the toilet.
  5. Never reuse a condom. It is difficult to put an already rolled out condom on a penis, and increases the risk of trapping air inside the condom which makes it more likely to split.