Contraception advice (Contraception consultation and method choice)
A consultation to help you choose a method of contraception that suits you, covering the full range of options honestly, including the most effective long-acting methods and emergency contraception.
✓ Medically reviewed by a GMC-registered consultant · last reviewed September 2026 · next review September 2027 · how we review
In short
- There is no single best method — good advice covers the full range honestly and helps you choose what suits you.
- Long-acting methods (implant, hormonal coil and copper coil) are the most effective because they don't depend on you remembering them.
- Emergency contraception is time-critical: act as soon as possible after unprotected sex, and the copper coil is the most effective option.
- Most contraception does not protect against sexually transmitted infections — only condoms do — and all contraception is free on the NHS.
A plain-English summary. The detail — including risks and recovery — is below.
At a glance
A general guide. Your specialist will give you advice for your situation.
Helps you choose a method that fits your health and life
Combined hormonal methods (combined pill, patch, ring) may not be safe if you have migraine with aura, certain clot risks, uncontrolled high blood...
You leave with a plan, a prescription, supplies, or a fitted method. The clinician explains when your method starts working and whether you need extra...
Clear written information on your method, when it works, and what to do if it fails.
You leave with a plan, a prescription, supplies, or a fitted method. The clinician explains when your method...
Depending on timing in your cycle, some methods work straight away and others need up to 7 days, with condoms used...
Irregular bleeding and other side effects often settle as your body adjusts. This is a common time to have a...
Most methods need little day-to-day attention beyond using them correctly; coils and implants are replaced after...
What is a contraception consultation?
A contraception consultation helps you choose a method to prevent pregnancy that fits your health, your life and your preferences. The clinician explains the full range of options, how well each works, how it is used, the benefits and side effects, and helps you weigh them up.
Methods range from long-acting reversible contraception (LARC) — the implant, the hormonal coil (IUS) and the copper coil (IUD) — which are the most effective because they do not rely on you remembering them, through to the pill, patch, ring, injection, condoms and natural methods. There is no single "best" method; the right one depends on you, and good advice is unbiased.
The consultation also covers emergency contraception, which can prevent pregnancy after unprotected sex but is time-critical — the sooner it is used, the better, and the copper coil is the most effective option.
Contraception advice does not protect you from sexually transmitted infections unless you use condoms, so safer sex is usually discussed too. You can change your mind and switch methods later — the consultation is the start of a decision, not a one-off commitment.
Types, options & approaches
There may be different ways to do this. The right approach depends on the clinical question and your circumstances.
How well methods work at preventing pregnancy
| Method | Perfect use | Typical use |
|---|---|---|
| Implant / coils (LARC) | Over 99% | Over 99% (no daily action needed) |
| Injection | Over 99% | Around 94% |
| Pill / patch / ring | Over 99% | Around 91% (about 9 in 100 pregnant a year) |
| External condoms | Around 98% | Around 82% (about 18 in 100 pregnant a year) |
"Typical use" reflects normal life, where doses or condoms are sometimes missed. This is why long-acting methods are the most effective. Figures are from NHS/FSRH.
Preparing for your appointment
- Think about what matters to you: effectiveness, convenience, periods, hormones, and whether you want children in future.
- Note the first day of your last period and your usual cycle, as this affects when methods can start.
- Bring a list of your medicines, as some interact with hormonal contraception.
- Mention your medical history, including migraines, blood clots, high blood pressure, smoking and any family history, as these affect which methods are safe.
- Tell the clinician if you are or might be pregnant, or are breastfeeding.
- Think about whether you also need protection from sexually transmitted infections.
- If you may want a coil or implant fitted, ask whether it can be done at the same visit.
What happens
The clinician asks about your health, medicines, periods and what you are looking for in a method. They use this to explain which options are safe and suitable for you, covering the full range without pushing any particular one.
They explain how each method works, how effective it is, how it is used, and the benefits and possible side effects, so you can make an informed choice. You can ask questions and take time to decide.
Depending on the method, you may leave with a prescription, be given supplies, or have a long-acting method such as an implant or coil fitted at the visit (sometimes a separate appointment is needed). If you need emergency contraception, this is dealt with promptly. You can change methods later if the first choice does not suit you.
Is this appointment right for me?
A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.
May not be suitable if…
- Combined hormonal methods (combined pill, patch, ring) may not be safe if you have migraine with aura, certain clot risks, uncontrolled high blood pressure, or you smoke and are over 35.
- A method chosen only for convenience may be the wrong choice if it does not match your health or your need for effectiveness.
- Contraception advice alone is not enough if you also need protection from sexually transmitted infections — condoms are needed for that.
- Long-acting fitting may be deferred if pregnancy cannot be excluded or there is a current pelvic infection.
Delay or rearrange if…
- Pregnancy is possible and cannot be excluded — this needs checking before some methods start.
- You have a current pelvic or genital infection, before fitting a coil.
- You have unexplained vaginal bleeding that has not been assessed.
- You need emergency contraception first — this is time-critical and comes before arranging an ongoing method.
Alternatives to discuss
- A different method if your first choice does not suit you — switching is straightforward.
- Condoms alongside another method for STI protection.
- Long-acting reversible methods if you want the most effective, low-maintenance option.
- Permanent methods (sterilisation) if your family is complete and you want a permanent solution.
- NHS contraception and sexual health clinics, which provide all methods free.
Before you decide
Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.
What matters most to me?
Think about symptoms, daily life, work, caring responsibilities, sport, fertility, travel, appearance and anxiety — the right choice depends on your priorities, not just the medical facts.
What are all my options?
Ask about waiting, monitoring, medicines, rehabilitation, a smaller or larger procedure, a different test, NHS referral, or a second opinion where that would help.
What would make me pause?
Active infection, pregnancy, unstable medical problems, smoking, medicines that increase bleeding, poor support at home, or feeling pressured are all reasons to slow down and get tailored advice.
What happens if I do nothing today?
For some problems, waiting is safe; for others, delay can make treatment harder. A good consultation should explain the trade-off in plain English.
Comfort, sedation or contrast choices
If local anaesthetic, sedation, contrast or pain relief is used, ask what is planned, why, and what it means afterwards.
Benefits
- Helps you choose a method that fits your health and life
- Explains the most effective options clearly and without bias
- Reduces the chance of unintended pregnancy
- Covers emergency contraception and how quickly to act
- Includes advice on protecting against sexually transmitted infections
- Lets you start a suitable method, sometimes the same day
Risks & complications
- Side effects from hormonal methods, such as changes in bleeding, headaches, breast tenderness or mood changes
- Irregular bleeding in the first few months with several methods
- No protection against sexually transmitted infections unless condoms are used
- Method failure if pills are missed or condoms used incorrectly
- Pain, bleeding or a fainting feeling when a coil or implant is fitted
- A method not suiting you, needing a switch
- The copper coil sometimes causing heavier or more painful periods
- Blood clots with combined hormonal methods, more likely with certain risk factors
- Expulsion or, very rarely, perforation of the womb when a coil is fitted
- Pregnancy despite contraception, including, rarely, an ectopic pregnancy with some methods
Different methods carry different risks, and the safest choice depends on your health. For example, combined hormonal methods may not be suitable if you have migraine with aura, certain clot risks, or you smoke and are over 35. Tell your clinician your full history so they can guide you, and ask which method is safest as well as most effective for you.
Published figures to discuss
Effectiveness depends heavily on the method and on how consistently it is used, which is why "perfect use" and "typical use" figures differ. The figures below are from NHS and FSRH patient information and are approximate; individual risk of side effects such as blood clots depends on your own health.
| Figure | Reported range | How to interpret it | Source / confidence |
|---|---|---|---|
| Pregnancy with long-acting methods (implant, coils) | Fewer than 1 in 100 users a year (over 99% effective) | Most effective because they do not rely on remembering them; from NHS/FSRH figures. | NHS — Contraceptionnhs.ukPublished figure |
| Pregnancy with the pill, patch or ring | About 9 in 100 users a year with typical use (over 99% with perfect use) | Typical-use failure mainly reflects missed or late doses. | NHS — Contraceptionnhs.ukPublished figure |
| Pregnancy with the contraceptive injection | Around 6 in 100 users a year with typical use (over 99% with perfect use) | Effectiveness depends on having it on schedule. | NHS — Contraceptionnhs.ukPublished figure |
| Pregnancy with external condoms | About 18 in 100 users a year with typical use (around 98% with perfect use) | Condoms also reduce STI risk; effectiveness depends on correct use every time. | NHS — Contraceptionnhs.ukPublished figure |
These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.
What happens afterwards
There is no recovery from advice itself. "Afterwards" means starting your method and knowing when it becomes effective, what is normal at first, and how to get emergency contraception if you need it.
- Irregular or lighter bleeding in the first few months with many methods
- Mild soreness or bruising at an implant or coil site
- A short settling-in period for side effects such as headaches or mood changes
- Needing extra protection (condoms) for the first few days with some methods
Aftercare
- Use your method correctly and on time, and use condoms as well if you need STI protection.
- Know when your method becomes effective and use back-up protection until then.
- Learn what to do if you miss a pill, are late for an injection, or a condom breaks.
- Keep emergency contraception in mind and act quickly if you need it.
- Attend any review, especially in the first few months or to replace a coil or implant.
- Check the threads of a coil as advised, and know the signs it may have moved.
- Go back if side effects are troublesome — switching method is normal and easy.
- The date of the first day of your last period
- Your medicines and relevant medical history (migraine, clots, blood pressure)
- Whether you also need protection from STIs
- Questions about the most effective options for you
- How to get emergency contraception quickly if needed
- A note of when your method starts working and when any review is due
⚠ Get urgent help if…
- Severe or persistent tummy pain after a coil fitting, or being unable to feel the threads
- A late or missed period, or pregnancy symptoms, while using contraception
- Severe one-sided tummy pain, shoulder-tip pain or feeling faint — possible ectopic pregnancy, seek urgent help
- Chest pain, breathlessness, or a painful, swollen leg — possible blood clot, call 999
- A sudden severe headache, weakness, or visual disturbance
- Heavy or unusual vaginal bleeding, or signs of infection after a fitting
- Needing emergency contraception — act as soon as possible
Who to contact: your clinician, clinic or test provider first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.
General guidance — it doesn't replace the specific advice your specialist gives you.
Results & realistic expectations
A good outcome is a method you can use reliably and are happy with, that fits your health and reduces your chance of unintended pregnancy. The most effective methods are the long-acting ones, because they do not depend on you remembering them.
No method is 100% effective, and most do not protect against sexually transmitted infections. A good consultation is honest about this, helps you weigh effectiveness against side effects and your preferences, and makes clear you can switch methods if your first choice does not suit you.
How long a method lasts varies: condoms and pills are used each time or daily, the injection lasts weeks to months, and implants and coils last several years before replacement. Your needs may change over time — for example after having children, around the menopause, or if your health changes — so it is worth reviewing your method periodically.
Related tests, treatments or support
Contraception advice is often combined with a sexual health check, cervical screening where due, or a conversation about future pregnancy. Condoms can be used alongside any other method to add STI protection. Emergency contraception can be followed by starting an ongoing method.
Follow-up & long-term care
Many methods need little follow-up beyond correct use, but a review in the first few months helps if side effects are troublesome. Coils and implants need replacing after their licensed lifespan, and the injection needs repeating on schedule. You can return any time to switch methods or discuss problems.
- Take pills, apply patches or use rings on schedule, and keep injections on time.
- Replace implants and coils before the end of their licensed lifespan.
- Check coil threads periodically as advised.
- Keep condoms available if you need ongoing STI protection.
- Review your method if your health, medicines or plans change.
Repeat, follow-on and what comes next
- Switching methods is common and usually straightforward if the first does not suit you.
- Side effects such as irregular bleeding often settle within the first few months.
- Coils and implants need replacing at the end of their licensed lifespan.
- A coil fitting is occasionally unsuccessful or the device can be expelled, needing a repeat.
Ask what happens if the result is unclear or needs repeating, and what is included if further tests or follow-up are needed.
What good aftercare looks like
- Clear written information on your method, when it works, and what to do if it fails.
- A named route to come back to switch methods or discuss side effects.
- A plan for replacing long-acting methods on time and for repeat injections.
- Easy, fast access to emergency contraception and STI testing when needed.
What affects the cost
Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:
- The length of the consultation and whether a method is fitted on the day
- Whether a long-acting method (implant or coil) is fitted, including the device and the fitting
- The cost of the chosen method itself, such as pills, patches or the injection
- Local anaesthetic for a fitting, if used
- Follow-up or method-switch appointments
- Emergency contraception, if needed urgently
- The clinician's fee and clinic facility fee
- The consultation fee
- The cost of the device and fitting for a long-acting method
- The cost of the method itself (pills, patch, ring, injection)
- Whether follow-up or removal is included
- The cost of emergency contraception if needed
- What happens, and what it costs, if the method needs changing or a fitting is unsuccessful
On the NHS? All contraception, including long-acting methods and emergency contraception, is free on the NHS through GPs, contraception and sexual health clinics, and some pharmacies; private care may be used for speed, choice or convenience.
You're entitled to your total cost in writing — including reports, follow-up and what happens if the result is inconclusive — before you decide.
Consent traps and marketing red flags
These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.
Consent traps
- Being steered towards one method rather than hearing the full range honestly.
- Not being told that most methods do not protect against STIs.
- No clear advice on when a method starts working or what to do about missed doses.
- Not discussing the most effective (long-acting) options because they take longer to fit.
- No mention of how quickly to act for emergency contraception.
Marketing red flags
- Promoting one method as best for everyone, rather than tailoring advice to you.
- Charging for advice or methods that are free on the NHS without making that clear.
- Downplaying side effects or the limits of "natural" methods.
- Implying any method gives complete protection from both pregnancy and STIs.
Choosing a specialist safely
- Check the specialist is on the GMC Specialist Register for this area.
- Make sure they work at a CQC-registered service, and look for membership of the relevant Royal College or professional body.
- You're entitled to time to consider and to have your questions answered before you agree — the specialist who looks after you should explain it, not a salesperson.
- Be wary of pressure: time-limited offers or deposits taken before you've had time to think are red flags, not bargains.
- You're entitled to your total cost in writing — including any follow-up — before you decide.
Questions to ask your medical professional
Take this to your consultation. A good specialist will welcome every one of these.
- Given my health and medicines, which methods are safe for me?
- Which is the most effective option for me, and which has the side effects I'd tolerate best?
- Can a long-acting method be fitted today, and what does fitting involve?
- What do I do if I miss a dose, am late for an injection, or a condom breaks?
- How quickly does my method start working, and do I need back-up protection?
- Do I also need condoms for STI protection, and should I be screened?
- Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
- Will you be the specialist who carries out my appointment, and who looks after me afterwards?
- What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
- What does a realistic result look like — and what can this appointment not achieve?
- What are my options, including waiting, doing nothing for now, or choosing a different approach?
- Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
- What is the total cost in writing, including any follow-ups, and how much time do I have to decide?
Frequently asked questions
Which contraception is the most effective?
How quickly do I need emergency contraception?
Will contraception protect me from STIs?
Is contraception free?
Can I change my method if it doesn't suit me?
Will it affect my fertility later?
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How we made this page
Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →
Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.
Sources & standards: NHS — Contraception NHS — How well different methods work at preventing pregnancy Brook — Contraception guide NICE CKS — Contraception
Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.
Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.
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