Contraception

Contraception COVID-19 update

  • In response to the Coronavirus pandemic we have closed our walk in services 
  • If your need is urgent, you will need to book a telephone appointment. You will only be given a face to face appointment if we deem it medically necessary after this phone appointment

I need the contraceptive injection (Depo), implant (Nexplanon) or intrauterine contraception (Coil/IUD/IUS/Mirena/Kyleena/Jaydess)

As always, we are following evidence based national guidelines from the Faculty of Sexual and Reproductive Healthcare (FSRH)

  • We are not fitting or removing implants (Nexplanon) at the moment.

Implants can be kept in for 4 years and do not need changing before that time

If you are having problems with your implant, please book a telephone appointment to discuss

  • We are only fitting Emergency IUDs

10 year Copper IUDs do not need changing before 12 years

Mirena and 5 year copper IUDS do not need changing before 6 years

If your Jaydess or Kyleena is due for removal, please use condoms or request the progesterone only pill via a telephone appointment

If you are having problems with your IUD, please book a telephone appointment to discuss

  • We are avoiding seeing people for the injection (Depo or Sayana)

Please book a telephone appointment to discuss

If it is 14 weeks or more since your last injection, please use condoms until your contraception is sorted

 

I need pills/patches/the ring 

  • Please book a telephone appointment online
  • We will call you to carry out a consultation and then arrange for:

       - A prescription or your medication to be sent to your home

OR

      -  Your prescription to be sent to one of our local pharmacies from where you can collect your medication

If you are unable get an appointment with us, you can access other NHS services, including online/app-based services for this:

  • You can request a prescription from your GP (they will probably do this over the phone or by e-consult).
  •  You can register with Echo https://www.echo.co.uk/ who will arrange for your medication from your GP to be sent to you by post. This is a free NHS service for repeat prescriptions.

If neither of these are possible or you don’t have a GP/your GP is not nearby

  • You can register with online GP services for example GP at hand https://www.gpathand.nhs.uk/  and your prescription can be sent to you by post. This is a free NHS service but you will be de-registered from your current GP
  • If you live in Essex, Hillingdon, Hertfordshire, East Berkshire or Medway you can order contraception online from SH:24 (STI testing also available) https://sh24.org.uk/contraception/order

You can also access non NHS online/app based services for this: Prices are about £15 to £20 for 6 months’ supply of pills and a bit more for the patch or NuvaRing.

I need emergency contraception (the morning after pill)

Emergency contraception is best taken as soon as possible after unprotected sex. It is likely to be easier and faster to go to your local pharmacy. You may be able to get this free of charge (depending on age and restrictions in your local area), if not it can be bought from the pharmacy.

  • If you cannot get this from the pharmacy then please book a telephone appointment
  • The emergency IUD (coil) is the most effective method of emergency contraception. Please book a telephone slot to discuss

I also want a sexual health screen

  • Please register for a home testing kit with SHL https://www.shl.uk/

Barrier methods

Male condom

The male condom is 98% effective against pregnancy if used correctly and also protects against sexually transmitted infections.

Female condom

The female condom is 95% effective if used correctly and also protects against sexually transmitted infections.

Diaphragms and cap

A contraceptive cap or diaphragm is a circular dome made of thin, soft latex (rubber) or silicone. Caps are smaller than diaphragms, but they work in the same way. They are inserted inside the vagina before sex and cover the cervix to create a physical barrier to sperm entering the womb.

Vaginal ring

The vaginal ring (also known as “Nuvaring”) is a flexible plastic ring that is inserted into the vagina, containing both oestrogen and progestogen.

Please walk in or reserve a time slot to talk to us about which contraceptive is right for you. 

Long lasting contraception

Sometimes known as 'long-acting reversible contraception' (LARC).

Implant

The contraceptive implant is a plastic rod the size of a matchstick that is inserted under the skin on your upper arm. It’s over 99.9% effective. We are not always able to fit contraceptive implants on the same day in the walk-in clinic, if we can’t, we will make you an appointment to come back and have one fitted.

Injection, Depo-provera

Depo-provera (also known as “the injection”) is an injection of long-acting progestogen, over 99% effective.

Coil IUD

The coil can be a hormone-free alternative to contraception. The intrauterine device (IUD, also known as 'the coil') lasts between three and 10 years and is a small plastic and copper ‘T’ shaped device that sits inside the womb (uterus). The main way an IUD works is to stop sperm reaching an egg. It does this by preventing sperm from surviving in the cervix, uterus or fallopian tube. 

It may also work by stopping a fertilised egg from implanting in the womb. IUDs are more than 99% effective. This means that less than one in every 100 women who use an IUD will become pregnant in a year.

It can also be fitted up to 5 days after unprotected sex to prevent pregnancy as a form of emergency contraception. Like many contraception methods, the IUD offers no protection against sexually transmitted infections

Coil IUS

The intrauterine system or IUS (also known as “Mirena”) is similar to the coil but is made of plastic and has the hormone progestogen in it.

Patch - combined hormonal patch

The combined hormonal patch (also known as “the patch”, “Evra”) is a patch you can put anywhere on your body that contains both oestrogen and progestogen.

Oral contraception

Oral contraceptives are more commonly just called ‘The Pill’. They are a small tablet you swallow to try to prevent pregnancy. The main way oral contraception works is by stopping the egg being released from the ovaries, it also thickens the mucus at the neck of the womb (making it harder for sperm to get through) and thins the lining of the womb (making it harder for a fertilised egg to implant). 

They offer no protection against sexually transmitted infections. There are two types of oral contraceptive – the ‘combined pill’ and the ‘progestogen-only pill’ (also known as the ‘mini pill’).

Combined pill - hormonal contraception

The combined hormonal contraceptive pill (also known as “the pill”, “COC”) is a pill containing two hormones, oestrogen and progestogen.

Mini pill – progestogen only pill

The progestogen only pill, also known as the “mini pill” is a daily pill only containing one hormone - progestogen - and is taken every day without a break. It is good for women who can’t take the combined pill. This pill may change your menstrual cycle, and sometimes stop your periods and has to be taken very regularly (at the same time, each day).

What to expect when choosing a Coil method

We offer two types of IUC; the copper IUD (intrauterine device) or hormonal IUS (intrauterine system).

If you have an existing device and want a check-up or to have this removed, please book a routine appointment.

If you want to have a device removed or changed, it is important that you use condoms or don’t have sex for seven days before having it removed.

Before you book or attend an appointment to have a device fitted, please follow the five steps below.

Step one: Watch this short video about intrauterine contraception

It is important that you watch this short video before your fitting as it contains important information.It is important that you have read and understood this leaflet (in portuguese) prior to the fitting of your device.

We may have to reschedule your appointment if we are concerned about risks, such as pregnancy. This video explains any risks and the steps you should take to avoid them.

Find out more about the copper IUD      

Find out more about the hormonal IUS 

Step two: How to make sure you are not at risk of being pregnant at the time of your fitting

We need to make sure that you are not at risk of being pregnant when you attend for a fitting. If there is a risk that you might be pregnant then we may have to reschedule your fitting.

The timing of your fitting will depend on what contraception you are currently using:

If you are currently using a hormonal method (pill, patch, vaginal ring, injection and non-expired implant) then your device can be fitted at any convenient time and you can continue to use your current method correctly until your fitting.

If you are currently using condoms, diaphragm, natural methods of contraception or have an expired implant or expired IUD/IUS device then you have two options:

  1. Abstain from sex from day one of your period until your fitting (or abstain from sex for three weeks if your periods are irregular)
  2. Arrange to use a short-acting form of contraception, for example, pill, patch, vaginal ring, for at least four weeks before the fitting.

If you need to replace your current IUD/IUS device and it has not yet expired then this can be done on any convenient day. Please make sure you abstain from sex or use condoms for seven days before the fitting.

This is to make sure that you are not at risk of being pregnant if for some reason we cannot fit the new device after the original one is removed.

Step three: Checklist and information leaflets

Our self-assesment checklist will help you to decide which device to choose, the information leaflet will help you to decide if you are ready to have an IUC fitting and tell you more about your appointment.

You will need to print a copy of our self-assessment checklist and bring a completed copy to your appointment.

Step four: Booking your appointment

To book a fitting, please book an appointment. You will need to book a general contraception appointment for a pre-fitting discussion if:

  • You have a learning disability
  • You require an interpreter
  • You are under 16 years of age
  • You have known complex medical or gynaecological problems. For example, fibroids
  • You have had difficult or failed IUC insertions in the past.

If for any reason you are unable to attend your appointment, please call us to cancel it so that the appointment can be given to someone else.

Step five: On the day of your appointment

Where possible we will fit your device at your appointment.

However, there may be reasons why the fitting may need to be deferred. If this happens then the doctor or nurse who is seeing you will explain why.

On the day of your appointment:

  • Please arrive 15 minutes before your appointment for registration
  • Please allow at least two hours for the appointment. Although the procedure does not take this long, some women need a little more time to recover after the procedure
  • We recommend that you eat and take pain relief before your appointment
  • If you need to bring your child or children then you must bring someone to look after them while you are having the fitting
  • Please bring sanitary protection, as you may experience some bleeding after the fitting
  • We advise you to avoid driving immediately after your fitting.