Contraception and effectiveness

Section 3: Contraception and effectiveness

Contraception options include;

  • Barrier contraception (including condoms, diaphragms, spermacides)
  • Natural methods
  • Combined Hormonal Contraception (including combined oral contraception, vaginal ring and patch)
  • Progestogen Only Pill
  • Progestogen Only Injection
  • Progestogen Only Implant
  • Intrauterine contraception (including copper and levonorgestrel containing intrauterine devices)
  • Sterilisation /vasectomy

All contraception methods are highly effective if used perfectly, according to manufacturers’ guidance.  However, human error often prevails and some methods of contraception become less effective with typical use (see table 1). Long Acting Reversible Contraception is much less user dependent and for that reason are highly effective in practice.  

Table 1: Comparison of pregnancy rates with contraception, adapted from table in FSRH guidance, (based on Trussell research:Trussell J. Contraceptive failure in the United States. Contraception 2011;83:397–404.)  

Contraception Type Percentage of women experiencing unintended pregnancy within the first year
Typical Use

Perfect Use

No method 85 85
Natural methods 24 0.4 -5
Diaphragm 12 6
Condoms 18 2
CHC 9 0.3
POP 9 0.3
PO Injectable 6 0.2
PO Implant 0.05 0.05
LNG IUS 0.2 0.2
Copper IUD 0.8 0.6
Female Sterilisation 0.5 0.5
Vasectomy 0.15 0.1

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