Sexual Health

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Contraception

There are a range of different contraceptive options currently available in the UK. The type that works best for you will depend on your health and circumstances. We have collated surveyed information from Downing members which may help your choice of contraception however these are merely individual and not medical advice (which will be also linked). Please keep in mind these are entirely subjective and may even be contradictory as forms of contraception can affect people very differently.

There are several issues to consider when deciding which method of contraception is right for you.

Once you have read this information, you can go to your GP or local contraceptive (or family planning) clinic to discuss your choices.

Remember, the only way to protect yourself against sexually transmitted infections (STIs) is to use a condom every time you have sex.

Other methods of contraception prevent pregnancy, but they do not protect against STIs.

Contraceptives available over-the-counter

Condoms:

Condoms are the only type of contraception that can both prevent pregnancy and protect against sexually transmitted infections (STIs) .

There are two types of condoms: male condoms, worn on the penis; and female condoms, worn inside the vagina.

This page is about male condoms, and explains how they work and where you can get them.

Male condoms are made from very thin latex (rubber), polyisoprene or polyurethane and are designed to stop a man's semen from coming into contact with his sexual partner.

Summary:

  • When used correctly every time you have sex, male condoms are 98% effective . This means 2 out of 100 women will become pregnant in one year when male condoms are used as contraception.
  • You can get free condoms from contraception clinics, sexual health clinics and some GP surgeries.
  • Oil-based products – such as moisturiser, lotion and Vaseline – can damage latex and polyisoprene condoms, but they are safe to use with polyurethane condoms.
  • Water-based lubricant is safe to use with all condoms.
  • It's possible for a condom to slip off during sex. If this happens, you may need emergency contraception and to get checked for STIs.
  • Condoms need to be stored in places that aren't too hot or cold, and away from sharp or rough surfaces that could tear them or wear them away.
  • Putting on a condom can be an enjoyable part of sex and doesn't have to feel like an interruption.
  • If you're sensitive to latex, you can use polyurethane or polyisoprene condoms instead.
  • A condom must not be used more than once. Use a new one each time you have sex.
  • Condoms have a use-by date on the packaging. Don't use out-of-date condoms.
  • Always use condoms that have the BSI kite mark and the CE mark on the packet. This means they've been tested to high safety standards.

For further medical information: Click here

Female condom:

Female condoms are made from soft, thin latex or latex. They’re worn inside the vagina to prevent semen getting to the womb.

Summary:

  • If used correctly, female condoms are 95% effective.
  • They protect against pregnancy and sexually transmitted infections (STIs) .
  • A female condom needs to be placed inside the vagina before there's any contact with the penis.
  • Always buy condoms that have the CE mark or the BSI Kitemark on the packet. This means they have been tested to high safety standards.
  • A female condom can get pushed inside the vagina during sex, but it's easy to remove them yourself if this happens.
  • Female condoms may not be suitable for women who are not comfortable touching their genital area.
  • Female condoms should not be reused. Open a new one each time you have sex.

For further medical information: Click here

The Morning After Pill:

Summary:

The emergency contraceptive pill can prevent pregnancy after unprotected sex or if the contraceptive you have used has failed – for example, a condom has split or you have missed a pill.

The pill can be bought over the counter at some pharmacies or is available from GPs and sexual health clinics.

There are two types:

Levonelle has to be taken within 72 hours of sex to prevent pregnancy.

ellaOne has to be taken within 120 hours of sex to prevent pregnancy.

For further medical information: Click here

Surveyed responses:

  • Some people reported little to no effect
  • Nausea
  • Fatigue
  • Mild cramps
  • Heavy bleeding
  • Spotting
  • Disrupted cycle
  • Low mood
  • Tender breasts
  • Water retention and bloating
  • Headaches

Contraceptives available from a GP or sexual health clinic

Diaphragm or cap:

A contraceptive diaphragm or cap is a circular dome made of thin, soft silicone that's inserted into the vagina before sex.

It covers the cervix so sperm can't get into the womb (uterus) to fertilise an egg.

Summary:

  • When used correctly with spermicide, a diaphragm or cap is 92-96% effective at preventing pregnancy – this means that between 4 and 8 women out of every 100 who use a diaphragm or cap as contraception will become pregnant within a year.
  • There are no serious health risks.
  • You only have to think about it when you have sex.
  • You can put in a diaphragm or cap with spermicide any time before you have sex.
  • More spermicide is needed if it's been in place for more than 3 hours.
  • The diaphragm or cap needs to be left in place for at least 6 hours after sex.
  • It can take time to learn how to use it.
  • Some women develop cystitis (a bladder infection) when they use a diaphragm or cap. Your doctor or nurse can check the size – switching to a smaller size may help.
  • If you lose or gain more than 3kg (7lbs) in weight, or have a baby, miscarriage or abortion, you may need to be fitted with a new diaphragm or cap.
  • By using condoms as well as a diaphragm or cap, you'll help to protect yourself against sexually transmitted infections (STIs).

For further medical information: Click here

Contraceptive Implant (lasts up to 3 years):

Summary:

The contraceptive implant (Nexplanon) is a small flexible plastic rod that's placed under the skin in your upper arm by a doctor or nurse. It releases the hormone progestogen into your bloodstream to prevent pregnancy and lasts for 3 years. It is worth noting that if you have difficulties or change your mind it can be removed at any time. When first put in it may cause some bruising, tenderness or swelling around the implant. Periods may become irregular, lighter, heavier or longer as a result. A common side effect is that periods stop all together (this is not harmful and is referred to as amenorrhea).

For further medical information: Click here

Surveyed advantages and disadvantages:

Advantages:

  • No unexpected weight gain (which the pill can often cause)
  • Practically painless insertion (mild bruising in the area for a few days afterwards)

Disadvantages:

  • Unpredictable bleeding
    • While some people noted little to no bleeding others had extremely heavy and irregular bleeding
  • Breakouts and bad skin
  • Potential hormonal impact on mental health

Intrauterine system, or IUS (lasts up to 5 years and also known as the hormonal coil):

Summary:

An IUS is a small, T-shaped plastic device that's put into your womb (uterus) by a doctor or nurse. It releases the hormone progestogen to stop you getting pregnant and lasts for 3 to 5 years, depending on the brand.

  • When inserted correctly, it's more than 99% effective.
  • It can be taken out at any time by a specially trained doctor or nurse. It's possible to get pregnant straight after it's removed.
  • It can make your periods lighter, shorter or stop altogether, so it may help women who have heavy or painful periods.
  • It can be used by women who cannot use combined contraception (such as the combined pill) – for example, those who have migraines.
  • Once the IUS is in place, you do not have to think about it.
  • Some women may experience side effects, such as mood swings, skin problems or breast tenderness.
  • There's a small risk of getting an infection after it's been fitted.
  • It can be uncomfortable when the IUS is put in, but painkillers can help.
  • The IUS can be fitted at any time during your monthly menstrual cycle, as long as you're not pregnant.

For further medical information: Click here

Surveyed advantages and disadvantages:

Advantages:

  • Reduced flow
  • Reduced period pain

Disadvantages:

  • Irregular and continuous bleeding for weeks after insertion

Intrauterine Device, or IUD/coil (lasts up to 5 to 10 years):

Summary:

  • When inserted correctly, IUDs are more than 99% effective.
  • An IUD works as soon as it's put in and lasts for 5 to 10 years, depending on the type.
  • It can be put in at any time during your menstrual cycle, as long as you're not pregnant.
  • It can be taken out at any time by a specially trained doctor or nurse. It's then possible to get pregnant straight away.
  • Your periods can be heavier, longer or more painful in the first 3 to 6 months after an IUD is put in. You might get spotting or bleeding between periods.
  • There's a small risk of getting an infection after it's been fitted.
  • There's a small risk that your body may push out the IUD or it may move. Your doctor or nurse will teach you how to check it's in place.
  • It can be uncomfortable when the IUD is put in, but painkillers can help.
  • It may not be suitable if you have had previous pelvic infections.

For further medical information: Click here

Surveyed advantages and disadvantages:

Advantages:

  • No bleeding after a few weeks
  • Little impact on mood

Disadvantages:

  • Painful cramps
  • Heavier and longer periods
  • Spotting
  • Painful insertion

Contraceptive injection (renewed every 8 weeks or every 12 weeks, depending on the type):

The contraceptive injection (Depo-Provera, Sayana Press or Noristerat) releases the hormone progestogen into your bloodstream to prevent pregnancy.

Depo-Provera is most commonly given in the UK and lasts for 13 weeks. Occasionally, Noristerat may be given, which lasts for 8 weeks.

Sayana Press also lasts for 13 weeks, but it's a newer type of injection so is not available at all clinics or GP surgeries.

Summary:

  • If used correctly, the contraceptive injection is more than 99% effective.
  • It lasts for 8 or 13 weeks (depending on which injection you have) so you do not have to think about contraception every day or every time you have sex during this period.
  • It's very useful for women who find it difficult to remember to take a pill at the same time every day.
  • It does require you to remember to have a repeat injection before it expires or becomes ineffective.
  • It can be useful for women who cannot use contraception that contains oestrogen.
  • It's not affected by other medicines.
  • Side effects can include weight gain, headaches, mood swings, breast tenderness and irregular bleeding.
  • Your periods may become more irregular, heavier, shorter, lighter or stop altogether.
  • It can take up to 1 year for your fertility to return to normal after the injection wears off, so it may not be suitable if you want to have a baby in the near future.

For further medical information: Click here

No one surveyed had used the contraceptive injection however information can be found in the link above.

Combined pill (taken every day for 3 weeks out of every month):

The combined oral contraceptive pill is usually just called "the pill". It contains artificial versions of female hormones oestrogen and progesterone, which women produce naturally in their ovaries.

A woman can get pregnant if a man's sperm reaches one of her eggs (ova). Contraception tries to stop this happening usually by keeping the egg and sperm apart or by stopping the release of an egg (ovulation).

Summary:

  • When taken correctly, the pill is over 99% effective at preventing pregnancy. This means that fewer than one woman in 100 who use the combined pill as contraception will get pregnant in one year. Other methods, such as the IUD, implant and injection, are more effective.
  • The usual way to take the pill is to take one every day for 21 days, then stop for seven days, and during this week you have a period-type bleed. You start taking the pill again after seven days.
  • You need to take the pill at around the same time every day. You could get pregnant if you don't do this, or if you miss a pill, or vomit or have severe diarrhoea.
  • Some medicines may make the pill less effective. Check with your doctor if you're taking any other tablets.
  • If you have heavy periods or painful periods, PMS (premenstrual syndrome) or endometriosis the combined pill may help.
  • Minor side effects include mood swings, nausea, breast tenderness and headaches.
  • There is no evidence that the pill makes women gain weight.
  • There's a very low risk of serious side effects, such as blood clots and cervical cancer.
  • The combined pill is not suitable for women over 35 who smoke, or women with certain medical conditions.

For further medical information: Click here

Progestogen-only pill (taken every day):

The "traditional" progestogen-only pill (POP) prevents pregnancy by thickening the mucus in the cervix to stop sperm reaching an egg. The desogestrel progestogen-only pill can also stop ovulation. Progestogen-only pills contain the hormone progestogen, but don't contain oestrogen.

You need to take the progestogen-only pill reliably every day.

Summary:

  • If taken correctly, it's more than 99% effective. This means fewer than 1 woman in 100 who uses the progestogen-only pill as contraception will get pregnant in 1 year.
  • With "typical use" of the progestogen-only pill (the way it's taken by a lot of women in real life), it's only about 92% effective.
  • You take a pill every day, with no break between packs of pills.
  • The progestogen-only pill can be used by women who can't use contraception that contains oestrogen.
  • You can take the progestogen-only pill if you're over 35 and you smoke.
  • You must take the progestogen-only pill at the same time each day. If you take it more than 3 hours late (traditional progestogen-only pill) – or 12 hours late (desogestrel pill) – it may not be effective.
  • If you're sick (vomit) or have severe diarrhoea, the progestogen-only pill may not work.
  • Some medicines may affect the progestogen-only pill's effectiveness – ask your doctor for details.
  • Your periods may stop or become lighter, irregular or more frequent.
  • Side effects may include spotty skin and breast tenderness – these should clear up within a few months.

For further medical information: Click here

Contraceptive patch (renewed each week for 3 weeks out of every month):

The contraceptive patch is a small sticky patch that releases hormones into your body through your skin to prevent pregnancy. In the UK, the patch's brand name is Evra.

Summary:

  • When used correctly, the patch is more than 99% effective at preventing pregnancy.
  • Each patch lasts for 1 week. You change the patch every week for 3 weeks, then have a week off without a patch.
  • You don't need to think about it every day, and it's still effective if you're sick (vomit) or have diarrhoea.
  • You can wear it in the bath, when swimming and while playing sports.
  • If you have heavy or painful periods, the patch can help.
  • The patch can raise your blood pressure, and some women get temporary side effects, such as headaches.
  • Rarely, some women develop a blood clot when using the patch.
  • The patch may protect against ovarian, womb and bowel cancer.
  • It may not be suitable for women who smoke and who are 35 or over, or who weigh 90kg (14 stone) or more.

For further medical information: Click here

No one surveyed had used the contraceptive patch however more information can be found in the link above.

Vaginal ring (renewed once a month):

The vaginal ring (NuvaRing) is a small soft, plastic ring that you place inside your vagina.

It releases a continuous dose of the hormones oestrogen and progestogen into the bloodstream to prevent pregnancy.

Summary:

  • If used correctly, the vaginal ring is more than 99% effective.
  • One ring provides contraception for a month, so you don't have to think about it every day.
  • You can continue to have sex when the ring is in place.
  • Unlike the pill, the ring still works if you have sickness (vomiting) or diarrhoea.
  • The ring may ease premenstrual symptoms, and bleeding will probably be lighter and less painful.
  • Some women have temporary side effects, including more vaginal discharge, breast tenderness and headaches.
  • A few women develop a blood clot when using the ring, but this is rare.
  • The ring can sometimes come out on its own, but you can rinse it in warm water and put it back in as soon as possible.
  • It doesn't protect against sexually transmitted infections (STIs), so you may need to use condoms as well.

For further medical information:

https://www.nhs.uk/conditions/contraception/vagina...

No one surveyed had used the vaginal ring however more information can be found using the link above.

HIV prevention

PrEP vs PEP

PrEP and PEP are methods for preventing HIV infection that involve taking HIV medicines. When you take steps to protect yourself against a disease, like HIV, it’s called prophylaxis.

PrEP and PEP are for people who don’t have HIV, but are at risk of getting it.

PrEP: Pre-exposure prophylaxis – it is not currently available in the UK but work is ongoing and hopefully this will change

When is it taken? PrEP is taken every day, before possible exposure.

Who’s it for? PrEP is for people have HIV and are at risk from getting HIV from sex or injection drug use.

How effective is it? Consistent use of PrEP can reduce the risk of getting HIV from sex by about 99% and from injection drug use by at least 74%.

PEP: Post-exposure prophylaxis

When is it taken? After HIV exposure. In emergency situations, PEP is taken within 72 hours after possible exposure.

Who’s it for? PEP is for people who don’t have HIV but may have been exposed; during sex, at work through an injury, by sharing injection drug equipment or during a sexual assault.

How effective is it? PEP can prevent HIV infection when taken correctly, but it is not always effective. Start PEP as soon as possible to give it the best chance of working.

Where can you get it? PEP can be obtained from A&E departments or sexual health clinics.

For further medical information: Click here

Advice from Downing students

Choosing to take contraception in the first place: Make sure you are doing it for you (i.e. don’t go on the pill just because your partner doesn’t want to use condoms) and that you are well-informed and prepared. In fact, no single method of contraception listed is 100% effective, including condoms, so wanting to use a second form of contraceptive is completely valid.

  • The GP and choosing a form of contraceptive
    • Make sure you talk through all your options before agreeing to something - doctors are there to help, not to brush off your issues. Take your time to find an option that suits you.
    • Your GP will often ask you about your family history with cancer and blood clotting, so know that this might affect your options.
    • Don’t be embarrassed to talk about side effects with your GP. If you have really bad mood swings/gain weight/get spots in reaction to hormonal contraception you don’t need to just accept it. A lot of the time, people settle for these effects and think that they are simply part of being assigned female at birth . This does not have to be the case. If you start a new contraceptive for the first time and experience bad reactions, you should feel comfortable to ask your GP for other options.
    • Methods of contraception other than condoms can take a long time to settle in, so you might need to wait a while before knowing whether it is the right fit for you. It’s worth talking to your GP about how your experience will change in the first few months of starting a new contraceptive method.
  • Side effects
    • Side effects vary with each person and contraceptive method, so don’t let one person’s experience scare you off.
    • They are very commonly experienced, and are valid reasons for wanting to switch to a different option that is better for you.
    • Read up on all of them and consider how they will affect you specifically: e.g. sporty people might avoid certain forms of contraceptives that might affect their training differently etc.
    • The importance of one side effect over another is completely valid. Different side effects can have different impacts on mental health, and your day to day life, so don’t feel like you’re overreacting for being worried about one of them.
    • Side effects that are frequently not mentioned include loss of libido and blood spotting, which can be common depending on the method chosen, so do your research on these.
    • Allergies
      • Allergies to latex condoms: Latex-free condoms most of the time cost more and won't be accessible from places which typically stock condoms for free like school nurses offices etc. But also they're often thinner because the material used in them is stronger so if you are using condoms (latex or otherwise) and your partner complains of reduced sensation latex-free condoms could help things be more enjoyable for all involved.
    • Mood Swings
      • Mood swings are a completely valid reason to need to change contraception.
      • Non-hormonal options are available if this is main source of concern (condoms, coil)
      • The pill is not always the easiest and least invasive method as it can affect your mental health. Think hard before choosing any hormonal contraception. However, GP’s prescribe the pill first, as you may want to start with contraception that is easy to stop if necessary eg. the pill which you take daily.
  • The Contraceptive Pill
    • Set an alarm for the time you’ve decided you’ll take the pill everyday
    • A time where you’re likely to be in your room is best
    • Some people suggest putting it next to your toothbrush to make it part of your routine
  • Morning After Pill
    • Do not feel pressure to be the one to pay for or go collect the morning after pill. Contraception is not just your responsibility, so asking for your sexual partner(s) to share that responsibility is completely within your rights/encouraged.
    • Don’t be embarrassed about going to get it. Getting it from a shop like Boots or Superdrug can be stressful as they ask many questions. This is not to judge or upset you, they have to do it legally and are just checking that it’s suitable for you to take.
    • There is a massive negative stigma surrounding the morning after pill, which really doesn't help when you find yourself in the situation where you need to take it. It can be pretty comforting to go with a friend to get it, which is recommended if you don't feel comfortable going alone. There are many locations in Cambridge such as Boots, where they offer the morning after pill completely free after a short consultation with one of the pharmacists there.
    • Try not to rely on the morning after pill too much as it does have side effects and can mess with your menstrual cycle, but take it when necessary even if you’re scared of the impacts because it’s better to be safe than sorry.

Menstrual Cycle tracking apps

  • Clue - most popular
  • Flow
  • MPT
  • Monthly cycles
  • Dot

All apps were generally useful for tracking period start dates however aren’t 100% accurate when it comes to things like missing a pill, changing your pill pack start date, other forms of contraception such as IUD and coil etc.

Supplies

FREE sexual health supplies available:

  • Condoms (small, regular, large)
  • Latex free condoms
  • Femidoms
  • Dental dams
  • Pregnancy tests
  • Lubricant

Rape alarms are also available.

Contact a welfare officer to receive these in your pidge, or come to Food & Love events to pick some up.

Also note that condoms are available outside the nurse’s clinic in O Staircase.

Sexual health clinics

The closest to Downing are:

Lime Tree Clinic
Brookfields Hospital, 351 Mill Road, Cambridge
Open Monday-Saturday

Woodlands (2 mins walk from Downing)
Woodlands Surgery, 48 – 49 Bateman Street, Cambridge
Open Wednesday: 9.00 - 4.30pm

See iCash website for opening hours and drop-in times

To book an appointment call for these clinics call 0300 300 3030