The aim of this book is to help women understand what they want from contraception – this may include control of heavy bleeding, for example, in addition to preventing pregnancy – and which options might meet those needs. The aim is not to be too prescriptive – it is a healthcare professional’s role to discuss underlying medical issues that might influence the choice of an individual brand of pill, for example. We want women to understand their choices and to feel empowered to have a meaningful discussion with healthcare professionals.
We start the book with a useful reminder of the menstrual cycle because this is fundamental to understanding when and how conception occurs, and therefore why and when contraception is needed. We urge women to read this first chapter, even though they may feel they know about their cycles.
Chapter 2 talks through factors that might influence the choice of contraception, including how different methods might suit women at different stages of their lives and the importance of user factors, such as remembering to take a pill daily compared with a ‘fit and forget’ method such as the coil. Chapters 3–8 then describe the different methods in more detail: barrier methods (diaphragm, male and female condoms), combined hormonal contraception (the pill, patch and vaginal ring – an underused method, in our opinion), the progestogen-only pill, long-acting reversible contraception (the implant, injection and coil), the fertility awareness method and emergency contraception. The final chapter describes ways in which hormonal contraception can benefit women with a range of gynaecological conditions, such as heavy or painful periods or polycystic ovary syndrome and during the perimenopause.
Chapters 3–8 each start with a summary of the methods discussed in that chapter – how they work, how well they work (effectiveness) and who they are and are not suitable for, so you can quickly see whether the chapter is relevant. Most methods are in fact suitable for most women until about age 50, but how well they work needs to be balanced against a woman’s medical history and whether the method will be used correctly. In each chapter we also address common myths that surround contraception, which we hope will help avoid some unplanned pregnancies!
While we are using the term ‘woman’ in this book, we want to highlight that not everyone with a male body is a man, and not everyone with a female body is a woman. Information in this book is for all genders and non-binary people. Anyone with ovaries, a vagina and a uterus who has unprotected sex with someone with a penis and testicles is at risk of pregnancy. It is a common misunderstanding that gender affirming hormone therapy provides contraception. They don’t, and an unplanned pregnancy could be particularly devastating for a trans or non-binary person. However, the long-acting reversible contraceptive methods provide an ideal option for everyone.
There is a lot of information and misinformation in the public domain. We urge readers to check that information they access has been written by suitably qualified experts, and to avoid being unduly influenced by friends and family or social media. People can be quick to complain or to blame contraception for changes such as weight gain or change in libido (sex drive). Misunderstandings and misinformation can be difficult to correct once established; hence, each chapter debunks common myths surrounding contraception.
Each woman is an individual, and what is right for your friend or sister may not be right for you. We hope women will feel informed and able to make their own decisions about the contraception that best suits their health and lifestyle.
