Contraception: which methods are available?
Long-acting reversible methods, hormonal options, barrier methods and permanent sterilisation — how each works, with typical failure rates and their trade-offs.
One of the questions asked most often in clinic is: which contraceptive method is right for me? Statistically, a substantial share of pregnancies both worldwide and in Türkiye are unplanned. Family planning matters a great deal — for the health of mother and baby, and for allowing couples to have children when they choose to.
The medical literature is clear that no single method is a flawless choice for everyone. The right method depends on age, medical history, lifestyle and plans for having children.
What follows sets out the contraceptive methods described in the literature — reversible and permanent — with their general advantages and drawbacks.
Reversible methods
These are for women who may want children in future or who wish to preserve their fertility. They fall into two broad groups.
Long-acting reversible methods
International guidelines place these methods — which do not have to be remembered every day — among the most effective for preventing pregnancy.
Intrauterine devices (coils). There are two basic types, hormonal and copper.
- Copper coils: contain no hormone. They prevent sperm reaching the egg and prevent fertilisation. They can provide protection for up to 10 years.
- Hormonal coils: release a low dose of progesterone inside the womb, thickening cervical secretions and preventing pregnancy. Depending on the type, they are effective for 3 to 7 years.
- Advantages: no daily routine; once fitted, they protect for years. Failure rates are below 1%. Fertility returns quickly once they are removed.
- Drawbacks: they can only be fitted and removed by a doctor. Copper coils can increase menstrual bleeding and cramps, while hormonal coils can cause irregular spotting in the first few months.
Subdermal implants. A flexible rod the size of a matchstick, placed under the skin on the inner side of the upper arm.
- Advantages: very high protection for 3 years — with a failure rate of 0.05%, the lowest among reversible methods.
- Drawbacks: fitted and removed by a doctor under local anaesthesia. The commonest side effect is irregular periods and spotting.
Short-acting hormonal methods
These contain hormones but depend on the user keeping to a routine.
The contraceptive pill. A daily tablet containing oestrogen and progesterone, which prevents ovulation.
- Advantages: regulates the menstrual cycle and reduces period pain and the amount of bleeding.
- Drawbacks: has to be taken at the same time each day. Protection drops when a dose is missed — in typical everyday use the failure rate is around 8-9%. It is medically inadvisable for women with a history of blood clots, for smokers over the age of 35, and for those with severe migraine.
Monthly or three-monthly injections, vaginal rings and patches. These work in much the same way as the pill, but are used weekly (patch), monthly (ring or monthly injection) or every three months (depot injection) rather than daily.
Barrier methods
These physically prevent sperm from entering the woman's reproductive tract.
Condoms (male and female).
- Advantages: available without a prescription. Besides preventing pregnancy, this is the only method that also protects against sexually transmitted infections.
- Drawbacks: must be used correctly before and during intercourse. With tearing or slipping, the chance of pregnancy in typical use can reach 15% to 21%.
Permanent methods (surgical sterilisation)
These are for couples who have completed their family and are certain they do not want children in future.
Tubal ligation (female sterilisation). The fallopian tubes are surgically tied, cut or blocked. It is generally carried out by laparoscopy — keyhole surgery — or during a caesarean birth.
Vasectomy (male sterilisation). The ducts carrying sperm are tied through a small surgical procedure. It can be done under local anaesthesia and is simpler, with fewer risks, than tubal ligation.
- Advantages of permanent methods: they last a lifetime and their protection rates are very high.
- Drawbacks: they require surgery. If the decision is reversed in later years and a pregnancy is wanted, reversal operations are difficult, costly and have a low chance of success — IVF is generally needed in that situation.
In summary
Which method you choose depends on your age, whether you smoke, whether you have a chronic condition and what your menstrual pattern is like. A detailed conversation with your own doctor is the way to arrive at the plan that suits your medical history and the way you live.
This page is for information. It does not replace an examination or individual medical advice.