WOMEN’S HEALTH
Contraception Options — How to Choose
What should shape a contraception decision, why a review should feel individual, and when it is worth revisiting your current method.
Choosing contraception is rarely just a question of which method is most effective on paper. Medical suitability, bleeding pattern, side effects, migraine history, blood pressure, smoking status, convenience, future fertility plans, and how a method fits everyday life all matter. That is why a good contraception review should feel individual rather than formulaic.
Some women want to start contraception for the first time. Others want to review a method that no longer suits them, is causing side effects, or has become inconvenient. Others want to stop hormonal contraception and understand what to expect next. The broader women’s health service covers the wider range of concerns.
ON THIS PAGE
What should shape the decision
A contraception choice should take account of medical suitability first, then personal preference. Combined hormonal methods (the combined pill, patch, or ring) provide good cycle control and can help with acne and period pain, but are not suitable for women with migraine with aura, uncontrolled hypertension, a history of venous thromboembolism, or significant cardiovascular risk factors.
Progestogen-only methods (the mini-pill, hormonal IUS, implant, injection) have fewer medical contraindications and suit a wider range of women, though each has a different bleeding pattern and side-effect profile. The hormonal IUS is one of the most effective methods available, significantly reduces menstrual bleeding, and is suitable for most women. Non-hormonal options including the copper IUD, condoms, or natural family planning suit women who want to avoid hormonal side effects entirely, though effectiveness varies significantly between methods.
When a review is worth arranging
A review is sensible if you are unhappy with your current method, developing side effects such as mood change, breakthrough bleeding, headaches or reduced libido, or if you are unsure what is medically suitable given your current health. It is also worth reviewing if your circumstances have changed: new migraine diagnosis, blood pressure change, starting or stopping smoking, approaching perimenopause, or planning pregnancy in the near future. Stopping hormonal contraception can itself produce temporary changes in cycle pattern, skin, mood and weight that benefit from a brief clinical discussion. A prescription for a new method can usually be issued during the same appointment.
The appointment
What happens at a contraception appointment
A contraception review at Basuto is a 30-minute consultation with a GP. Your doctor will review your medical history, current medications, blood pressure, migraine history, smoking status, and any relevant family history. If a new method is agreed, a prescription can usually be issued during the same visit. If blood tests are relevant, these can be arranged from the same appointment.
Same-day appointments available. Book online or call 020 7736 7557.
Perimenopause
Contraception and perimenopause
Contraception remains relevant for many women well into their 40s, even when cycles become irregular. Perimenopause does not mean infertility, and unplanned pregnancy in the late 40s carries higher clinical risk. Some hormonal methods, particularly the hormonal IUS, can also help manage heavy or irregular bleeding during the menopausal transition, and may be used alongside HRT to provide the progestogen component. The women’s health service at Basuto covers this full pathway.
FURTHER READING