What method of contraception's best for me?

Your first crush, your first kiss, your first sex: so many new experiences, and so many butterflies in your stomach, is what makes becoming an adult so exciting. You also have to start thinking about the right method of contraception. So what is the best contraceptive now available? "That can vary from woman to woman," explains Irène Dingeldein, president of the Swiss Society of Gynaecology and Obstetrics. "The most important thing is to choose a method that's safe, easy to use, doesn't have major side effects, and matches your lifestyle."

Consultation with a gynaecologist: not just for women

To find out the best type of contraceptive for you it's crucial to get advice from a gynaecologist. Most young women are aged between 14 and 17 when they first visit a gynaecologist. "Often they go because of pain or discomfort during their period, or when they have their first boyfriend," says Dingeldein. "In the consultation we talk about the young woman's lifestyle, whether they smoke or take medication. I ask whether the family has any history of disease, for example thrombosis, lung embolism, heart attack, high blood pressure or cancer."– This influences the choice of recommended contraception.

"I'm glad when a girl's mother comes with her and supports her," adds Dingeldein. "And of course also if her boyfriend is with her too. After all, contraception also affects him." Nobody has to be examined during the consultation,  unless they opt for an IUD: "This has to be placed in the uterus. So I first examine the woman and show her how it all works."

Preference for natural contraception

At the moment gynaecologist Irène Dingeldein is noticing a trend to natural contraceptives: "More and more young adults are interested in a copper IUD. They'd prefer not to take hormones and avoid affecting their body or the environment," says Dingeldein. Ruth Drahts at the Buchenhof women's practice in Sursee observes the same development: "I also hear a growing number of women say they don't want to take hormones. But when I explain all the pros and cons they often end up choosing the pill after all. It's often the best solution, at least as their first contraceptive," she explains. It's important to realise that "there's no such thing as a completely natural –safe contraceptive. You're always interfering with nature." 

Drahts also points out that there aren't actually that many alternatives to choose from. Either you suppress ovulation, –which is very reliable but affects the woman's body, or you prevent pregnancy mechanically or chemically, for example using a copper IUD.– This isn't completely free of risks and side-effects either.

How safe are cycle tracking, the temperature method, and so on?

The gynaecologist doesn't recommend young women to rely completely on tracking their cycle, for example by monitoring temperature or using an app to calculate ovulation. "It's supposed to work out your fertile days. But that's very unreliable and requires a lot of discipline. A woman has to abstain from sex or use a condom around ovulation, the very time she most want it. So it's not an actual method of contraception."

The other options aren't likely to change any time soon either: "There's research being done into preparations which have even fewer hormones, or other forms of the coil. But there's no real prospect of really new methods, for example contraceptives that put more of the onus on the man," says Drahts. "But if you take the time you'll find a good, safe contraceptive to suit you."

Three contraceptive options

1. Combined hormonal birth control: pill, patch and ring

These forms of contraception contain a combination of oestrogen and progesterone. These synthetic hormones suppress the woman's cycle and come with some desirable side-effects: they can reduce acne, heavy bleeding and pain during her period. They can also bring about improvements in benign conditions of the uterus such as myoma.

But they do slightly raise the risk of thrombosis. This option is not suitable for seriously obese women, those with a family history or an underlying condition such as thrombosis, epilepsy or diabetes, and smokers. It's also important to realise that antibiotics, diarrhoeal disorders and vomiting render the contraceptive less effective. "Some women also gain weight and feel that the hormones are causing a physical change. They can trigger depression in those with a predisposition. On the other hand the hormones can also help reduce mood swings," says Dingeldein.

2. Oestrogen-free contraception: Minipill, hormone implant, hormone IUD and hormone injection

These contraceptives only contain the hormon progesterone. The main advantage is that they don't increase the risk of thrombosis. "These methods are getting more and more popular. Taking them long term often substantially or completely reduces menstrual bleeding and pain. The downside is that it can lead to a less clear complexion and recurring mid-cycle bleedings," explains Ruth Drahts. Unlike combined methods, its efficacy isn't affected by diarrhoea, vomiting, medication, jet lag or wrong application.

3. Hormone-free contraceptives: copper IUD, condom, diaphragm, sterilisation

Non-hormonal birth control methods rely on mechanical or chemical contraception.