Contraception

GP Community LARC Service 

If you wish to have a coil or implant fitted as part of your HRT regime or for managing heavy menstrual bleeding you can contact the following services for a triage appointment:

For South Sefton GP Patients please call 0151 944 6503

For North Sefton GP Patients please call 01704 395755

There are two main types of contraception:

Short acting requires users to take medication at the same time every-day. If the medication is not taken at the correct time, the contraception may not be reliable.

Long-acting methods are inserted or injected into the body (usually the arm, buttock/stomach, or uterus) and last for a longer period of time depending on the method, this can be between 12 weeks to 10 years. Once inserted, the user does not have to think about contraception until it’s time to be replaced.

There are some ‘methods’ that we do not recommend, these include:

• Pull out method (removing the penis from the vagina just prior to ejaculation)
• Showering after sex 
• Having sex standing up 

We recommend accessing emergency contraception as soon as possible if these methods have been used.

Finding the right method for you can be daunting, especially when faced with all the different options. It’s a good idea to firstly think of you and your needs; do you have medical history that may make certain contraception unsuitable? What about your lifestyle; would you have trouble remembering to take medication at the same time every-day? Do you expect to have children soon?  These are all questions to ask yourself to help narrow down your choices. During your consultation, the nurse will discuss this with you to help find the most suitable method.

Like all medication, contraception has side effects. The exact side effects someone may experience will depend on the method used and the person using the method. While each method may have its own set of potential side effects, people can respond to contraception differently. It’s important to note that just because someone you know experienced a side effect, it doesn’t mean you will also experience the same effects. Some common side effects include headaches, nausea, irregular bleeding or changes to periods.

 Most side effects are temporary and short lived, usually passing in a few months. However, if your side effects are severe or long lasting, please return to clinic to discuss your options with a nurse/doctor.

If you are unhappy with your current method, please return to clinic to discuss your options. Sometimes it takes trying a few different methods until you find the right one for you.

For the pill to be effective, you must take at the allocated time. If you miss the time to take the pill, you must follow the instructions given to you at the time of prescription (this is usually inside your pill packet). If you cannot find the leaflet or are still unsure, please call clinic as soon as possible. If clinic isn’t open, you may need to visit your nearest pharmacy for emergency contraception, depending on whether you’ve recently had unprotected sex.

All long-acting methods have a date that they are no longer effective against preventing pregnancy. If you haven’t had the device changed, or had a repeat injection, by the date given to you at the time of insertion, it probably will no longer be effective at preventing pregnancy. The devices won’t cause you harm by being in longer than intended, but it is recommended calling clinic to discuss, even if you think you no longer require contraception.

Oral emergency contraception is available up to 5 days after sex (120 hours to be precise!). A copper IUD can be inserted up to 120 hours after unprotected sex, depending on where you are up to in your cycle.

Emergency contraception is available free from our clinic, please call to book an appointment. If clinic is closed, Emergency Hormonal Contraception (EHC), previously known as the morning after pill, is available from pharmacies. There may be charge but some pharmacies can offer it for free, we advise to call up prior to visiting to make sure it is available for free. Free EHC is also available from walk in centres and A&E.

Our clinic now offers an appointment service. This allows patients to attend clinic with a pre-booked appointment, meaning your wait will be much quicker. 

There may be a wait for some contraception appointments, we recommend calling in well advance to avoid your current method current running out/expiring. If your method does run out or expire, click here to order condoms by post.

If you suspect you may be pregnant, we will need to rule this out before we can provide you with contraception. You can test for pregnancy 21 days after unprotected sex or the from the first day of a missed period. We offer pregnancy testing in clinic. Once a pregnancy has been ruled out, we can offer contraception as usual. However, if we’re still unsure, we may ask you to return to clinic in a few days or weeks for another test.

Like most medication, contraception may have side effects. While side effects differ between methods and from person to person, we’ve got a few top tips to help you manage some common side effects:

Breast Tenderness

• Invest in a good fitting bra.
• Consider using over the counter pain medication such a paracetamol.
• Some people report Evening Primrose may help ease symptoms (although there is a lack of evidence to support this claim)

Nausea

• Try to eat little and often.
• Avoid taking pills on an empty stomach.
• Taking your pill at bedtime may help.

Headaches

• Make sure to drink plenty of fluids.
• Consider using over the counter pain medication such a paracetamol.
• If you’re on the pill, making sure you take the pill at the same time each day may help to regulate hormones quicker.

Mood Changes

• Talk to your partner to help them understand the changes in your body, a supportive partner can help when your mood is low.
• Exercise, healthy eating, and hobbies are known to help with low mood.
• Speak to your GP if you experience severe and persistent mood changes.

Bleeding and changes to periods

• Take your pill at the same time every day to help regulate hormones quicker.
• Always keep extra sanitary products in your bag for heavy bleeding
• Wearing panty liners can help with infrequent bleeding.

Reminder!

Contraception side effects are usually mild and only last a few months. If you experience any of the following contact your GP or contraception provider:

• Long-lasting or persistent side effects
• Severe side effects
• Severe or unusual changes to periods
• Persistent breast lumps or other unusual breast symptoms
• Severe or persistent mood changes

Put your pills in a place you use everyday.

Pop it by the kettle, in your underwear drawer, or bedside table. Placing it in an easy-to-see and well-used place can increase your chance of remembering to take the pill.

Ask someone to remind you.

Asking a partner to remind you to take your pill can help you remember, plus it can also help your partner take some responsibility too.

Give enough time

Make sure you have enough time to get more pills, calling the day before you run out probably won't give you enough time. Ideally, call the clinic a few weeks before you finish your current pack of pills.

Set an alarm

Once you decide on the time you want to take your pill every day, set an alarm on your phone to remind you.

Reflect

Every few months, think about if the pill still suits you and your lifestyle. If you're forgetting to take it or maybe you've had a few flare-ups of IBS recently, this could mean you need to think of more reliable method.

Beware

Remember, vomiting or diarrhoea can reduce the effectiveness of the pill. Make sure to carefully read the instructions that come with your pill and if you're unsure, use condoms for 7 days.

Before having your coil fitted or changed, it’s important to abstain from unprotected sex 7 days before your appointment. This is to reduce the risk of you being or becoming pregnant. It’s important to let the nurse/doctor know if you’ve recently had unprotected sex.

On the day of your appointment:

• Consider taking over the counter painkillers just before your appointment.
• Bring sanitary products with you to your appointment and have a supply at home, it’s common to bleed for a few days afterwards (Don't worry if you forget, we do have a supply in clinic). 
• Arrange for someone to collect you, we advise to avoid driving yourself if possible.
• Try to make sure you eat something prior to your appointment.
• Try to take it easy after your appointment, avoid heavy lifting or prolonged standing is possible.
• Make sure to give yourself enough time for your appointment, while it only takes a second to insert the coil, the appointment could last up to an hour. Knowing your medical history and making sure you’ve abstained from sex can help speed up your appointment.
• We advise against brining children to your appointment, unfortunately we cannot accommodate them in our clinic rooms during fittings, but they can wait in our waiting area with a responsible adult.
• You will be offered STI testing during your appointment as this may be a good time to update your tests or have a test done, if you have never had one.

To have an implant inserted is a relatively pain-free procedure, we will use local anaesthetic to numb your arm, then use a pre-loaded device to insert the implant just beneath the skin. A plaster and a bandage will be applied, this will need to remain in place for 3 days. The implant will take 7 days to work, you may need to use a barrier method for contractive during this time.

Inserting the implant only takes a few minutes but your appointment will be longer as you will need to wait for the arm to numb fully and answer questions, including medical history. We recommend allowing up to 1 hour for your appointment.

The implant is made of strong plastic, but it can be damaged once it's inserted. After insertion, you no longer need to think about contraception until it's time to remove/replace the implant. However, you still need to be responsible for making sure the implant isn't damaged. Poking, bending, and squeezing the implant under the skin can cause damage that may make it less effective. If you suspect your implant is damaged, return to clinic as soon as you can.

The implant can prevent pregnancy for up to 3 years. If you are unhappy with the implant or want to get pregnant, you can have it removed earlier. If you want to get it removed due to side effects, your healthcare provider may recommend waiting 6 months to see if your symptoms settle down (most people experience side effects in the first 6 months while the body adjusts, after this time the side effects are much less noticeable or may go altogether).

A small cut is made in the inner upper arm, this cut doesn't require stitches but may be sore for a few days. Once healed, a very small scar may be visible on some people. Until the cut is fully healed, take care not to irritate or bang the incision.  It shouldn't be painful but painkillers such as paracetamol may help with any pain or discomfort.

It is unlikely to protect against pregnancy after 3 years. You will be given a card with the date you had it fitted but putting a reminder in your phone calendar can help you remember to replace it in time. If your implant expires, call make a clinic appointment as soon as possible and use condoms until it's replaced. 

Contraception isn’t 100% effective at preventing pregnancy, but most are up to 99% effective if used correctly. However, some methods are considerably less effective if people don’t use them as intended. This could lead to contraception failing and result in an unplanned pregnancy.  Here are some of the common reasons why contraception fails:

1. Not taking the pill on time. For the contraceptive pill to be effective at preventing pregnancy, it must be taken at the same time every day. Forgetting to take the pill, even for just few hours, could make it less effective!
2. Using methods past expiration. Implants and devices such as the IUS have expiry dates. Continuing to use these methods past the expiration date may result in an unplanned pregnancy.
3. Vomiting or Diarrhoea. Experiencing vomiting or diarrhoea a few hours after taking the pill can make them less effective as the body hasn't had enough time to absorb the hormones required to prevent pregnancy.
4. Incorrect use. Using condoms, diaphragms and caps incorrectly can make them less effective. Putting on a condom incorrectly can lead to it ripping, tearing, or even bursting!