|Contraception is designed
to ensure that sexual intercourse does not result in pregnancy.
This fact sheet outlines the non-hormonal methods. For more information
on the 'pill' please see a separate fact sheet on hormonal contraception.
Non-hormonal contraception works by either preventing sperm fertilising
an egg, or preventing the implantation of a fertilised egg into
the lining of the womb. The main techniques are:
- Barrier methods
- Intra Uterine Devices (IUDs)
- Natural family planning
|These are physical barriers
that stop the sperm coming into contact with the egg, thereby
A condom is a thin, sheath usually made out of latex, which is
rolled onto an erect penis before any sexual contact. Oil-based
lubricants such as Vaseline should not be used with latex condoms
because they can cause the latex to break down. Water-based lubricants,
such as K-Y Jelly, and spermicidal creams or pessaries are safe.
Oil-based lubricants do not affect condoms that are made from
Carefully follow the instructions that come with the condoms.
After sex, you should check the condom for leaks and tears before
it's discarded (don't flush condoms down the toilet). If there
is a problem, emergency contraception (the 'morning after' pill),
may be needed. For more information on this please see the factsheet
on hormonal contraception.
If used according to the instructions, condoms are 98 per cent
effective at preventing pregnancy. They may also protect both
partners against certain sexually transmitted infections such
as HIV and genital warts.
A female condom (Femidom) is a thin, soft polyurethane pouch,
which is fitted inside the vagina before sex. It has an inner
ring that goes into the upper part of the vagina, and an outer
one, which should be visible. The female condom is less likely
to tear than the male condom.
Carefully follow the instructions that come with the condom. If
used according to the instructions, they are 95 percent effective.
The diaphragm and the cap
The diaphragm and cap are devices made of thin, soft rubber that
are inserted into the upper part of the vagina to cover the cervix
(neck of the womb). They act as a barrier to sperm.
Caps are smaller than diaphragms, but both are available in several
types and sizes. In the first instance the cap or diaphragm needs
to be fitted by a doctor or family planning nurse to make sure
it's the right size and is positioned correctly. After the initial
fitting, they are put in place up to a few hours before sex. They
need to be used with a spermicidal cream or pessary, and should
be left in place for at least six hours after sex.
If used correctly, with spermicide, caps and diaphragms are 92-96
per cent effective at preventing pregnancy.
This is a small sponge impregnated with a spermicidal gel or cream.
It is moistened with water before use, and then inserted high
into the vagina to cover the cervix. It needs to be left in place
for at least six hours after sex, and can be left for up to thirty
hours, although there is a risk of infection if left in for longer
This method offers 70 - 90 per cent protection.
|These are creams, gels or
pessaries (dissolvable tablets) that contain a chemical that kills
sperm. You can use these to increase the effectiveness of barrier
methods of contraception but do not provide reliable contraception
when used alone. Spermicides can be bought without prescription
at pharmacies. Some condoms have a coating of spermicidal lubricant.
|The IUCD or coil
|The intra-uterine contraceptive
device (IUD) - or coil - is a small plastic and copper device,
which is fitted into the womb by a doctor or nurse. It is designed
to prevent the sperm meeting the egg, and may also make the egg
move down the Fallopian tube more slowly and stop an egg settling
in the womb.
The main advantage of a coil is that, once fitted, there is no
need to worry about contraception. As long as the coil remains
in place, it can be left for three to ten years. They are up to
98 per cent effective.
There are, however, disadvantages. Coils can make a woman's periods
heavier, longer or more painful. This may improve after a few
months. There's a small chance of getting an infection during
the first 20 days after a coil is put in. Many doctors will advise
a check-up for any existing infection before they fit one. Infection
can spread to the womb and Fallopian tubes, and can possibly result
in infertility. For this reason, a doctor may not recommend the
coil unless the woman has already had any children she wants.
It's possible for the coil to be pushed out by the womb (expulsion)
in the first few months after fitting. It has fine plastic threads,
which pass into the vagina. The doctor or nurse will give advice
on how to check the coil is still in place every month by feeling
for the threads.
Rarely a coil might go through (perforate) the womb or cervix
when it is fitted. This may cause pain but often there are no
symptoms. If this happens, the coil may have to be located with
an X-ray and removed in a small operation. Perforation is rare
when a coil is fitted by an experienced doctor or nurse.
If pregnancy does occur while using a coil, there is a small risk
of an ectopic pregnancy. This is when the pregnancy develops outside
the womb, usually in a Fallopian tube. Although this is rare,
it is dangerous. So, if you miss a period, see your doctor. An
IUCD does not protect against sexually transmitted infections.
|Natural family planning
|This involves reducing the
chance of becoming pregnant by avoiding sex around the most fertile
period during the woman's monthly cycle. If the woman has a regular
cycle, it can be 80-98% effective at preventing pregnancy.
The key is for the woman to keep a diary to work out when she
ovulates - the part of the cycle where sex is most likely to result
in pregnancy. It involves recording the dates of her periods for
three to six months - taking day one as the first day of menstruation.
Ovulation occurs around 12 -16 days before the start of the next
period. The fertile period lasts for around eight or nine days
around ovulation because although an egg only lives for 24 hours,
sperm can survive in the woman's body for up to seven days.
Measuring and recording body temperature with an accurate thermometer
each morning can help determine when ovulation is occurring. After
ovulation, body temperature can rise by between 0.2 and 0.6 degrees
C. But a higher temperature can happen for other reasons, such
as illness, so it's not a failsafe indicator.
Cervical secretions also change during the monthly cycle, so the
woman can monitor vaginal discharge. Early in the month, it's
scant and thick - it then becomes more watery as ovulation approaches.
After ovulation the mucus returns to being thick and sticky once
more. However, a vaginal infection can distort these patterns.
To find out more on natural family planning, contact your doctor
or the Family Planning Association of Hong Kong. There are also
devices available (Persona) that measure body temperature and
hormone levels. If used according to the instructions, this is
|The withdrawal method
|This involves withdrawing
the penis before ejaculation. This is not a reliable method because
some sperm can leak out of the penis before ejaculation.
|This is an operation to
permanently prevent fertilisation. It is a permanent method of
contraception and is only recommended for people who are sure
they do not want to have any more children.
This is an operation performed under general anaesthetic, usually
as day case surgery. The Fallopian tubes are cut, tied or blocked,
often through keyhole surgery. The alternative is a hysterectomy,
when the womb is removed.
In men - vasectomy
This is a minor operation usually performed under local anaesthetic.
It involves cutting or tying the tubes (vas deferens) which carry
sperm from the testicles to the penis.
The failure rate of sterilisation is around one in 2,000 for men,
and about one in 200 for women, depending on the procedure. After
a hysterectomy, pregnancy is impossible. These operations are
not easily reversible, with attempts only 50 to 60 per cent successful.
|The Family Planning Association
Tel : (852) 2575-4477
Fax : (852) 2572-2222
Kely Support Group
2/F, East Wing, 12, Borrett Road
Hotline: (852) 9032 9096 (English)
The Family Planning Association (UK)
Brook Advisory Centres
Planned Parenthood Federation of America
U. S. Food and Drug Administration
|Healthwise (Health Information Resource
Tel : (852) 2849 2400
Fax : (852) 2849 2900
Email : firstname.lastname@example.org
Homepage : http://www.healthwise.org.hk/
This leaflet is for information only. For a detailed
opinion or personal advice, please consult with your own