Today, there are many contraceptives and birth control methods to choose from to prevent pregnancy. It can feel like a difficult and tricky jungle to know how they work and what suits you. Therefore, we have designed a basic guide to the various methods so that you can gain an insight into what is available and how they work. Finding the right birth control method is a personal journey; we are here to help you along the way.

What does "hormonal contraceptives" mean and how do they work?

Hormonal contraceptives have the task of "shutting down" or "disrupting" the body's own sex hormones to prevent ovulation so that no egg can be fertilized. Hormonal contraceptives affect the body's own functions regardless of whether you experience side effects or not. The side effects can vary from person to person depending on how you are affected by the composition of synthetic hormones found in the type of hormonal contraceptive you use. The point of most hormonal contraceptives is to shut down ovulation, which is done by "turning off" your own sex hormones. The sex hormones estrogen and progesterone control much of our mood and health and are produced precisely through ovulation.

An important aspect of hormonal contraceptives is that if you don't ovulate (which you don't with hormonal contraceptives) you don't have a period either. However, you can get a so-called withdrawal bleed, which is what you get during the days you take sugar pills if you take birth control pills. The bleeding is reminiscent of menstruation but is therefore withdrawal bleeding because you did not ovulate. You may also experience withdrawal bleeding with the other hormonal contraceptives listed below.

As I said, the point of hormonal contraceptives is to prevent ovulation. Even with hormonal contraceptives, there can be exceptions where the body still manages to get through its own ovulation, but this is more unusual than usual as most hormonal contraceptives have a very high level of safety.

What types of hormonal contraceptives are there?

Now that we have a better understanding of how hormonal contraceptives work, we thought we'd go through the different options to choose from. We start with contraceptives that contain the two hormones estrogen and progestin and then finish with contraceptives that only contain the hormone progestin.

Birth control pills

This is a hormonal contraceptive that you take once a day in the form of a hormone tablet. Combined birth control pills contain estrogen and progestin which shuts down your ovulation. Some contain more oestrogen, others more progestin, hence you can get different side effects from different types of birth control pills. When it comes to birth control pills, it is important to remember to take the tablets at about the same time each day for maximum safety. With birth control pills, it is possible to skip the withdrawal bleeding by continuing on a new map and ignoring the sugar tablets. If you start to bleed, you should stop taking the hormone-based tablets and bleed completely, then start on a new chart when the withdrawal bleeding is over. If you have just started taking birth control pills, it is usually not possible to skip bleeding because it often leads to breakthrough bleeding instead.

To think of:

• Brings increased risk of blood clots and should not be used if you or family members/close relatives have had problems with blood clots, stroke and/or breast cancer. Birth control pills should also be avoided in case of other serious diseases. If any of this applies to you, an estrogen-free protection against pregnancy or one of the hormone-free alternatives is recommended instead.
• Provides safe protection against pregnancy when used correctly.
• Does not provide protection against sexually transmitted diseases.
• Can reduce problems with period pain, PMS, PMDS and acne when ovulation shuts down.
• Can cause side effects such as headache, acne, light bleeding, tense breasts, low mood, reduced sex drive and nausea.
• Read the package leaflet where potential side effects are listed. If you experience side effects and they haven't gone away after two to three months, you can switch to another type of birth control because you're not supposed to feel bad. The most important thing is that you find a method you feel good about, so test yourself and get to know your body.

P ring

This is a contraceptive that you insert into your vagina in the same way you insert a tampon. Once it is inside the vagina, it should not be felt at all. You use it for three weeks and then take it out, take a week off and then insert a new o-ring. The ring itself is about five centimeters in diameter and consists of soft, transparent plastic. The P-ring contains two hormones, estrogen and progestin, which, among other things, prevent you from ovulating. The same hormones are found in birth control pills and birth control patches. The P-ring does not need to be in place during intercourse itself, but does need to be in place for most of the day. Namely, the P-ring may only be removed for a maximum of three hours per day in order to function as an effective contraceptive method.

To think of:

• Brings increased risk of blood clots and should not be used if you or family members/close relatives have had problems with blood clots, stroke and/or breast cancer. P-ring should also be avoided in case of other serious diseases. If any of this applies to you, an estrogen-free protection against pregnancy or one of the hormone-free alternatives is recommended instead.
• If you are without a contraceptive ring for more than three hours (per day) or if you miss putting it in after the seven days without a ring with withdrawal bleeding, you can no longer be sure that you are protected against pregnancy. Then, in addition to inserting the ring, you must also protect yourself in some other way during the following week (e.g. a condom).
• Provides safe protection against pregnancy when used correctly.
• Does not provide protection against sexually transmitted diseases.
• Can reduce menstrual cramps and PMS problems.
• Contains less hormones compared to combined birth control pills.
• You can insert a new birth control ring immediately after three weeks instead of having your days without a birth control ring if you want to avoid having a withdrawal bleed every month. If you've just started using the I-ring, it's usually not possible to skip bleeding because it often leads to breakthrough bleeding instead.
• The P-ring should not be thrown in the garbage or in the toilet, but should be rinsed off and returned to the pharmacy. It is important because after use the ring still has an excess of hormones that will affect our environment and animals in the wild.
• Can cause side effects such as vaginal yeast infection, headache, depression, reduced sex drive, painful bleeding, acne and cysts on the ovaries, especially in the beginning.
• Read the package leaflet where potential side effects are listed. If you experience side effects and they haven't gone away after two to three months, you can switch to another type of birth control because you're not supposed to feel bad. The most important thing is that you find a method you feel good about, so test yourself and get to know your body.

Birth control patch

The birth control patch is a contraceptive that you put on the skin. The patch itself is about five by five centimeters and is thin and beige in color. The contraceptive patch contains the same synthetic hormones as the contraceptive pill and contraceptive ring (estrogen and progestin) and works in the same way by preventing ovulation so that fertilization cannot take place. Birth control patches are put on a protected part of the skin and should stay on for a week. It can be anywhere on the body except the breasts or any place where the skin is irritated. When you change the patch, you should also change the place. The patch almost never comes off by itself and you can live as usual with it. When you have had the patch for three weeks, you should be without it for a week and have your withdrawal bleed. When the fourth week has passed, put a new patch back on even if you are still bleeding.

To think of:

• The estrogen in the contraceptive patch increases the risk of blood clots and should not be used if you or family members/close relatives have had problems with blood clots, stroke and/or breast cancer. The risk of blood clots also increases if you are severely overweight or if you smoke large amounts. Contraceptive patches should also be avoided in case of other serious diseases such as previous heart valve surgery, ongoing acute liver disease and bed rest/immobility in connection with major operations. If any of this applies to you, an estrogen-free protection against pregnancy or one of the hormone-free alternatives is recommended instead.
• You can continue to put on a new patch after three weeks if you want to avoid a withdrawal bleed every month. In order for it to work as well as possible, you should ideally first have used the birth control patch as usual for two to three months. If you have just started using the birth control patch, it is usually not possible to skip bleeding because it often leads to breakthrough bleeding instead.
• Provides safe protection against pregnancy when used correctly
• Does not provide protection against sexually transmitted diseases.
• Can reduce menstrual cramps and PMS problems.
• Birth control patches should not be thrown in the toilet, but should be returned to the pharmacy, or alternatively thrown away together with combustible rubbish. It is important because after use the patch still has an excess of hormones that will affect our environment and animals in the wild.
• Can cause side effects such as vaginal yeast infection, headache, depression, reduced sex drive, painful bleeding, acne, cysts on the ovaries and hair loss, especially in the beginning.
• Read the package leaflet where potential side effects are listed. If you experience side effects and they haven't gone away after two to three months, you can switch to another type of birth control because you're not supposed to feel bad. The most important thing is that you find a method you feel good about, so test yourself and get to know your body.

Intermediate and mini pills

Intermediate pills and minipills are a contraceptive that you take every day in the form of a hormone tablet. They contain the hormone progestin. The difference between them is that intermediate pills contain more hormone than minipills and that minipills must be taken at the same time every day, while intermediate pills in most cases do not need to be taken at the same time every day. Intermediate pills and minipills make the secretion in the cervix tough so that the sperm find it difficult to enter the uterus. They also cause the lining inside the uterus to become thin so it cannot receive a fertilized egg. Intermittent pills also prevent you from ovulating. If you forget to take your pill, take it as soon as you remember. For intermediate pills, a maximum of 36 hours may pass between two tablets. For minipills, a maximum of 27 hours may pass between two tablets.

To think of:

• Provides safe protection against pregnancy when used correctly.
• Can be used if you cannot use a contraceptive that contains estrogen.
• Requires you to remember to take one tablet each day.
• Does not provide protection against sexually transmitted diseases.
• Is an unsafe protection if you vomit, have severe diarrhea or forget to take a tablet.
• Irregular bleeding is common.
• Can cause side effects such as vaginal yeast infection, headache, depression, reduced sex drive, painful bleeding, acne, cysts on the ovaries and hair loss, especially in the beginning.
• Read the package leaflet where potential side effects are listed. If you experience side effects and they have not gone away after two to three months, you can switch to another type of birth control because you are not meant to feel bad. The most important thing is that you find a method you feel good about.

P rod

This is a protection against pregnancy that is inserted under the skin of the upper arm. The stick is about the size of a match and consists of soft plastic. It contains the hormone progestin, which affects the lining of the uterus and the secretions in the cervix so that you do not get pregnant. The progestin also means that you usually do not ovulate. The P sticks are effective for 3 years, depending on the type you get, but you can take it out sooner if you want.

To think of:

• Provides safe protection against pregnancy.
• The protection is effective for three years.
• Does not provide protection against sexually transmitted diseases.
• Can be used if you cannot use a contraceptive that contains estrogen.
• Not suitable if you think it feels strange or uncomfortable to have something in your body.
• Irregular bleeding is common.
• Can cause side effects such as nausea, headache, depression, reduced sex drive, painful bleeding, acne, cysts on the ovaries and hair loss, especially in the beginning.
• You need the help of a midwife or doctor when you want to insert or remove an IUD.
• Read the package leaflet where potential side effects are listed. If you experience side effects and they have not gone away after two to three months, you can switch to another type of birth control because you are not meant to feel bad. The most important thing is that you find a method you feel good about.

P-syringe

This contraceptive is taken as a shot and protects against pregnancy. It contains the hormone progestogen, which you receive in a syringe every three months. The progestagen affects the endometrium and secretions in the cervix so that you do not become pregnant. It also means that you will not ovulate. The same hormone is found in intermediate and minipills as well as contraceptive sticks. However, the contraceptive injection contains a much higher dose of progestogen than, for example, minipills. Therefore, it is enough to take the shot every three months. It is the high dose of hormones that prevents you from ovulating. Normally you get the shot in the butt.

To think of:

• Bleeding may decrease or disappear completely, but irregular bleeding is also common.
• Brings increased risk of osteoporosis as you get older. The high hormone dose puts you at risk of losing bone mass
• Provides safe protection against pregnancy.
• Does not provide protection against sexually transmitted diseases.
• Just need to remember to take another shot every three months.
• Can be used if you cannot use a contraceptive that contains estrogen.
• The hormone dose is very high.
• It can take up to six months and sometimes longer before ovulation starts after you have used the contraceptive injection. It is therefore not a good method if you want to be able to get pregnant quickly.
• You need the help of a midwife or doctor when you get the shot.
• Can cause side effects such as headache, upset stomach, low mood, reduced sex drive, nausea, acne, hair loss, skin rash, back pain, weakness and sore breasts, especially in the beginning.
• Read the package leaflet where potential side effects are listed. If you experience side effects and they have not gone away after two to three months, you can switch to another type of birth control because you are not supposed to feel bad. The most important thing is that you find a method you feel good about, so test yourself and get to know your body.

Hormonal IUD

The hormone coil is a few centimeters long and looks like a T and is inserted into the uterus. The hormonal coil contains the hormone progestin and affects the secretion in the cervix so that it becomes tough and thick, making it difficult for sperm to penetrate the uterus. The spiral also affects the lining inside the uterus and causes it to become thin and therefore unable to receive a fertilized egg. Ovulation may also not occur when you use hormonal IUDs. Hormonal IUDs are available in different strengths and in different sizes. The hormonal IUD is inserted into the uterus by a midwife or doctor. When the IUD is put in place, it can hurt. Talk to the person who inserts the IUD to find out how long the IUD protects against pregnancy. It can vary from three to six years. After that time, the IUD must be removed or replaced. You can take out the hormonal IUD whenever you want.

To think of:

• For the first time after the IUD is inserted, you may feel a pain similar to menstrual cramps. These period pains can last for a few days and up to a week or two. Contact the person who inserted the IUD if the menstrual cramps have not gone over two weeks after the IUD was inserted.
• Bleeding may decrease or disappear completely, but it is also common to have irregular bleeding.
• Provides safe protection against pregnancy.
• Does not provide protection against sexually transmitted diseases.
• The protection lasts for three to six years.
• Can reduce problems with menstrual pain.
• Can be used if you cannot use a contraceptive that contains estrogen.
• Not suitable if you think it feels strange or uncomfortable to have something in your body.
• It may hurt when the IUD is inserted.
• There is a very small risk that the hormonal coil will partially or completely come out of the uterus and vagina.
• You need the help of a midwife or doctor when you want to insert and remove the hormonal coil.
• Can cause side effects such as headache, abdominal pain, depression, migraine, nausea, breast pain, decreased sex drive, acne, seborrhea (itching), bleeding disorders, spotting, cysts on the ovaries and inflammation of the vagina.
• Read the package leaflet where potential side effects are listed. If you experience side effects and they have not gone away after two to three months, you can switch to another type of birth control because you are not supposed to feel bad. The most important thing is that you find a method you feel good about, so test yourself and get to know your body.

What hormone-free alternatives are there?

Now that we have gone through different hormonal contraceptives, it is time to turn to the hormone-free methods of contraception. A hormone-free contraceptive method means that no synthetic hormones are added that can disrupt the natural menstrual cycle.

Copper spiral

Another way to protect yourself against pregnancy is with a copper coil, which is similar to the hormonal coil. Unlike the hormonal IUD, however, the copper IUD does not contain any hormones and therefore does not affect ovulation. The copper coil looks like a small T containing a copper wire. Instead of hormones, it gives off copper ions that make the sperm unable to move and prevent them from fertilizing the egg. If the sperm does manage to get through, copper also prevents a fertilized egg from attaching to the lining of the uterus. The copper IUD is inserted into the uterus by a midwife or doctor. When the IUD is put in place, it can hurt. During the first few days, you may experience pain similar to menstrual cramps. If you do not have your period when the spiral is inserted, it is important that you first take a pregnancy test. The copper coil should be removed or replaced after five years.

To think of:

• In the weeks after the IUD is inserted, you may have some spotting or blood-tinged discharge. Contact the person who inserted the IUD if you continue to have breakthrough bleeding after the first few weeks.
• Provides safe protection against pregnancy.
• Does not provide protection against sexually transmitted diseases.
• Contains no hormones which can be good if you get side effects from it.
• The protection lasts for five years.
• Not suitable if you think it feels strange or uncomfortable to have something in your body.
• It may hurt when the IUD is inserted.
• Some experience discomfort that can be similar to period pains after insertion.
• You may bleed more and have more period pain.
• There is a very small risk of the copper IUD being expelled during menstruation.
• You need the help of a midwife or doctor when you want to insert and remove the copper IUD.
• Can cause side effects such as pain, pelvic pain, headache, and acne.
• Read the package leaflet where potential side effects are listed. If you experience side effects and they have not gone away after two to three months, you can switch to another type of birth control because you are not supposed to feel bad. The most important thing is that you find a method you feel good about, so test yourself and get to know your body.

Pessary

Pessar is a contraceptive without hormones that is used together with pessargel. A pessary is a small silicone cup that is inserted into the vagina to cover the cervix. To protect against pregnancy, you must insert the pessary before intercourse and use it together with pessargel. Pessargel forms an extra barrier and reduces sperm mobility. You insert the pessary yourself by pressing it together and then inserting it into the vagina much like a tampon. A pessary that fits correctly and has the right size should not be felt. There are two different types of pessas. One type is slightly larger and also covers the cervix more and is called a vaginal pessary. A vaginal pessary can be in the vagina for a maximum of 24 hours and a cervical pessary can be in for a maximum of 48 hours. If you have sex more than once, you should apply more sperm inhibitor (pessargel). You should also leave the pessary on for at least six hours after sex. When you have removed the pessary, wash it with soap and water and then you can use it again.

To think of:

• A midwife or gynecologist can do an initial try-on to make sure you're the right size, but it's up to you.
• In addition to making sure that it fits properly, it is also good to occasionally check that it is not damaged.
• It may be helpful to have a midwife or gynecologist check the pessary after you've given birth, or if you've lost a lot of weight, to make sure it fits properly.
• Provides good protection against pregnancy when used correctly.
• Does not provide protection against sexually transmitted diseases.
• Can be used many times.
• Contains no hormones which can be good if you get side effects from it.
• It does not affect your natural fertility.
• Environmentally friendly.
• Not suitable if you think it feels strange or uncomfortable to have something in your body.
• You must plan and insert the pessary before intercourse.
• You may need some practice before it is easy to insert.
• Some women experience irritation, allergic reactions and urinary tract infections.
• Read the package leaflet where potential side effects are listed. If you experience side effects and they have not gone away after two to three months, you can switch to another type of birth control because you are not supposed to feel bad. The most important thing is that you find a method you feel good about, so test yourself and get to know your body.

Fertility understanding

Understanding fertility is about getting to know your body and how female biology works in order to be able to track your cycle and learn to determine when during the month you are fertile. To do this there are several different methods, in general these are: measuring basal body temperature daily, tracking your secretions, feeling the cervix and analyzing other changes/symptoms in the body during the phases of the menstrual cycle in the form of mood, energy, physical symptoms and more. To use fertility awareness as a safe method of knowing when you can get pregnant and choosing to protect yourself on those days, it is most effective to combine the methods.

What do the "fertile window" and "safe periods" mean?

To understand fertility understanding and the different methods, we need to understand the menstrual cycle, ovulation and when we are fertile during the cycle. You can only get pregnant about 6 days per cycle, this is called the "fertile window". The fertile window is "open" from about 5 days before ovulation and during ovulation (1 day). Sperm can survive about 5 days inside the vagina, therefore your fertile window is open from 5 days before ovulation and 24 hours during ovulation. During these approximately 6 days, you are fertile and can become pregnant. If you want to avoid pregnancy, these are the days you should protect yourself during intercourse with, for example, a condom. Since the fertile window does not always occur on exactly the same days in the menstrual cycle, it is good to take height for 7-10 days, regardless of how carefully you have tracked the cycle.

"Safe periods" are the remaining days of the menstrual cycle, i.e. the parts of the menstrual cycle when you are not fertile. The "safe period" therefore ends about five days before ovulation if you have a completely regular period and starts again a few days after ovulation, when the egg can no longer be fertilized by a sperm. Even if you have regular periods, your ovulation may be irregular and occur on different days in different cycles. Ovulation does not occur at a fixed time based on the period, but approximately fourteen days before the next period. In other words, it is ovulation that controls when the period comes and not the other way around. The more irregular your period, the more risky it is to rely on "safe periods".

The safe period after ovulation can be determined by checking your body temperature, which should rise about half a degree due to the corpus luteum hormone progesterone that is produced after ovulation. It is also possible to learn to recognize the secretions that the cervix produces during the fertile period. Vaginal secretions change during the menstrual cycle and by studying your secretions you can learn when you ovulate.

The billing method

The billing method is called the method where you learn which days during the menstrual cycle you are fertile by studying your fertile secretions.

The justice method

The Justisse method involves mapping three biomarkers daily in order to determine when you are fertile and when you are not. These markers are changes in vaginal secretions, measurement of basal body temperature and feeling of the cervix. Other cyclical changes and symptoms are also taken into account. By mapping all these markers, you get a daily status of your fertility based on your body. With the Jusstisse method, you don't have to have a regular cycle because it is based on your daily status.

Natural Cycles

Natural Cycles is a method based on daily measurement of basal body temperature. With natural cycles, you measure and record your basal body temperature every day in an app. You can also register other cyclical changes. Based on your body temperature, the app can then predict when you are fertile next time and when your "safe periods" will take place. In order for the method to be completely effective, it is important to measure body temperature at the same time when you wake up every morning and that the app receives a lot of data in order to have enough data to be able to make a future assessment. The less data the app has received, the fewer "safe days" it will be able to show.

To think of:

• The methods under Fertility Understanding provide good protection against pregnancy when used correctly.
• You get the best protection if you combine the different ways of reading the body.
• Does not affect your natural fertility.
• It is hormone-free and without side effects.
• Many people find it positive to gain an increased knowledge of their menstrual cycle and body.
• It is an unsafe protection if you do not have good knowledge of your body and master the method in the right way.
• May take time to learn the methods.
• Requires planning, discipline and accuracy.
• Can be a difficult and unsafe method if you have irregular periods.
• Does not provide protection against sexually transmitted diseases.

Other methods

Canceled intercourse

Interrupted intercourse is exactly what it sounds like, the penis being pulled out of the vagina before ejaculation is on its way. In this way, you avoid sperm entering the vagina. Interrupted intercourse is not a completely safe protection against pregnancy because the method requires you to react at the right time, which is not always easy. In addition, sperm can sometimes come even before ejaculation, in the so-called precum. Sperm from a previous ejaculation may also remain in the urethra for a certain period of time, which can lead to pregnancy if you have another intercourse afterwards. If the ejaculation comes close to the opening of the vagina, there is also a chance that the sperm find their way into the vagina to the uterus.

Sterilization

Sterilization is an operation that makes you completely remove the possibilities of getting pregnant (or for men being able to get someone pregnant). The procedure means that the path for egg cells and sperm cells is blocked so that fertilization cannot take place. You must therefore be completely sure of your case before sterilizing yourself. Sterilization of a man is a much simpler procedure than sterilization of a woman. You must be at least 25 years old to be sterilized.

To think of:

• The method is safe if you know that you never want to have children or that you do not want to have more children.
• Hormone-free method without side effects.
• It is difficult and complicated to repent and it is not certain that it will work.
• Does not provide protection against sexually transmitted diseases.

Condom/femdom

Condoms are the contraceptive method that also provides protection against sexually transmitted diseases. Therefore, it is recommended to use a condom even if you use another contraceptive method if you are with a new sexual partner. A male condom is rolled out over the erect penis. The femdom, the equivalent for women, works in a similar way. It is inserted into the vagina where it forms a thin, lubricant-treated barrier that prevents the sperm from reaching the cervix. Condoms and femdoms protect against sexually transmitted diseases and do not require hormones or other contraceptive methods to work. In order for them to protect against sexually transmitted diseases and pregnancy, it is important that it is on during the entire time you have intercourse and every time you have intercourse.

To think of:

• If a condom or femdom should break or slip off, there are emergency contraceptives to use within three to five days, to avoid pregnancy. You can find emergency contraceptive pills at pharmacies.
• Provides good protection against pregnancy when used correctly.
• Provides protection against sexually transmitted diseases.
• Easy to get hold of.

What is right for someone else may not be right for you

Contraceptive method is a highly personal choice. It is very important that you familiarize yourself with how the contraceptive method you want to try works, what risks and side effects there are and how you can make sure you use the method correctly. What is right for one person is not right for everyone. We hope that the guide provides a basic understanding so that you can make an informed decision that feels right for your body. Remember that you can always change methods if something doesn't feel right.