An important tool for your life planning

Which contraceptives are available for men and women?

There are numerous contraceptive options that can be chosen depending on life stage and individual needs.

For women, natural methods such as Natural Family Planning (NFP) are available, where fertile days are calculated based on body temperature and cervical mucus, as well as hormonal preparations such as the pill, the hormonal intrauterine device or the three-month injection, which suppress ovulation and thicken cervical mucus.

Mechanical methods such as the diaphragm or the copper IUD provide hormone-free alternatives, while chemical measures like contraceptive gels or spermicides can be used as supplements.

For men, the condom or the female condom (5 to 25), which protect against pregnancy and sexually transmitted infections, and vasectomy, a permanent and reliable method, are the best known. In female sterilisation, the fallopian tubes are cut or closed to prevent eggs from meeting sperm on their way through the tubes.

Innovative approaches are also under development, such as Vasalgel, an injectable gel that blocks sperm, or hormonal methods like the testosterone injection or the pill designed to temporarily suppress sperm production.

Despite the many options, choosing the right contraceptive is often a matter of personal circumstances, health considerations and life planning.

Pearl index: how safe is your contraceptive?

The Pearl index is a key measure for assessing the safety of contraceptive methods. It indicates how many women out of 100 become pregnant despite using a given contraceptive method over one year. The lower the Pearl index, the more effective the contraception. For example, the hormonal IUD with a Pearl index of only 0.16 is among the safest methods, while chemical contraceptives with values between 18 and 28 are among the least reliable alternatives.

Pearl index values can vary widely depending on the method and correct usage. Hormonal contraceptives such as the pill (Pearl index 0.2 to 0.5), the hormonal IUD (0.16) or the hormonal implant (0 to 0.05) offer very high protection when used correctly. However, side effects such as headaches, mood changes or nausea can occur. Medical advice, ideally from a gynaecologist, is therefore essential.

Mechanical methods such as the condom (2 to 12), the diaphragm (4 to 18) or the cervical cap (6 to 36) are also reliable, with effectiveness often depending on correct use.

Natural methods such as the symptothermal method (NFP) can also achieve high effectiveness (Pearl index 0.4 to 12), but require close observation and good body awareness. Less effective are withdrawal (4 to 20) or chemical products like suppositories and creams, which should ideally be combined with other contraceptive methods to increase protection.

The least safe option is no contraception at all, which, with a Pearl index of about 85, almost certainly leads to pregnancy.

The Pearl index shows that the choice of contraceptive should be considered carefully — depending on personal needs, life circumstances and the ability to use the method correctly. A discussion with a doctor can help identify the most suitable option for you.

Hormonal contraception: which methods are available?

Hormonal contraception offers a range of methods that can reliably prevent unwanted pregnancies. They are based on the administration of hormones that prevent ovulation or the implantation of a fertilised egg. Despite their high effectiveness, application methods and characteristics differ depending on lifestyle and the woman's health status.

An oral contraceptive (the pill) is the classic method. It combines oestrogen and progestin and is typically taken daily for three weeks, followed by a seven-day break during which menstruation occurs. Women who cannot tolerate oestrogens can use the mini-pill, which contains only progestin.

A vaginal ring is a flexible plastic ring inserted deep into the vagina that releases hormones there for three weeks. After a one-week break it is removed again. This method requires little effort and is a practical alternative to daily intake.

A hormone patch is applied to the torso (excluding the breast area), abdomen, buttocks or upper arm and continuously releases hormones through the skin. It must be changed weekly, with a break in the fourth week. It is particularly suitable for women who find daily pill intake inconvenient.

A hormonal IUD is inserted by a doctor into the uterus and protects for three to five years. It releases the progestin locally in the uterus. This method is ideal for women who want long-term contraception.

The three-month injection and the hormonal implant, long-acting methods, release hormones over an extended period. The injection is given every three months, the implant is placed under the skin and lasts up to three years. They are useful when other methods are not suitable.

Hormonal contraceptives are very effective and convenient when used correctly. Nevertheless, side effects such as headaches, mood swings or nausea can occur. Oestrogen-containing preparations may also increase the risk of thrombosis. Medical consultation is therefore essential to find the method that fits individual needs and medical conditions.

Does hormonal contraception protect against sexually transmitted infections?

It provides reliable protection against pregnancy, but does not protect against sexually transmitted infections. Because these methods do not create a physical barrier between partners, infections such as HIV, chlamydia, genital herpes, syphilis or gonorrhoea can be transmitted.

The only protection against infection is provided by barrier methods such as the condom. It prevents not only direct contact with bodily fluids but also exposure to pathogens transmitted by skin contact.

Therefore, when there are new or changing sexual partners it is advisable to combine hormonal contraception with condoms to avoid both pregnancy and health risks.

Which contraception is best after childbirth?

After childbirth, choosing the right contraceptive is crucial, as the body is still recovering and the timing of the first ovulation varies depending on breastfeeding.

Breastfeeding women should choose methods that do not affect milk production or the quality of breast milk. Barrier methods such as condoms or female condoms are simple and safe, while the diaphragm should be refitted after childbirth, as anatomy may have changed due to pregnancy and delivery.

Non-hormonal long-acting methods such as the copper IUD, the copper ball or the copper chain are also suitable and are inserted at least six weeks after delivery, when the uterus has fully involuted.

Progestin-only contraceptives such as the mini-pill, the hormonal IUD or the hormonal implant offer a safe alternative, as they neither reduce milk production nor alter the composition of breast milk. For experienced users, Natural Family Planning (NFP) may also be an option, although cycle observation is more difficult during breastfeeding.

Women who are not breastfeeding have more options but should bear in mind the increased risk of thrombosis in the first weeks after childbirth. Combined hormonal contraceptives such as the pill, the vaginal ring or the patch can be used no earlier than six weeks after delivery. The three-month injection is also possible but is less recommended because of potential side effects.

Breastfeeding can offer short-term protection against another pregnancy, as the hormone prolactin suppresses ovulation. This protection, however, applies only if the mother is exclusively breastfeeding, menstruation has not yet returned and the infant is under six months old.

Since this protection is not completely reliable, an additional contraceptive method is recommended. A consultation with a doctor helps to assess the individual situation and find the appropriate method.

Does the "morning-after pill" completely prevent pregnancy?

It does not offer complete protection against pregnancy, but is effective only under certain conditions. It can delay or prevent ovulation if taken in time before ovulation. If ovulation has already occurred, it will not be effective, since the product does not affect the fertilisation or implantation process.

Therefore it is important to take the pill as soon as possible after unprotected intercourse to maximise its effectiveness. If the next period is absent, a pregnancy test should be performed to clarify the situation. This pill is an emergency solution and not a regular contraceptive method.

Contraceptives: how to choose the right method for your needs

• Think about contraception early once you become sexually active. This not only protects against unwanted pregnancies but also gives you time to find the method that suits you.
• Consider the Pearl index when selecting a contraceptive method. The lower the value, the more effective the method.
• Get thorough advice before using hormonal contraceptives such as the pill. An initial check-up helps find the right method for your needs.
• The pill is one of the most effective contraceptives, but consider possible side effects such as an increased risk of thrombosis. Weigh whether the benefits outweigh the risks for you.
• If the pill does not suit you, consider alternatives such as condoms, IUDs or hormonal implants. These also provide reliable protection.
• There is still a risk of pregnancy during the transition to menopause. Continue using contraception until you are certain you are in menopause.
• If you choose the mini‑pill, take it at the same time every day. This is crucial for its effectiveness.
• Combine condoms with another method to protect not only against pregnancy but also against sexually transmitted infections.
• Do not rely on unreliable methods such as withdrawal or counting fertile days. They do not provide dependable protection.
• Adolescents under 14 require parental consent for hormonal contraceptives. Discuss the topic early to avoid misunderstandings.
• If your family planning is complete, sterilisation may be a permanent and reliable option.
• Regularly check the tolerability and effectiveness of your contraceptive with your physician, especially for hormonal preparations.

Contraceptives not only provide reliable protection against unwanted pregnancies but also contribute to individual health prevention. The variety of available methods makes it possible to find the right option for different life situations and needs. Professional counselling is essential to better understand the benefits and potential risks of each method and to make an informed decision.