Contraception is often necessary throughout the childbearing years. What is the best contraception method in different life stages and how do I know? Can I go back to my previous birth control after having a child? And what is the best form of contraception for people in their 40s who are approaching menopause?

Kia Lampi, Sisko’s specialist in gynaecology and obstetrics, answers frequently asked questions about the choice of birth control methods at different stages of life.

In her work as a doctor, Kia has encountered hundreds of women and other people with vulvas who have started, continued or stopped using contraception in different situations.

Q: What is the best contraception method for a young person and why?

A: Young people often choose birth control pills because they are an easy choice to start with. There are several pills, so by testing them, many can find the right option for them.

Young people often feel that they benefit from pills from even other than contraception perspective. With pills, you can greatly reduce and regularize menstrual bleeding and they also treat acne, which can be relevant for many young people.

The flip side is that young people, according to research, more easily forget to take their pills regularly. Therefore, the IUD (intrauterine device) and the capsule are also good options for them. There are no age limits for the use of these forms of contraception, even though it may sometimes be thought so, but they require a doctor’s visit, which can be a threshold for a young person.

In addition, I would also mention the birth control ring, which is less known or talked about. It works the same way as birth control pills. Everyone can put it in the vagina themselves and you only need to remember to change it once a month.

Q: What about birth control in your twenties, when your sex life may be active, but there is not necessarily a permanent relationship?

A: In general, you should continue with the contraceptive method that suits you.

The IUD is easy because once it’s placed, you can forget about it. It can stay in place for 3-8 years, so it is suitable for people who are not planning to have children soon.

The capsule has the same ease, you can kind of forget it after it’s been placed.

Of course, it is important to remember that these are good methods of preventing pregnancy, but do not protect against sexually transmitted diseases. Condom or oral sex protection protect agains STDs.

Q: You often hear talk about “safe days” or calendar method – how safe are they from gyno’s point of view?

A: Not very safe. Pearl’s number, which means how many women or people with uterus out of a hundred become pregnant during a year, is 25. So one in four. Of course, this depends on how well you know your cycle and whether it is regular or not.

In addition, you must remember that sperm can live in the uterus for up to a week. If you wish not to get pregnant, then calendar method is not a good contraceptive method.

Q: When you start considering having children, how should you take care of birth control?

A: If having children is on your mind or planned soon, the easiest may be e-pills, mini-pills or the birth control ring, which are easy to stop. An IUD or a capsule is then not the easiest method, although these can of course also be used.

If you have used hormonal contraception and stop taking it, the hormones leave the body almost immediately. So, you shouldn’t worry about that. However, it is good to keep in mind that pregnancy often does not happen immediately.

Another thing to consider is that if you have been using hormonal contraception for a long time, you may not feel your own natural menstrual cycle. Menstruation may be irregular for the first couple of months after stopping contraception, but if the irregularity continues for longer, it may be that your periods are just naturally irregular. If you have been taking pills for a long time, for example at the age of 20-30, then at the same time your own fertility has also changed.

Q: What is good contraception method after pregnancy?

A: During the first weeks after pregnancy, good options are contraception with no hormones or only luteinizing hormone, such as an IUD, minipills, or a contraceptive capsule. Combined contraceptives, i.e. birth control pills, patches or rings, are not recommended in Finland during the first six months, as they may slightly reduce milk supply. According to NHS (NHS) it is safe to start with these methods after 6 weeks. If a new pregnancy is not planned soon, then IUD is a good option.

Q: 35 is an age that is somehow significant from contraception perspective. What is it about?

A: At the age of 35, closer attention is paid to the risk factors predisposing to blood clots. These include, for example, smoking, being overweight and migraines. If a person has these risk factors, combined contraceptives are not recommended. If there are no risk factors, you can happily continue with these contraceptives.

Also, the risk or probability of pregnancy usually starts to decrease around the age of 35, which means that younger people especially need to have a more accurate method for contraception.

Q: What about when menopause is approaching, what is a good contraception for let’s say a 45-yo?

A: If you already have found the best contraception method for you, continue with it. If there are changes in your health, it is good to talk about the suitability of contraception with your gynaecologist.

If there are bleeding disorders, menopausal symptoms or if you want to start a new method of contraception, I would prefer an IUD. With it, you can add estrogen, for example, as a gel to the skin or with a patch, if menopause symptoms start to appear and you want to treat them with hormone therapy.

Sources: Terveyskirjasto, NHS