Not sure which contraception is right for me.
CONTRACEPTION
Contraception is used to prevent transmission of Sexually Transmitted Infections and unwanted pregnancy. Contraception is often discussed in a heteronormative way - i.e. people who are not heterosexual are often not included in conversations about contraception. This is due to misinformation and a lack of understanding. Whatever your sexual orientation or gender, if you are sexually active, you are at risk of contracting a Sexually Transmitted Infection (STI). Hormonal contraception works by stopping the female eggs from being released from the ovaries. It is important to weigh up the advantages and disadvantages of each method and find one that meets your particular needs. You can go to your GP or contact the Sexual Health Centre for more information on contraception. Please note that some GPs may require that a guardian is informed before prescribing contraception to people under the age of 17.
BARRIER CONTRACEPTION
CONDOMS
These work by stopping the male sperm from reaching a female egg and preventing fertilisation. They are considered to be 98% effective against pregnancy when properly used. (See our condom checklist).
DENTAL DAM
This is a sheet of latex that is used to cover the vulva during oral sex. A dental dam protects against Sexually Transmitted Infections. Dental dams are often more expensive to purchase compared to condoms. By cutting a condom open, you can use it as a dental dam. At the end of this section, you can see how to make your own dental dam by cutting up a condom.
THE DIAPHRAGM (THE CAP)
The diaphragm is a dome of thick rubber which fits inside the vagina over the cervix. It acts as a barrier to stop the sperm reaching an egg. It must be inserted prior to sex and left in for a number of hours after sex. The diaphragm must be used in conjunction with spermicidal gel. It must be specially fitted for each individual person. The diaphragm does not provide protection against Sexually Transmitted Infections.
WITHDRAWAL (PULLING OUT) IS NOT A FORM OF CONTRACEPTION.
Withdrawal (pulling out) is not a form of contraception. Some people think that if you have sexual intercourse and withdraw the penis from the vagina before ejaculation, that there is no risk. This is not true as fluid containing sperm (precum) comes out of the top of the penis when it is erect and this can cause pregnancy and STIs.
CONTRACEPTION METHODS FOR BOYS, MEN AND PEOPLE ASSIGNED MALE AT BIRTH (AMAB)
Contraception methods for boys, men and people assigned male at birth (AMAB) are limited to condoms and vasectomy operations. While potential hormonal contraception methods have been studied since the 1970s, none are yet commercially available and it’s likely that we won’t see a commercially available product yet for many years.
CONDOM CHECKLIST
Always check the date on the packet and never use any condom that is passed its ‘use by’ date.
Make sure that the condom you are using has a safety mark e.g. ‘CE’.
Keep your condoms away from heat, light and damp as these can damage them. Wallets and pockets can expose a condom to heat and friction so they are not good places to store your condoms.
Open the packet carefully and watch out for nails, jewellery etc. as they can tear a condom easily.
Wait for the penis to go hard. With one hand, squeeze the tip of the condom with your thumb and finger to get rid of all of the air at the tip. Put the condom on the penis with the other hand and roll it all the way down. Be sure to put it on with the roll on the outside.
If you need lubricant (to add wetness) make sure it is a water-based lubricant. Never use anything that is oil based such as Vaseline, baby oil etc. as these will rot the condom very quickly so it will not protect you.
Withdraw the penis straightaway after ejaculation.
Hold the condom firmly at the base of the penis to stop any leaks.
Knot the base of the condom, check for any tears, wrap it in a tissue and throw it in the bin.
Do not throw it down the toilet, as condoms won’t flush!
Always only use one condom at a time and do not re-use.
If you’ve never used a condom before, practice by yourself first.
For more information on how to use condoms and lubricant, check the link below: www.sexualhealthcentre.com/relationships-and-sex
HORMONAL CONTRACEPTION
Hormonal contraception is prescribed by a doctor for girls, women, and people assigned female at birth.
THE PILL
The pill works by stopping eggs being released from the ovaries. It must always be taken as prescribed and never shared with friends even if they are on the pill also. If taken correctly (every day) the pill is considered to be 99% effective against pregnancy. If you have been vomiting or you forget to take the pill you may not be protected. It is important to always use a condom for 7-10 days afterwards. The pill does not provide any protection against Sexually Transmitted Infections.
THE PATCH
Patches are thin, beige and about the size of a matchbox. They work by releasing hormones through the skin which stop the eggs from being released from the ovaries. They can be applied to various parts of the body but should not be put on the breasts or anywhere above the neck. They are used for three of the four weeks of the cycle and are changed weekly. Patches do not provide protection against Sexually Transmitted Infections.
IMPLANTS (ALSO KNOWN AS THE BAR)
These are flexible tubes containing a hormone. They prevent ovulation and are a long term contraceptive, lasting up to 3 years. They are placed under the skin on the inside of the arm by a doctor. Implants do not provide protection against Sexually Transmitted Infections.
CONTRACEPTIVE INJECTIONS
These injections slowly release the hormone progestogen. They work by stopping ovulation and prevent fertilisation. Each injection lasts for 8-12 weeks. Contraceptive injections do not provide protection against Sexually Transmitted Infections.
THE INTRAUTERINE DEVICE (IUD) (ALSO KNOWN AS THE COIL)
The IUD (or coil) is a small piece of plastic and copper placed inside the womb by a doctor. The Mirena and JayDez IUDs are plastic and contain hormones. This method is normally prescribed to people who have already experienced a pregnancy. It lasts for 3-10 years. The IUD does not provide protection against Sexually Transmitted Infections.
EMERGENCY CONTRACEPTION (ALSO KNOWN AS THE MORNING AFTER PILL)
This can be used if you had sex without contraception or if you think your contraception may not have worked. Emergency contraception is a high dose of hormone which can stop ovulation and /or makes the womb shed its lining to prevent fertilisation. There are two types of emergency contraception pills that are available from pharmacies and GPs.
Progesterone (must be taken within 72 hours /3 days).
Ulipristal (must be taken within 120 hours /5 days).
The earlier emergency contraception is taken (within 24 hours), the more effective it will be. You can buy either type of pill in a pharmacy without a prescription.
The pharmacist will ask you some questions to check that you are not on any other medications that will make the morning after pill less effective and to make sure that it is safe for you to take it. Emergency contraception is not a substitute for regular contraception - it should be used only as an emergency solution. Emergency contraception does not provide any protection from Sexually Transmitted Infections
HORMONAL CONTRACEPTION IS NOT SUITABLE FOR SOME PEOPLE
including people with high blood pressure, as it can increase the risk of forming blood clots. For this reason, a doctor should take your blood pressure and ask about your medical history before prescribing any contraceptives.
HORMONAL CONTRACEPTION SIDE EFFECTS AND RISKS
Each type of hormonal contraception has its own set of side effects and risks. These side effects might be severe in some people and non-existent in others. If you are using hormonal contraception and feel unwell (physically, mentally, emotionally or sexually), do not suffer in silence! Discuss other contraceptive options with your GP.
NOT JUST FOR BIRTH CONTROL
Hormonal contraception is not just used for birth control - some people use it to regulate their periods, or to minimise acne, or to deal with other medical issues.
CONTRACEPTION FOR BISEXUAL AND PANSEXUAL GIRLS AND WOMEN AND PEOPLE ASSIGNED FEMALE AT BIRTH
No matter what your sexual orientation is, it is essential that you have considered how to protect yourself from Sexually Transmitted Infections before you have any physical sexual contact with another person. If you do not have access to dental dams, you can make them by cutting up condoms (see the image below.) You can avail of free condoms from the Sexual Health Centre. If you usually are not sexually interested in boys, you might not consider the risk of unplanned pregnancy. However, it is important to remember that any unprotected penetrative vaginal sex with someone who has a penis can lead to unplanned pregnancy.
CONTRACEPTION FOR PEOPLE ASSIGNED FEMALE AT BIRTH UNDERGOING HORMONE THERAPY
• Hormone therapy is not an effective form of contraception. Even if hormone therapy has caused your periods to stop, you may still be ovulating, which means that you can still become pregnant.
•Hormonal contraception and testosterone (hormone therapy) can be used together. Some people may not prefer this method due to concerns about having estrogen in their system.
CONTRACEPTION FOR PEOPLE ASSIGNED MALE AT BIRTH UNDERGOING HORMONE THERAPY
• Hormone therapy is not an effective form of contraception. Hormone therapies do not always stop sperm from developing in the testicles, which means that you can still impregnate someone.
• You should not take hormonal contraception that is intended for people assigned female at birth. Instead, use a barrier contraception (e.g. condoms).
RECENT HISTORY OF CONTRACEPTION AND IRISH LAW
While owning and using contraceptives was always legal, laws restricting the sale of contraceptives meant that many Irish women and men drove across the border into the North of Ireland to bring back illegal contraceptives.
In 1971, the Irish Women’s Liberation Movement published the “Chains or Change” booklet, calling for contraception access (and an end to other human rights abuses faced by Irish women). They travelled to Belfast in the North of Ireland (where contraception was legal). They returned to the Republic of Ireland on the ‘contraceptive train’, waving contraceptives at the (very upset) custom officials.
From 1978 - 1985 the Irish law allowed the provision of contraceptives under prescription only.
In 1985, the law was updated to allow condoms and spermicides to be sold without prescription, but under strict regulation and only in medical settings.
In 1990, the Irish Family Planning Agency (IFPA) was prosecuted for illegal sale of condoms at Virgin Megastore (a music/record shop in Dublin). Despite legal repercussions, the IFPA continued to sell condoms at the Virgin Megastore, arguing that, due to the AIDS crisis, they had “a duty to save people’s lives”.
1992: Condoms could be sold in retail outlets to people over the age of 17.
1993: The age restriction on the purchase of condoms was removed.
Today in Ireland, there is a variety of contraception available. However, it is not always accessible, because it is not affordable for many people. A survey by the United Nations’ reproductive health agency (UNFPA) found that 11 per cent of women in Ireland were still facing an “unmet need” for contraception, with cost of contraception being the main barrier.
Further Resources
