Contraception

In short

  • A contraceptive prevents you from getting pregnant.
  • The most reliable contraceptives are the IUD (coil), the combined pill, the minipill, the contraceptive injection, the hormonal implant and the vaginal ring.
  • Which contraceptive suits you depends on what you find important: hormones or not, how often you want to think about it, and what you want for your period.
  • Gynaecologie Amsterdam places the hormonal IUD, the copper IUD and the hormonal implant.
  • Only condoms also protect you against STIs.

What is a contraceptive?

A contraceptive prevents you from getting pregnant when you have sex. Contraceptives are also called birth control. There are methods with hormones and methods without hormones.

  • With hormonal methods, hormones enter your bloodstream and temporarily stop you from getting pregnant. This can happen in different ways: by taking a pill, through your skin (hormonal patch), or through an injection into your muscle (contraceptive injection).
  • Contraceptives without hormones include condoms, the copper IUD and the diaphragm.
  • There are also apps that calculate your fertile days based on the information you enter.

How well a contraceptive prevents pregnancy differs from method to method. These protect best against pregnancy: the IUD, the combined pill, the minipill, the contraceptive injection, the hormonal implant and the vaginal ring.

How do I choose a contraceptive?

The best contraceptive is the one that fits what you find important — every method has advantages and disadvantages. These questions can help you choose:

  • Do you want to use hormones? Hormones can have advantages, such as less bleeding, less pain, or being able to delay your period. But they can also cause unexpected bleeding or sore breasts, and they sometimes have serious side effects, such as thrombosis (blood clots in a blood vessel), which means they are not suitable for everyone.
  • How often can you manage to think about your contraceptive? Every day, every week, or as little as possible?
  • What do you want for your period? Keep having a period every month, decide yourself when it comes, or change periods that are painful or heavy?
  • Do you want children in the future?
  • Do you want to take care of contraception yourself, or do you want your partner to do that — or both?

Think it over and talk about it with your partner. There are comparison charts that help you compare the different contraceptives — including one for methods without hormones and one for after giving birth or while breastfeeding (see “Read more” below). Your GP can help you choose, and — after a referral — you can discuss it with the gynaecologist at Gynaecologie Amsterdam.

Which contraceptive methods are there?

The main contraceptive methods are the IUD, the combined pill, the minipill, the contraceptive injection, the hormonal implant, the vaginal ring, the condom, sterilisation and hormone-free (natural) methods. Open the sections below to read how each method works and which side effects it can have.

  • An IUD (coil) is a small anchor-shaped device of 3 to 4 cm that the doctor places in your uterus (womb). We place IUDs at Gynaecologie Amsterdam.
  • You can choose between a hormonal IUD or a copper IUD (without hormones). Both work equally well at preventing pregnancy, and with both you do not have to think about it.

Hormonal IUD

  • Can stay in place for 8 years.
  • Contains 1 hormone (a progestogen).
  • Often your periods stop completely. If you do have a period, you bleed less. Sometimes you have a little irregular bleeding.
  • Especially in the first months you may also have these side effects: headache, spots (acne), hair loss, sore breasts, more vaginal discharge. You may also have no problems at all.

Copper IUD

  • Can stay in place for 5 or 10 years.
  • Contains no hormones.
  • Especially in the first 3 months your periods may be longer, with more bleeding and pain. Sometimes this continues. You may also have no problems at all.

  • The combined pill (“the pill”) contains 2 hormones (an oestrogen and a progestogen).
  • You take the pill every day for 21 days. Then you take no pills for 7 days: the pill-free week. After that you take the pill again for 21 days, and so on.
  • You have your period during the pill-free week. It is usually shorter, with less bleeding and less pain. You can also delay your period with the pill.
  • Especially in the first months you may have side effects, for example headache, tense breasts, low mood, less interest in sex, or a little bleeding on days when you are not having your period. You may also have no problems at all.

  • The minipill contains 1 hormone (a progestogen).
  • You take the minipill every day at the same time. You never stop taking it.
  • If you are breastfeeding, you can take the minipill. The minipill does not affect breastfeeding.
  • In the first months your bleeding may be irregular. After that your periods stop, or you keep having a little irregular bleeding.
  • In the first months you may have side effects: headache, spots (acne), hair loss, sore breasts, mild low mood. You may also have no problems at all.

  • The contraceptive injection is an injection into your buttock containing a hormone (a progestogen).
  • You have an injection once every 12 weeks. Make an appointment with the assistant at your GP practice.
  • In the first months your bleeding may be irregular. After that your periods stop, or you keep having a little irregular bleeding.
  • If you stop having the injection, it can take 6 to 12 months before your periods come back. So it can also take that long before you are fertile again and can get pregnant.
  • Especially after the first injection you may have side effects, for example headache, spots (acne), hair loss, mild low mood, weight gain. You may also have no problems at all.

  • The hormonal implant is a thin, flexible rod of 4 cm. The doctor places it under your skin with a small injection. We place the implant at Gynaecologie Amsterdam.
  • It can stay in place for 3 years. You do not have to think about it.
  • The implant releases 1 hormone (a progestogen).
  • In the first months your bleeding may be irregular. After that your periods stop, or you keep having a little irregular bleeding. The longer you have the implant, the more likely it is that your periods stop completely.
  • Side effects can include: headache, spots (acne), hair loss, mild low mood. You may also have no problems at all.

  • The vaginal ring is a flexible ring that you place in your vagina yourself. Most women do not feel the ring during sex.
  • The ring contains 2 hormones (an oestrogen and a progestogen). It works the same way as the pill, but the hormones enter your blood through your vagina.
  • The ring can stay in for 3 weeks. Then you leave it out for 7 days — that is when you have your period, usually shorter and with less bleeding. After that you insert a new ring, and so on.
  • Especially in the first months you may have the same side effects as with the pill: headache, tense breasts, low mood, less interest in sex, a little bleeding on days when you are not having your period. The ring can also cause itching and more vaginal discharge. You may also have no problems at all.
  • With the vaginal ring you have a higher risk of thrombosis (blood clots in a blood vessel) than with the pill.

  • Sterilisation is an operation after which you can no longer have children. You can choose sterilisation if you are sure you do not want (more) children.
  • Sterilisation of a woman is done in a hospital. Sterilisation of a man is usually done in a hospital, sometimes at the GP practice.
  • A man must have a check 3 months after the sterilisation to confirm that it was successful. Keep using another contraceptive until then.
  • Sterilisation is not performed at Gynaecologie Amsterdam; for this you need to go to a hospital.

  • A condom is a thin rubber sheath. The male condom is rolled over the penis; the female condom is placed in the vagina.
  • Condoms often also have a lubricant on them that kills sperm.
  • The condom prevents pregnancy less well than hormonal contraceptives or an IUD.
  • The condom also protects against STIs.

Many women nowadays choose hormone-free methods to prevent pregnancy. If you and your partner can deal well with your fertile days when you feel like having sex, hormone-free methods can also be a choice for you. We do advise keeping an emergency (morning-after) pill at home in case something goes wrong. In general, hormone-free methods are somewhat less reliable than hormonal methods or the copper IUD.

The methods below are not safe: there is a high chance that you will still get pregnant. Of every 1,000 couples using one of these methods, more than 50 become pregnant each year. Only choose them if you would not mind becoming pregnant after all:

  • Withdrawal (pulling out before ejaculation). The man takes his penis out of the vagina before he ejaculates (comes). Sperm can leak from the penis into the vagina well before ejaculation, so you can still get pregnant.
  • No sex on fertile days (natural family planning). You can learn to know on which days you are fertile, for example by writing down when your periods start, taking your temperature and checking the mucus in your vagina. On your fertile days you do not have sex. Your fertile days can be different from what you expect — because of stress, illness, or for no clear reason — so you can still get pregnant.
  • The diaphragm. A diaphragm is a rubber cap. You first put sperm-killing gel on it, then push it into your vagina, over the cervix (the opening of the womb) — just before sex or up to 2 hours beforehand. After sex it must stay in place for at least 6 hours. It is difficult to place the diaphragm exactly right, so you can still get pregnant.

Which contraception does Gynaecologie Amsterdam place?

At Gynaecologie Amsterdam we place the hormonal IUD, the copper IUD and the hormonal implant, after a referral from your GP. The contraceptive injection is given at your GP practice, and you take the pill, the minipill and the vaginal ring yourself.

Sterilisation is not performed at Gynaecologie Amsterdam; for this you need to go to a hospital.

Whatever method you choose: also use condoms to protect yourself against STIs.

Frequently asked questions

Which contraceptive protects best against pregnancy?

The IUD, the combined pill, the minipill, the contraceptive injection, the hormonal implant and the vaginal ring protect best against pregnancy. The condom prevents pregnancy less well, but it is the only contraceptive that also protects against STIs.

How long can an IUD stay in place?

A hormonal IUD can stay in place for 8 years; a copper IUD for 5 or 10 years. In that time you do not have to think about your contraception.

Which contraception can I use while breastfeeding?

You can take the minipill while breastfeeding; it does not affect breastfeeding. There is also a separate comparison chart with contraceptive options for women who have just given birth or are breastfeeding.

Does contraception protect against STIs?

Only condoms protect against STIs. If you use the pill, an IUD or another contraceptive, also use condoms to protect yourself against STIs.

Can I get pregnant again after stopping contraception?

With most methods, yes. After stopping the contraceptive injection, however, it can take 6 to 12 months before your periods come back — and it can take that long before you are fertile again.

Related care

  • Menstrual problems — hormonal contraception can help with heavy or painful periods.
  • Treatments — overview of the care we offer at Gynaecologie Amsterdam.

Would you like to discuss contraception, or have an IUD or implant placed? After a referral from your GP, you can make an appointment at Gynaecologie Amsterdam.

Read more

We based this information on the Dutch guideline on contraception for GPs and gynaecologists.