Women spend most of their fertile lives trying not to get pregnant, and primitive methods of contraception have been around for thousands of years. Women have inserted pastes, fruit acids or other dubious mixtures into the vagina, and used lemons or sponges as vaginal barriers. Some of these methods may have worked to a degree, but there were still many unwanted pregnancies. By the eighteenth century there were male condoms made of animal intestines, and Victorian women used an early form of rubber diaphragm, but it is only relatively recently that women have had easy access to reliable methods of contraception.
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We tend to think that as soon as we have unprotected intercourse we will get pregnant, but our choice of contraceptive can have an effect on our future fertility. It may take a while for a normal menstrual cycle, and normal fertility, to be restored after using some methods of contraception.
Barrier methods are one of the simplest forms of contraception, which work by stopping sperm getting into the womb to meet an egg. Barrier methods include male and female condoms, which have the added advantage of helping to protect against sexually transmitted diseases, and the cap or diaphragm, which fits over the neck of the womb and stops sperm getting past. It is possible to get pregnant the moment you stop using barrier methods of contraception as they have no effect on your future fertility.
Spermicides are put in the vagina before intercourse and can kill sperm. They may help protect against some sexually transmitted diseases as they can also kill bacteria and viruses, but the downside of this is that they can cause irritations and allergic reactions. Spermicides are not very reliable when they are used as the sole method of contraception, but it is possible to get pregnant as soon as you stop using them.
Combination oral contraceptive pills contain synthetic oestrogen and progesterone. They work by stopping ovulation, thickening the cervical mucus to prevent sperm penetrating it and by thinning the lining of the womb to stop a fertilized egg implanting. There are no long-term links with infertility after taking the combined oral contraceptive pill, but it can take two or three months for the menstrual cycle to return to normal. Some women do experience longer-term difficulties conceiving after taking the pill, but these are usually related to underlying medical problems or age, rather than the pill itself.
The contraceptive patch works the same way as the combination pill, but instead of swallowing the hormones in a pill, you stick them to your body in a sort of square plaster. Hormones are then slowly released through the skin. It can take a few months for your periods to return to normal when patches have been used.
The progesterone-only pill is also commonly known as the mini-pill. It contains synthetic hormones similar to progesterone, and works by thickening the cervical mucus and thinning the lining of the womb. Some progesterone-only pills stop ovulation in some women too. One common side effect of the progesterone-only pill is irregular or unpredictable bleeding. There is also an increased risk of ovarian cysts, and if you do get pregnant while on this pill there is a small risk of having an ectopic pregnancy, which can cause fertility problems in the future. It may take a few months for your cycle to get back to normal when you stop taking the pill, but generally women on the progesterone-only pill return to normal fertility fairly quickly and longer-term problems are usually to do with underlying medical problems.
The contraceptive injection is an injectable synthetic progesterone, which lasts for up to three months. Some women do suffer a loss in bone density with this method of contraception, leading to concerns about osteoporosis, and it can cause weight gain and irregular bleeding. After the last injection, it may take six months for the drug to leave the body entirely and for the menstrual cycle to return to normal. For some women, it can take more than a year for their fertility to be restored after using the contraceptive injection, but the length of time it takes to conceive afterwards does not seem to be related to the length of use.
The contraceptive implant is a small flexible rod, thinner than a matchstick, which is inserted under the skin in your upper arm. It releases a synthetic progesterone and is effective for up to three years. It can cause weight gain, and irregular or heavy periods, but once the implant has been removed your normal cycle should return quickly. To find out more, you can check out Injectables For Infertility.
