Contraception and emergency contraception

What contraception does

Contraception helps prevent pregnancy. Options include condoms, different pills, a patch, a vaginal ring, an injection, an implant, a copper coil called an IUD, and a hormonal coil called an IUS. Some methods need action every day or when having sex; others last longer. Condoms also reduce the risk of sexually transmitted infections. Other contraceptive methods do not provide that protection.

Choosing a method that suits you

Ask a clinician to compare how well methods work, possible side effects, changes to periods, and how they are started and stopped. Discuss what you can comfortably use, reminders, privacy, needle worries and any support you want. There is no single best method for everyone with a learning disability. A longer-lasting method should be offered as a choice, not used simply to make someone else’s work easier.

Where to get free help

NHS sexual health clinics and some GP surgeries provide free contraception. Participating pharmacies provide free contraceptive pills and oral emergency contraception through the NHS Pharmacy Contraception Service in England. You can approach a participating pharmacy yourself without being registered with a GP. A pharmacy may also sell products privately, so ask for the NHS service. Not every location supplies every method; an implant or coil may need another appointment.

Your decision and support to understand

A learning disability does not automatically mean someone cannot decide about contraception. Staff should explain the choices accessibly and support the person to decide. For people aged 16 and over, any capacity assessment must concern this particular decision at the relevant time. If the person lacks that capacity despite support, treatment decisions must follow the Mental Capacity Act, including their wishes, best interests and consideration of less restrictive options. Relatives do not automatically have authority to consent.

Consent to treatment is separate from consent to sex

Agreeing to contraception does not mean agreeing to sex. Nobody can consent to sex on another person’s behalf under the Mental Capacity Act. If contraception is being proposed against someone’s wishes, or professionals and family disagree, ask for an advocate and specialist advice about the lawful decision process. Contraception must not be treated as a substitute for responding to sexual abuse or coercion.

Make the appointment accessible and private

Ask for Easy Read information, an interpreter, a communication aid, extra time, an accessible examination room or a supporter you choose. Ask staff to explain before touching you. You can request a private conversation without a partner or carer. Sexual health services normally keep information confidential, including from your GP, but may need to share information to protect someone from harm. Ask what would be shared and why.

Check medicines and health conditions

Tell the clinician or pharmacist about all medicines, herbal remedies and recent changes. Some epilepsy medicines can reduce the effectiveness of some hormonal contraception, including emergency pills. Hormonal contraception can also affect lamotrigine treatment. Your epilepsy team and contraception clinician may need to agree a plan. Do not stop epilepsy medicines yourself. Ask for advice before starting, stopping or changing a contraceptive method, especially if you take other medicines.

Emergency contraception: seek help the same day

Ask a pharmacist, sexual health clinic or GP urgently after sex without effective contraception, a condom failure or a possible contraceptive mistake. Levonorgestrel emergency pills are taken within 72 hours, or 3 days. Ulipristal acetate pills are taken within 120 hours, or 5 days. A copper IUD can usually be fitted within 5 days after sex and is the most effective emergency method. Do not wait until these limits. Tell staff exactly when sex happened and what medicines you take.

If time has passed or you are unsure

Contact a clinician even if more than 5 days have passed, or you are unsure about the timing. They can assess any remaining options and arrange pregnancy and infection advice. Emergency pills do not protect against later sex or infections. Ask when to start or restart your usual contraception and how long extra protection is needed; the instructions differ between emergency pills. Do not guess from instructions for a different product.

Missed pills, illness and pregnancy tests

If pills are missed, vomiting or diarrhoea may have affected them, or a method seems to have failed, ask a pharmacist or contraception service promptly. Bring the packet or its name. Pregnancy tests are generally reliable from the first missed period. If the next period date is unknown, NHS advice is to test at least 21 days after the last unprotected sex. Follow any additional advice from your clinician and seek advice after a positive test.

Young people and pressure from others

Young people under 16 can seek free, confidential contraception advice. The clinician checks their understanding and considers safeguarding needs; confidentiality is not absolute when someone is at risk of harm. For any age, pressure to become pregnant, avoid pregnancy or use a particular method deserves attention. A person can ask to speak privately about contraception being hidden, damaged or controlled by someone else. Use safeguarding or sexual-assault support when needed.

Choosing contraception

Your contraception choices

Understand options and protect privacy

Medicines and condoms

Emergency contraception

Your choice about sex

What you can do next

More useful links