UTI Info Accordion Archive - Chronic UTI Info

Combined pill

There are many different brands of the combined pill, made up of three main types – combined 21 day pills, phasic 21 day pills and everyday (ED) pills.

21-day pills
This is the most common type. Each pill has the same amount of hormone in it. One pill is taken each day for 21 days and then stoped for the next seven days. Microgynon, Marvelon, Yasmine and Cilest are examples of this type of pill.

Phasic 21-day pills
Phasic pills contain two or three sections of different coloured pills in a pack. Each section contains a different amount of hormones. One pill is taken each day for 21 days and then stopped for the next seven days. Phasic pills need to be taken in the right order. Logynon is an example of this type of pill.

Every day (ED) pills
There are 21 active pills and seven inactive (dummy) pills in a pack. The two types of pill look different. One pill is taken each day for 28 days with no break between packets of pills. Every day pills need to be taken in the right order. Microgynon ED is an example of this type of pill.

Progesterone pill

The “traditional” progestogen-only pill (POP) prevents pregnancy by thickening the mucus in the cervix to stop sperm reaching an egg. The desogestrel progestogen-only pill can also stop ovulation. Progestogen-only pills contain the hormone progestogen, but don’t contain oestrogen.

Key points

You only have to use a diaphragm or cap when you have sex, but you must leave it in for at least 6 hours after the last time you had sex. You can leave it in for longer than this, but don’t take it out before.

You need to apply more spermicide if:

you have sex again with the diaphragm or cap in place
the diaphragm or cap has been in place for three hours or more before you have sex
Don’t take the diaphragm or cap out to reapply spermicide.

You shouldn’t use a diaphragm or cap during your period as there is a possible link with toxic shock syndrome (TSS), a rare condition that can be life threatening.
Most women are able to use a diaphragm or cap, but it may not be suitable for you if you:

have an unusually shaped or positioned cervix (entrance to the womb), or if you can’t reach your cervix
have weakened vaginal muscles (possibly as a result of giving birth) that can’t hold a diaphragm in place
have a sensitivity or an allergy to latex or the chemicals in spermicide
have ever had toxic shock syndrome
have repeated urinary tract infections
currently have a vaginal infection (wait until your infection clears before using a diaphragm or cap)
aren’t comfortable touching your vagina
have a high risk of getting an STI – for example, if you have multiple sexual partners

Research shows spermicides that contain the chemical nonoxynol-9 don’t protect against STIs, and may even increase your risk of getting an infection.
A diaphragm or cap may be less effective if:

it’s damaged – for example, it’s torn or has holes
it’s not the right size for you
you use it without spermicide
you don’t use extra spermicide with your diaphragm or cap every time you have more sex
you remove it too soon (less than 6 hours after the last time you had sex)
you use oil-based products, such as baby lotion, bath oils, moisturiser or some vaginal medicines (for example, pessaries) with latex diaphragms – these can damage the latex

If any of these things happen or you’ve had sex without contraception, you may need to use emergency contraception.

Key points

Depo-Provera is most commonly given in the UK and lasts for 13 weeks. Occasionally, Noristerat may be given, which lasts for 8 weeks. Sayana Press also lasts for 13 weeks, but it’s a newer type of injection so is not available at all clinics or GP surgeries. You usually have the Depo-Provera and Noristerat injections in your bottom, but you can have them in your upper arm. You can have the Sayana Press injection in your tummy (abdomen) or thigh and would normally learn to do this yourself.

Advantages and disadvantages

Advantages:

each injection lasts for either 8 or 13 weeks
it does not interrupt sex
it’s an option if you can’t use oestrogen-based contraception
you do not have to remember to take a pill every day
it’s safe to use while you’re breastfeeding
it’s not affected by other medicines
it may reduce heavy, painful periods and help with premenstrual symptoms for some women

Disadvantages:

your periods may change and become irregular, heavier, shorter, lighter or stop altogether – this can carry on for some months after you stop the injections
Using Depo-Provera affects your natural oestrogen levels, which can cause thinning of the bones, but it does not increase your risk of breaking a bone. Sometimes the doctor may recommend that you stop after 2 years so there’s no long-term effect on your bones.
it does not protect you against STIs
there can be a delay of up to 1 year before your periods return to normal and you can become pregnant
some people may put on weight when they use Depo-Provera or Sayana Press contraceptive injections
you may experience side effects like headaches, acne, hair loss, decreased sex drive and mood swings
any side effects can continue for as long as the injection lasts (8 or 13 weeks) and for some time after

Advantages and disadvantages

Advantages:

it works for 3 years
it doesn’t interrupt sex
it’s an option if you can’t use oestrogen-based contraception, such as the combined contraceptive pill, contraceptive patch or vaginal ring
it’s safe to use while you’re breastfeeding
your fertility will return to normal as soon as the implant is taken out
it may reduce heavy periods or painful periods

Disadvantages:

you may experience temporary side effects during the first few months, like headaches, nausea, breast tenderness and mood swings
your periods may be irregular or stop altogether
you may get acne or your acne might get worse
you’ll need a small procedure to have it fitted and removed
it doesn’t protect you against sexually transmitted infections (STIs), so you may need to use additional contraception (such as condoms) as well

Key points

It can be useful for women who can’t use contraception that contains oestrogen and can be taken out if you have side effects. A common side effect is that your periods stop (amenorrhoea). It’s not harmful, but you may want to consider this before deciding to have an implant.

Most women can be fitted with the contraceptive implant but it may not be suitable if you:

don’t want your periods to change
some medicines can make the implant less effective. These include complementary remedies, such as St John’s Wort, some antibiotics such as rifabutin or rifampicintake and medicines for HIV, epilepsy and tuberculosis. If you’re taking any of these medicines, you’ll need additional contraception (such as condoms), or you may wish to use a different method of contraception that isn’t affected by your medicine.
have unexplained bleeding in between periods or after sex
have arterial disease or a history of heart disease or stroke
have liver disease
have breast cancer or have had it in the past
have a medical condition that may affect which contraception you can use – speak to your GP or practice nurse, or visit your nearest sexual health clinic to discuss further

Advantages and disadvantages

Advantages and disadvantages of the IUS

Advantages:

It works for 5 years or 3 years, depending on the brand.
Your periods can become lighter, shorter and less painful – they may stop completely after the first year of use.
It’s safe to use an IUS if you’re breastfeeding.
It’s not affected by other medicines.
It may be a good option if you cannot take the hormone oestrogen, which is used in the combined contraceptive pill.
It’s possible to get pregnant as soon as the IUS is removed.

Disadvantages:

There’s a small risk of getting an infection after it’s been fitted. If you get an infection when you have an IUS fitted, it could lead to a pelvic infection or UTI if not treated.
If you have an IUS fitted, you may have a slightly higher chance of getting thrush that keeps coming back. This is because candida spores can anchor to the strings of the IUS and despite treatment, the spores can keep causing reinfections. Speak to a GP if you keep getting thrush. You might want to think about trying a different type of contraception.
Your periods may become irregular or stop completely, which may not be suitable for some women.
Some women experience headaches, acne and breast tenderness after having the IUS fitted.
Some women experience changes in mood and libido, but these changes are very small.
An uncommon side effect of the IUS is that some women can develop small fluid-filled cysts on the ovaries – these usually disappear without treatment.
An IUS does not protect you against STIs, so you may need to use condoms as well.
If you get an infection when you have an IUS fitted, it could lead to a pelvic infection if it’s not treated.
Most women who stop using an IUS do so because of vaginal bleeding and pain, although this is less common.

Key points

It can be used by women who cannot use combined contraception (such as the combined pill) – for example, those who have migraines. Most women can use an IUS, including those who are HIV positive. A GP or nurse will ask about your medical history to check if an IUS is suitable contraception for you. If you’re 45 or older when you have the IUS fitted, it can be left in until you reach the menopause or no longer need contraception. The IUS may not be suitable if you have:

breast cancer, or have had it in the past 5 years
cervical cancer or womb (uterus) cancer
liver disease
unexplained bleeding between periods or after sex
arterial disease or a history of serious heart disease or stroke
an untreated sexually transmitted infection (STI) or pelvic infection
problems with your womb or cervix

Advantages and disadvantages

Advantages and disadvantages of the IUD

Although an IUD is an effective method of contraception, there are some things to consider before having one fitted.

Advantages:

It protects against pregnancy for 5 or 10 years, depending on the type.
Once an IUD is fitted, it works straight away.
Most women can use it.
There are no hormonal side effects, such as acne, headaches or breast tenderness.
It does not interrupt sex.
It’s safe to use an IUD if you’re breastfeeding.
It’s possible to get pregnant as soon as the IUD is removed.
It’s not affected by other medicines.

Disadvantages:

There’s a small risk of getting an infection after it’s been fitted. If you get an infection when you have an IUD fitted, it could lead to a pelvic infection or UTI if not treated.
If you have an IUD fitted, you may have a slightly higher chance of getting thrush that keeps coming back. This is because candida spores can anchor to the strings of the IUD and despite treatment, the spores can keep causing reinfections. Speak to a GP if you have an IUD and keep getting thrush. You might want to think about trying a different type of contraception.
There’s a small risk that your body may push out the IUD or it may move. Your doctor or nurse will teach you how to check it’s in place.
It can be uncomfortable when the IUD is put in, but painkillers can help.
It may not be suitable if you have had previous pelvic infections.
It does not protect against sexually transmitted infections (STIs), so you may need to use condoms as well.
Your periods may become heavier, longer or more painful, though this may improve after a few months.
Most women who stop using an IUD do so because of vaginal bleeding and pain, although these side effects are uncommon.