Types,how to use,side effects, contraindications of Contraceptive

Types of Contraceptives

Hormonal and Barrier Contraception

There are about 15 different types of contraceptives which allow you to enjoy sex without the risk of getting pregnant.

These birth control methods include:
1.Condoms,
2.The diaphragm,
3.The contraceptive pill,
4.Implants,
5.IUDs (intrauterine devices),
6.Sterilization and the morning after pill.
7.Injectable
8.

Many of these methods of contraception also lower your chance of getting an STI.

Condoms, spermicides and sponges aside, most types of contraception can only be obtained with the help of a doctor.

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Which methods of contraception are there?

In the last 50 years, the number of contraception methods has dramatically increased. You can differentiate between different types of contraception based on how they work: there are barrier methods (e.g. condoms or a cervical cap), hormonal methods (e.g the pill), intrauterine devices (IUD) and sterilization.

Emergency contraception (morning after pill) is another method, but we will only review "planned contraception" here.

Most types of contraceptives work by:

a) preventing an egg from being released every month (hormones)

b) preventing sperms from reaching the egg (barrier and some IUD methods)

c) blocking the reproductive function – in men or women (sterilization)

d) preventing a fertilized egg from implanting in the uterus (hormones)

The Pill

The condom and the pill consistently rank at the top as the most commonly used types of contraception. 

The contraceptive pill was invented in 1960. Fifty years on, many new inventions have been added to the list of available contraception methods, but the pill remains the most popular form of female contraception.

The contraceptive pill will prevent you from getting pregnant in 95% of cases and it comes close to providing 99% protection if you take one pill every day as prescribed.

The pill can come in two forms:
The combined contraceptive pill (containing the hormones estrogen and progestin) or the mini-pill (only progestin). In the case of the mini-pill, it's important that you take your pill every day at the same time (you should not be late by more than three hours).

Keep in mind that the pill does not provide any protection against STIs and that a doctor's prescription is required to buy it.

The Male Condom 

Among the different types of contraceptives, the male condom is a strong contender to the title of most common contraception method. It is easy to use, affordable and offers the best protection against STIs (e.g. gonorrhoea, chlamydia, HIV).

Condoms are usually made of latex, but if you are allergic to latex, some brands also specialize in condoms made of polyurethane or lambskin. These two are also compatible with lube (latex condoms are not, unless with water-based lubricant); however lambskin condoms do not provide protection against STIs.

For safety reasons, make sure you use a new condom each time you have sex.

The Female Condom

How to insects in  the vagina

Just like the male condom, the female condom is one of the few types of contraception that you can buy over-the-counter at pharmacies and grocery stores without a prescription.

It was first introduced twenty years ago and offers 95% effective protection for pregnancy, as well as some protection against STIs. Female condoms are generally more expensive than the male ones but they are less likely to burst. They can be inserted up to eight hours before sex.

The Diaphragm

Continuing with the list of barrier contraception methods, there is the diaphragm which is placed inside the vagina so that it prevents the sperm from getting into the uterus. Despite being a barrier method, it doesn't protect against STIs.

The diaphragm must be coated with spermicide each time before sex and a doctor needs to show you how to use it (you need a prescription to get one). It is inserted at least six hours before sex and it needs to be removed after 24 hours for cleaning. Depending on the material and type of the diaphragm, it can be reused many times.

The Cervical Cap - Femcap

The cervical cap (sold as Femcap) is a thimble-shaped latex cup, basically like a diaphragm but smaller. It also needs to be used with a spermicide. The cervical cap must remain in the vagina at least 6 hours after sex, but it also has to be taken out within 48 hours after sex.

Because some women get cystitis (bladder infection) from using a diaphragm, the cervical cap is a useful replacement because it has less contact with the vagina (it only covers the cervix).

The problem with types of contraceptives such as the Femcap or the diaphragm is that their effectiveness -  92 to 95% protection in ideal use - is lower than other types (98-99%) and that they offer only partial protection against STIs (e.g. no HIV protection).

The Intrauterine Device (IUD)

You have the choice between two types of IUDs: hormonal or copper-based devices. Hormonal and copper IUDs are part of the few long-term solutions, meaning that you can keep them inside the vagina for up to five or ten years respectively.

The effectiveness rate for IUDs is above 99%, however they provide no protection against STIs. Note that IUDs can be a form of emergency contraception if the device is inserted within 5 days after unprotected sex. You will nonetheless need to visit a doctor to have it properly inserted and follow the prescription (e.g. a few follow-ups and check-ups for possible infection in the first weeks).

The Contraceptive Implant

The implant is another option among the types of contraceptives that offer long term protection. It lasts for about three years on average. Just like IUDs, the implant does not protect against STIs.

The contraceptive implant contains progestin (progesterone), the same hormone as the contraceptive pill. The hormone is released into your body at a steady, slow pace for three years, producing the same effects as the pill.

The implant is inserted in the arm by a healthcare specialist and must be removed after three years. Since the risk of human mistake is ruled out, the implant has a much higher effectiveness rate than the pill – around 99.99%.

The Contraceptive Sponge

The sponge is a small, round-shaped foam (polyurethane) placed deep inside the vagina. It contains spermicide so that sperm does not get past the foam. You should leave the sponge inside the vagina for at least six hours after sex, but remove it within 24 hours following sexual intercourse (to lessen the risk of toxic shock).

The sponge does not protect past those 24 hours and does not provide any STI protection. It is sometimes used as a backup for other contraception methods (e.g. when you forgot to take the pill) and you can buy it without a prescription from the pharmacy.

Spermicide

Spermicide is a recurrent "ingredient" in contraception because it proves very effective when used in combination with other methods (e.g. diaphragm, sponge). In itself spermicide doesn't always offer the best protection against pregnancy, although this is also due to inconsistent use of the product.

You don't need a prescription to buy spermicide and it has very few associated side-effects, but keep in mind that it does not protect against STIs.

Contraceptive Injections

This method dates back to the 60s with the invention of artificial progesterone (progestin). One shot of hormones lasts in the body for 8 to 12 weeks (3 months) and has the same effect as the pill.

Injections are about 99% effective, with pregnancy occurring mostly with women who forgot to renew their contraceptive shot in time (i.e. past weeks 11 to 12). Obviously, once the shot is given it cannot be reversed, so you are effectively infertile for the next three months.

Just like the contraceptive pill, contraceptive injections do not protect from STIs.

The Vaginal Ring

The vaginal contraceptive ring is a small, transparent plastic ring that is inserted in the vagina and kept for three weeks. You should then remove it during your periods and replace it with a new one after that.

The ring contains the same hormones as the contraceptive pill (progesterone and estrogen), therefore providing the same kind of effective protection and side effects. You will need your doctor's prescription to buy the ring.

Just like other hormonal contraception, the vaginal ring does not protect from STIs.

The Contraceptive Patch

The contraceptive patch is exactly the same thing as the contraceptive pill but in the form of a patch. It provides the same effective protection against pregnancy and has the side effects (positive and negative). It does not protect from STIs.

You wear the patch for three weeks, take it off for one week - allowing your menstrual cycle – then you start with a new patch. The patch is an interesting option in as much as you don't need to think about taking the pill every day.

There is however a risk of skin irritation, and a (rare) chance that the patch accidentally comes off.

Emergency Contraception

SAVE FOR LATER

Emergency contraception exists to stop you getting pregnant if you have had unprotected sex.

This method is for one-off occasions and is not recommended for daily use. It is particularly useful if a condom broke or if you missed one of your contraceptive pills.

The most common brand of morning after pill is Levonelle®. You should take it ideally within 24 hours after unprotected sex (this offers over 95% protection). The longer you wait, the less effective it will be. After 72 hours (3 days) the effectiveness drops to below 50%.

If you vomit within three hours after taking the pill, you must take another one.Postinor 2 is an emergency contraceptive only or is a medication to prevent pregnancy if you shine the sperm into the ovary, whether intentional or not. It can prevent pregnancy 95% in the first 24 hours after intercourse, it is used as a form of emergency contraception (more commonly known as a morning after pill).
Postinor-2 is formulated to function in a manner similar to the female hormone progesterone allowing for prevention of pregnancy if taken within a reasonable period of time. Generally, it is recommended that Postinor-2 be taken no later than three days after having unprotected sex.

postinor 2 side effects

POSTINOR 2

postinor two have many side effects that can be dangerous. before I explain what side effects if taken postinor 2. I want to tell in advance what the contents of the medicine and all of postinor 2.

postinor 2 is a medication to prevent pregnancy if you shine the sperm into the ovary, whether intentional or not. it can prevent pregnancy 95% in the first 24 hours after intercourse. but it has side effects that are not good for women

Postinor-2 is used as a form of emergency contraception (more commonly known as a morning after pill). Postinor-2 contains 750 micrograms of the drug levonorgestrel, and also contains such ingredients as potato starch, gelatin, and talc. Postinor-2 is formulated to function in a manner similar to the female hormone progesterone, allowing for prevention of pregnancy if taken within a reasonable period of time. Generally, it is recommended that Postinor-2 be taken no later than three days after having unprotected sex. However, it has proven to be more effective in cases where the treatment was started closer to the time of the sexual encounter.

ACTIVE SUBSTANCE

0.75 levonorgestrel in each tablet. other ingredients : silica colloidal anhydrous, magnesium stearate, pottato starch, talc, maize starch, lactose monohydrate.

ACTION OF THE POSTINOR 2

levenorgestrel is a progestogen inhibiting the implanttation of the ovum into the endometrium, stimulating the mobility of the oviduct and increasing the viscosity of the cervical mucus.
when taken in the middle of the menstrual cycle, the preparation may inhibit ovulation.

INDICATION OF POSTINOR 2

postinor 2 tablet is an emergency contraceptive preparation that can prevent conception if it taken within 72 hours following unprotected intercose.

the administration of postinor 2 as an emergency contraceptive is recommended in the following cases.

if no contraceptive measure of any kind was taken during intercoseif the applied contraceptive measure cannot be considered reliable- tear or slip or inapproprite use of condom
- disposition or tear or premature removel of diaphragm or pressary
- unsuccessfully interrupted coitus
- erroneous calculation of fertile days in case of periodic abstinence
- in case of IUD loss or removal
- omitting the ingestion of 3 or more hormonal contraceptive tablets to be taken regularly

rape
CONTTRAINDICATION OF POSTINOR 2

except for existing pregnancy, there are no other absolute medical contraindication for the administration of postinor 2 tablet.

in case of vaginal bleeding of unknown origin, hepatic and biliary disease, history of gestational jaundice, breast, ovarian or uterine carcinoma, it should be administered after careful consideration of the risk/ benefit ratio ( unwanted pregnancy/ abortion)

DOSAGE OF POSTINOR 2

one postinor 2 tablet should be ingested within 72 hours following intercourse and another one 12 hours after taking the first tablet.

according to data of clinical studies, it is advisable to take the first tablet within 48 hours ( but not later than 72 hours) after intercourse. since the efficacy of the preparation decreases if more than 48 hours elapse between intercourse and drug ingestion.

postinor 2 tablet may be used at any time within the menstrual cycle.

if vomitting occurs within 2 hours after drug intake. the dose must be repeated.

SIDE EFFECTS OF POSTTINOR 2

nausea : it occurs in approximately 25% of users

vomiting : in 5%

bleeding disturbances : in some cases, 2-3 days following tablet ingestion breakthrough or withdrawal bleeding may occur that generally ceases spontaneously. in the majority of cases the next period starts as expected or somewhat earlier. if the period is more than 7 days late it is recommended to perform a pregnancy test.

in case of prolonged or heavy bleeding, gynaecological examinationis advised.

other side effects : breast tenderness, headache, dizziness, fatigue.

DRUG INTERACTIONS

concomitant use of ampicillin, rifampicin, chloramphenicol, neomycin, sulphonamides,
tetracyclines, barbiturattes and phenylbutazone may reduse the contraceptive effects.

WARNING
CANNOT TAKE THE DRUG WHEN THIS CONDITION. MAY MAKE A BAD SIDE EFFECTS

use with utmost care in case of asthma, heart failure, hypertension, migraine, epilepsy, renal impairment, diabetes mellitus, hyperlipidaemia, depression, and in case of existing or former thrombophlebitis, thromboembolic disease or stroke.

the preparation may be used exclusively in the above mentioned emergency cases. it is not appropriate for regular use.

STORAGE OF POSTINOR 2

protected from humidity at temperature between 15-30*c

PACKAGE

2 tablets in a blister in an inner carton. 5 inner carton in a box.

Sterilization

A sterilization is an option available to both men and women.

As far as male contraception is concerned, the technique is called vasectomy and consists in tying off and cutting the tubes that carry sperm – without the need for a scalpel intervention or stitches. The man can then go home in the same day.

This provides no protection against STIs and the effects are for life. In very rare cases (less than 1%), the tubes can grow back, making pregnancy a risk.

As for female sterilization, this is also a very simple operation after which you can go back home the very same day. You have the choice between surgical and non-surgical types of sterilization.

Surgical sterilisation (known as tubal litigation) requires very small cuts in the belly to access the Fallopian tubes, cut them and tie them so that they cannot link the ovaries with the uterus any more. The effects are permanent so you must be sure of your choice concerning sterilization.

Non-surgical sterilisation consists of placing a coil in each Fallopian tube – through the vagina and uterus – so that scars appear and eventually block each tube completely. The scars may take up to 3 months to completely block the tubes, so you need to use another method of contraception in the meantime.

Both options also offer more than 99% of protection against pregnancy (and none against STIs) because of rare cases where blocked tubes happen to grow back and reconnect (1 in 200 women).

Natural Family Planning

Although not a device or a pill, this is still a method of contraception. Natural family planning relies on knowing the menstrual cycle (periods) so that couples avoid having sex when the woman is fertile.

Three techniques (basal body temperature, cervical mucus and rhythm/calendar method) can be used for this, with higher protection rates when all three methods are used in combination. The effectiveness of this type of contraception varies between 75% to 99% (but 85% on average) with the higher uncertainty due to the fact that most women do not have a perfectly regular menstrual cycle.

What If I Use No Contraception?

In the absence of contraception, over 80% of women will fall pregnant within one year.

Needless to say, abstinence remains the only way to enjoy 100% protection from both pregnancy and STIs.

The use of contraception is widespread. It is used by anyone who wants to have sex, but avoid getting pregnant or contracting a sexually transmitted infection.

Contraception effectiveness

There is no such thing as a contraception method that offers 100% protection against pregnancy or STIs, because there is always a risk (even one in a thousand) that an accident could happen, be it rupture of a condom or human error (e.g. forgetting to take the contraceptive pill).

This makes it all the more important to look at effectiveness rates for different methods. Overall it's important to take into account that human errors can happen (e.g. more with the pill than with injections), how easy it is to use (e.g. condoms vs. diaphragm), and how good the effectiveness is for every method, in ideal use.

On average, hormonal contraception methods (e.g. the pill) are over 95% effective or more, and the condom is about 99% effective, although other barrier methods such as the diaphragm offer a protection rate between 80% to 95%.

The more careful and consistent you are, the higher is the contraceptive effectiveness for each method. For example, a careless use of condoms can make the effectiveness rate drop to nearly 85%.

Vasectomy (male sterilisation)

A woman can get pregnant if a man’s

 sperm reaches one of her eggs (ova). 

Contraception tries to stop this 

happening by keeping the egg and

 sperm apart or by stopping egg

 production.

 One method of contraception is

 vasectomy (male sterilisation).

At a glance: vasectomy

How vasectomy works

Who can have a vasectomy

Advantages and disadvantages

Risks

Common questions

During a minor operation, the tubes that carry sperm from a man's testicles to the penis are cut, blocked or sealed.

This prevents sperm from reaching the seminal fluid (semen), which is ejaculated from the penis during sex. There will be no sperm in the semen, so a woman's egg can't be fertilised.

Vasectomy is usually carried out under local anaesthetic, and takes about 15 minutes.

At a glance: facts about vasectomy

• In most cases, vasectomy is more than 99% effective. Out of 2,000 men who are sterilised, one will get a woman pregnant during the rest of his lifetime.
• Male sterilisation is considered permanent – once it's done, you don't have to think about contraception again.
• You need to use contraception for at least eight weeks after the operation, because sperm stay in the tubes leading to the penis.
• Up to two semen tests are done after the operation, to ensure that all the sperm have gone. 
• Your scrotum (ball sack) may become bruised, swollen or painful – some men have ongoing pain in their testicles.
• As with any surgery, there's a slight risk of infection. 
• Reversing the operation isn't easy, and is rarely available on the NHS.
• Vasectomy doesn't protect against sexually transmitted infections (STIs). By using a condom, you’ll protect yourself and your partner against STIs. 

How vasectomy works

Vasectomy works by stopping sperm from getting into a man’s semen. This means that when a man ejaculates, the semen has no sperm and a woman’s egg cannot be fertilised.

How vasectomy is carried out 

Conventional vasectomy

No-scalpel vasectomy

Before you decide to have a vasectomy

How long will I have to wait for the operation?

Recovering after the operation

How will I know if the vasectomy has worked?

Is reversal possible?

How vasectomy is carried out

Vasectomy is a quick and relatively painless surgical procedure. The tubes that carry sperm from a man's testicles to the penis are cut, blocked or sealed with heat. In most cases, you will be able to return home the same day.

Most vasectomies are carried out under local anaesthetic. This means that only your scrotum and testicles will be numbed, and you will be awake for the procedure. You will not feel any pain, although it may feel slightly uncomfortable.

In rare cases, a general anaesthetic may be required. This means that you will be asleep during the procedure. A general anaesthetic may be used if you are allergic to local anaesthetic or have a history of fainting easily. However, most people will only need a local anaesthetic.

A vasectomy has no effect on sex drive or ability to enjoy sex. You will still have erections and ejaculate normally. The only difference is that your semen will not contain sperm. 

A vasectomy can be performed at:

• your local GP surgery
• a hospital as a day-patient appointment
• a sexual health clinic
• a private clinic  

There are two types of vasectomy. The traditional technique, called conventional vasectomy, involves making two small incisions in the scrotum (the pouch of skin that surrounds your testicles) using a scalpel (surgical knife).

The other type, called a no-scalpel vasectomy, is a newer technique now in common use. The doctor doing your vasectomy will discuss with you which is best.

Conventional vasectomy

During a conventional vasectomy, the skin of your scrotum is numbed with local anaesthetic. The doctor makes two small cuts, about 1cm long, on each side of your scrotum.

The incisions allow your surgeon to access the tubes that carry sperm out of your testicles. These tubes are known as "vas deferens". Each tube is cut and a small section removed. The ends of the tubes are then closed, either by tying them or sealing them using diathermy (an instrument that heats to a very high temperature).

The incisions are stitched, usually using dissolvable stitches, which will disappear naturally within about a week.

No-scalpel vasectomy

You can get contraception at:

• most GP surgeries
• community contraception clinics
• some GUM clinics
• sexual health clinics
• some young people's services

Find a clinic near you

No-scalpel vasectomy is usually carried out under local anaesthetic. During a no-scalpel vasectomy, the doctor will feel the vas deferens underneath the skin of your scrotum and then hold them in place using a small clamp.

A special instrument is then used to make a tiny puncture hole in the skin of the scrotum. A small pair of forceps is used to open up the hole, allowing the surgeon to access the vas deferens without needing to cut the skin with a scalpel. The tubes are then closed in the same way as in a conventional vasectomy, either by being tied or sealed.

During a no-scalpel vasectomy, there will be little bleeding and no stitches. The procedure is also thought to be less painful and less likely to cause complications than a conventional vasectomy.

Before you decide to have a vasectomy

Your doctor will ask about your circumstances and provide information and counselling before agreeing to the procedure.

You should only have a vasectomy if you are certain that you do not want to have any, or any more, children. If you have any doubts, consider another method of contraception until you are completely sure.

You shouldn't make the decision about having a vasectomy after a crisis or a big change in your life – for example, if your partner has just had a baby, or has just terminated a pregnancy.

If you have a partner, discuss it with them before deciding to have a vasectomy. If possible, you should both agree to the procedure, but it is not a legal requirement to get your partner's permission.

You can have a vasectomy at any age. However, if you are under 30, particularly if you do not have children, your doctor may be reluctant to perform the procedure.

Your GP does have the right to refuse to carry out the procedure or refuse to refer you for the procedure if they do not believe that it is in your best interests. If this is the case, you may have to pay to have a vasectomy privately.

How long will I have to wait for the operation?

In most parts of the UK, a vasectomy is available free of charge from the NHS. However, waiting lists can be several months, depending on where you live.

Speak to your GP or ask at your local contraception clinic about vasectomies in your area. As waiting lists for vasectomies can be long, some men choose to pay to have the procedure carried out privately.

You can request a male doctor, but in some cases this may mean having to wait longer. Your GP may be able to offer you options of where the vasectomy can be carried out.

Recovering after the operation

It’s common to have some mild discomfort, swelling and bruising of your scrotum for a few days after the vasectomy. If you have pain or discomfort, you can take painkillers, such as paracetamol. Contact your GP for advice if you are still experiencing considerable pain after taking painkillers.

It’s common to have blood in your semen in the first few ejaculations after a vasectomy. This isn’t harmful.

Some other common questions about recovery are outlined below.

Underwear

Wearing close-fitting underwear, such as Y-fronts, during the day and at night will help to support your scrotum and will also help ease any discomfort or swelling. Make sure you change your underwear every day.

Hygiene

It is usually safe for you to have a bath or shower after your operation – check with your doctor what is suitable for you. Make sure you dry your genital area gently and thoroughly.

Returning to work

Most men will be fit to return to work one or two days after their vasectomy, but you should avoid sport and heavy lifting for at least one week after the operation. This is to minimise the risk of developing complications (see below). If any symptoms continue after a few days, consult your GP.

Having sex

You can have sex again as soon as it is comfortable to do so, although it is best to wait for a couple of days. However, you will still have sperm in your semen immediately after the operation, as it takes time to clear the remaining sperm in your tubes. It takes an average of 20-30 ejaculations to clear the tubes of sperm. You will need to use another method of contraception until you have had two clear semen tests.

Once the operation has been carried out successfully and semen tests have shown that there is no sperm present, long-term partners may not need to use other forms of contraception.

However, a vasectomy does not protect against HIV infection or any other STIs, so you should still use condoms with any new partner.

How will I know if my vasectomy has worked?

After the vasectomy, there will be some sperm left in the upper part of the vas deferens tubes. It can take more than 20 ejaculations to clear these sperm from the tubes so, during this time, there is still a risk of pregnancy.

Until it has been confirmed that your semen is free of sperm, you should continue to use another form of contraception.

At least eight weeks after the procedure, you will need to produce a sample of semen, which will be tested for sperm. This will also help to identify the rare cases in which the tubes naturally rejoin themselves. Once tests have confirmed that your semen is free of sperm, the vasectomy is considered successful and you can stop using additional contraception.

A few men continue to have small numbers of sperm in their system, but these sperm do not move (they are known as non-motile sperm). If you are one of these men, your doctor will discuss your options with you. The chances of making your partner pregnant may be low enough to consider the vasectomy successful, or you may be advised to have further tests or consider other options.

Is reversal possible?

It is possible to have a vasectomy reversed. However, the procedure is not always successful. You have a better chance if it is done soon after the vasectomy.

If a reversal is carried out within 10 years of your vasectomy, the success rate is about 55%. This falls to 25% if your reversal is carried out more than 10 years after your vasectomy.

Even if a surgeon manages to join up the vas deferens tubes again, pregnancy may still not be possible. This is why you should be certain before going ahead with the vasectomy. Your doctor can help you to make your decision.

Reversal is rarely available on the NHS and the operation can be expensive if done privately.

Who can have a vasectomy

Having a vasectomy should always be viewed as permanent sterilisation. This is because, although reversal is sometimes possible, it may not be successful. A reversal operation requires delicate microsurgery to join the tubes together again. Even with a successful operation, it still may not be possible to father a child.

Advantages and disadvantages of vasectomy

Advantages

• The failure rate is only one in 2,000 – out of 2,000 men who have a vasectomy, only one will get a woman pregnant in the rest of his lifetime.
• There are rarely long-term effects on your health.
• Vasectomy does not affect your hormone levels or sex drive.
• It will not affect the spontaneity of sex or interfere with sex.
• Vasectomy may be chosen as a simpler, safer and more reliable alternative to female sterilisation.

Disadvantages

• Vasectomy doesn’t protect against STIs
• It’s difficult to reverse, and reversal may not be available on the NHS.
• You need to use contraception after the operation until tests show your semen is free of sperm – if your semen contains sperm, you could make your partner pregnant.
• Complications can occur – the risks are listed below.

Risks

Most men feel sore and tender for a few days after the operation, and will usually experience some bruising and swelling on or around their scrotum.

However, in some cases, a vasectomy can cause more serious problems, some of which are outlined below.

Haematoma

A haematoma is when blood collects and clots in the tissue surrounding a broken blood vessel. Following a vasectomy, you may develop a haematoma inside your scrotum.

Haematomas are mostly small (pea-sized), but can occasionally be large (filling the scrotum) and, rarely, they can be very large. This can cause your scrotum to become very swollen and painful. In severe cases, you may need further surgery to treat the blood clot.

Sperm granulomas

When the tubes that carry sperm from your testicles are cut, sperm can sometimes leak from them. In rare cases, sperm can collect in the surrounding tissue, forming hard lumps that are known as sperm granulomas.

Your groin or scrotum may become painful and swollen either immediately or a few months after the procedure. The lumps are not usually painful and can often be treated using anti-inflammatory medication, which your GP will prescribe. If the granulomas are particularly large or painful, they may have to be surgically removed.

Infection

After a vasectomy, you may be at risk of developing an infection as a result of bacteria entering through the cuts made in your scrotum. Therefore, after the operation, it is important to keep your genital area clean and dry to keep the risk of infection as low as you can.

Long-term testicle pain

Some men get pain in one or both of their testicles after a vasectomy. It can happen immediately, a few months or a few years after the operation. It may be occasional or quite frequent, and vary from a constant dull ache to episodes of sharp, intense pain. For most men, however, any pain is quite mild and they do not need further help for it.

Long-term testicular pain affects around one in 10 men after vasectomy. The pain is usually the result of a pinched nerve or scarring that occurred during the operation. You may be advised to undergo further surgery to repair the damage and to help minimise further pain.

Testicles feeling full

After a vasectomy, some men may develop the sensation that their testicles are "fuller" than normal. This is usually caused by the epididymis becoming filled with stored sperm. The epididymis is the long, coiled tube that rests on the back of each testicle. It helps to transport and store sperm.

Any such feelings should pass naturally within a few weeks. However, speak to your GP if you are still experiencing fullness after this time.

Fertility

In a very small number of vasectomy cases, the vas deferens reconnects over a period of time. This means that the vasectomy will no longer be an effective form of contraception. However, it is rare for this to happen.

Common questions about vasectomy

Can I have the operation if I am single?

Yes, but if you are under 30 you will find that many surgeons are reluctant to do it, in case your circumstances change and you regret it later.

Will it affect my sex drive?

No. After a successful vasectomy, your testicles will continue to produce the male hormone (testosterone) just as they did before the procedure. Your sex drive, sensation and ability to have an erection won’t be affected. The only difference is that there will be no sperm in your semen. Your body still produces sperm, but they are absorbed without harm.

Could being sterile affect me emotionally?

It is a big decision to end the part of your life where you could father a child. This is another reason to think it over carefully.

If you are sure about your decision to have a vasectomy, you may feel relieved that the worry of possible pregnancy is over and you do not need to think about contraception again.

If you feel anxious or uncomfortable about the procedure, or if you think you would suffer mentally from being infertile, then it is not the best type of contraception for you. You can discuss alternatives with your GP or with a professional at a contraception clinic (sometimes called a family planning clinic).

Is there any risk of vasectomy causing cancer?

Although prostate cancer and testicular cancer can occur in men who have had a vasectomy, research suggests that vasectomy does not increase your risk of cancer.

Can I use IVF to father a child?

If you have a vasectomy, and then decide later that you want a child, there may be the option of doing so by IVF (in vitro fertilisation). To do this, a surgeon would retrieve sperm from your testicles and use this to fertilise your partner’s egg. However:

• IVF may not be available on the NHS
• IVF done privately can be expensive 
• IVF is not always successful

Can I store sperm in a sperm bank, just in case?

You could but, as with IVF, sperm stored in a sperm bank cannot be relied on to bring about a pregnancy. It can also be expensive.

Where to get contraception

Most types of contraception are available for free in the UK. Contraception is free to all women and men through the NHS. You can get contraception, and information and advice about contraception, at:

• most GP surgeries – talk to your GP or practice nurse 
• community contraception clinics 
• some genitourinary medicine (GUM) clinics 
• sexual health clinics – they also offer contraception and STI testing services 
• some young people’s services (call 0300 123 7123 for more information)

Find your nearest sexual health clinic.

Contraception services are free and confidential, including for people under the age of 16.

If you're under 16 and want contraception, the doctor, nurse or pharmacist won't tell your parents (or carer) as long as they believe you fully understand the information you're given, and your decisions. Doctors and nurses work under strict guidelines when dealing with people under 16.