Mechanical (barrier) methods
Condoms (male and female) are physical barriers that prevent sperm from reaching the egg. They also reduce the transmission of sexually transmitted infections (STIs). The mechanism is simple: if sperm cannot enter the oviduct, fertilisation cannot occur.
Other barrier methods include the diaphragm, which covers the cervix and blocks sperm from entering the uterus. Barrier methods have no hormonal side effects and are the only contraceptive methods that also protect against STIs.
Hormonal methods
Hormonal contraceptives such as the combined oral contraceptive pill contain synthetic oestrogen and progesterone. These hormones prevent ovulation by inhibiting the release of FSH and LH from the pituitary gland. Without ovulation, there is no egg to be fertilised.
Progesterone-only methods also thicken the cervical mucus, making it more difficult for sperm to pass through, and thin the uterus lining, making implantation less likely. Hormonal implants and injections work on the same principles but deliver hormones over longer periods.
Chemical methods and IUDs
Spermicides are chemical substances that kill or immobilise sperm. They are often used alongside barrier methods for increased effectiveness. On their own, spermicides are less reliable.
An intrauterine device (IUD) is inserted into the uterus. Copper IUDs release copper ions that are toxic to sperm and also make the uterus lining unsuitable for implantation. Hormonal IUDs release progesterone locally, thickening cervical mucus and thinning the uterus lining.
Abstinence and natural methods
Abstinence (avoiding sexual intercourse) is the only method that is 100% effective at preventing pregnancy and STI transmission. Natural family planning involves tracking the menstrual cycle and avoiding intercourse during the fertile window around ovulation.
Natural methods require careful monitoring of cycle length, body temperature and cervical mucus changes. They are less reliable than other methods because cycles can be irregular and sperm can survive in the female reproductive tract for several days.