Overview of factors affecting contraceptive choice

Contraceptive choice is influenced by multiple factors. Medical practitioners must ensure the safety of the method for the individual’s situation, and support informed decision-making based on patient preference.

Contraception may be relevant to all individuals, regardless of gender identity. Conception may be possible for anyone presumed female at birth (this includes cis women, trans men and some nonbinary individuals). Contraception may also be relevant to anyone presumed male at birth (this includes cis men, trans women and some nonbinary individuals). See Trans and gender diverse health for more information on terminology.

Factors influencing contraceptive choice include:

  • contraindications and precautions (see Medical eligibility criteria for contraceptives), and adverse effects of the method
  • potential for drug interactions
  • effectiveness of the contraceptive method and consequences of unintended pregnancy
  • need for immediate start (including Quick Start of hormonal contraceptives)
  • reproductive stage of life
  • timeframe for planned pregnancies—return of fertility may be delayed with depot medroxyprogesterone injection
  • mechanism of action—a method that does not prevent implantation or ovulation may be preferred for religious or cultural reasons
  • reversibility
  • noncontraceptive benefits, such as improvement in acne, dysmenorrhoea or heavy menstrual bleeding with some hormonal contraceptives
  • need for a discreet method of contraception (eg for young people or anyone experiencing pressure to avoid contraception against their will)
  • risk of sexually transmitted infections—discuss use of condoms as part of a dual-method approach to contraception
  • cost and accessibility.
Note: Long-acting reversible contraception is the most reliable and cost-effective reversible method of contraception.

If reliability and cost effectiveness are paramount, long-acting reversible contraception (LARC) is an appropriate choice for females of all ages. LARCs include the etonogestrel subcutaneous implant, levonorgestrel-releasing intrauterine contraceptive devices (LNG-IUDs) and copper IUDs. Misinformation and misperceptions about adverse effects and contraindications of LARCs are common; ensure awareness of the available LARC methods and their ease of use, efficacy and safety, including in young nulliparous individuals.

Note: Intrauterine contraceptive devices can be safely used by young nulliparous individuals.