Non-hormonal methods of contraception

Non-hormonal methods of contraception cover a range of methods from permanent sterilization, requiring an invasive surgical procedure, to natural family planning, which relies on women’s own fertility awareness, and is often taught by non-clinical volunteers. Sterilization and IUDs are the most popular methods worldwide, with 200 million and 100 million users respectively. Sterilization is intended to be permanent, and comprehensive preoperative counselling is essential to ensure appropriate client selection and reduce subsequent regret and reversal requests. IUDs offer long-acting, reversible and highly effective contraception. Post-insertion complications are rare, but infection is increased in the first 3 weeks after insertion. Sexual history-taking before insertion identifies those in whom an STI screen is indicated. Male condoms have regained popularity over the last two decades and can offer reliable contraception when used consistently. Protection against STIs, including HIV, is an obvious advantage. Female barrier methods include the female condom and diaphragm and are used by a small number of women, but offer a female-controlled method, with minimal associated health risks. Natural family planning, when used by motivated couples, can offer acceptable fertility control, and is often attractive to those who may find other methods unacceptable.