There's no "best" contraception, only the best fit for you right now — and that changes across life. Here's the plain-language map so you can walk into a clinic informed.

Hormonal methods (they use synthetic hormones to prevent pregnancy, and often change or stop your bleed):

• Combined pill (oestrogen + progestogen): familiar, can ease acne and heavy/painful periods, but not suitable for everyone (e.g., migraine with aura, certain risk factors).
• Progestogen-only pill ("mini-pill"): an option when oestrogen isn't suitable.
• Hormonal IUD (coil): very effective, often makes periods much lighter or absent — popular for heavy bleeding.
• Implant and injection: long-acting, low-maintenance options.
• Trade-offs: convenience and symptom control versus potential side effects (mood, libido, breakthrough bleeding) that vary hugely between women and methods.

Non-hormonal methods (no synthetic hormones; your natural cycle continues):

• Copper IUD (coil): highly effective, hormone-free, long-lasting — though it can make periods heavier or crampier for some.
• Barrier methods (condoms — which also protect against STIs — diaphragms): no hormones, used as needed.
• Fertility awareness methods: tracking your cycle to avoid fertile days — requires diligence and teaching to be effective.
• Sterilisation: permanent.

How to choose: think about what matters most to you — effectiveness, whether you want lighter or no periods, avoiding hormones, convenience, reversibility, STI protection, and any health conditions. There's no shame in trying one and switching; many women do.

A note for perimenopause: you can still get pregnant until menopause is confirmed, so contraception still matters in your 40s — and some methods can also help manage perimenopausal symptoms, which is worth discussing.

This is a conversation to have with a clinician who can factor in your health history. Use this guide to walk in knowing the questions to ask.

Common questions

Is non-hormonal contraception better?

Not better or worse — just different. The copper IUD and barrier methods avoid synthetic hormones, while hormonal methods can also ease periods or acne. The best choice depends on your priorities and health.

Do I still need contraception in perimenopause?

Yes — you can get pregnant until menopause is confirmed (12 months with no period), so contraception still matters in your 40s.

Related reading: Coming off the pill · Hormonal headaches and migraines · Take the free Hormone Quiz