REPRODUCTION IN MAN
INTRODUCTION TO REPRODUCTION
Reproduction is a characteristic of life. Reproduction is when living things are able to produce and give rise to
young ones similar to them.
Reproduction prevents living things from becoming extinct or dying off entirely from the face of earth. If
animals do not reproduce as quickly as they die, they would become extinct.
They are two main types of reproduction:
- Asexual reproduction (one parent)
- Sexual reproduction (two parents)
ASEXUAL REPRODUCTION
Asexual reproduction involves only one parent producing offspring without fertilization. The parent organism
produces new cells by mitosis, which grow into a new organism which is genetically identical to the parent cell.
Examples include binary fission and vegetative propagation (in plants).
SEXUAL REPRODUCTION
Sexual reproduction involves two parents producing an offspring with fertilization. In sexual reproduction, the
parent organism produces gametes which are known as sex cells; this happens as a result of meiosis. It
involves the fusion of gametes: eggs and sperm cells which is fertilization. When fertilization occurs, a zygote is
formed. The zygote then divides continuously to grow into a new organism.
ASEXUAL VS SEXUAL REPRODUCTION
MALE REPRODUCTIVE SYSTEM
The penis and the scrotum (sacs) are the two visible
parts of the male reproductive system.
The scrotum contains a pair of testes that are both composed of seminiferous tubules. Spermatozoa (sperm) is
produced in the testes. After formation, the sperms are stored in the epididymis.
During sexual intercourse, the sperms move out of the epididymis and pass through the vas deferens (sperm
duct) tube to the penis.
The vas deferens join up with the urethra just below the bladder. The urethra continues downwards and opens
at the tip of the penis.
In the prostate gland and seminal vesicles, fluid is made. This fluid mixes with sperm to make semen. This
semen is ejaculated from the erect penis during mating or copulation.
The urethra can carry both sperm and urine at different times.
FUNCTIONS OF THE PARTS OF THE MALE REPRODUCTIVE SYSTEM
THE TESTES
The testes are the site f production for spermatozoa and testosterone (male hormone). Sperm is made in the
seminiferous tubules. It is stored in the epididymis. It is taken away from the testes by the vas deferens or
sperm duct.
GAMETES
Eggs and sperm are known as gametes. Eggs are produced in the ovaries and sperm is produced in the testes.
The ovaries and the testes are referred to as gonads.
Gametes contain half the number of chromosomes as an ordinary cell. This ensures that the zygote will have
the correct number of chromosomes when the two gametes fuse.
E.g., Human body cells: 46 chromosomes; Sperm cells (eggs and sperm): 23 chromosomes.
A cell with the total number of chromosomes is called a diploid cell (2n). A cell with half the number of
chromosomes is called a haploid cell (n).
Gametes are always haploid i.e. eggs -23 chromosomes, sperm – 23 chromosomes, and when they fuse, they
form a diploid zygote; full 46 chromosomes.
MALE GAMETE: SPERMATAZOA (SPERM CELLS)
ADAPTATIONS OF THE SPERM CELL
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Has a tail/flagellum to propel itself forward.
Chromosomes are tightly packed together in the nucleus
Mid-piece that contains numerous mitochondria to supply the energy it needs to
swim.
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Nucleus containing 23 chromosomes carrying the genes required to create new
organisms.
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The acrosome contains an enzyme which allows the sperm to penetrate the egg.
THE FEMALE REPRODUCTIVE SYSTEM
The female reproductive system is made up of the ovaries fallopian tubes, uterus and the vagina.
The ova (sex cell: egg) are made in the ovaries. The eggs are made from cells in the outside layer/epithelium.
Leading away from the ovaries are oviducts (Fallopian tubes) [are above the ovaries] which do not connect
directly to the ovaries but have a funnel-shaped opening a short distance away. The Fallopian tubes provide a
site for fertilization of the egg. The oviducts lead to the uterus (womb), which has very thick walls made of
muscle. At the base of the uterus is a narrow opening which is guarded by muscles. This is called the cervix.
This leads to the vagina, which opens to the outside.
INSIDE THE OVARIES
It is believed that a female is born with all of her eggs. However, inside the ovaries, these eggs are not mature.
These immature eggs are referred to as the ovarian follicle. A female may be born with 1-2 million eggs, most of
these will be lost due to natural processes before puberty. However, at puberty, a female will begin to
regularly lose eggs each month during menstruation until menopause.
THE FEMALE GAMETE (EGG/OVUM)
ADAPTATIONS OF THE EGG CELL/OVUM
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The nucleus contains 23 chromosomes carrying genes required to create new offspring
Yolk/cytoplasm supplies developing egg with nutrition as it continuously divides after fertilization.
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Outer barrier of the egg only allows one sperm to enter, preventing the fusion of more than two
gametes, resulting in an organism that
has more than the required number of chromosomes.
SPERM CELL AND EGG CELL COMPARED
THE MENSTRUAL CYCLE
Around 12 years old, a female reaches puberty and she will start to release ova from her ovaries every month.
This is known as Ovulation. Ovulation is a process that takes place in women once every month from puberty
to menopause.
During puberty, reproductive hormones cause secondary sex characteristics to develop. The main male
reproductive hormone is testosterone which is produced by the testes; testosterone stimulates sperm
production. The main female reproductive hormone is oestrogen which is produced by the ovaries. Oestrogen
plays an important role in the menstrual cycle which begins at puberty, as well as causing physical changes to
occur in the body (such as breast development).
During the menstrual cycle, eggs in the ovaries begin to mature and one is released approximately every 28
days in a process called ovulation.
• Stages of the menstrual cycle
During the menstrual cycle, the lining of the uterus builds up, and ovulation occurs. The average menstrual
cycle is 28 days long, and there are four overall stages:
- Menstruation – loss of lining from the uterus, occurs at the start of the cycle if no fertilization has
occurred. This lasts for about 5 days.
- The lining starts to thicken. By the time the 14th day rolls is, the uterus lining is thickened considerably
and there is an increase in blood supply. This is the follicular phase (is controlled by oesttogen).
- Ovulation occurs around the middle of the cycle (about day 14); the egg travels down the oviduct
towards the uterus
- The lining is maintained and ready to accept a fertilized egg. If the ovum is not fertilized by a sperm, it
passes through the uterus and the vagina during menstruation.
HORMONAL CONTROL OF THE MENSTRUAL CYCLE
Four hormones control the events that occur during the menstrual cycle. Two of these hormones are produced
by the pituitary gland in the brain:
• Follicle-stimulating hormone (FSH) causes the maturation of an egg in the ovary.
• Luteinizing hormone (LH) stimulates the release of the egg.
• The other two hormones, oestrogen and progesterone, are involved in maintaining the uterus lining,
with oestrogen being made by the ovaries and progesterone specifically by an empty egg follicle
called the corpus luteum.
INTERACTION OF HORMONES IN THE MENSTRUAL CYCLE
• The pituitary gland produces FSH, which stimulates the development of a follicle in the ovary.
• An egg matures inside the follicle, and the follicle produces the hormone oestrogen – so FSH stimulates the
production of oestrogen.
• Oestrogen causes growth and repair of the lining of the uterus wall and inhibits the production of FSH.
• When oestrogen rises to a high enough level, it stimulates the release of LH from the pituitary gland, which
causes ovulation (usually around day 14 of the cycle).
• The follicle becomes a corpus luteum and starts producing progesterone.
• Progesterone maintains the uterus lining (the thickness of the uterus wall).
• If the egg is not fertilised, the corpus luteum breaks down and progesterone levels drop.
• This causes menstruation – commonly known as having a period.
• If fertilisation does occur the corpus luteum continues to produce progesterone, preventing the uterus lining
from breaking down (breakdown of the lining would prevent a pregnancy).
• Once the placenta has developed, it starts secreting progesterone and continues to do so
throughout the pregnancy to maintain the lining.
CHANGES IN THE LEVELS OF THE PITUITARY HORMONES IN THE BLOOD DURING THE MENSTRUAL CYCLE
• FSH (follicle-stimulating hormone) is released by the pituitary gland and causes an egg to start maturing in
the ovary, and it also stimulates the ovaries to start releasing oestrogen.
• LH (luteinising hormone) is released from the pituitary gland.
• This is stimulated when oestrogen levels have reached their peak.
• LH causes ovulation to occur and also stimulates the ovary to produce progesterone.
• Oestrogen levels rise from day 1 to peak just before day 14.
• This causes the uterine wall to start thickening and the egg to mature.
• The peak in oestrogen occurs just before the egg is released.
• Progesterone stays low from day 1 - 14 and starts to rise after ovulation.
• The increasing levels cause the uterine lining to thicken further; a fall in progesterone levels causes the
uterine lining to break down (menstruation).
COPULATION
When a male becomes sexually excited, blood spaces in the penis fill with blood. The penis becomes erect and
is placed into the female vagina. Semen, composed of sperm and secretions from the seminal vesicles and
prostate gland, is ejaculated into the top of the vagina by muscular contractions of the tubules of the
epididymis and sperm ducts. The sperm swims through the cervix and the uterus and into the oviducts.
Copulation is the act of having sexual intercourse.
FERTILIZATION
One sperm enters the ovum, leaving its tail outside. The ovum immediately develops a fertilization membrane
preventing other sperm from entering the nuclei of both the gametes fuse, forming the zygote.
IMPLANTATION
After the repeated division of the zygote by mitosis it forms a ball of cells called the embryo. These cells move
down the oviduct and sink into the uterus lining. If this is done successfully the female is said to be pregnant.
The uterus lining must stay as this nourishes the embryo.
PREGNANCY AND DEVELOPMENT
The cells of the embryo continue to divide, and some of the cells develop into the placenta. The placenta is a
disc of tissue with capillaries running throughout and finger-like projections called villi that project into the
uterus lining. The embryo is joined to the placenta by the umbilical cord, which has an umbilical artery and
umbilical vein running through it. These connect the capillaries in the embryo with those in the placenta. The
placenta allows the exchange of materials between the mother’s blood and the embryo’s blood but prevents
the mixing of the two types of blood, which may be of different types. It also prevents certain unwanted
substances from entering the embryo’s blood from the mother’s blood, e.g., many bacteria and viruses. The
developing embryo is surrounded by a thin, tough membrane called the amnion, which forms a sac containing
the amniotic fluid.
AMNION
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Stores amniotic fluid, which stores and protects the embryo.
Shock protector.
Keeps a constant environment around the foetus.
PLACENTA
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The wall of the placenta prevents the mixing of the mother's and embryo's blood.
Prevents unwanted substances from entering the embryo's blood and damage to embryonic
capillaries from the mother's high blood pressure.
The placenta also provides a large surface area for the exchange of substances between the mother's
and embryo's blood.
Produces hormones important for a successful pregnancy.
THE UMBILICAL CORD
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Connects the baby to the placenta.
Carries oxygenated blood and nutrients from the placenta to the foetus.
It also carries deoxygenated blood and waste products from the foetus to the placenta.
GESTATION
• The ball of cells which have embedded itself into the uterine wall gradually divides and grows to form a baby.
• By around eleven weeks after fertilization, the embryo is now referred to as a foetus.
• After this stage, the foetus grows, and it takes around 9 months before it is ready to be born.
• The length of time between fertilization and birth is referred to as the gestation period which lasts for 40
weeks, 9 months or 280 days.
BIRTH
• The foetus usually turns over a few weeks before birth.
• Secretion of progesterone by the placenta is reduced and this stimulates the pituitary gland to secrete the
hormone oxytocin.
• Its head is now lying downwards just over the opening of the cervix.
• Oxytocin stimulates muscles in the uterus wall to start contracting and birth begins. This is called labour.
• The amnion bursts and the contractions cause the cervix to dilate.
• After several hours, the cervix is wide enough for the baby’s head to pass through.
• The muscles start to push the baby down through the cervix and the vagina.
• The baby is still attached to the uterus by the umbilical cord and the placenta.
• As the placenta is no longer needed, it falls away from the uterine wall and passes out of the vagina and this
is called afterbirth.
• The umbilical cord is cut and clamped, just above the point where it reaches the baby.
LACTATION
• During pregnancy, the glands in the mother’s breast will have become larger.
• After birth, they start to produce milk.
• This is called lactation.
• Lactation occurs in all mammals.
• Breast milk contains all the nutrients that the baby requires. Breast milk also contains antibodies which aid
the baby in resisting infection.
BIRTH CONTROL AND ITS IMPORTANCE
Birth control is any method that prevents the birth of a baby. This involves methods to prevent fertilization or
implantation from occurring, removing the embryo or foetus at some stage during pregnancy. Methods that
prevent fertilisation are methods of contraception. If conception and implantation have occurred and the
embryo or foetus has started to develop, then the destruction of this is an abortion. Abortion is birth control
but not a method of contraception.
Birth control is used to prevent unintended pregnancies; therefore, it allows couples to plan when they have
children and how many. Access to birth control decreases health risks to women and maternal deaths caused
by unintended pregnancies and unsafe abortions. It decreases infant deaths and improves the health and
overall care of infants by enabling women to increase the spacing between births. It also enables family sizes
to be limited so each child is provided for emotionally, physically and educationally by having frequent contact
with parents. It enables women to participate fully in society and advance in the workplace by allowing them
to plan for their future and invest in their careers.
Contraceptives and sterilization can be used to control excessive population growth. As the population
increases, the demand for food and other resources also increase. Thus, problems that may arise from
population growth are food shortages, overcrowding and the spread of disease. There is also the depletion of
natural resources (non-renewable and renewable), such as fossil fuels and forests. Deforestation, soil erosion,
industrialization, disruption of food chains and pollution are possible effects of depletion of natural resources
due to increased population. Human population growth is not as affected as other animals or organisms
because of man’s ability to increase food production using improved agricultural techniques, developments in
modern medicines, improved water supplies, sanitation and housing, knowledge of nutrition and healthy
lifestyles. However, developing countries may not access this knowledge and services and still suffer
significantly from excessive population growth.
BARRIER METHODS OF CONTRACEPTION
• Barrier methods of contraception
prevent pregnancy by blocking sperm.
Barrier methods stop the sperm from
reaching an egg. Types of barrier
methods include condoms, diaphragms
and cervical caps.
EXTERNAL CONDOM/MALE CONDOM
External condoms or male condoms are worn on the penis. Most condoms are made from latex or, less
commonly, from other materials such as polyurethane. External condoms need to be put on when the penis is
erect. Different sizes are available depending on the size of the penis. When semen is ejaculated, it is trapped
inside the condom, preventing sperm from entering the female’s body. Male condoms also prevent the
exchange of bodily fluids, effectively protecting both partners against most STIs.
• 98% effective with perfect use.
• 82% effective with typical use.
Condom usage is the only other method of birth control besides sterilization that is used by men.
-ADVANTAGES
• Protects against most STIs as well as pregnancy.
• Easy to use and readily available.
• Very reliable if used correctly.
• Only need to use them when you have sex.
-DISADVANTAGES
• May tear or slip off during sexual intercourse, allowing sperm to enter the vagina.
• May reduce sensitivity, so interferes with enjoyment.
• Some people are allergic to the material that condoms are made from.
INTERNAL CONDOMS/FEMALE CONDOM
Internal condoms, female condoms or ‘’femidoms’’ are larger than the male condom and are worn inside the
vagina. Female condoms are thin rubber or polyurethane tubes with a closed end which fits inside the vagina.
They have two flexible rings to keep them in place. An internal condom creates a barrier to stop any sperm
cells from coming into contact with the vagina. The effectiveness of this method is increased by use with
spermicidal cream placed inside of the vagina. They can be put in up to 8 hours before sexual intercourse.
Internal condoms prevent the exchange of bodily fluids, effectively protecting both partners against most STIs.
• 95% effective with perfect use.
• 79% effective with typical use.
-ADVANTAGES
• Protects against most STIs as well as pregnancy.
• Can be put in up to 8 hours before sexual intercourse.
• Only need to use them when you have sex.
-DISADVANTAGES
• Can slip or get pushed up into the vagina if not used properly.
• Not as easy to get hold of as external condoms and can be more expensive.
DIAPHRAGM AND CERVICA CAP
A diaphragm is a dome-shaped device made of flexible rubber or silicone that is positioned inside the vagina
during sexual intercourse. It forms a barrier to prevent sperm from entering the cervix.
A cervical cap is slightly smaller and just covers the cervix. They can both be put in place at any time before
sexual intercourse (up to the maximum time stated in the instructions) and must be left in position for at least
6 hours after sex.
Both the diaphragm and cap should be used with a spermicide, a gel or cream that kills sperm cells. The
spermicide is put inside the diaphragm or cap before it is placed inside the vagina. More spermicide needs to
be used if the diaphragm or cap has been in place for more than 6 hours before sex. When used correctly,
diaphragms and caps are 92-96% effective at preventing pregnancy but only 71- 88% effective with typical use.
They do not protect against STIs.
-ADVANTAGES
• Safe to use while breastfeeding.
• The diaphragm and cap do not contain hormones, so they are generally safe for women who smoke or who
have health problems such as heart disease or blood clots.
• These methods of contraception do not affect a woman's menstrual cycle. The ability to get pregnant
returns as soon as a woman stops using these methods of contraception.
-DISADVANTAGES
• Do not protect against sexually transmitted infections (STIs)
• The cervical cap does not work as well as the other barrier methods for women who have delivered a child
through the vagina.
• The cervical cap and diaphragm cannot be used by people who are allergic to latex.
• Can cause toxic shock syndrome (TSS) in women. Toxic shock syndrome (TSS) is a rare but life- threatening
condition caused by bacteria getting into the body and releasing harmful toxins.
NATURAL METHODS OF CONTRACEPTION
Natural methods of contraception aim to prevent pregnancy without the use of medications or physical
devices. Natural methods of contraception include the calendar rhythm method, withdrawal method and
abstinence.
WITHDRAWL METHOD
The withdrawal method of contraception (coitus interrupts) happens when you take the penis out of the
vagina and ejaculate outside the vagina to try to prevent pregnancy. The goal of the withdrawal method —
also called "pulling out" — is to keep sperm from entering the vagina.
-ADVANTAGES
• No cost associated with this method of contraception.
• Natural method so use of hormones or medication is not involved.
-DISADVANTAGES
• Using the withdrawal method requires self-control.
• Sperm may enter the vagina if withdrawal is not timed correctly or if pre-ejaculatory fluid (pre-cum) contains
sperm.
• The withdrawal method does not offer protection from sexually transmitted infections (STIs).
CALENDAR RHYTHM METHOD
The calendar rhythm method is a natural form of birth control. It relies on a person tracking their fertility
throughout the menstrual cycle, ensuring they do not have sex on days when they are most fertile.
Alternatively, people may use backup forms of contraception on these days.
The rhythm method requires a person to know when they are ovulating. Ovulation is the point in the menstrual
cycle when the ovaries release an egg. Tracking this is essential to the rhythm method, as sperm can fertilize an
egg anytime during the fertile window. This is the period shortly before, during, and after ovulation.
Some signs a person might track include:
• their average date of ovulation.
• cervical fluid, which changes consistency when a person approaches ovulation. Early in the cycle, a person
may notice very little fluid or thick fluid. As they become more fertile, the fluid may become very watery or
develop the consistency of egg whites. There may also be more of it.
• cervical position and texture.
• basal body temperature, which is a person’s body temperature as soon as they wake up, and which goes up
after ovulation.
-ADVANTAGES
• Causes no side effects.
• Does not involve taking medications.
• Does not require doctor appointments or prescriptions.
• Inexpensive and accessible.
-DISADVANTAGES
• Does not protect against STIs.
• With typical use, natural family planning methods are not very effective in preventing unplanned
pregnancies.
• Learning one's menstrual patterns takes time and ongoing diligence.
• Accuracy may be influenced by hormonal disorders, vaginal infections, or other illnesses.
ABSTINENCE
Abstinence means not having any kind of sex with a partner.
-ADVANTAGES
• Abstinence is 100% effective in preventing pregnancy and sexually transmitted infections (STIs).
• No costs associated with abstinence.
• Does not involve the use of hormones or medication.
- DISADVANTAGES
• May be difficult for some persons to abstain from sex.
HORMONAL METHODS OF CONTRACEPTION
Hormonal methods of contraception contain the synthetic hormones oestrogen and/or progestogen (a
synthetic form of progesterone), which are similar to hormones that are produced naturally in the body. These
hormones work to disrupt the processes that lead to pregnancy in people with a uterus:
• They stop the release of eggs from the ovaries (ovulation).
• They thicken the mucus in the cervix (the entrance to the uterus) to make it
harder for sperm to enter.
• They make the lining of the uterus thinner, so it is harder for a fertilised egg
to implant and develop into a baby.
Examples of contraceptives that contain hormones are oral contraceptives (the combined pill and
progestogen-only pill), the patch, the vaginal ring, the implant, the injection and the intrauterine system (IUS).
Some hormonal contraceptives can help to make periods lighter, more regular and less painful, as well as
reduce symptoms of premenstrual syndrome (PMS).
COMBINED ORAL CONTRACEPTIVE PILL (‘’THE PILL’’)
This pill is taken orally and contains the hormones oestrogen and progestogen. Oestrogen and progestogen
prevent the release of eggs from the ovaries (ovulation), thicken the mucus in the cervix to make it more
difficult for sperm to enter, and make the uterus lining thinner to make it harder for a fertilized egg cell to
implant.
The pill must typically be taken around the same time every day. There are three main types of the combined
pill:
• Monophasic 21-day pills have the same amounts of hormones in each pill. These need to be taken
every day for 21 days, followed by a 7-day break.
• Phasic 21-day pills come in different colours, with each section of the pack containing different
amounts of hormones. One pill is taken every day for 21 days, followed by a 7-day break. It is essential
that these pills are taken in the correct order.
• Every day pills which are taken every day for 28 days, with no break between packets. 21 pills contain
hormones, and the other seven are ‘’dummy’’ or ‘’placebo’’ pills with no effect. Again, these must be
taken in the right order.
• 99% effective with perfect use.
• Around 92% effective with typical use.
• The pill can also be used to treat other medical conditions such as polycystic ovary syndrome
(PCOS), endometriosis, acne, menstrual cramps, and menorrhagia (excessive menstrual bleeding).
ADVANTAGES
• Can make periods lighter, more regular and less painful.
• Can reduce symptoms of premenstrual syndrome (PMS).
• Does not interrupt sex.
• Can reduce the risk of certain types of cancer.
-DISADVANTAGES
• The pill needs to be taken correctly in order to be effective. This can be a problem for people who find it
difficult to remember to take the pill at the correct time every day.
• Some people experience temporary side effects such as headaches, mood swings, weight gain, breast
tenderness and nausea.
• There is a small risk of blood clots associated with some types of contraceptive pills.
• The pill does not protect against sexually transmitted infections (STIs).
PROGESTOGEN-ONLY PILL (‘’MINI PILL’’)
The progestogen-only pill, also known as the ‘’progesterone-only pill’’ or ‘’mini pill’’, is an oral contraceptive
that contains progestogen. Progestogens are synthetic forms of progesterone that produce effects similar to
the natural hormone progesterone in the body.
It works by thickening the cervical mucus to reduce the chances of sperm entering the uterus. Some
progestogen-only pills also suppress ovulation (the release of an egg from the ovaries).
The progestogen-only pill is useful for people who cannot use contraceptives containing oestrogen, such as
those with certain medical conditions like breast cancer or high blood pressure. The progestogen-only pill
typically needs to be taken around the same time every day, with no break between packs.
• 99% effective with perfect use.
• 92% effective with typical use.
-ADVANTAGES
• Can make periods lighter and less painful.
• Can reduce symptoms of premenstrual syndrome (PMS).
• Does not interrupt sex.
• Can be used by people who cannot have contraceptives that contain oestrogen.
-DISADVANTAGES
• Requires the user to remember to take it every day.
• Can cause temporary side effects, including headaches, nausea, breast tenderness and acne.
• Can make periods irregular, more frequent or they may stop altogether.
• May cause breakthrough bleeding and spotting.
• Does not protect against STIs.
LONG-ACTING REVERSIBLE CONTRACEPTION (LARC)
Long-acting reversible contraception (or LARC) refers to methods of contraception that prevent pregnancy for
an extended period of time, without the user needing to think about it every day. Some people find these
methods more useful than oral contraceptives, the patch and the vaginal ring, which need to be taken or
changed regularly.
Examples of LARC methods include some hormonal methods, such as the implant, intrauterine system (IUS)
(hormonal IUD) as well as the intrauterine device (IUD).
These methods are very effective at preventing pregnancy but do not protect the user against STIs.
INTRAUTERINE SYSTEM (IUS)
The IUS is also known as the hormonal coil. It releases the hormone progestogen into the uterus to prevent
pregnancy. The IUS prevents the release of eggs from the ovaries (ovulation), thickens the mucus in the cervix
to make it more difficult for sperm to enter, and makes the uterus lining thinner to make it harder for a
fertilized egg cell to implant.
It is a method of long-acting reversible contraception (LARC). The IUS protects against pregnancy for between
3 and 5 years, depending on the type. It can be removed at any time by a medical professional, and it’s then
possible to get pregnant straight away.
• It is 99% effective at preventing pregnancy.
An IUS is fitted by a medical professional. An internal examination is required to check the position and size of
your uterus before the IUS is fitted. The procedure can be uncomfortable or even painful, but painkillers can be
taken beforehand to reduce any discomfort. Sometimes, the procedure is carried out under local anesthesia.
-ADVANTAGES
• Can make periods lighter or shorter, or they may stop altogether.
• Effective for up to 5 years without having to think about it.
• Does not interrupt sex.
• Can be used by people who cannot have contraceptives that contain oestrogen.
• It can be taken out at any time by a specially trained doctor or nurse. It's possible to get pregnant straight
after it is removed.
-DISADVANTAGES
• There is a small risk of infection or damage to the uterus occurring when an IUS is inserted.
• Some people experience headaches, acne and breast tenderness after having the IUS fitted, but these
usually settle with time.
• Some people experience changes in mood.
• An IUS does not protect against STIs.
• Can initially cause irregular bleeding.
INTRAUTERINE DEVICE (IUD)
The IUD (also known as the copper coil) is similar to the IUS but does not contain hormones. It is a small Tshaped device made from copper and plastic which is inserted into the uterus. It releases copper, which
prevents sperm from surviving in the uterus. Essentially, the copper kills the sperm. The IUD is effective for
between 3 and 10 years, depending on the type, but it can be taken out earlier by a medical professional if
desired. It is possible to get pregnant straight away after removal.
The IUD is 99% effective against pregnancy. The IUD or IUS needs to be fitted by a specialist doctor or nurse.
This is an invasive process which can cause discomfort, so it may be done under local anesthesia.
- ADVANTAGES:
• The IUD is an alternative to hormonal methods of contraception.
• The IUD is useful for people who do not want to become pregnant for a long time as they are effective for
several years.
• The IUD can make periods shorter, lighter and less painful.
-DISADVANTAGES
• Having an IUD or IUS fitted can be uncomfortable or even painful for some people.
• There is a risk of infection when the IUD is fitted.
• Periods may become longer, heavier or more painful with the IUD.
• There is a risk of ectopic pregnancy (where a fertilised egg implants itself outside the womb) if the IUD fails.
• The IUD does not protect against sexually transmitted infections (STIs).
CONTRACEPTIVE INJECTION
The contraceptive injection releases the hormone progestogen directly into the bloodstream. The
contraceptive injection is usually administered by a medical professional but there are some types of injection
that you can use yourself at home.
The injection prevents the release of eggs from the ovaries (ovulation), thickens the mucus in the cervix to
make it more difficult for sperm to enter, and makes the uterus lining thinner to make it harder for a fertilized
egg cell to implant. Each injection is effective for between 8 and 13 weeks, so it is a good option for people
who want to be protected against pregnancy for a longer time without having an invasive procedure. It can
take up to a year for fertility to return to normal after the injection wears off.
• 99% reliable with perfect use.
• 94% effective with typical use.
- ADVANTAGES:
• Can make periods lighter and less painful.
• Effective for up to 13 weeks without having to think about it.
• Does not interrupt sex.
• Can be used by people who can’t have contraceptives that contain oestrogen.
-DISADVANTAGES
• Requires the user to get regular repeat injections for it to remain effective.
• Can cause side effects such as thinning of bones, weight gain, headaches, breast tenderness and mood
swings.
• It can cause acne (or make it worse).
• Can make periods irregular, heavier, longer, or they may stop altogether.
• It can take up to a year for fertility to return to normal after the injection wears off.
• Does not protect against STIs.
SURGICAL METHODS OF CONTRACEPTION (STERILIZATION)
Sterilization involves having surgery to cut, seal or block the tubes that carry sperm cells or egg cells. This form
of contraception should always be considered permanent, although the procedures can sometimes be
reversed.
• 99% effective.
Male sterilization (vasectomy) involves cutting or sealing the sperm ducts to stop sperm being released from
the penis. It is still possible to ejaculate after having a vasectomy, but there will be no sperm cells present in
the semen.
Female sterilization (tubal ligation) involves sealing or blocking the oviducts to stop the eggs reaching the
sperm. Hormone levels are not affected, and periods still happen after the procedure.
- ADVANTAGES:
• No other method of contraception needed once sterilization has been confirmed as working.
• Useful for people who know that they definitely do not want children.
-DISADVANTAGES
• In rare cases, the tubes may rejoin, making the person fertile again.
• Almost impossible to reverse if you change your mind.
• Does not protect against STIs.
ADDITIONAL METHODS OF CONTRACEPTION

The vaginal ring is a flexible, plastic ring that is inserted into the vagina and protects against pregnancy
for one month. It releases the hormones oestrogen and progestogen into the bloodstream through
the walls of the vagina. The ring is normally left in the vagina for 21 days, then removed for a 7-day
break. A new ring is then put in for another 21 days. The ring is over 99% effective at preventing
pregnancy, but this relies on the person remembering to change it once a month. With typical use, it is
about 91% effective. The ring does not protect against STIs.

The contraceptive patch is a sticky, square patch that looks a bit like a plaster. It is stuck onto the skin
and changed once a week. Like the combined pill, the patch releases the hormones oestrogen and
progestogen into the bloodstream. The patch is easy to apply and can be left on while playing sports,
swimming or having a bath. If used correctly, the patch is 99% effective at preventing pregnancy.
However, some people find it difficult to remember to change the patch at the same time each week,
so it is only around 91% effective with typical use. The patch does not protect against STIs.

The contraceptive implant is a small plastic rod that is placed under the skin in the upper arm. The
contraceptive implant gradually releases the hormone progestogen into the bloodstream.
Progestogen thickens the cervical mucus, making it harder for sperm to enter the cervix. It also makes
the uterus lining thinner to make it harder for a fertilized egg cell to implant. The implant needs to be
fitted by a medical professional under local anesthetic. It is removed by making a small cut in the skin
to gently pull the implant out. It can be removed at any time by a medical professional, and natural
fertility will return quickly.
It is a method of long-acting reversible contraception (LARC). Once inserted, the implant can be left in
place for up to 3 years, so it is a good option for people that know they don’t want to get pregnant for
a long period of time. It is useful for people who cannot use contraceptives containing oestrogen, for
example those who have certain medical conditions like breast cancer or high blood pressure.
Can cause temporary side effects, including headaches, nausea, breast tenderness and mood swings.
Does not protect against STIs.
EMERGENCY CONTRACEPTION
Emergency contraception can prevent pregnancy after unprotected sex or if the contraception you have used
has failed – for example, a condom has split, or you have missed a pill. Often called the morning-after pill,
emergency contraceptive pills (ECPs) are pills that can be taken up to 120 hours (5 days) after having
unprotected sex. Some types of emergency contraception work best when taken within 72 hours (3 days) after
intercourse. The copper IUD can sometimes be used as a form of emergency contraception. Emergency
contraceptive pills work by delaying ovulation (the release of an egg during the monthly cycle). If fertilization
and implantation have already happened, ECPs will not interrupt the pregnancy.
Emergency contraception does not protect against STIs. ECPs can cause some minor side effects for a few
days, including:
• nausea
• vomiting
• breast tenderness
• headaches
• spotting
SEXUALLY TRANSMITTED INFECTIONS (STIs)
Sexually transmitted infections (STIs) are infections that are spread by sexual activity, including sexual
intercourse, anal sex and oral sex. STIs are also referred to as sexually transmitted diseases or venereal
diseases (old term). These include HIV/AIDS, gonorrhea, syphilis, and genital herpes.