Contraception is with most of us for years, sometimes decades, and yet it remains a subject where we often feel alone with our questions. In my consultations, I hear many people tell me they never really chose their contraception: they were given it, out of habit or by default. My aim here is simple: to give you a clear, caring overview so that the conversation with your doctor starts from solid ground. Because the right contraception is, above all, the one that suits you, at a particular point in your life.
An overview of female contraception
Female contraception is still the most widespread today, and it offers a wide range of options that are often poorly understood. First come the hormonal methods: the pill (combined estrogen-progestogen or progestogen only), the patch, the vaginal ring, the implant and the hormonal IUD. They work by blocking ovulation or by altering the lining of the uterus and the cervical mucus. Alongside them, non-hormonal methods have regained a genuine place: the copper IUD, the internal condom, the diaphragm, and the so-called natural methods of cycle tracking, which require discipline and learning.
No method is universal
Each option has its strengths and limits when it comes to effectiveness, tolerance and comfort. A contraception that is perfectly suited to a friend may not suit you at all. That is why a consultation with a gynecologist or a midwife is central: it takes into account your medical history, your lifestyle and your preferences. The midwife Charline Gayault lays out this very overview of female contraception in episode #34 of the podcast, a valuable guide for finding your bearings without feeling overwhelmed.
Male contraception
We forget it far too often: male contraception exists, and it is not limited to the condom. The external condom remains essential, of course, since it is also the only method that protects against sexually transmitted infections. Then there is the vasectomy, a simple and now better-known procedure, which provides a highly reliable permanent contraception for men who have come to terms with not having future children.
Emerging, reversible methods
Beyond these, reversible approaches are being developed: thermal contraception, using a ring or specially designed underwear that lifts the testicles slightly to limit sperm production, as well as hormonal avenues still under evaluation. These methods remain little known and call for careful medical follow-up, but they open up a new field. Maxime Labrit, a nurse and pioneer of thermal contraception, speaks about it remarkably in episode #36, “contraception in the 21st century”, while a solo episode (#35) surveys the male contraception methods available. To go further on the male body and pleasure, the male sexual health page usefully complements the topic.
The contraceptive load and sharing it
Remembering the pill every day, booking appointments, managing side effects, anticipating stock shortages, monitoring your cycle: all of this has a name, the contraceptive load. It still rests overwhelmingly on women, like an extension of the mental load of daily life. Yet contraception, in a heterosexual couple, concerns two people and a shared goal: not conceiving right now.
Rebalancing this load does not necessarily mean changing method overnight. It starts with talking about it: having your partner become informed, offer support, share the costs, and consider male contraception in turn when possible. This is precisely a subject where communication within the couple changes everything: naming what weighs on you makes it possible to move past the silent assumption and decide together.
Contraception, desire and libido
One question comes up again and again in my practice: “can my contraception lower my libido?” The honest answer is: sometimes, yes, for certain people and certain hormonal methods, but it is neither systematic nor inevitable. The effects on sexual desire vary enormously from one person to another, and desire depends on so many other factors — fatigue, the relationship, life circumstances — that it would be simplistic to attribute everything to contraception.
Speaking up, rather than putting up with it
The essential point: if you feel a drop in desire or pleasure that you connect to your contraception, it is not “all in your head” and it deserves to be heard. Note what you observe and talk to your doctor about it: adjusting the dose, changing the molecule or switching to a non-hormonal method sometimes makes a real difference. You have the right to look for a contraception that protects your intimate life as much as your fertility.
Fertility and planning a baby
A persistent misconception: contraception, even taken for a long time, does not cause infertility. After stopping a reversible method, fertility returns to its usual level, sometimes as soon as the next cycle. When a plan to have a child takes shape, the time to leave your contraception behind becomes, on the contrary, a meaningful step, one you can prepare for calmly with your doctor.
Conceiving is not just a matter of calendars or cycle-tracking apps, whose promises episode #203 rightly questions. It is also a matter of desire and pleasure: episode #204, “planning a baby: conceiving through pleasure”, reminds us that we can step away from the mechanical logic of the “scheduled encounter”. And when conception is slow to come or difficulties arise, Dr Samuel Salama explores the links between infertility and sexual difficulties in episode #23, with great insight. After the child arrives, the question of contraception comes up again, often in a transformed body: I discuss this on the sexuality after baby page.
Where to find trustworthy information
The internet is overflowing with information about contraception, and not all of it is equal. Favor reliable sources: your family doctor, your gynecologist, your midwife, family planning centers, or institutional public health websites. These people take your situation into account, which no article — including this one — can do.
Taking care of your contraception also means taking care of your intimate health in the broadest sense, vulvar hygiene included; Sokona discusses this with great care in episode #129. Seeking information, asking your questions without shame, daring to say what is not working: this is what turns a contraception you simply endure into a conscious and peaceful choice.
Frequently asked questions
Which contraception should I choose?
There is no best contraception in absolute terms, only the one that suits you at a given moment. The choice depends on your medical history, your tolerance to hormones, your lifestyle and your preferences. It is a decision to build with a healthcare professional, who can weigh the benefits and limits of each method for you.
Is there such a thing as male contraception?
Yes. Beyond the condom, the vasectomy offers a permanent and reliable male contraception, while thermal contraception (a ring or special underwear) is an emerging, reversible option. Hormonal avenues are still being studied. These methods require medical follow-up, but they make it possible to better share contraceptive responsibility within the couple.
Does the pill lower libido?
Sometimes, in certain people, some hormonal contraceptions can influence desire, but this is neither systematic nor permanent. Desire depends on many other factors. If you connect a drop in desire to your contraception, talk to your doctor: changing the dose, the molecule or the method can make a real difference.
Does contraception cause infertility?
No. Reversible contraceptive methods do not harm fertility in the long term. After stopping them, fertility returns to its usual level, sometimes as soon as the next cycle. Only permanent methods, such as tubal ligation or vasectomy, are designed to be permanent.
How can the contraceptive load be shared within the couple?
By starting to talk about it openly. The partner can become informed, attend appointments, share the costs and consider male contraception when possible. Contraception concerns a shared goal: dividing it fairly eases the mental load that still too often weighs on women.
Do I need to see a professional to change contraception?
Yes, a change of contraception is decided with a healthcare professional, who will check that there are no contraindications and guide you toward the most suitable method. Never hesitate to seek another consultation if your current contraception no longer suits you, whether physically or intimately.