Women's health · 5 min read · Updated October 2026
Contraception: your options, side by side
From pills to implants to condoms, here is how each method works, how well it works, and what to think about when choosing.
Clinician review pending This article is awaiting sign-off by a doctor.
Choosing contraception is personal: what matters is a method you can use correctly and are comfortable with. Most methods are free or low-cost at government clinics across Africa. None, apart from condoms, protects against sexually transmitted infections, so many people use condoms as well.
Long-acting methods (most effective, nothing to remember)
The implant is a small rod under the skin of the arm that lasts 3 to 5 years; fewer than 1 in 100 users become pregnant per year. The intrauterine device (IUD) sits in the womb: the copper IUD lasts 10 years and is hormone-free, the hormonal IUD lasts 5 to 8 years and usually makes periods lighter. Both are put in and taken out by a trained provider and fertility returns quickly after removal. Irregular bleeding in the first months is common with the implant and hormonal IUD.
Injections
Depo-Provera (DMPA) is given every three months, including a version you can inject yourself (Sayana Press). It is private and effective, and often stops periods. Return of fertility can take several months to a year after the last injection. Long use may slightly reduce bone density, which recovers after stopping.
Pills
The combined pill (oestrogen and progestogen) is taken daily and also helps acne and heavy, painful periods. It is not suitable if you have migraines with aura, high blood pressure, smoke and are over 35, or have had a blood clot. The progestogen-only pill suits breastfeeding women and those who cannot take oestrogen but must be taken at the same time each day. Missing pills is the main reason pills fail.
Barrier and other methods
Male and female condoms prevent pregnancy and infections when used every time. Fertility awareness (tracking cycles) and withdrawal are less reliable. Breastfeeding gives good protection only in the first six months, only if the baby is exclusively breastfed and periods have not returned. Sterilisation (vasectomy for men, tubal ligation for women) is permanent.
Emergency contraception
The emergency pill (levonorgestrel) works best within 72 hours of unprotected sex, and is sold at pharmacies without prescription in most countries. A copper IUD fitted within 5 days is the most effective option and then gives ongoing protection.
When to seek help
See a doctor if you have severe or persistent bleeding on any method, want to switch methods, or have missed pills and need advice. Go to a hospital now if you have severe leg pain or swelling, chest pain, sudden severe headache or vision changes while using a hormonal method, or severe belly pain after a missed period.
How Telafia can help
A doctor can help you compare methods, prescribe pills or self-injection for collection at a pharmacy, and refer you to a clinic for an implant or IUD. Your choice stays confidential.
Emergency numbers
767 works in Lagos State; 112 is the national number. Numbers change: please check locally. If a number does not connect, go straight to the nearest hospital.
Related doctors
Questions about this? A women's health doctor can help today.