Dr Jan AdlamGynaecologist & Urogynaecologist

Your cycle & contraception

Guide tools

Contraception, with your needs in mind.

Prevent pregnancy, manage difficult periods, or both. Explore the options, compare everyday use and find an approach that fits your health and plans.

Start with a type of contraception below, or compare two methods side by side.

Approaching menopause? HRT does not prevent pregnancy, and hormonal contraception can hide your natural period pattern. Read when contraception can stop and how HRT fits, or return to the menopause overview.

How Dr Adlam can help

A consultation brings your contraceptive goals and symptoms into the same discussion.

  • Review bleeding, pain, previous side effects and future pregnancy plans.
  • Consider migraine or clot history, blood pressure, medicines and your daily routine.
  • Agree how to start or switch, what to expect and when to follow up.
About the pill’s additional benefits · WHO ↗

Start with the type of method

Explore your contraception options

Open a guide to explore the method and choose a product. These are options to discuss, not a recommendation for you.

Hormonal IUD

A small device placed in the uterus. Mirena and Kyleena are included.

Copper IUD

A device placed in the uterus, without hormones.

Implant

A small rod under the skin of the upper arm.

Pills

Taken every day. Explore the pill type and your exact brand.

Injection

Contraception given at repeat appointments.

Patch

A patch worn on the skin, changed on a weekly schedule.

Vaginal ring

A flexible ring placed in the vagina and used on a schedule.

Condoms

Used for each act of sex. Also help reduce the risk of STIs.

This guide covers the methods illustrated here. A consultation can also discuss other options, including permanent contraception.

Practical choices

Compare ongoing methods

Compare the routines and effects that matter to you.

Choose two methods to compare

Perfect and typical use over the first year · general estimates, not an individual prediction. Injectables and IUDs use SA July 2026 class estimates; other methods use their linked references.

See all methods in one table

Swipe or scroll sideways to see all columns →

Perfect- and typical-use effectiveness and practical differences between ongoing methods
MethodPerfect useTypical useDuration or routineReturn of fertilityExplore

Same first-year estimates and denominator as the paired comparison. Open a card’s source notes for its population and reference. Rows summarise method families using the displayed product examples; duration and routine are product-specific. This table covers the methods illustrated above, not every contraceptive option.

What brings you here?

Open the illustrations

Optional: understand your natural cycle

Illustrated examples · not a fertility forecast or a check of contraceptive protection.

Follow the changes

Natural cycle

Reference physiology
Ovulation

At the selected day

Ovulation

How this method works Illustration & use timeline

Relative hormone patterns · Each hormone has its own illustrative scale. Compare timing, not heights.

Ovary & lining

Full timeline · tap to choose a day.

EXAMPLE CYCLE DAY

Hormone signals

FSH supports follicles; the LH surge precedes egg release.

FSHLH

Ovarian hormones

OestrogenProgesterone

Ovary

Oocyte enlarged for visibility
Illustrative snapshots

Uterine lining

Pale tubes: glands · red: vessels
Illustrative tissue, not a measurement
Why does withdrawal bleeding happen?

Bleeding pattern

Separate from tissue thickness

One invented example; marks do not predict your bleeding dates or amounts.

Cervical mucus

Blue shapes = sperm
Illustrative snapshots

Contraceptive input

Read the diagram as text

GnRH from the hypothalamus coordinates pituitary FSH and LH. Its rapid pulses are not plotted against a day-scale axis here.

About this method

Effectiveness, routine & further detail
Pregnancy prevention and STI protection are different. Most contraceptive methods do not prevent sexually transmitted infections. Condoms can be used alongside another method to reduce STI risk. CDC guidance ↗

Sources and model notes

Clinical review · 6 Oct 2026

Clinically reviewed by Dr Jan Adlam · 6 October 2026.

Clinical references, local products & model limitations

Named combined-pill packs use South African professional information from SAHPRA or the local manufacturer. Evra, NuvaRing, Mirena and Kyleena use linked South African PIs; injection intervals and Implanon NXT duration use South African national guidance. POP formulation examples are labelled where a local brand has not been verified. CDC, WHO and FSRH supply additional mechanism, bleeding and effectiveness context. Restart guidance after ulipristal follows CDC 2024; the older local ella PI has different wording.

About the illustrations. Graphs are illustrative shapes, not laboratory data, a pharmacokinetic simulation or a validated pregnancy-risk model. They do not select a suitable method for an individual.

How the model works

Natural examples place ovulation 14 days before the next cycle. Combined methods use treatment days, with the selected regimen determining the break. Named pills show the documented pack sequence with locked ingredients and regimen. Generic teaching examples are separate and do not identify South African products. The generic 84/7 view shows the full 91-day regimen; its optional natural reference repeats a 28-day example. DMPA and NET-EN display their 12- and 8-week reinjection intervals. Implant views show a 28-day teaching interval within longer use, not a monthly biological cycle. Traditional pills and hormonal IUDs offer explicit ovulatory and non-ovulatory examples.

All pill-omission scenarios leave the response unpredicted from the first omitted tablet to the end of the displayed pack. This is a limit of the illustration, not a duration of additional precautions or a prediction of contraceptive failure. Local product instructions are linked separately. Emergency graphs never assign a post-dose hormone trajectory or period date. A separate follicle illustration can explain a hypothetical delay without shifting the whole cycle. Cyclic combined regimens illustrate a usual withdrawal bleed. Its exact onset, duration and amount are not individual predictions. A separate bleeding strip offers menstrual, withdrawal, spotting and absent-bleeding examples as appropriate. Its marks are invented teaching patterns, never observed probabilities or predicted dates. Cervical mucus changes gradually through a blended transition illustration; its texture is not a microscopic measurement. Ovarian snapshots start with an antral cohort whose development began months earlier. The LH peak precedes release in this illustration; hormone shapes, the lag and stage boundaries are schematic. A functional corpus luteum is shown around the mid-luteal progesterone peak, with regression later if pregnancy does not occur.

Hormone graphs use independent illustrative scales. They show a late-cycle FSH rise, an oestrogen peak before the LH peak, and a mid-luteal progesterone peak. No numerical hormone trajectory is assigned to uncertain responses or suppressed ovarian activity. Grey comparisons are labelled natural examples; an emergency reference ends with the original cycle. Dose steps mark the beginning of a treatment day and use the stage lengths and relative ingredient doses of the referenced pack examples. Drug input is not a blood concentration curve.

The optional date helper counts calendar days from entered period or current treatment-start dates. Three period starts yield two observed intervals; an arithmetic average, rounded to a whole day, can select a 24–38-day illustration. Dates do not confirm ovulation or cycle phase. Counts continue beyond an expected cycle length without an automatic restart. Dates stay in the current tab unless “Remember on this device” is chosen; they are separate from shared or saved teaching views and excluded from printouts.

Endometrial stages distinguish shedding and repair, proliferative growth and secretory differentiation. Glands are pale epithelial-lined tubes; red vessels are separate. The basalis remains through menstruation, above the underlying myometrium. Late-secretory tissue is retained until breakdown rather than drawn as a fixed premenstrual collapse. Hormonal-method images are examples of tissue response, not biopsy or bleeding predictions; cyclic combined regimens illustrate withdrawal bleeding around the planned break. Timing and absent-bleeding patterns vary by formulation; Zoely also highlights absent withdrawal bleeding as a recognised pattern.

Open the clinical references

    Change your view

    Choose a method

    Count from your dates, then explore an example.

    Educational examples, not a fertility forecast or personal risk calculation. Hormone levels, tissue thickness and timing are schematic. Bleeding and individual responses vary.

    More diagram options
    Changes appear in the diagram.

    About this method

    Your dates · your device

    Where am I in my cycle?

    Count the first day of a period as day 1. Dates help locate a day on an example; they cannot confirm ovulation or your biological phase.

    Use the date the period started, not the date it ended.

    Count from one period start to the next. Leave blank to get only your day count.

    Dates are kept in this tab by default. They are not sent anywhere or included in shared links, teaching-view saves or printouts.

    This helper does not identify fertile or “safe” days. About cycle timing ↗

    Anatomy close-up

      Tissue detail; not a measurement or bleeding forecast.

      The natural-cycle reference begins with antral follicles, not primordial follicles. Stage boundaries are illustrative; a completed corpus albicans is not assigned to day 28.

      How to explore

      1. Choose a method or open the separate emergency contraception view.
      2. Use the day slider, number field or key-day buttons. A floating day navigator appears as you scroll through the diagrams. Arrow keys also work on either slider.
      3. Follow the selected-day line through each diagram. On smaller screens, use Overview / Close-up above the diagrams or in the floating bar. Overview shows the complete ovary and lining timeline; tap a day on the artwork or use the overview ruler with arrow keys. Close-up keeps the selected ovary and a separately labelled seven-day lining window. Your preferred view is remembered on this device. Grey dashed lines show the natural reference.
      4. For combined pills, choose a South African formulation, tap a tablet and compare exact pack contents. Actual missed-pill instructions are separate from the omission teaching scenario.

      Open the method selector for cycle or method information and “Find my cycle day” (or “Find my treatment day”). Count from period dates, or the current pack start for supported treatment schedules. “Today” returns to that date-based position when it fits the example; it does not confirm a biological phase. Save a teaching view, copy its settings, or print a handout. Personal dates and the Today marker are excluded.

      Terms used in this guide
      FSH / LH
      Pituitary signals involved in follicle development and ovulation.
      Progestogen / progesterone
      Progestogen is the broader hormone class used in contraception. Progesterone is the ovarian hormone plotted here.
      Withdrawal bleeding
      Bleeding that can follow a fall in contraceptive hormones.
      Endometrium
      The lining of the uterus.

      Display settings

      Your operating system’s reduced-motion setting is respected.

      Save this teaching view

      Only diagram settings are saved, on this browser. Cycle dates and the personal Today marker are excluded.

      Saved views