Contraception Guide

It is important to remember that only condoms protect against sexually transmitted infections. Even if you use another method of contraception, we recommend that you use a condom as well if you have sex with a new partner. You can order condoms for free from gratiskondomer.no.

Find out more about contraception (in Norwegian) here. You can also contact us via our live anonymous chat.

All the information in the Contraception Guide has been quality-controlled by Sex og samfunn and University of Oslo employees.

Different types of contraceptives

There are benefits and disadvantages to all contraceptives. The advantage of hormonal contraceptives, of any kind, is that they often reduce bleeding and pain during menstruation. An important difference between the methods is how long must be taken for.

Non-hormonal contraceptives

Non-hormonal contraception does not affect ovulation, so it does not alter your regular menstrual cycle

The advantage is that you do not need to think about the side effects of taking hormones. In addition, condoms protect you against sexually transmitted infections. The downside is that you cannot control your menstruation, and the copper IUD can give you heavier bleeding and worse menstrual cramps than before.

Hormonal contraception with progesterone only

These contraceptives contain hormones similar to the ovarian hormone progesterone. Progesterone makes it harder for sperm cells to enter the uterus and often prevents ovulation.

Your ovulation cycle will quickly return once you stop taking the contraceptive. The only exception is contraceptive injections: with them, it often takes a long time before your ovulation returns to normal.

Contraceptives that only contain progesterone do not increase the risk of blood clots or cardiovascular disease, so most people who are advised not to take oestrogen can use contraceptives that only contain progesterone.

Some people stop bleeding, and this is nothing to be worried about. Your bleeding may become irregular, and you cannot decide when your period comes.

Hormonal contraception with both oestrogen and progesterone (combined hormonal contraceptives)

These contraceptives are called combined oral contraceptive pills because they contain a combination of hormones similar to the ovarian hormones oestrogen and progesterone. They protect against pregnancy by preventing ovulation and making it harder for sperm to enter the uterus. The effect is temporary. Your ovulation cycle will quickly return once you stop taking these contraceptives.

Combined hormonal contraceptives often give you good control of your bleedings, meaning you can decide when you want to “menstruate”. If you follow the instructions by taking a break from the birth control pills each month, you will get a bleeding similar to your menstruation every month. You can also “skip” this bleeding by not taking a break. Contraceptives containing oestrogen carry a slightly higher risk of harmful side-effects, such as blood clots and cardiovascular disease. You will therefore be asked about your and your family’s health (see page 27) and your blood pressure will be taken.

Correct use is most effective!

Most contraceptives are very safe, but for them to work properly, you must be careful to use them exactly the right way. The risk of unplanned pregnancy is largely related to how good you are at remembering your contraception, whether that be taking a pill daily, using a condom, or changing to a new patch or vaginal ring at the right time.

Taking other medicines, such as anti-epileptic medication, may reduce the effectiveness of your contraception. For those taking the pill, other conditions such as vomiting and diarrhoea can also affect the effectiveness of the pills.

The safest contraceptives are the ones that make it impossible to forget anything or do anything wrong. The lowest likelihood of an unplanned pregnancy is with long-acting contraceptives such as implants and IUSs

Using a copper IUD for the first time

You need a prescription from a doctor, public health nurse or midwife to get the IUD from a pharmacy. You can also buy copper IUDs without a prescription at a pharmaci or at the local healthcare centre where your IUD is going to be inserted.

Before insertion, you must be sure that you are not pregnant. You may need to take a pregnancy test and a test for sexually transmitted infections, such as chlamydia. You must not have any vaginal intercourse in the first 7 days after insertion.

Use of copper IUD

Copper IUDs are inserted during a gynaecological check-up by a public health nurse, midwife or doctor. They are effective for 5 years but can be removed earlier if so desired. The actual insertion process can be unfomfortable and painful, but for most people, the discomfort quickly subsides.

Stopping using a copper IUD

IUD removal is fast and is different from the insertion process. You can insert a new IUD when you remove the old one. Your fertility will not decrease, even if you have been using a copper IUD for a long time.

• Price: about 6-13 kroner per month*
• Inserted by a doctor/midwife/ public health nurse every 5 years

*Price at Sex og samfunn is 399 kroner
The price at your pharmacist’s/doctor’s may vary, up to about 800 kroner.
Free for 19-year-olds, and 20-year-olds pay about half price.

Using a condom for the first time

You can get free condoms at health centres, from your school public health nurse, or order them free of charge from www.gratiskondomer.no. You can also buy them at stores and pharmacies.

Practice makes perfect, and we recommend that everyone practise on their own. Once you get good at putting condoms on, it hardly takes any time, and you have less risk of the condom breaking.

Using a condom

Condoms are rolled onto an erect (stiff) penis before sex and are kept on until you have finished having sex. Anyone can use a condom. See instructions for use on the next page.

Unfortunately, sometimes a condom can break during sexual intercourse if it is not put on correctly, or it can slide off if you forget to hold the condom when pulling out. It may be a good idea to carry emergency contraception if a condom is the only contraceptive you are using.

• Price: free from www.gratiskondomer.no; otherwise about 60-100 kroner for a pack of 10.
• Needs to be put on before sex.

Using a hormonal IUD for the first time

You need a prescription from a public health nurse, midwife or doctor to get an IUD from a pharmacy. In some cases, you can buy the IUD at the healthcare centre where your IUD is going to be fitted. The packaging is very large, even though the IUD itself is small.

Before insertion, you must be sure that you are not pregnant. You may need to take a pregnancy test and a test for sexually transmitted infections, such as chlamydia. You should not have any vaginal intercourse in the first 7 days after insertion.

Using hormonal IUDs

Hormonal IUDs are inserted during a gynaecological check-up by a public health nurse, midwife or doctor. The actual insertion process can be uncomfortable and painful, but for most people, the discomfort quickly subsides.

Hormonal IUDs are effective for 8, 6, 5 or 3 years, but can be removed earlier if so desired. There is a small difference in the quantity of hormones. The greater the quantity of hormones, the safer the IUD and the greater the likelihood of little or no menstruation. All IUD types can be used by persons who have not given birth.

Stopping using hormonal IUDs

IUD removal is fast and is not like the insertion process, and you can insert a new IUD when you remove the old one. Your fertility will not decrease, even if you have been using a hormonal IUD for a long time.

• Price: approx. 20-30 kroner per month*
• Is inserted by a doctor/midwife/public health nurse every 3, 5, 6 or 8 years

*A hormonal IUD costs about 1300 kroner, and can be used for 3-8 years. Hormonal IUDs are free for those below 18 years. If you are 19 you must pay about one third of the price, and 20-year-olds pay about two-thirds of the price.

Using contracteptive implants for the first time

You need a prescription from a public health nurse, midwife or doctor to get a contraceptive implant from a pharmacy.

It is important to be sure that you are not pregnant before inserting the implant, and you may need to take a pregnancy test. If you start using the implant by the 5th day of your menstruation cycle, you are protected from the first day on. If not, you need to wait 7 days before you can have sex without a condom.

Use of contraceptive implants

The contraceptive implant is inserted straight under the skin of your upper arm by a doctor, public health nurse or midwife. You will be given a local anaesthetic so that the implantation is painless. The implant is effective for three years but can be removed earlier if so desired. If you wish to continue with birth control/ contraceptive implants, you can have new one inserted when the old one is removed.

Stopping using contraceptive implants

When the implant is removed, you will be given a local anaesthetic. Removal is painless and only leaves a small cut. Once the implant is removed, you will soon start ovulating again. Your fertility will not be affected, even if you have been using an implant for a long time.

• Costs about 40 kroner per month*
• Is implanted by your doctor/public health nurse/midwife every 3 years

* A contraceptive implant costs about 1300 kroner, and can stay in for up to 3 years. Contraceptive implants are free for those below 19 years. If you are 19 you will have to pay about one third of the price, and 20-year-olds pay about two-thirds of the price.

Using birth control shots for the first time

You can get a prescription from your public health nurse, midwife or doctor. Contraceptive injections can be bought at pharmacies. You must be sure that you are not pregnant before you are given a contraceptive injection. Contraceptive injections also carry a slightly increased risk of adverse side effects that are not associated with other contraceptive types that only contain progesterone. For that reason, you will be asked about your and your family’s health (see checklist) and your blood pressure will be taken. You might also need to take a pregnancy test.

Use of birth control shots

Once you been to the pharmacy to get your contraceptive injections, a public health nurse, midwife or doctor can inject it for you. It is important for you to get a new injection within 12 weeks to be protected against pregnancy.

Stopping using the contraceptive injections

Once you stop taking contraceptive injections, it can take a long time before you start ovulating again. you may find that it can take 6-12 months for you to regain your normal menstruation pattern. However, birth control shots do not affect fertility after that point, no matter how long you have been taking them for.

• Costs 30 kroner per month*
• Is injected by your doctor/nurse/midwife every 12 weeks

* One Depo-Provera contraceptive injection costs 100 kroner, and lasts for 12 weeks. If you are aged below 20, contraceptive injections are free.

Using pops for the first time

You need a prescription from a public health nurse, midwife or doctor. You can buy progesterone-only pills at a pharmacy.

If you start by the 5th day of your menstruation cycle, you are protected from the first pill on. If not, you will need to use a condom for 2 days (7 days it you use Slinda).

Using pops

For progesterone-only pills to be effective, it is important for you to take them every day, and without any break between one blister card and the next. Slinda should be taken with a 4-day break. It is important to take them at around the same time every day to prevent interim bleeding and to better protect you against pregnancy.

Stopping using pops

Once you stop taking progesterone-only pills, you will soon start ovulating again. Your fertility will not decrease, even if you have been using POPs for a long time.

• Cost between 40-116 kroner per month*
• To be taken daily without a break

*One pack of 3 blister cards (3 months’ supply) costs between 90-350 kroner. If you are aged below 22 years, you get a 129 kroner discount every three months, meaning that you get some of the POPs for free.

Using vaginal rings for the first time

You can get a prescription from your public health nurse, midwife or doctor, then buy a vaginal ring at a pharmacy. Since vaginal rings contain oestrogen, not everybody can use them, as they carry a slightly higher risk of adverse side effects. For that reason, you will be asked about your and your family’s health (see checklist) and your blood pressure will be taken.

You are protected against pregnancy if you start within the 5th day of your menstruation cycle. If you start at any other time in your cycle, you should use a condom or refrain from vaginal intercourse for 7 days.

Using vaginal rings

You leave the vaginal ring in your vagina for 3 weeks, then you take it out and go without a ring for 1 week. You will experience bleeding this week but are still protected against pregnancy. You can skip menstrual bleeding by inserting a new ring when you remove the old one. You can even skip several periods. You can also leave your vaginal ring in during intercourse. If you wish to take it out during intercourse, it is important for you to put it back in before 3 hours have passed.

Stopping using vaginal rings

Once you stop using a vaginal ring, you will soon start ovulating again. Vaginal rings do not affect your fertility, no matter how long you have them in for.

• Costs about 120 kroner per month*
• Needs to be changed every 3 weeks

*A pack of three vaginal rings costs about 360 kroner and lasts for 3 months. If you are aged below 22 years, the state will cover 129 kroner.

Using birth control patches for the first time

You can get a prescription from your public health nurse, midwife or doctor, then buy a patch at a pharmacy. Since birth control patches contain oestrogen, not everybody can use them, as they carry a slightly higher risk of adverse side effects. For that reason, you will be asked about your and your family’s health (see checklist) and your blood pressure will be taken.

You are protected against pregnancy if you start within the 5th day of your menstruation cycle. If you start at any time in your cycle, you should use a condom or refrain from vaginal intercourse for 7 days.

Using birth control patches

You need to change patches once a week for 3 weeks. After that you have a patch-free week. You will experience bleeding in the week you’re not wearing a patch, but you are still protected against pregnancy. You can skip your bleeding by putting on a new patch straight away instead of taking a break.

Stopping using birth control patches

Once you stop using birth control patches, you will soon start ovulating again. Birth control patches do not affect your fertility, no matter how long you use them for.

• Costs 105 kroner per month*
• Needs to be changed every week

* One packet of 9 contraceptive patches (3 months’ supply) costs 315 kr. If you are aged below 22 years, you get a 129 kroner discount every three months.

Using birth control pills for the first time

You can get a prescription from your public health nurse, midwife or doctor, then buy the birth control pills at a pharmacy. Since birth control pills contain oestrogen, not everybody can use them, as they carry a slightly higher risk of adverse side effects. For that reason, you will be asked about your and your family’s health (see checklist) and your blood pressure will be taken.

You are protected against pregnancy if you start within the 5th day of your menstruation cycle. If you start at any time in your cycle, you should use a condom or refrain from vaginal intercourse for 7 days.

Use of bitrh control pills

There are many kinds of birth control pills, each containing different levels and types of hormones, so the side effects you may experience vary between the different brands. With some trial and error you should be able to find the brand that suits you the best

The numbers of pills per blister card may vary depending on the brand of pill, so read the instructions for your pills at www.sexogsamfunn.no.

With most brands, you need to take pills for 21 or 24 days and then have a break of 4-7 days without hormones. Some pill blister cards have 4-7 ‘reminder pills’ that do not contain hormones. You will experience bleeding this week but are protected against pregnancy the entire time. You can skip bleedings by starting a new blister card. For more information, see the instructions for your pills on the Sex og samfunn website.

Stopping using birth control pills

Once you stop using birth control pills, you will soon start ovulating again. The pill does not affect your fertility, no matter how long you take it for.

• Costs 30-120 kroner per month*
• Must be taken daily, break optional

*Prices vary. The cheapest pill costs about 80 kroner, and the most expensive about 350 kroner, per package. Each package contains 3 blister cards of pills (3 months’ supply). If you are aged below 22 yeats, you get a 129 kroner discount every three months, meaning that you get some pills for free.