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Dr. Chrysoula I. Liakou MD, PhD
- Treated online: Yes, usually. A doctor can compare the hormone-free methods and plan a switch by video; a copper coil fitting, a diaphragm fitting and sterilisation are in person.
- Most effective: the copper coil, female sterilisation and vasectomy: fewer than 1 in 100 users become pregnant in a year.
- Barrier methods and fertility awareness: with typical use, about 12 to 24 in 100 users become pregnant in a year, because they depend on getting it right every time.
- Emergency contraception: the copper IUD is the only hormone-free emergency method, and the most effective one; it can be fitted up to 5 days after unprotected sex.
- Emergency: call 112 for sudden, severe pain low in your tummy with a missed period or a positive pregnancy test, which can be an ectopic pregnancy.
Call 112 if you have sudden, severe pain low in your tummy with a missed period or a positive pregnancy test. If a condom split or you had sex without contraception, emergency contraception works best the sooner it is used, and the copper IUD is the hormone-free option.
Can an online doctor help with non-hormonal contraception?
Yes, usually. Choosing a hormone-free method is mostly a conversation: how well each method works, what suits your body and plans, and how to switch from a hormonal method without a gap. A doctor can go through this by video and arrange emergency contraception if you need it. A copper coil, a fitted diaphragm, female sterilisation and vasectomy are done in person, and the doctor tells you where.
How an online consultation helps with non-hormonal contraception
- Comparing methods: How well each hormone-free method works, what it involves, and which suits your health and plans.
- Coming off hormones: Why you want to stop, what changes to expect, and how to switch without a gap in protection.
- Natural methods: How fertility awareness works, how long it takes to learn, and when it is not reliable.
- After a mistake: Emergency contraception, including the copper IUD, and a better plan from then on.
What the doctor checks in an online consultation about non-hormonal contraception
The doctor asks about any warning signs first, then about your health, your cycle and your plans. The doctor asks about:
- Warning signs: a missed period, tummy pain, or unprotected sex in the last few days.
- How important avoiding pregnancy is: for some people a pregnancy would be a serious risk, which points to the most effective methods.
- Your periods: heavy or painful periods, which a copper coil can make worse.
- Your health: migraine with aura, a blood clot, breast cancer, latex allergy, and your risk of sexually transmitted infections.
- Your cycle: how regular it is, recent hormonal contraception, breastfeeding, and age, which all affect fertility awareness.
- Your plans: whether you want children later, which decides between reversible and permanent methods.
Before the call, note the methods you have used before, what you liked and disliked about each, and the date of your last period.
Which methods of contraception have no hormones?
The methods that work without hormones are the copper coil, external and internal condoms, the diaphragm or cap with spermicide, fertility awareness, the lactational amenorrhoea method while breastfeeding, withdrawal, female sterilisation and vasectomy. Spermicide can also be used on its own. They differ a lot in how well they work:
Swipe sideways to compare →
| Method | Perfect use | Typical use | What it involves |
|---|---|---|---|
| Copper coil (IUD) | Fewer than 1 in 100 | Fewer than 1 in 100 | Fitted in the womb; lasts 5 or 10 years |
| Female sterilisation | Fewer than 1 in 100 | Fewer than 1 in 100 | An operation; permanent |
| Vasectomy | Fewer than 1 in 100 | Fewer than 1 in 100 | A minor procedure; permanent |
| Lactational amenorrhoea | Fewer than 1 in 100 | About 2 in 100 | Full breastfeeding, first 6 months only |
| External (male) condom | About 2 in 100 | About 13 to 18 in 100 | Every time you have sex |
| Internal (female) condom | About 5 in 100 | About 21 in 100 | Every time you have sex |
| Diaphragm with spermicide | About 6 in 100 | About 12 to 17 in 100 | Every time you have sex |
| Fertility awareness | About 1 to 9 in 100 | About 24 in 100 | Daily records, and no sex or a condom on fertile days |
| Withdrawal | About 4 in 100 | About 20 to 22 in 100 | Pulling out before ejaculation |
| Spermicide on its own | About 19 in 100 | About 28 in 100 | Every time you have sex |
Without any contraception, about 85 in 100 sexually active women become pregnant within a year. Only condoms protect against sexually transmitted infections.
The copper coil: the most effective hormone-free method
The copper coil, or copper IUD, is a small T-shaped device that a trained doctor or nurse fits in the womb. The copper stops sperm and an egg from meeting and being fertilised. It works as soon as it is fitted, lasts 5 or 10 years depending on the type, and can be taken out at any time, after which fertility returns straight away.
- Periods: they carry on, but can become heavier, longer or more painful, often for the first few months.
- Over 40: a copper coil fitted at 40 or over can usually stay in until after the menopause.
- After a birth: it can sometimes be fitted within 48 hours of the birth, but it is usually fitted from 4 weeks afterwards.
- As emergency contraception: it is the most effective emergency method, fitted up to 5 days after unprotected sex, or up to 5 days after the earliest likely day of ovulation.
The copper coil page explains the fitting, the risks and what to do if you cannot feel the threads.
Condoms, the diaphragm and spermicide
Barrier methods stop sperm reaching an egg and are only used when you have sex, so they have no effect on your body the rest of the time. They work well only when used correctly every time.
- External condoms: the only method that protects both against pregnancy and against sexually transmitted infections. Use water-based or silicone-based lubricant with latex condoms, because oil-based products can damage them. See condoms.
- Internal condoms: worn inside the vagina, and can be put in up to 8 hours before sex. See female condoms.
- Diaphragm or cap: a soft dome over the cervix, used with spermicide and left in for at least 6 hours after sex. See diaphragm and cap.
- Spermicide on its own: one of the least effective methods, and frequent use can irritate the vagina and may make it easier to catch HIV.
Natural family planning: how does fertility awareness work?
Fertility awareness, also called natural family planning, means tracking the signs of your cycle each day to work out when you could get pregnant, then avoiding sex or using a condom on those days. Sperm can occasionally survive up to 7 days inside the body and an egg lives for about a day, so the fertile time in each cycle can last up to 8 or 9 days.
- Temperature: take it at the same time each morning, before getting up. After ovulation it rises slightly; once it has been at least 0.2°C higher than the previous 6 days for 3 days in a row, the fertile time for that cycle is over.
- Cervical secretions: the fertile time starts with the first secretions and ends on the fourth day after the last wet, slippery day.
- Cycle length: from at least 12 cycles, the first fertile day is your shortest cycle minus 20, and the last is your longest cycle minus 10.
Does natural family planning work?
It can, but it depends on how strictly it is followed. Used perfectly, 91% to 99% effective; with typical use, about 24 in 100 women become pregnant in a year. Combining all 3 signs, called the symptothermal method, is the most reliable: with perfect use, fewer than 1 in 100 become pregnant. Counting days on the calendar alone fails for about 20 in 100, and checking the cervix alone is not recommended.
How do you learn it?
It can take 2 to 3 cycles to learn properly, ideally with a trained fertility awareness teacher, and you need a condom or no sex during that time. Apps and monitors can help you keep records, but UK guidance does not recommend any particular one, and most ovulation tests are designed to help you get pregnant rather than avoid it.
When is fertility awareness not reliable?
When your cycle is irregular or changing: in the first cycles after stopping hormonal contraception, while breastfeeding, around the menopause, and in the first years after periods begin. Illness with a temperature, some medicines, alcohol and stress can also upset the signs or the routine. After the contraceptive injection, fertility can take up to a year to return.
Breastfeeding and withdrawal as contraception
The lactational amenorrhoea method
Full breastfeeding delays ovulation. It is more than 98% effective, but only while all 3 of these are true:
- your baby is under 6 months old
- your periods have not come back
- you breastfeed fully or nearly fully, day and night, with no more than about 4 hours between feeds in the day and 6 hours at night
It stops working once any of these changes, for example when your baby starts formula or solid food. Expressing milk may make it less reliable.
Is the withdrawal method safe?
Withdrawal, or pulling out before ejaculation, is not recommended. About 20 to 22 in 100 couples who rely on it have a pregnancy within a year, partly because the fluid released before ejaculation can contain sperm. If it fails, emergency contraception works best the sooner it is used.
Permanent methods: female sterilisation and vasectomy
Both are among the most effective methods and leave your hormones and periods unchanged. They are meant to be permanent, because reversal does not reliably work.
- Vasectomy: a minor procedure under local anaesthetic. About 1 in 2,000 fail. It does not work straight away: other contraception is needed until a semen test, usually about 12 weeks later, shows there are no sperm. See vasectomy.
- Female sterilisation: an operation, usually under general anaesthetic. About 1 in 200 fail over a lifetime. Contraception is needed until the operation and for 7 days afterwards. See female sterilisation.
Long-acting methods such as the copper coil are about as effective as female sterilisation and can be removed, so they are worth comparing before you decide.
Why choose a non-hormonal method, and how to switch
People choose a hormone-free method for different reasons: side effects such as mood changes, bleeding problems or lower sex drive, a medical reason not to use hormones, or simply wanting to know how their own cycle works.
- Migraine with aura: combined methods (the combined pill, patch and ring) are not routinely offered, but progestogen-only methods usually are, so a hormone-free method is one choice among several. See migraine with aura.
- Breast cancer: hormonal methods are usually avoided, and a copper coil or a barrier method is usually advised.
- A blood clot in the past: combined methods are usually avoided; progestogen-only and hormone-free methods remain options.
Switching without a gap
Keep using your current method until the new one is working. A copper coil works as soon as it is fitted, so it can usually be arranged with no gap. If you stop a pill, patch or ring part way through a pack, use condoms from then on. If you plan to use fertility awareness, the signs of your cycle can take a few months to become reliable, so use condoms meanwhile.
What might the doctor recommend about non-hormonal contraception?
This is the framework the doctors use:
Swipe sideways to compare →
| What you have | Likely first step | Suitable for online care? | When in-person care is needed |
|---|---|---|---|
| You want to stop hormones but need reliable contraception | A comparison, often pointing to the copper coil, and a plan to switch without a gap | Yes | For the coil fitting |
| Side effects from a hormonal method | A review of whether another hormonal method or a hormone-free one suits you better | Yes | If bleeding needs an examination |
| You want to use fertility awareness | How to learn it, and condoms while you learn | Yes | Rarely; a trained teacher helps |
| Migraine with aura, a past clot or breast cancer | A method that is safe with that history | Yes | For a coil fitting |
| A condom split or withdrawal failed | Emergency contraception as soon as possible | Yes | If a copper IUD is the best option |
| Sudden, severe tummy pain with a missed period | Emergency care | No | Call 112 now |
Not sure which hormone-free method suits you? A doctor can help you decide in one consultation.
See available times →Non-hormonal contraception: practical steps and options
What you can do yourself
- Keep condoms with you, check the expiry date, and use a new one every time.
- If you want to use fertility awareness, learn it with a trained teacher and use condoms for the first 2 to 3 cycles.
- Know where to get emergency contraception, and that the copper IUD is the hormone-free option.
- Take a pregnancy test 3 weeks after any unprotected sex.
- Use condoms as well as any other method if you might be at risk of a sexually transmitted infection.
Prescription treatment
A prescription is never issued without a consultation. The doctor may prescribe emergency contraception, tell you where a copper coil can be fitted or a diaphragm sized, or, if a hormonal method turns out to suit you better, prescribe one. If the doctor prescribes, use the prescription at a pharmacy near you.
What does not help
Relying on withdrawal. Relying on an app or calendar alone when your cycle is irregular. Using spermicide on its own. Washing or passing urine after sex, which does not prevent pregnancy.
Special situations
Over 40
Fertility falls with age but does not stop until after the menopause, and fertility awareness gets harder as cycles change. The contraception in perimenopause page explains when you can stop.
After a birth
Full breastfeeding protects for up to 6 months if all its conditions are met. A copper coil can be fitted within 48 hours of the birth but is usually fitted from 4 weeks afterwards, and a diaphragm is not used in the first 6 weeks.
Children
Mobi Doctor consultations are for adults aged 18 and over. A child who is unwell needs a paediatrician or a local doctor in person, and emergency signs in a child mean 112.
When non-hormonal contraception is handled online, and when you need in-person care
Handled online: choosing a method, coming off hormonal contraception, fertility awareness questions, condoms and spermicide, emergency contraception advice, and problems with a method you already use.
In-person care: fitting or removing a copper coil, sizing a diaphragm or cap, sterilisation and vasectomy, examinations, and any signs of an ectopic pregnancy.
When to get in-person care
Call 112 or go to an emergency department now for:
- sudden, severe pain low in your tummy, especially with a missed period, a positive pregnancy test or vaginal bleeding
- pain in the tip of your shoulder, fainting or feeling very dizzy with tummy pain
- a sudden high temperature with a rash like sunburn, vomiting or fainting while using a diaphragm or cap
Get medical advice the same day for:
- unprotected sex, a condom that split or came off, or withdrawal that failed, for emergency contraception
- pain and a high temperature in the weeks after a copper coil fitting
- a copper coil whose threads you cannot feel, or that you can feel coming out
- a positive pregnancy test with a copper coil in place
How Mobi Doctor works
- Book a time that suits you: daily 7am–11pm CEST. You can see a doctor over video, usually within 15 minutes. No subscription, and the exact price is shown before you pay.
- Speak to a licensed doctor about non-hormonal contraception: say why you want to avoid hormones, what you have used before, and how important avoiding pregnancy is right now.
- Leave with a plan: what to do, what to take and for how long, and which signs mean you should be seen in person. If the doctor prescribes, use the prescription at a pharmacy near you.
No sign-up needed
Noticed a new symptom on a non-hormonal method? Tick every symptom you have to see each condition page that mentions it. It finds the right page, not a diagnosis: a doctor gives you that on a video call.
Tap the body — an area or a point — to browse symptoms anywhere
Similar symptoms, different condition? Copper Coil (IUD) can start the same way. Compare them, or look up any other symptom in the full symptom checker.
Frequently asked questions about non-hormonal contraception
Which types of contraception have no hormones?
The copper coil, external and internal condoms, the diaphragm or cap with spermicide, fertility awareness, the lactational amenorrhoea method while breastfeeding, withdrawal, female sterilisation and vasectomy.
What is the most effective non-hormonal birth control?
The copper coil, female sterilisation and vasectomy: fewer than 1 in 100 users become pregnant in a year. Of these, only the copper coil is easily reversible.
How effective is natural family planning?
Used perfectly, natural family planning is 91% to 99% effective. With typical use, about 24 in 100 women become pregnant in a year, because it relies on daily records and avoiding sex or using a condom on fertile days.
How do you do natural family planning?
For natural family planning, record your temperature each morning, your cervical secretions and the length of your cycles, ideally after learning from a trained teacher. It can take 2 to 3 cycles to learn, and you need condoms or no sex meanwhile.
What is the best natural family planning method?
The symptothermal method, which combines temperature, cervical secretions and cycle length, is the most reliable form of natural family planning: used perfectly, fewer than 1 in 100 women become pregnant in a year, though typical use is far less reliable. Learning it from a trained teacher improves the results.
Does natural family planning work with irregular periods?
It is much less reliable. It is also harder to use after stopping hormonal contraception, while breastfeeding and around the menopause, so another method is usually better at those times.
Are fertility apps reliable for contraception?
Fertility apps and monitors can help you keep records, but UK guidance does not recommend any particular one, and most ovulation tests are designed to help you get pregnant. They are only as reliable as the records you give them and the rules you follow.
Does the copper coil have side effects?
The copper coil has no hormonal side effects, so mood, weight and sex drive are unaffected, but because copper changes the womb lining, periods are often heavier, longer and more painful in the first 3 to 6 months and bleeding between periods can occur. Rarer problems are the coil being expelled, an infection in the 3 weeks after fitting and, in about 1 to 2 in 1,000 fittings, a perforation of the womb.
How do I switch from hormonal to non-hormonal contraception without a gap?
Keep using your hormonal method until the non-hormonal one is working. A copper coil protects from the moment it is fitted, so it can usually be arranged with no gap, and it can be fitted while you are still on the pill. If you stop a pill, patch or ring part way through a pack, use condoms from that day. If you plan to use fertility awareness, use condoms for the few months it takes for your cycle signs to become reliable.
What happens to your body when you come off hormonal contraception?
Your own cycle returns, usually within a few weeks of stopping the pill, patch, ring, implant or hormonal coil, and up to a year after the last injection. Periods may be heavier, longer or more painful than they were on the method, and acne or mood changes you had before can come back. This is usually your own cycle re-establishing itself rather than a problem, and a non-hormonal method such as the copper coil or condoms does not change it.
Is the withdrawal method safe?
No, withdrawal is not recommended. About 20 to 22 in 100 couples who rely on it have a pregnancy within a year, partly because fluid released before ejaculation can contain sperm.
Do non-hormonal methods protect against sexually transmitted infections?
Only condoms do. The copper coil, the diaphragm, fertility awareness, withdrawal and sterilisation do not, so use condoms as well if you might be at risk.
Is there a non-hormonal emergency contraception?
Yes, the copper coil (IUD), the only hormone-free emergency method. It is the most effective emergency method and can be fitted up to 5 days after unprotected sex, or up to 5 days after the earliest likely day of ovulation.
Can an online doctor help me come off hormonal contraception?
Yes. A doctor can talk through why you want to stop, compare the hormone-free methods, and plan the switch so you are not left without protection. A copper coil is fitted in person.
- Natural family planning (fertility awareness), NHS, National Health Service (UK), reviewed 9 February 2024.
- FSRH Clinical Effectiveness Unit guidance: Fertility Awareness Methods, Faculty of Sexual and Reproductive Healthcare (now the College of Sexual and Reproductive Healthcare), June 2015, updated November 2015.
- Which methods are best at preventing pregnancy?, Contraception Choices, College of Sexual and Reproductive Healthcare (UK), accessed 15 October 2026.
- FSRH Clinical Guideline: Intrauterine Contraception, Faculty of Sexual and Reproductive Healthcare (now the College of Sexual and Reproductive Healthcare), March 2023, amended July 2023.
- FSRH Clinical Guideline: Emergency Contraception, Faculty of Sexual and Reproductive Healthcare (now the College of Sexual and Reproductive Healthcare), March 2017, amended July 2023.
- Barrier and other pericoital contraceptives, MSD Manual Professional Version, Casey FE, reviewed December 2025.
- Female barrier methods of contraception, Patient.info, professional reference, Tidy C, updated 15 August 2023.
- What is a vasectomy?, NHS, National Health Service (UK), reviewed 28 February 2024.
- What is female sterilisation?, NHS, National Health Service (UK), reviewed 14 February 2024.
This page is for information only and is not a substitute for a medical consultation. Guideline links are provided for transparency; treatment decisions are made with your doctor.
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