Contraception allows you to decide if and when you want to become pregnant. It is not only about avoiding pregnancy. The right method can also improve menstrual symptoms, skin, anemia and quality of life.
There is no single best method for everyone. Your health, values and future plans all matter. In Lisbon, Dra. Joana Faria offers contraception counseling in Portuguese, English, French, and Spanish, with time to explain each option clearly.
This page focuses on contraception itself. For information about hormonal changes and symptoms around the end of fertility, you can also read the menopause page.
What it is
Contraception includes all methods that reduce the chance of pregnancy during sexual intercourse. They can be grouped into several categories:
- Long acting reversible contraception (LARC)
Intrauterine devices (IUDs) with or without hormones, and implants placed under the skin of the arm. They work for several years and can be removed when you wish to conceive. - Short acting hormonal methods
Combined pills, patches and rings that contain oestrogen and progestogen, and progestogen only methods such as the mini pill or some injections. - Non hormonal methods
Condoms, copper IUDs, diaphragms and fertility awareness based methods that track the cycle. - Permanent methods
Sterilisation procedures for women or men, suitable only when you are sure you do not want future pregnancies.
Each method has its own advantages, possible side effects and specific contraindications. A good consultation helps you understand how each option works in real life, not only in theory.
Main symptoms and when to worry
Many effects of contraception are expected and not dangerous. Others are warning signs that deserve urgent attention. Knowing the difference can make you feel safer and helps you react in time if needed.
Common effects that are usually not dangerous (but can be bothersome) include:
- Irregular bleeding or spotting in the first months after starting a new method.
- Lighter or absent periods with some hormonal methods, especially hormonal IUDs.
- Mild nausea, breast tenderness or mood changes after starting the pill.
- Local discomfort in the days after insertion of an IUD or implant.
These symptoms often improve over time. However, they should still be discussed in consultation if they are intense or persistent.
Warning signs that require urgent medical attention include:
- Strong chest pain or difficulty breathing.
- Sudden weakness in an arm or leg, trouble speaking or severe headache.
- Sudden vision changes.
- One leg that becomes swollen, red and painful.
- Severe abdominal pain or fever after IUD insertion.
These symptoms can signal rare but serious complications such as thrombosis or infection. If they occur, you should seek emergency care immediately and inform the team about the contraceptive method you are using.
Diagnosis: exams and what to expect
Choosing contraception starts with a detailed conversation. Exams are requested when they help to increase safety or clarify specific issues.
In a contraception consultation you can usually expect:
- Clinical history
Discussion about your periods, pregnancies, miscarriages or abortions, past contraception, migraines, blood pressure, smoking, personal and family history of thrombosis, stroke, heart disease or cancer. - Physical examination
Measurement of blood pressure and weight, and if indicated a gynecologic examination. This is especially important before inserting an IUD or when there are symptoms such as pain or abnormal bleeding. - Pelvic ultrasound when relevant
Used to assess the uterus and ovaries, to check for fibroids, polyps or other conditions that may influence the choice of method. - Laboratory tests in selected cases
Blood tests may be recommended, for example to evaluate clotting risk factors or to check other health conditions.
Most women do not need many tests before starting contraception. The main goal is to select methods that are safe for your age, health and lifestyle, based on international criteria.
Treatment options and follow up
Deciding on a contraceptive method is a form of treatment choice. The plan can change as your life evolves. Important questions include: how long you want to avoid pregnancy, whether you prefer hormones or not, how regularly you can take a pill and how you feel about devices or procedures.
Examples of options that may be discussed:
- Hormonal IUDs
Very effective, make periods lighter and sometimes absent, often chosen by women with heavy bleeding or painful periods. - Copper IUDs
Highly effective and hormone free, but may increase bleeding and cramps in some women. - Implants
Placed under the skin of the arm, effective for several years. Irregular bleeding is common but not dangerous. - Combined pills, patches and rings
Offer good cycle control and can improve acne or premenstrual symptoms. Not suitable for some women with specific risk factors. - Progestogen only pills and injections
Useful for women who should avoid oestrogen, including some smokers or women with certain health conditions. - Condoms
Protect against sexually transmitted infections and can be combined with other methods for extra pregnancy protection.
Follow up visits or messages are important during the first months after starting a new method. They allow you to discuss bleeding patterns, side effects and practical questions. If a method does not suit you, changing is always possible.
How Dra. Joana Faria approaches contraception in practice
Dra. Joana Faria sees contraception as a partnership, not a prescription imposed from above. She aims to create a space where you can talk openly about relationships, sexual life, fears and expectations.
In practice she:
- Takes time to understand your priorities, such as reliability, natural cycles, symptom control or avoiding weight changes.
- Explains, in simple language, how each method works, its true effectiveness and its most frequent side effects.
- Uses evidence based criteria to identify which methods are safe or unsafe in your specific situation.
- Performs IUD and implant insertions gently, explaining each step in advance and discussing pain relief options.
- Encourages you to contact her team if you experience worrying symptoms or if you want to change the plan.
For many women, this approach makes contraception feel less stressful and more like a tool that supports their projects and health.
