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Contraceptive guide
Abstract
- Contraceptives reduce the risk of unwanted pregnancies.
- A distinction is made between mechanical, chemical and hormonal contraceptives, and a prescription is required for the latter in particular.
- Hormonal contraception should be tailored to the patient’s lifestyle and health.
Contraceptives: these solutions are available
The effectiveness and safety of contraception vary. Safety is measured by the so-called Pearl Index (number of pregnancies per 100 women). The following over-the-counter and prescription contraceptive options are available:
| Contraceptive | Mode of action | Classification | Safety according to the Pearl Index | Prescription only |
|---|---|---|---|---|
| Condoms and female condoms | Creates a barrier between sperm and uterus, provides additional protection against sexually transmitted diseases. | mechanical | 2-12 | No |
| Diaphragm | The contraceptive cap is designed to prevent sperm from entering the uterus. | mechanical | 4-10 | Yes, fitting by the doctor |
| IUD or hormonal coil | The IUD simulates pregnancy, additional hormone release increases safety. | mechanical / hormonal | 0,9-0,16 | Insertion by the doctor/specialist |
| Birth control pills, also known as micro and mini pills | Hormones simulate pregnancy and thicken the cervical mucus. | Hormonal | 0,1-0,5 | Yes |
| Three-month injection | Progestogen-containing active ingredients are injected every three months. | hormonal | 0,3-1,4 | Injection by a specialist |
| Hormone rods | A hormone implant is inserted under the skin on the inside of the upper arm. | hormonal | 0,1 | Insertion by a specialist |
| Gels, creams, suppositories | The locally applied substances foam up, form a barrier and kill sperm. | Chemical | 18-29 | No |
Why can I only get the pill and similar contraceptives on prescription?
Contraceptives containing hormonal active ingredients are only available on prescription. While the doctor is responsible for administering the three-month injection and the IUD anyway, the question sometimes arises as to why the pill is not available without a prescription. This is because every contraceptive of this kind interferes with a woman’s hormonal balance. In addition, not every preparation is suitable for every woman. The following steps are therefore necessary before the first prescription is issued:
In-depth discussion with the doctor: Questions about
- State of health,
- Age of the patient,
- Possible intolerances or chronic diseases,
- Consumption of alcohol and nicotine,
- Medication taken on a regular basis
Comprehensive investigation:
- Ultrasound of the internal genital organs,
- Exclusion of an existing pregnancy,
- Examination of the external genital organs,
- Smear of the cervical mucosa.
Based on the consultation and examination, the gynecologist will prescribe or recommend a pill – or another suitable contraceptive. However, a contraceptive online prescription can be issued as a follow-up prescription without further ado, either by filling out a questionnaire or after a consultation with a doctor.
Questions and answers
Why not buy contraceptives online without a prescription?
Hormone-based contraceptives can cause side effects such as thrombosis if they are not adapted to the patient’s state of health.
Are there contraceptives for men?
Apart from the use of condoms, there are no “contraceptives” that can be used by men. However, men who want to be relatively sure that they will not impregnate a woman can have themselves sterilized (vasectomy) from a certain age and under certain conditions. This involves cutting the vas deferens. This method is considered to be very safe, but it does not provide one hundred percent protection against conception.
How safe are over-the-counter contraceptives?
As the Pearl Index shows, between 2 women (condoms) and 29 women (gels or suppositories) become pregnant for every 100 women using over-the-counter contraception.
Sources
- https://www.aerzteblatt.de/nachrichten/sw/Kontrazeption
- https://www.aerzteblatt.de/nachrichten/106140/Pille-und-Kondom-meistgenutzte-Verhuetungsmittel
- https://www.familienplanung.de/verhuetung/rezeptpflicht-und-kostenuebernahme/
These articles are intended solely to provide you with preliminary information on various topics and are not a substitute for a medical diagnosis. Experienced doctors are available to provide further advice via TeleClinic. We will first assess whether your concern is suitable for a video consultation.
- Last updated: 11. May 2026
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