Does contraception cause infertility?

No. Fertility returns after stopping all reversible methods. The injection is the one where return can be delayed by several months to a year, which is worth knowing if you are planning a pregnancy soon — but it is a delay, not damage.

Can I use a coil if I have not had children?

Yes. Both types are suitable, and this is a common and outdated reason women are turned away. Insertion may be more uncomfortable, and pain relief can be discussed beforehand.

What if I am breastfeeding?

The progestogen-only pill, the implant, the injection and both coils are suitable while breastfeeding. The combined pill is generally avoided in the early weeks. Breastfeeding itself is not reliable contraception unless very specific conditions are met.

Health library

Women's health

Contraception – the options available in South Africa

What is offered free at public clinics, how well each works in real use, and the questions worth asking before choosing.

Perfect use and real use are different numbers

Every method has two effectiveness figures: how it performs when used exactly right, and how it performs in ordinary life. For methods that depend on remembering something, the gap is large. For methods that do not, it barely exists.

That single fact matters more than most other considerations, and it is why long-acting methods are increasingly recommended first rather than last.

The methods

Implant — a small rod in the upper arm, lasting several years. Among the most effective methods there is, because nothing depends on you.
Hormonal coil — placed in the womb, lasting years, and it usually makes periods much lighter or stops them.
Copper coil — hormone-free, lasting many years. Periods often become heavier and more painful.
Injection — every two or three months depending on type. Effective and private, but return of fertility after stopping can take many months.
Combined pill — daily, also helps period pain, acne and cycle regularity. Not suitable with migraine with aura, smoking over 35, or certain clotting risks.
Progestogen-only pill — daily, suitable for many who cannot take the combined pill, including while breastfeeding.
Condoms — the only method that also prevents HIV and other sexually transmitted infections.
Sterilisation — permanent, for people certain they want no more children.

Available in South Africa, most free at public clinics:

Levonorgestrel / Ethinylestradiol (Combined OCP) — Ovral, Nordette, Triphasil, Yasmin (drospirenone/EE)
Contraception; menstrual regulation; dysmenorrhoea; acne
Norethisterone (Progestogen-only pill) — Microval, Noriday
Contraception — suitable for breastfeeding women and those who cannot use oestrogen
Medroxyprogesterone Acetate (Depo-Provera) — Depo-Provera, Petogen, Nur-Isterate
Contraception (injectable — every 12 weeks)
Etonogestrel Implant — Implanon NXT, Nexplanon
Long-acting reversible contraception (LARC)
Copper IUD — Copper T 380A, Paragard
Long-acting contraception; emergency contraception (within 5 days of unprotected sex)
Levonorgestrel Intrauterine Device — Mirena
Long-acting reversible contraception (up to 5 years); heavy menstrual bleeding; endometrial protection during HRT

Two things that get forgotten

Emergency contraception is available from pharmacies without a prescription and from clinics free. It works better the sooner it is taken, and a copper coil fitted within five days is the most effective emergency option — considerably more so than the tablet, and rarely mentioned.

For emergency contraception:

Levonorgestrel (Emergency Contraception) — Escapelle, Norlevo, EContra EZ
Emergency contraception (within 72 hours of unprotected intercourse)
Copper IUD — Copper T 380A, Paragard
Long-acting contraception; emergency contraception (within 5 days of unprotected sex)

Choosing, and switching

Be honest about whether a daily tablet fits your life. There is no prize for choosing the method that needs the most from you.
Say what matters most: heavier or lighter periods, privacy, returning to fertility soon, avoiding hormones, or simply not thinking about it.
Mention every medicine you take. Some epilepsy medicines and some HIV and TB regimens reduce hormonal contraceptive effectiveness, and that interaction is important.
Mention migraine with aura, smoking, high blood pressure, clots and breast cancer history — all change what is suitable.
Expect irregular bleeding in the first three to six months with most hormonal methods; it usually settles, and stopping early is the commonest reason people end up unprotected.
You can switch. A method that does not suit you is a reason to change it rather than to stop contraception.

Common questions

Does contraception cause infertility?: No. Fertility returns after stopping all reversible methods. The injection is the one where return can be delayed by several months to a year, which is worth knowing if you are planning a pregnancy soon — but it is a delay, not damage.
Can I use a coil if I have not had children?: Yes. Both types are suitable, and this is a common and outdated reason women are turned away. Insertion may be more uncomfortable, and pain relief can be discussed beforehand.
What if I am breastfeeding?: The progestogen-only pill, the implant, the injection and both coils are suitable while breastfeeding. The combined pill is generally avoided in the early weeks. Breastfeeding itself is not reliable contraception unless very specific conditions are met.

Sources

National Contraception and Fertility Planning Policy and Service Delivery GuidelinesNational Department of Health, South Africa
Primary Healthcare Standard Treatment Guidelines and Essential Medicines ListNational Department of Health, South Africa
Clinical and public health guidanceWorld Health Organization

Last reviewed 4 August 2026.