There are 23 types of Pill for women. So why do doctors prescribe only five?

IoS investigation: The latest contraceptives can help users avoid weight gain, pain and bad skin - but they are hard to get, because GPs prefer older, cheaper versions

Health experts say clinicians are sticking to "old favourites" of brands of contraceptive Pills, which are cheaper to prescribe than "designer" Pills.

The Family Planning Association (FPA) says that, as a result, many women are forced to put up with painful periods, water retention and problem skin because their contraception is not being tailored to alleviate these symptoms, which in some cases could be helped by new style Pills.

The majority of women still bear the responsibility for contraception, but clinicians are not making their patients properly aware of long-term protection such as implants and hormone-releasing devices (IUS) because these require specialist expertise to fit.

The FPA warns that women are at risk of unwanted pregnancy because they are prescribed contraception that does not suit their lifestyles. They end up ditching it altogether rather than facing the embarrassment of demanding something more suitable.

This month, the National Institute for Health and Clinical Excellence(Nice), the body responsible for providing advice to the NHS, is expected to tell GPs and clinics that they need to offer women more choice, especially with products that offer long-term protection, and that clinicians need more training in how to fit these devices.

The Royal College of Obstetricians and Gynaecologists, which sets standards to improve women's health, is to publish evidence in November highlighting the lack of contraceptive choice for women.

From hormone implants to the rhythm method, there are currently as many as 14 different types of contraception on offer to women in this country. With the Pill alone, there are now 23 different brands available, each suited to women's individual lifestyles and medical histories. For example, Yasmin, a "fourth-generation" Pill reputedly aids weight loss.

Another product, Mirena, an intrauterine device that pumps hormones directly into the bloodstream, has been shown to reduce heavy bleeding and therefore the need for women to undergo hysterectomies.

Yet official figures indicate that clinicians are failing to tailor contraception to their patients' needs and are sticking to old favourites that are also cheaper. Despite the wide range of products available, the condom and the Pill account for nearly half of all contraception used by women aged between 16 and 49, a figure that has remained relatively constant for the past seven years. The most commonly prescribed type of Pill is Microgynon, which was developed in the 1970s and accounts for nearly half of total sales. "New generation" brands are used by less than a quarter of women on the Pill.

The popularity of some "designer" Pills has declined partly because of health scares about the risk of blood clots, but experts say the real reason they are not being widely used is because they are more expensive than older brands.

An investigation by The Independent on Sunday found that some clinics were failing to tell women about the choices available. One clinic in north London visited by an IoS reporter did not have the facilities to offer a proper check-up and did not offer any explanation about the different types of contraceptives available.

The nurse there was vague about contraception that offers long-term protection against pregnancy and suggested that the Pill was the best option. At one point, she became angry when our reporter suggested that she was planning to get a second opinion about the most suitable type of Pills on offer.

Another clinic, based at a London hospital, was better equipped to advise patients. The senior nurse there pointed out that GPs often did not have proper sexual health training to fit devices such as IUDs, which have to be placed within the uterus. She did suggest that the contraceptive patch may be suitable but admitted that the clinic had limited resources and did not normally tell patients about the patch.

The FPA said increasing numbers of callers to its helpline were complaining that they were not being offered enough advice from their doctors or from clinics.

"There are a few favourites [Pills] - the cheaper ones - that get picked over and over again," said Toni Belfield, from the FPA.

"Women should have the choice to be able to tailor contraception throughout their lives but they are not doing so. It is well recognised that women are not told about longer-lasting contraception methods."

Bea Hodgkin, who works in publishing, wanted a natural method of contraception but spent three years on the Pill because her doctors were reluctant to prescribe the coil.

The 25-year-old, who lives in west London, said she has friends who have had similar experiences where they have not been told about or offered more choice over the type of contraception they use.

"With the Pill, I didn't like the thought of having hormones that meant I was not in control of my emotions," explains Ms Hodgkin, who eventually persuaded her clinic to fit the coil.

"But I would say they actively discouraged me from getting it [the coil]. They're really reluctant to give it to people who are not married or don't have kids, and they thought I was too young."

Only around eight per cent of women use a long-acting method of contraception, an issue that health experts say needs to be investigated.

Dr Anna Glasier, from the Royal College of Obstetricians and Gynaecologists, said that women can expect to require contraception for at least 30 years of their lives, and that their changing needs during this time needed to be properly addressed.

"There is a feeling that the low uptake of long-acting methods of contraception is because they are not easily available," said the director of family planning at Lothian Primary Care NHS trust.

"It's women who bear the brunt of contraception but often the benefits are not stated clearly enough. "

Additional reporting by Sara Newman and Hannah Swerling

The five pills GPs like most

Microgynon: Most commonly prescribed. Like all "combined Pills" contains oestrogen and progestogen. NHS cost £2.82

Cilest: Very popular. £8.57

Ovranette: Can help women with heavy periods. £2.46

Marvelon: Combined Pill whose use fell briefly after scare. £6.70

Yasmin: Advert claiming it helped weight loss was withdrawn. Ensuing media attention ensured popularity. £14.70

Pills they don't push

Ovysmen: May reduce acne, period pains and premenstrual symptoms. NHS cost £1.70

Binovum: 21-day course Pill. £2.24

Brevinor: Has far lower doses of oestrogen than early Pills. £1.99

Loestrin: A low-dose Pill for older pre-menopausal women. £3.93

Logynon: Pack includes "dummy" pills for the forgetful. £3.92

Norimin: Unsuitable for women with high blood pressure. £2.28

Noriny: Recommended for women with epilepsy. £9.98

Synphase: Low on oestrogen. NHS cost £3.60

Trinordiol: Comes in three different strengths, with the highest one the week before the period. NHS cost £4.34

Trinovum: Low dosage increases throughout the monthly cycle. NHS cost £3.11

Mercilon: Contains hormones desogestrel or gestodene. £8.57

Femodene: Subject of recent failed lawsuit claiming that users developed blood clots. £6.84

Minulet: New low-dose combination Pill. NHS cost £6.84

Tri-Minulet: Suitable for heavy or painful periods. £9.54

Dianette: Often prescribed to teenagers. £3.70

Microval: Contains only progestogen, so ideal for women with history of blood clots. £1.89

Femulen: OK for nursing mothers. £3.31

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