Background Long-acting reversible contraceptives (LARC) have become more commonly promoted in the UK, but most young women still rely on the contraceptive pill. Here, we describe young women's accounts of hormonal contraceptive use to explore why this might be the case.

Methods In-depth interviews with twenty 20-year-old women from eastern Scotland in the UK.

Results All but one woman reported use of the pill. It was the method they expected to use, sought out, and received. Belief in the pill's efficacy was maintained even when knowledge or experience of failure suggested otherwise. Only four women reported using alternative hormonal methods and only did so after experiencing unmanageable problems with the pill (side effects or forgetting to take it). All then discontinued use because of weight gain or dislike of menstrual suppression.

Conclusions Attempts to promote LARC must address these issues. Pill use can be unproblematic if managed well, and should continue to be promoted as an appropriate contraceptive for young women.