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Contraception Options

WHAT IS CONTRACEPTION?

Contraception means prevention of pregnancy. There are a number of different methods of contraception available. It is important to choose a method that best suits your needs at the time. Using contraception gives you more control and allows you to decide if, and when, to have children. Contraception also allows you to enjoy sex without having to worry about an unplanned pregnancy.

WHICH CONTRACEPTIVE IS RIGHT FOR ME?

Many factors may affect your choice of a contraceptive method including:

  • How effective the method is.
  • Your stage of life.
  • Your lifestyle.
  • Ease of use of the method.
  • Any possible side effects.
  • Cost and availability. 
  • Reversibility.
  • Any health issues that may limit some choices.
  • Protection against sexually transmissible infections.

LARCs

First a word about Long Acting Reversible Contraceptives (LARCs). LARCs are methods of contraception that are highly effective, work for a long time, need very little action by you the user, and are quickly reversible when you stop using them. 

THE CONTRACEPTIVE IMPLANT

The contraceptive implant (Implanon®) is a small flexible rod which is inserted under the skin on the underside of the upper arm. It releases a hormone called progestogen continuously. 

The contraceptive implant is a LARC and works for 3 years.

IT WORKS BY:

  • Preventing ovulation (egg release from the ovary).
  • Thickening the mucus in the cervix so that sperm cannot enter the uterus (womb). 

HOW EFFECTIVE IS IT?

The contraceptive implant is over 99% effective.

Intrauterine devices (IUD)

Intrauterine devices IUD

Intrauterine devices are small devices that are placed in the uterus (womb) to prevent pregnancy. There are two types of IUDs in Australia, the hormone releasing IUD, and the copper IUD. IUDs need to be inserted by a doctor who has been trained in doing this.

THE HORMONE RELEASING IUD

 The hormone releasing IUD (Mirena®) is a small plastic T shaped device that has a progestogen hormone called levonorgestrel in the stem, which is released continuously.            

 The hormone releasing IUD is a LARC and lasts for 5 years.

IT WORKS BY:

  •  Thickening the mucus in the cervix so that sperm cannot enter the uterus (womb).
  •  Thins and stabilises the lining of the uterus making it unsuitable for pregnancy.

HOW EFFECTIVE IS IT?

The hormone releasing IUD is over 99% effective.

STERILISATION

Sterilisation is a permanent method of contraception. 

Male sterilisation (vasectomy) involves a minor surgical procedure performed by a specially trained doctor that involves cutting the vas deferens (the small tubes leading from the testes). It is effective 3 months after the procedure. 

IT WORKS BY:

  • Preventing sperm entering the ejaculate. 

HOW EFFECTIVE IS IT?

Vasectomy is over 99% effective. 

Female sterilisation (tubal ligation) is a surgical procedure done under general anaesthetic and performed in hospital by a surgeon. It involves blocking the fallopian tubes that transport eggs to the uterus. It is effective immediately.

IT WORKS BY:

  • Preventing fertilisation by stopping the sperm reaching the egg.

HOW EFFECTIVE IS IT

Tubal ligation is over 99% effective.

THE CONTRACEPTIVE INJECTION

The contraceptive injection or DMPA (Depot Medroxyprogesterone Acetate) is a hormonal contraception containing a progestogen.  It is given by an injection in the buttock or upper arm every 12 weeks.

IT WORKS BY: 

  • Preventing ovulation (release of an egg by the ovary).
  • It also thickens the mucus in the cervix.

HOW EFFECTIVE IS IT?

The contraceptive injection is 96% effective. It is more effective if given on time every 12 weeks.

THE COMBINED ORAL CONTRACEPTIVE PILL (THE PILL)

The Contraception Pill

The combined oral contraceptive pill is commonly referred to as ‘the pill’. It is a pill that contains two hormones, oestrogen and progestogen and must be taken every day.

The pill is usually taken for three weeks then sugar pills are taken for one week before starting a new pill pack.

There are many different types of the pill available and your doctor can help find one that suits you.

IT WORKS BY:

  • Preventing ovulation (release of an egg by the ovary).
  • It also thickens the mucus in the cervix.

HOW EFFECTIVE IS IT?

The pill is 93% effective.

The contraceptive vaginal ring (NuvaRing®)

The vaginal ring is a plastic ring that is placed in the vagina. It is similar to the pill and contains two hormones, oestrogen and progestogen. It is placed into the vagina for 3 weeks, removed for one week then replaced with a new ring. 

IT WORKS BY:

  • Preventing ovulation (release of an egg by the ovary).
  • It also thickens the mucous in the cervix.

HOW EFFECTIVE IS IT?

The contraceptive vaginal ring is 93% effective. 

THE PROGESTOGEN ONLY PILL (MINI PILL)

The mini pill is a pill that contains only progestogen. It must be taken every day and at the same time each day. It is taken continuously with no break.

IT WORKS BY:

  • Thickening the mucous in the cervix.

HOW EFFECTIVE IS IT?

The mini pill prevents 93% of possible pregnancies.

CONDOMS

Condoms are a barrier method of contraception that work by stopping semen entering the vagina during intercourse.

They are the only contraception that also provide protection from sexually transmissible infections. 

The male condom is a sheath made of thin, strong latex or polyurethane, which is rolled onto the erect penis before vaginal, anal or oral sex.

They can only be used once and are then discarded. Male condoms are available from supermarkets, pharmacies, clinics, sex shops, and vending machines.

HOW EFFECTIVE IS IT?

Male condoms are 88% effective.

The female condom is a synthetic sheath which is inserted into the vagina before sexual intercourse.

They are about 15cm long and have two flexible rings to keep them in place. They can only be used once and then discarded.

They are available online and from some sex shops.

HOW EFFECTIVE IS IT?

Female condoms are 79% effective.

THE DIAPHRAGM

The diaphragm Contraception

The diaphragm is a dome of soft silicone with a flexible rim which is placed inside the vagina to cover the cervix (the lower part of the uterus or womb). 

It is inserted before intercourse and is then left in place for a minimum of six hours afterwards because it takes 6 hours for sperm to die in the acid environment of the vagina.

 Diaphragms should be fitted by a specially trained nurse or doctor to make sure that the type or size is correct for you. They can then be ordered online.

IT WORKS BY:

The diaphragm provides a barrier that prevent sperm getting into the uterus and fertilising an egg. 

HOW EFFECTIVE IS IT?

The diaphragm is 82% effective.

Fertility Awareness Methods (FAM)

These methods use an awareness of the fertile phase in the menstrual cycle to indicate when sexual intercourse should be avoided in order to prevent pregnancy.

This can include monitoring body temperature and the days of the menstrual cycle, and checking cervical mucus. It is important to learn how to use these methods correctly before using them to prevent pregnancy.

For more information visit the Australian Council of Natural Family Planning website.

HOW EFFECTIVE IS IT?

FAMS are between 75% and 93% effective.

Lactational Amenorrhoea (LAM)

LAM is the use of breastfeeding as a contraceptive method. For LAM to be effective women need to meet the following criteria:

  • Have given birth less than six months ago.
  • Menstrual periods should not have returned after the birth.
  • Must be fully breastfeeding and not giving the baby any formula or food. 

HOW EFFECTIVE IS IT?

Used correctly LAM is 98% effective.

Withdrawal

This is the withdrawal of the penis from the vagina before ejaculation. There are more effective forms of contraception and withdrawal is generally not recommended.

HOW EFFECTIVE IS IT?

Withdrawal is 80% effective.

EMERGENCY CONTRACEPTION (EC)

Emergency contraception can be used to reduce the risk of pregnancy after unprotected sex (unprotected sex means where semen has entered the vagina, usually when no other form of contraception was used or where a method of contraception failed, such as a condom breaking). There are several methods of emergency contraception available.

Levonorgestrel

This is a hormone based EC which contains Levonorgestrel which is a hormone. The sooner you take it the better but it works up to 72 (3 days) hours after unprotected sex.

IT WORKS BY:

Levonorgestrel works by preventing or delaying ovulation.

WHERE CAN I GET IT?

From most pharmacies, SHFPACT, Canberra Sexual Health Centre, The Junction Youth Health Centre (if you are under 25), and Walk in Centres.

ULIPRISTAL (ELLAONE)

Uliprista is an emergency contraception that can be used up to 120 hours (5 days) after unprotected intercourse. Ulipristal is more expensive then the Levonorgestrel EC but is considered more effective.

IT WORKS BY:

It works by delaying or preventing ovulation. 

WHERE CAN I GET IT?

Ellaone is available from most pharmacies. 

THE COPPER IUD

The copper IUD (intra uterine contraceptive device) is a method of contraception that can be used as emergency contraception. The copper IUD is inserted into the uterus up to 120 hours (5 days) after unprotected intercourse and is the most effective emergency contraception. It is useful for women who need a very effective method or are also looking for an ongoing method of contraception. The hormone releasing IUD Mirena is not suitable as emergency contraception.

IT WORKS BY:

The copper IUD works by interfering with fertilisation and preventing implantation of a fertilised egg.

WHERE CAN I GET IT? 

The copper IUD needs to be inserted by a specially trained doctor or nurse. For further information contact your local family planning, your GP, or SHFPACT on 02 62473077 if you are in the ACT region.

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