BHC home - health and medical information for consumers

Health and medical information for consumers, quality assured by the Victorian government (Australia).

23 November, 2009

Home > Fact sheets by category > Healthy living > Sex > Contraception > Contraception - choices ....

Health information

Resources and tools

Healthy eating

Find help

Contraception - choices explained

There are a number of contraception choices available in Australia. Options include barrier methods (male and female condoms and diaphragms), hormonal methods (pills, vaginal rings, implants and injections), intrauterine devices (IUDs or coils), female and male sterilisation, emergency contraception and ‘natural’ methods.

Choose the method that suits you
Choosing contraception that is right for you requires accurate information as well as negotiation and the ability to be able to communicate freely with your partner on this subject. Issues like effectiveness, safety and freedom from adverse effects need to be weighed up against convenience, cost and issues of trust and control.

The method you choose will depend on a range of factors such as your general health, lifestyle and relationships, your risk of contracting a sexually transmissible infection (STI) and how important it is that you don’t fall pregnant.

Some methods require more ‘motivation’ than others so you need to think about what suits you. For example, you need to remember to take the pill every day, but an implant can last up to three years.

You need to weigh up the pros and cons and think about how these methods fit your current and future needs. You can discuss your options with your doctor, reproductive health nurse or trained staff at Family Planning Victoria.

Protect against STIs
It is important to practice safe sex as well as to protect yourself against pregnancy. Not all contraception methods provide protection against sexually transmissible infections (STIs). The best way to reduce your risk of STIs is to use barrier protection such as male and female condoms and dams (a thin piece of latex placed over the anal or vulval area during oral sex). Condoms can be used for oral, vaginal and anal sex to help prevent the spread of infections.

Physical barrier methods
Barrier methods of contraception stop sperm from getting into the womb (uterus). Options include:

Male condom
Female condom
Diaphragm.

Male and female condoms also decrease the risk of STIs.

Male condom
This is a latex (or polyurethane) sheath that covers the erect penis and prevents semen entering the vagina. This is an effective form of contraception when used properly (95–98% effective). This means using a condom every time you have sex and putting it on before there is any contact between the penis and vagina.
Male condoms are relatively cheap and are available over the counter from supermarkets, pharmacies and sexual health clinics.

Female condom
This is a loose polyurethane sheath with a flexible ring at each end that sits in the vagina and collects semen. It can be inserted many hours before intercourse and is stronger than the male latex condom, but may take some practice with insertion and use. Female condoms are available through mail order from Family Planning Victoria. They may also be available in some retail outlets and sexual health clinics.

Diaphragm
This is a soft, shallow rubber dome that fits in the vagina, covers the cervix and stops sperm from entering the uterus. The diaphragm must stay in place for at least six hours after intercourse and is 85–95 per cent effective if used, fitted and positioned correctly. Diaphragms must be fitted by a suitably trained doctor or nurse. They may decrease the risk of STIs, but should not be relied on for this.

Intrauterine devices (IUD)
An IUD, sometimes known as a coil, is a small plastic device with either added copper or hormones (Mirena). It is inserted into your uterus by a doctor. It can stay in the uterus for five to eight years, depending on the type used, and can easily be removed before that if you would like to fall pregnant or are having problems.

Both types are 99 per cent effective and work by changing the lining and environment of the uterus, effectively killing off sperm. If any sperm survive and fertilise an egg, the egg is unable to stick to the wall of the uterus, so a pregnancy can’t continue.

The Mirena IUD also slowly and continuously releases a small amount of progestogen, and can thicken the mucus made by the cervix to further block sperm. This may also cause minor effects on the hormones controlling your menstrual cycle.

The Mirena is occasionally removed because of hormonal symptoms such as headache, breast tenderness, acne and increased appetite. However it generally gives very light periods. The copper IUD tends to make periods heavier, but doesn’t cause hormonal side effects.

Hormonal contraceptives – pills and vaginal rings
Hormonal contraception for women is available in the form of either a pill (oral contraceptive) or a vaginal ring. Both are available by prescription. Hormonal contraceptives are highly effective (94–99%) if used correctly. However, they may produce side effects and don’t protect against STIs.

Combined pill
This is made up of the synthetic forms of the hormones oestrogen and progesterone. The combined pill prevents ovulation, thickens cervical mucus to make it harder for sperm to enter the uterus and changes the lining of the uterus to make it less suitable for a fertilised egg to stick.

There are many types of combined pills with different dose and hormone combinations. Generally this form of contraception is not recommended for women who are at risk of heart disease, such as smokers aged over 35 years.

Vaginal ring
This contains similar hormones to the combined pill and works in the same way. A ‘one size fits all’ ring is inserted into the vagina and stays there for three weeks. During that time, it slowly releases hormones that pass from the vagina into the bloodstream. It is then removed and a new ring is inserted a week later. It is low dose and saves remembering to take a pill every day. It is as easy to insert as a tampon and, like the combined pill, is 99 per cent effective if used correctly.

Mini pill
This contains only the synthetic form of progesterone. It makes the cervical mucus thicker, which prevents sperm from entering the uterus. This pill must be taken every day at the same time and is not as effective as the combined pill. It is usually suitable for women who either experience side effects from oestrogen or shouldn’t take it for health reasons.

Hormonal contraceptives – implants and injections
Hormonal contraceptives for women are also available as implants and injections. These methods are more effective than other hormonal methods, but may produce side effects and don’t protect against STIs. Male injectable contraceptives are currently being trialled.

Implanon
This is a hormone implant that is inserted under the skin at the inner side of the upper arm. It contains etonogestrel, a progesterone-like hormone that prevents ovulation and hinders sperm from entering the cervix (by changing cervical mucus).
Implanon lasts for three years, is close to 100 per cent effective and is suitable for most women who can’t tolerate synthetic oestrogens. The device is inserted by a doctor under local anaesthetic.

DPMA injections (Depo-Provera/Depo-Ralovera)
These are long-acting (12 to 14 weeks) injectable contraceptives containing the hormone progestogen. They prevent ovulation, block sperm by thickening the mucus made by the cervix and cause changes in the lining of the uterus so it is unsuitable for a fertilised egg to stick. DPMA injections are highly effective and provide a very private method of contraception.

Sterilisation
Sterilisation is a permanent surgical procedure that requires referral to a specialist. Female and male sterilisation are highly effective methods of contraception but do not provide protection against STIs.

Female sterilisation
This procedure blocks the fallopian tubes, preventing an egg from passing down the tube and being fertilised. The two common surgical methods used are:

Tubal ligation (having your tubes tied)– performed under general anaesthetic.
Essure micro-inserts – doesn’t require a general anaesthetic.

Vasectomy (male sterilisation)
This involves blocking sperm by cutting the tubes they pass through from the testes to the penis.

Emergency contraception
Sometimes it is necessary to prevent pregnancy after sex rather than before: for example, when a pill is forgotten or a condom breaks, or in the case of rape. Emergency contraception is a hormonal method of contraception that prevents or delays ovulation in that cycle. It may also stop a fertilised egg from sticking to the wall of the uterus. It is 85 per cent effective. Emergency contraception was previously known as the ‘morning after’ pill.

There are different types of emergency pills available. The most commonly used form – two tablets of progestogen hormone – can be prescribed by a doctor or is available over the counter at most pharmacies. These pills should be taken as soon as possible after sex and must be started within 120 hours of unprotected sex.

Natural methods
Natural family planning is based on an understanding of the menstrual cycle. Monitoring cervical mucus changes, body temperature changes and rhythm or cycle calculations are different methods used to help determine when a woman is most likely to be fertile each month.

The effectiveness of natural family planning varies in relation to whether one or a combination of methods is used. Confidence, correct use and effectiveness improve the longer the method is used. Natural family planning methods do not protect against STIs.

Where to get help

Your doctor
Family Planning Victoria Tel. 1800 013 952 or (03) 9257 0100
The Action Centre (for young people under 25) Tel. (03) 9654 4766 or 1800 013 952
Melbourne Sexual Health Centre Tel. (03) 9341 6200 or 1800 032 017 or TTY (for the hearing impaired) (03) 9347 8619
RWH Women’s Health Information Centre Tel. (03) 9344 2007
Community health centre
Reproductive specialist
Pharmacist

Things to remember

Discuss your options with your doctor, reproductive health nurse or reproductive health service.
Different methods may suit you at different times in your life.
Contraceptives available include physical barriers and devices, hormonal methods, sterilisation, emergency and ‘natural’ methods.
Condoms provide the best available protection against sexually transmissible infections (STIs).

You might also be interested in:
Contraception - condoms for men.
Contraception - condoms for women.
Contraception - diaphragms and cervical caps.
Contraception - emergency contraception.
Contraception - female sterilisation.
Contraception - implants and injections.
Contraception - injections for men.
Contraception - intrauterine devices.
Contraception - the Billings method.
Contraception - the pill.
Contraception - vasectomy.
Disability and sexual issues.
Sex - are you ready.
Sex education - talking to teenagers.
Sexually transmissible infections - overview.
Sexually transmissible infections - signs and symptoms.
Teenagers - sexual behaviour.
Teenagers - sexual knowledge.

Want to know more?
Go to More information for support groups, related links and references.

This page has been produced in consultation with and approved by:

(Logo links to further information)