There are many contraceptive methods available in Australia, including implants and injections, intrauterine devices (IUDs, both copper and hormonal), emergency contraception, pills and vaginal rings, barrier methods (male and female condoms and diaphragms), female and male sterilisation and natural methods (natural family planning).
Choosing the right contraception for you
When you are choosing the method of contraception that is right for you, it is important to have accurate information and to talk openly about your options with your partner. It is also important to think about how well each method works, the possible side effects, how easy it is to use and how much it costs.
The method you choose will depend on a range of factors, such as your general health, lifestyle and relationships, your risk of getting a sexually transmissible infection (STI) and how important it is for you to not get pregnant.
Some methods require more motivation than others. You will need to think about which option best suits you. For example, if you choose oral contraception, you will need to remember to take a pill every day, whereas if you choose the contraceptive implant, it can last for up to three years.
It is important to weigh the pros against the cons and think about how each method meets your current and future needs. It can help to talk about your options with a doctor or reproductive health nurse.
Contraceptive protection from STIs
It is important to practise safer sex, as well as to prevent an unintended pregnancy. Not all methods of contraception give protection from STIs. The best way to lessen the risk of STIs is to use barriers 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 stop infections from spreading.
Contraceptive implants and injections
Hormonal contraception for women is available as implants and injections. These methods, particularly the implant, are more effective than contraceptive pills and rings, but like other contraceptive methods, may cause side effects and do not give protection from STIs.
The contraceptive implant (Implanon NXTTM
) is a hormonal, rod-shaped device that is inserted under the skin at the inner side of the upper arm. It contains etonogestrel, a progesterone-like hormone that stops ovulation and makes the fluid at the opening to the uterus (womb) thicker, stopping sperm from getting through.
The contraceptive implant lasts for three years, is close to 100 per cent effective and suits most women who cannot take synthetic oestrogens. The implant is put in by a doctor under local anaesthetic.
The contraceptive injection (Depo-ProveraTM
) is a hormonal injection. It contains a progesterone-like hormone that is given every 12 to 14 weeks. Also known as Depo, this method stops ovulation and makes the fluid at the opening to the uterus thicker, stopping sperm from getting through. The contraceptive injection is a very effective and private method of contraception.
Contraceptive intrauterine devices (IUDs)
The IUD is a small plastic device with added copper or hormones that is put into the uterus by a doctor. It can stay in place for up to 10 years, depending on the type used. Women who want to get pregnant or are having problems can easily have the IUD taken out earlier.
Both types of IUD (copper and hormonal) are more than 99 per cent effective and work by changing the lining and environment of the uterus so sperm cannot survive. If any sperm do survive and fertilise an egg, the egg cannot stick to the wall of the uterus, which means a pregnancy cannot happen.
The hormonal IUD (MirenaTM
) makes periods lighter or stop altogether. It may need to be taken out because of hormonal symptoms such as headaches, breast tenderness, acne and increased appetite, but this is rare. The copper IUD tends to make periods heavier, but does not cause hormonal side effects.
The hormonal IUD slowly and continuously releases a small amount of hormones, which may make the fluid at the opening to the uterus thicker, stopping sperm from getting through. This may also prevent pregnancy by slightly change the hormones that control the menstrual cycle.
Emergency contraception, also known as ‘the morning after pill’, is a hormonal method of contraception that may stop ovulation. It can be taken to avoid getting pregnant in an emergency situation, such as after having unprotected sex, if a condom slips off or breaks during sex, or if the contraceptive pill is missed. It prevents 85 per cent of pregnancies that would otherwise have happened.
There are different types of emergency contraception available. The most commonly used type is a single pill containing the hormone progestogen. It can be prescribed by a doctor or bought from most pharmacies without a doctor’s prescription. It is best to take emergency contraception as soon as possible, ideally within 24 hours of having sex, but it still works well within 96 hours (four days). It can be taken within 96 to 120 hours (five days), but it will not be very effective.
Contraceptive pills and vaginal rings
Hormonal contraception for women is also available with a doctor’s prescription as a pill (oral contraception) or a vaginal ring (NuvaRingTM
). These methods are very effective (99.7 per cent) if used the right way, but allowing for missed pills or forgetting to put a new ring in on time, may only be 91 per cent effective. Pills and vaginal rings may cause side effects and do not give protection from STIs.
The combined pill contains synthetic forms of the hormones oestrogen and progesterone. It stops ovulation and makes the fluid at the opening to the uterus thicker, stopping sperm from getting through.
There are many types of combined pills with different doses and hormones. This method is generally not recommended for women who are at risk of heart disease, such as smokers who are over 35 years of age.
The mini pill contains a synthetic form of only one hormone, progesterone. It makes the fluid at the opening to the uterus thicker, stopping sperm from getting through. The mini pill is not as effective as the combined pill and needs to be taken every day at the same time. It usually suits women who either have side effects when they take oestrogen or cannot take oestrogen for health reasons.
The vaginal ring has similar hormones to the combined pill and works in the same way. A ‘one size fits all’ ring is put into the vagina and stays in place for three weeks. It slowly releases hormones that move from the vagina into the bloodstream. After this three-week period, the ring is taken out and a new ring is put in one week later.
The vaginal ring releases a low dose of hormones and saves having to remember to take a pill every day. It is also as easy to put in as a tampon and, like the combined pill, is 99.7 per cent effective if used the right way.
Barrier methods of contraception
Barrier methods of contraception stop sperm from getting into the uterus. Options include the:
- male condom
- female condom
Male and female condoms also lessen the risk of STIs. Barrier methods can be very effective if used the right way every time you have sex.
The male condom is a latex (or polyurethane) covering that is put over the erect penis, stopping sperm from getting into the vagina. The method is 98 per cent effective if used the right way. 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 not as expensive as other methods and are available from pharmacies without a doctor’s prescription, as well as from supermarkets and sexual health clinics.
The female condom is a loose polyurethane pouch with a flexible ring at each end that sits in the vagina, stopping sperm from getting into the uterus. It can be put in several hours before having sex and is stronger than the male latex condom, but using this method may take some practise. If the female condom is used the right way every time you have sex, it is 95 per cent effective.
Female condoms are available from Family Planning Victoria (by mail order) and some retail outlets and sexual health clinics.
The diaphragm is a soft, shallow, silicone dome that fits in the vagina. It covers the opening to the uterus, stopping sperm from getting through. The diaphragm needs to stay in place for at least six hours after having sex. If it is used, fitted and positioned the right way, the method is 94 per cent effective. Diaphragms need to be fitted by a trained doctor or nurse. The method may not give protection from STIs.
This type of diaphragm will not be available from early 2016. It will be replaced with a self-fitted ‘one size fits all’ diaphragm (CayaTM
), which can be bought online and from some pharmacies. If used the right way, this method is 86 per cent effective.
Permanent methods of contraception
Sterilisation is a permanent method of contraception that involves having a surgical procedure. Female and male sterilisation are very effective, but these methods do not give protection from STIs.
Female sterilisation blocks the fallopian tubes, stopping an egg from moving down the tube and being fertilised. The two commonly used methods are:
- tubal ligation, known as ‘having your tubes tied’, where a clip is put on each tube under general anaesthetic
- tubal occlusion, where a small coil (Essure™) is put in each tube under local anaesthetic.
Vasectomy (male sterilisation)
Vasectomy involves cutting the tubes that carry sperm to stop sperm from moving from the testes to the penis.
Natural methods of contraception
Natural methods, known as natural family planning, are based on monitoring body changes during the menstrual cycle to know when a woman is most fertile. These changes are used as a guide to know when to have sex and when to avoid having sex. Methods include monitoring changes to the body’s temperature and to the fluid at the opening to the uterus.
The effectiveness of natural family planning varies, depending on which method or combination of methods is used. Natural family planning does not give protection from STIs.
Where to get help