Clearing the confusion on contraception

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Choosing the right contraception method for many women can feel like playing hormonal Russian roulette. Contraception isn't a one-size-fits-all solution.

We forget our GPs aren't psychics and the more information we provide about our lifestyle, personal and family medical history the better the chance of finding the right solution.

A word of warning: for some finding the right contraceptive solution is just like finding the perfect man; it's trial and error and requires a whole lot of patience.

So besides the condom, what are our other main contraceptive options and more importantly which one is the right one for you?

Dr Mary Stewart has over a decade of experience in this field, as the acting medical director of Family Planning NSW she sheds some light on some of the contraceptives available and their effectiveness.

There is a range of contraceptive solutions known as 'Long Acting Reversible Contraception' that can be just as effective as permanent contraception i.e., sterilisation, these include:

The Combined Pill

The most widely used form of hormonal contraception, combining two hormones progestogen and oestrogen; its key function is to stop ovulation.

“When used properly it's typically 99 per cent effective, however many women do forget to take their pill religiously so with typical use it's only 91 per cent effective and that's when unwanted pregnancies can occur,” warns Dr Stewart.


The Vaginal Ring

Dr Stewart describes this device as being akin to a plastic bangle. A new ring is inserted and left in the vagina every three weeks. During that time hormones similar to the pill are released into the body to prevent ovulation.

“The vaginal ring has its advantages and disadvantages,” says Dr Stewart. “This is another way of taking the hormones that are in the pill but only requires monthly upkeep. Like the pill, some women can't use it for medical reasons and it's a pricier option as it isn't covered by the PBS.”

The Contraceptive Injection (progestogen only)

The injection is administered every 12-14 weeks by a GP or health care professional, and is typically 94 per cent effective, being progestogen only, it's also a safe alternative for women who can't use methods containing oestrogen.

“The advantages: the longer you use it, the more likely your periods will stop, with up to 50 per cent of women after the first year reporting their period stopped all together,” says Dr Stewart.

“The disadvantages; unlike other methods it can delay the return of normal fertility up to a year and there is a small risk of decrease in bone density, so it's important to consult your healthcare professional before using this option,” cautions Dr Stewart.

The Implant (progestogen only)

This solution is effective for up to three years, at the size of a matchstick; a special insertion device is used to place it under the skin on the arm, with local anaesthetic.

When inserted correctly you should be able to feel it but not see it, it can be removed any time and is one of the most effective forms of contraception available with a 99.5 per cent prevention rate.

“Obviously the advantages are its effectiveness. It's set and forget and the fact that once removed your fertility returns immediately,” says Dr Stewart.

“The disadvantages, there are no guarantees of a regular bleeding pattern with 15-20 per cent of women reporting irregular bleeding, leading them to remove the implant within the first year of use,” says Dr Stewart.

The IUD (Intra Uterine Device)

Dr Stewart refers to this as one of the most effective and under utilised forms of contraception. There are two types of IUD a hormonal (progestogen only) and a copper version.

The IUD is a T-shaped device that is inserted into the womb. The procedure takes about 15 minutes and can be carried by a qualified GP, gynaecologist or at a family planning clinic. It only needs to be replaced every five to 10 years, and is 99.8 per cent effective.

“The advantages of the hormonal IUD are the hormones are released directly to the area they are needed, instead of passing through the body like they would with the pill,” says Dr Stewart.

“It's incredibly cost-effective as it's covered by the PBS, is immediately reversible once removed, can really help women who suffer from painful or heavy periods and requires no maintenance,” says Dr Stewart.

“The disadvantages, there can be a three to six month settling period and some women could experience irregular but usually light bleeding,” explains Dr Stewart.

“For the copper IUD, women prone to heavier periods can find their periods can last longer on this device, however it's the most effective reversible non-hormonal method available.”

Dr Stewart reminds us to be self-educated and aware of side effects, “know the potential side effects and if you are experiencing them, go back and talk to your GP or healthcare professional to find another solution.”

Lastly Dr Stewart emphasises that while controlling our fertility and preventing unintended pregnancy is important, using condoms in conjunction with contraception to prevent STI's is equally as important.

*Go to for more information or to find a clinic in your state.