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Contraception - Your Choices
Contraception - Your Choices
Using a worry free contraception that suits you is your best protection against unplanned pregnancy. Your options are explained in this fact sheet.
|If you don’t want to get pregnant, you need to use contraception.|
|Every month your ovaries produce an egg. The semen that is released from a man when he ejaculates contains millions of sperm. It takes only one of these sperm to fertilise one of your eggs to begin a pregnancy. Using contraception reduces your risk of getting pregnant when you have sex.|
|No matter what contraception you choose, you still need a condom to protect you from sexually transmitted infections.|
|In Australia, there are more than 20,000 new sexually transmitted infections every year. One of the most common is chlamydia, which can lead to infertility if left untreated. A condom is your best protection against infections. If you use a condom with a water-based lubricant every time you have sex you will have less chance of getting HIV/AIDS and many other sexually transmitted infections (STIs).|
Choosing your contraception
|The Pill is not your only option. Other ‘worry free’ options might work better.|
|You and your health provider can talk about the best contraception for you. Most women are comfortable and familiar with the Pill, though this is not always the most reliable method. Other methods known as LARCs or Long Acting Reversible Contraception can protect you for long periods of time without you having to do anything. Even though they are worry free methods, women are still becoming familiar and comfortable with the idea of using them. The following is a brief description of all of your contraception choices. For more detail see our other fact sheets about each contraceptive method.|
The Male Condom
|The male condom is a fine rubber or synthetic sheath that is worn on a stiff (erect) penis. It collects the sperm and stops them entering your vagina and uterus. You can easily buy condoms from a chemist or supermarket. Condoms reduce the risk ofbothpregnancy and sexually transmitted infection. |
Condoms are 98 per cent effectiveif they are used correctly. Typically though, if they are not used correctly they are 82 per cent effective, which means you have a 2 in 10 (18 per cent) chance of getting pregnant or catching a STI. Our condom fact sheet will tell you more.
|A diaphragm is a soft silicone cap worn inside the vagina to cover the entrance to the uterus (the cervix). It stops the sperm from getting into the uterus. A diaphragm can be used at any time, even during your period, and can be washed and used over and over again. A diaphragm has to be put in before having sex (up to 24 hours before) and removed after sex. When used correctly diaphragms are 94 per cent effective at preventing pregnancy, but if they are not used properly (e.g. the diaphragm slips) they are 88 per cent effective, which means you still have a 1 in 10 chance of getting pregnant.|
|There are two main types of oral contraceptive pills.|
The combined pill
|This Pill has two hormones, which stop the ovaries releasing an egg each month. You still bleed each month but not as much as usual. The combined Pill can also bring some relief for acne and premenstrual syndrome (PMS). Some women have side effects with the Pill, such as bloating, feeling sick sometimes or minor weight gain. The combined pill is 99.7 per cent effective with perfect use but one in ten or (10 per cent) may still get pregnant on the Pill. There are a number of reasons for this, such as women forgetting to take it, which is a common. See The Pill fact sheet for more information.|
The progestogen-only pill (mini pill or POP)
|This pill has only one hormone and works by changing the mucus at the entrance to the womb (uterus) so that sperm cannot pass through to fertilise the egg.|
The progestogen-only pill is different to the combined pill because it doesn’t stop ovulation. The POP is 99.7 per cent effective with perfect use. If mistakes happen, such as missed pills, around one in ten women (10 per cent) may get pregnant.
The Vaginal Ring
|The vaginal ring contains two hormones, just like the combined Pill. It works in the same way as the Pill to prevent an egg being released each month. The ring is placed high in the vagina and left in place for three weeks. It is removed for one week to allow you to have a regular monthly bleed. After you bleed a new ring is put in. It is not listed on the PBS (Pharmaceuticals Benefits Scheme) which makes it more expensive. The vaginal ring is 99.7 per cent effective with perfect use. Like the Pill, 1 in 10 women (10 per cent) who are using a vaginal ring may get pregnant if they are not using the vaginal ring correctly.|
|(Sometimes called the Morning After Pill)|
|If you had sex without contraception, or you were using a condom that broke, you can take an emergency pill.|
Emergency pills are available from the chemist with no prescription.
Emergency pills must be started within three days (72 hours) after unprotected sex and work best if they are taken as soon as possible after sex.
The Contraceptive Injection
|DMPA (also called Depo Provera or Depo Ralovera) is an injection of a long-acting synthetic hormone. Women have the injection every 12 weeks for contraception. It can also be used when you are breastfeeding. There can be irritating side effects, such as mood changes, tummy discomfort and headaches, which can last for up to 12 weeks. Depo Provera is 99.8 per cent effective with perfect use. Even though it is a very effective form of contraception around one in twenty (six per cent) women will still get pregnant using this method, usually because more than 12 weeks has passed without having another injection.|
Contraceptive Skin Implant
|This is a small plastic rod, which is inserted underneath the skin on the inside of the upper arm. It slowly releases the synthetic hormone progestogen, which stops the ovaries releasing an egg each month. Most women will have a different bleeding pattern and some stop bleeding altogether. Some women will notice skin changes, mood changes or minor weight gain. The implant will last for three years and is a very effective method for preventing pregnancy (99.95 per cent effective). It can be removed.|
Intra Uterine Device (IUD)
|This is a small contraceptive device that is placed in your uterus. There are two kinds of IUD:|
|Although the IUD has been used for more than 30 years to prevent pregnancy, how it works is still not fully understood. The IUD affects sperm movement and survival in the uterus (womb) so that they cannot reach the egg to fertilise it. The IUD also changes the lining of the womb (endometrium) so that it is not suitable for pregnancy. This prevents a fertilised egg from developing.|
It is a very effective long-term contraception.
The copper IUD may cause your periods to be heavier and the progestogen IUD will make your periods lighter.
|Both men and women can have an operation to make them sterile. The woman’s operation involves blocking the fallopian tubes. It is done through the abdomen and called a tubal occlusion and tubal ligation. The male operation is called a vasectomy. The operations are more than 99 per cent effective and are permanent. This method is for people who have already had all the children they want.|
There are also now tiny inserts that can be placed inside a woman’s tubes by means of a special instrument. This procedure is done through the vagina and can be done while the woman is awake.
Natural Methods of Contraception
|The rhythm or Billings methods, fertility awareness, mucus, ovulation and temperature monitoring – are all methods you can use to understand your cycle and when you are fertile. These methods take practice and are most effective when you have regular periods. If they are done perfectly these methods are effective most of the time (between 95-99.6 per cent effective). However, five in twenty women (24 per cent) may get pregnant using these methods.|
|This is when the man takes his penis out of the vagina before he ejaculates and sperm is released from the penis. This doesn’t work if he forgets to withdraw his penis or is not quick enough. Also there may be some sperm in the pre-ejaculate (fluid that comes out of his penis before he ejaculates). If he ejaculates at the entrance to the vagina some sperm may still swim inside and a woman could still get pregnant. Perfect use of the withdrawal method is 96 per cent effective. Approximately 2 in 10 women (78 per cent) get pregnant using this method of contraception.|
Where to get more information
|The Royal Women’s Hospital|
Tel: (03) 8345 3045 or 1800 442 007 (rural callers)
Related fact sheets
|The Royal Women’s Hospital does not accept any liability to any person for the information or advice (or use of such information or advice) which is provided in this fact sheet or incorporated into it by reference. We provide this information on the understanding that all persons accessing it take responsibility for assessing its relevance and accuracy. Women are encouraged to discuss their health needs with a health practitioner. If you have concerns about your health, you should seek advice from your health care provider or if you require urgent care you should go to the nearest Emergency Dept.|
|Last updated August 2013|