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Contraception is necessary if you wish to avoid an unintended pregnancy.
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Every month a woman's ovary produces an egg. When a man ejaculates, his semen contains millions of sperm. It takes only one of these sperm to fertilise an egg and begin a pregnancy. If a couple has sex and do not take precautions, there is a high risk of pregnancy. Using contraception allows you to have sex and avoid an unintended pregnancy.
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A condom is always a good idea
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In Australia, there are more than 20,000 new sexually transmitted disease infections every year. One of the most common of these is chlamydia, which can lead to infertility if left untreated. A condom is your best protection against infections. If you use a condom and water-based lubricant every time you have sex you will have less chance of getting HIV/AIDS and many other sexually transmitted infections (STIs).
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Choosing your contraception
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You and your doctor or women's health nurse can talk about the best contraception for you. The following information is only a brief description of your contraception choices.
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The Male Condom
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TThe male condom is a fine rubber or synthetic sheath that is worn on an erect (stiff) penis. It collects the sperm and stops them entering the vagina and uterus. You can easily purchase condoms from the chemist or supermarket; they reduce the risk of both pregnancy and sexually transmitted infection. Condoms are 98% effective with perfect use. If not used correctly or mistakes happen, there is a 2 in 10 chance (82%) of getting pregnant or catching a STI.
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Diaphragms
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These are soft silicone caps worn inside the vagina to cover the cervix (the entrance to the uterus). They prevent the sperm entering the uterus. They can be used at any time, even during menstruation and can be washed and used over and over again. They have to be put in before having sex (up to 24 hours before) and removed after sex. When used correctly diaphragms are 94% effective at preventing pregnancy, but if mistakes happen (e.g. the diaphragm slips) there may be a 1 in 10 chance (88%) of getting pregnant.
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Pills
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There are two main types of oral contraceptive pills.
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The combined pill
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Contains two hormones and stops the ovaries releasing an egg each month. You still bleed each month but often with a reduced loss. Acne and premenstrual syndrome can be improved with the combined pill. Occasional side effects include bloating, nausea, and minor weight gain. The combined pill is 99.7% effective with perfect use. 1 in 10 women (91%) taking the Pill may get pregnant; there are a number of reasons why its effectiveness may be reduced, see The Pill fact sheet for more information.
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The progestogen-only pill (minipill or POP)
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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 from the combined pill as it does not stop ovulation. The POP is 99.7% effective with perfect use. If mistakes happen, such as missed pills, 1 in 10 women (91%) may get pregnant.
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The Vaginal Ring
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The vaginal ring contains the same two hormones as in some types of the 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 3 weeks. It is removed for one week to allow you to have a regular monthly bleed. A new ring is then inserted. It is not listed on the PBS (Pharmaceuticals Benefits Scheme). The vaginal ring is 99.7% effective with perfect use. Like the Pill, 1 in 10 women (91%) using a vaginal ring may get pregnant.
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Emergency Pill
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(Previously known as the Morning After Pill)
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If you were not using contraception and you had sex when you did not plan to, or the condom broke, and you don't want to get pregnant, then you can take the 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 most effectively if taken as soon after unprotected sex as possible.
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The Contraceptive Injection
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DMPA (also called Depo Provera or Depo Ralovera) is an injection given to a woman every 12 weeks for contraception. It is a long-acting synthetic hormone. It can be used when breastfeeding. Any side effects can last for up to 12 weeks. Depo Provera is 99.8% effective with perfect use. Even though it is a very effective form of contraception, approximately 1 in 20 women (94%), may get pregnant when using DMPA.
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Contraceptive Skin Implant
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This is a small plastic rod containing one hormone, progestogen, which is inserted underneath the skin on the inside of the upper arm. It stops the ovaries releasing an egg each month. Most women will have a different bleeding patterns and some stop bleeding altogether. Some women experience skin changes, mood changes and/or minor weight gain. The implant last for 3 years and is a very effective method for preventing pregnancy (99.95% effective).
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Intra Uterine Device (IUD)
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This is a small contraceptive device that is placed in the woman's uterus. There are two kinds of IUD:
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- copper IUD – last for 5-10 years and is 99.4% effective
- progestogen IUD – lasts for 5 years and is 99.8% effective.
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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 and prevents an egg - if it does become fertilised - from developing.
It is very effective long-term contraception.
The copper IUD may cause your periods to be heavier and the progestogen IUD will reduce your period loss.
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Sterilisation
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Both men and women can have an operation to make them sterile. The woman's operation is done through the abdomen and is called a tubal occlusion and the man's is called a vasectomy. The operations are more than 99% 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.
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Natural Methods of Contraception
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The rhythm, Billings, fertility awareness, mucus, ovulation and temperature methods are all names for ways a woman can tell when she is fertile (most likely to get pregnant). They can also tell her when to avoid having sex, but if a woman's periods are not regular it can be harder to use these methods. They take a lot of practice to use well and are 95-99.6% effective with perfect use. However, 5 in 20 women (76%) may get pregnant using these methods.
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Withdrawal
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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 with this method. Perfect use of the withdrawal method is 96% effective. Approximately 2 in 10 women (78%) get pregnant using this method of contraception.
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Where to get more information
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Women's Health Information Centre
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Ground floor, near main entrance
Royal Women’s Hospital
Tel: (03) 8345 3045 or 1800 442 007 (rural callers)
Email: whic@thewomens.org.au
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Choices Clinic at the Women's
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A low cost service offering advice, consultation and treatment for all contraceptive and sexual health requirements.
Hours: Tuesday, Wednesday, Thursday and Friday mornings
Location: Level 1 South, Royal Women's Hospital
Tel: (03) 8345 3032 to make an appointment.
Visit the Choices Clinic service information page for more information.
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Related fact sheets
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Disclaimer
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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.
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Last updated October 2012
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