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Contraception is all about choice. Given that many different methods of contraception now exist in Australia, everyone should be able to find a suitable method.

The type of contraception you choose depends on your personal circumstances – your age, your way of life, whether or not you have children, whether you have multiple partners, your health and the need to avoid unplanned pregnancy and sexually transmitted infections (STIs). Your choice should also take into account that no method of contraception is 100% reliable and only condoms offer dual protection against both STIs and unplanned pregnancies.

Barrier methods

Male Condom

Male condoms are made of very thin latex or plastic and work by being placed over a man’s erect penis. They act as a physical barrier and trap sperm at the point of ejaculation. Along with reducing the likelihood of an unplanned pregnancy, they also reduce the rick of sexually transmitted infections, including HIV/AIDS. Condoms are readily available from chemists and free from family planning clinics. Women can carry them as well as men.

Care should be taken when taking a condom out of its wrapper as sharp objects such as fingernails, jewellery or teeth may tear it. The male condom should be placed on the penis as soon as it becomes erect and before any contact takes place with the vagina. When putting it on, ensure the condom is fully unrolled to the base of the penis, squeezing the tip as you go to prevent air being trapped. Men need to withdraw as soon as they have ejaculated and be careful not to spill any semen. Condoms should never be used with oil based products such as Vaseline and suntan oil, as these will damage the rubber.

Can be 94% – 98% effective depending on how correctly they are used.

Did you know: A survey of unplanned pregnancy in Australia found: one in 10 women either rarely or never felt comfortable asking their partner to wear a condom! It is often said that using condoms reduces spontaneity, but using flavoured SNAKE condoms makes it fun!

Buy SNAKE condoms online.

Check out our step-by-step guide to putting on a condom.

Female Condom

The female condom, or Femidom®, is a disposable thin polyurethane plastic sheath designed to line the inside of the vagina and prevent sperm from entering. The female condom sheath has two rings: the inner and outer ring. The inner ring inside the sheath, helps to insert the condom similarly to a tampon. The outer ring, at the opening of the sheath, remains outside the vagina, and is pushed flat against the labia.

A female condom can be put in any time before sex and has many of the advantages of the male condom, as well as being stronger. Also, because the female condom lines the inside of the vagina, the penis does not have to be withdrawn immediately after ejaculation.

It is especially good for women who suffer from allergic reactions to the spermicidal lubricants used with condoms.

You need to be sure that the penis enters the condom and isn’t inserted between the condom and the vaginal wall.

If used correctly it is 95% effective.

Diaphragm- Cap

The diaphragm or cap is a circular dome made of rubber, which is fitted by the woman over her cervix before sex. It acts as a barrier to stop sperm getting through to the uterus. It should be used with a spermicide cream, jelly or pessaries, which contain a chemical that destroys sperm. A doctor or nurse will need to fit a diaphragm initially to check what size you need and teach you how to use it.

The diaphragm does not affect your menstrual cycle and it may protect against cancer of the cervix. Like other barrier methods, you need only use it when you are sexually active. It may protect against cancer of the cervix.

The diaphragm must stay in place for six hours after sex. More spermicide must be inserted again if you have sex before this time is up. Spermicides may cause irritation or an allergic reaction. Does not protect against sexually transmitted infections and HIV/AIDS.

If used correctly it is 92% to 96% effective.

Hormonal Methods

The Pill- Combined Pill

Contraceptive pills or oral contraception are a common form of contraception for women. The combined pill is a hormonal method of contraception. It contains two hormones, oestrogen and progestogen, which prevent an egg from being released by a woman’s ovary each month and/or causes the cervical mucus to thicken which prevents sperm from reaching an egg.

Prescribed by your doctor, the combined pill is taken at the same time once daily for 21 consecutive days. To complete the 28 day cycle, no pills or ‘sugar pills’ (without any hormones) are taken for the remaining 7 days, during which time you will menstruate (have your period). There are several different types of pill, so if one does not suit you then another one might.

It can reduce pre-menstrual syndrome (PMS) and period pain. There is also evidence that the pill offers some protection against cancer of the uterus and ovaries, and may reduce the risk of pelvic inflammatory disease (PID). You don’t need to worry about any devices or spermicides and it does not interfere with spontaneity of sex.

The combined pill is not reliable if taken over 12 hours late, or if you have vomiting and diarrhoea. It may have some side effects such as nausea, headaches and weight gain. Some drugs, such as antibiotics may affect its reliability. Contraceptive pills do not protect against sexually transmitted infections and HIV.

If taken correctly, the combined pill is 99% effective.

Missed a pill? Here’s what to do…

If you are less than 12 hours late taking a pill- Take the missed pill immediately and the rest of your pills at the usual time.

If you are more than 12 hours late taking a pill (for the 28 day combined pill)- Take the forgotten pill immediately and the rest of your pills at the usual time, using condoms for the next 7 days. If you have less than 7 hormonal pills left in yout packet, do not take the ‘sugar’ pills- go straight onto the hormonal pills in a new packet. Your period will be delayed untill the next set of ‘sugar’ pills.

(For the 21 day combined pill)- Take the forgotten pill immediately and the rest of your pills at the usual time, using condoms for the next 7 days. If you have less than 7 hormonal pills left in your packet, start a new packet (on the corresponding day) without taking a break. Your period will be delayed until the next set of ‘sugar’ pills. Click here for more information.

Contraception Implant (Implanon®)

Known as Implanon® in Australia, the contraceptive implant is a small rod containing the hormone progestogen. It is inserted under the skin in the arm by a doctor under local anaesthetic. The hormone is slowly released into the body, preventing eggs from being released, sperm from reaching an egg or an egg settling into the womb. Implants are a good method for women who want a long term contraceptive, as each implant lasts for three years. It is easily removed and quickly reversible. The implant may move from its original position under the skin.

Considerations: Period can become irregular or stop altogether. Implants do not offer protection against sexually transmitted infections or HIV/AIDS

99% effective.

Contraception Injection (Depo-Provera®)

The contraceptive injection is an injection of hormones that provides a longer acting alternative to the pill. It works by slowly releasing the hormone progestogen into the body to prevent ovulation.

It can give some protection against cancer of the uterus. It is important to attend for the next injection on time, every twelve weeks otherwise it becomes ineffective. Irregular bleeding is a possible side effect. You should not use this method of contraception if you think you might be pregnant or if you do not want your periods to change. It can delay your return to normal rates of fertility and also offers no protection against sexually transmitted infections and HIV.

NuvaRing

Vaginal ring containing both oestrogen and progestogen released from the ring and absorbed through the wall of the vagina. Prevents egg being released. The ring is inserted for three weeks and removed for one week, which means that it must be changed every four weeks.

Possible slight weight gain and acne. Some medications can affect the reliability. Inform your doctor of your current medications frst. The NuvaRing does not protect against STIs.

Intrauterine methods

IUD (Multiload)

An IUD is a small plastic and copper intrauterine device (commonly known as Multiload® in Australia), usually shaped like a ‘T’, that is fitted into the uterus by a doctor. This only takes a couple of minutes, and it can stay in place for up to five years.

The device has a fine nylon string attached to it which, when in place, comes out through the cervix. You and your doctor can check that the device is still in place by reaching right up inside the vagina and feeling for the string. The IUD works by preventing sperm from meeting an egg, or by preventing an egg settling in the uterus. IUDs can be used as an emergency method of contraception within five days of unprotected intercourse, or five days after expected ovulation.

IUDs may increase the risk of pelvic inflammatory disease (PID), and may cause periods to be heavier and more painful. The IUD offers no protection against sexually transmitted infections or HIV/AIDS.

IUS (Mirena®)

This is a small, plastic, T shaped device with a cylinder around its stem that releases the hormone levonorgestrel to prevent pregnancy. It is referred to as a ‘system’ to distinguish it from the copper-bearing IUDs which do not release hormones.

As with the IUD, the IUS is placed inside the uterus by a doctor and can stay in place for up to 5 years. It can be easily removed by the nylon string which is attached to it. It is important to check the length of the string initially at 6 weeks then once a year, to make sure the device has not shifted and is correctly in place.

The cylinder component of the IUS is covered with a membrane that regulates the release of the hormone levonorgestrel, which changes the lining of the uterus so that it does not get thick enough to allow the egg to grow in it, even if the egg is fertilised. The release of this hormone also causes the mucus in the cervix to become thicker so that sperm cannot enter the uterus. In some women, ovulation will cease altogether.

Mirena is useful for women with heavy, painful periods as it may make periods lighter, shorter and less painful. It is also a particularly suitable contraceptive for women approaching or undergoing menopause as it can be used as the progestogen component of hormone replacement therapy (HRT). The device offers no protection against sexually transmitted infections or HIV/AIDS.

Over 99% effective.

Permanent methods

Male and female sterilisation are permanent methods of contraception. They are for people who feel that their family is complete or who are certain that they will never want to have children. Many couples find greater sexual freedom once the risk of unwanted pregnancy has been removed. Whatever your age, you should consider sterilisation to be a permanent, irreversible procedure. You should not undergo the procedure if you have any doubts.

Vasectomy is the only permanent method of contraception for men where the tubes carrying sperm closed.

Female Sterilisation is the only permanent method of contraception for women where the fallopian tubes are closed – which prevents egg and sperm meeting.
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Emergency methods

Emergency contraception can prevent unplanned pregnancy following unprotected sex. Unprotected sex can happen if a condom splits, contraceptive pills are missed, or if you don’t use any contraception. It is always best to use a reliable method of contraception and to be aware of the risk of STIs and HIV from unprotected sex. However, it is not recommended that emergency contraception be used as a regular form of contraception.

The Emergency Contraceptive Pill – ‘The Morning After Pill’

Prevents a fertilised egg implanting itself in the uterus lining and can be taken up to 120 hours after sex but is 95% effective if taken up to 24 hours after unprotected sex (keep in mind lapse time increases failure rate). You can buy The Pill from your local chemist with no prescription needed but is recommended as a last resort.

PREGNANCY AND USE OF CONTRACEPTION

A survey of unplanned pregnancy in Australia found:

  • 60 per cent of women were on at least one form of contraception at the time of their unplanned pregnancy.
  • 43 per cent were on the pill, while 22 per cent used a condom.
  • 21 per cent of the women were using more than one method.
  • Nearly half of all women do not consider sexually transmitted infections when choosing contraception.
  • One in 10 women either rarely or never felt comfortable asking their partner to wear a condom.
  • 36 per cent of women who were not using contraception had not been expecting to have sex.
  • 17 per cent of women who hadn’t used contraception at the time of their unplanned pregnancy believed they weren’t fertile.
  • 80 per cent didn’t seek emergency contraception.
  • Two-thirds were aged 24 or younger.

- AAP

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