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What is contraception and why is it used?

Contraception (or birth control) includes a variety of methods used by men and women who are sexually active to prevent pregnancy.

There many different types of contraceptives. A person makes a choice depending on a number of factors including:

Not all forms of contraception provide protection against STIs. The best way to reduce the risk of STIs is to use barrier protection such as condoms and dams (a dam is 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 prevent the spread of some infections.

Who needs contraception?

If a girl or woman is sexually active and has periods she can become pregnant. If she does not want to become pregnant then she (or her partner) will need to use contraception.

A woman does not need contraception if she:

Contraception types, effectiveness, benefits and risks

The main forms of contraceptives are:

Barrier methods

A male condom is a latex (polyurethane) sheath which is rolled onto the erect penis before sex, to prevent semen entering the vagina. It:

A female condom is a latex sheath with a ring at each end, which is placed inside the vagina before sex to collect semen. It:

A diaphragm is a soft, dome-shaped silicone cap with a flexible rim, which is placed inside the vagina before sex, to cover the cervix and stop sperm getting into the uterus. A diaphragm should be fitted for the right size by a doctor or nurse. It requires instructions for use, can be tricky to fit correctly. It:

Hormonal contraception: pills and rings

There are two hormones called oestrogen and progesterone that may be in contraceptives. These hormones are usually made by the ovaries and by using them in contraceptives, they change the way the hormones work and the messages they send. This usually stops the growth and release of an egg (ovulation) from the ovary every month and makes the fluid at the opening of the womb thicker which makes it harder for sperm to get into the uterus.

Combined oral contraceptive pill (COC Pill) or ‘the pill’

The combined pill is an oral contraceptive taken daily made from oestrogen and progestogen. Each pack contains a mixture of hormone pills and sugar pills, usually either 21 days of hormone pills and 7 days of sugar pills or 24 days of hormone pills and 4 days of sugar pills. When a woman takes the sugar pills she will have a period.

What’s good about it?

What’s not so good about it?

Who shouldn’t use it?

What else?

What happens if a woman misses a pill?

Progestogen only contraceptive pill or ‘the mini pill’

The mini pill is an oral contraceptive taken daily with no sugar pills.

What’s good about it?

What’s not so good about it?

Who shouldn’t use it?

What else?

What happens if you miss a pill?

Contraceptive vaginal ring (NuvaRing)

The contraceptive vaginal ring is made of soft plastic and slowly releases low doses of the hormones oestrogen and a progestogen (similar to the COC Pill) into the vagina and then into the blood stream. A woman inserts the ring into the vagina herself. It remains in place for three weeks, is removed so the woman has a period and replaced a week later.

What’s good about it?

What’s not so good about it?

Who shouldn’t use it?

Hormonal contraception – implants and injections

Contraceptive ‘rod’ implant (Implanon)

The contraceptive rod-shaped implant (Implanon) is inserted under the skin on the inside of the upper arm. It slowly releases a low dose of progestogen hormone into the blood stream and needs to be replaced every three years. The implant works by preventing ovulation (the release of an egg each month) and changing the cervical mucus making it harder for sperm to enter the uterus.

What’s good about it?

What’s not so good about it?

Who shouldn’t use it?

Contraceptive injection – Depot

The contraception, Depot is an injection given into a muscle every 12 weeks.

What’s good about it?

What’s not good about it?

Who shouldn’t use it?

IUD (intrauterine device)

There are two kinds of IUD or intrauterine devices one is hormonal called Mirena and one is a copper IUD.

Mirena is a small T-shaped piece of plastic with a nylon string at the end. It is placed inside the uterus/womb by a doctor and can stay there for five years. It slowly releases a low dose of progestogen hormone into the uterus. It stops sperm meeting an egg and prevents an egg from implanting/sticking to the lining in the womb.

What’s good about it?

It:

Also:

What’s not so good about it?

Who shouldn’t use it?

What else?

A Copper IUD is a small device made from copper and plastic that is fitted by a doctor inside the uterus/womb. It stops the sperm from reaching the egg and prevents an egg from implanting/sticking to the lining of the womb. It does not release hormones.

What’s good about it?

What’s not so good about it?

Who shouldn’t use it?

What else?

Fertility awareness based contraception

This method of contraception does not rely on the use of hormones, barriers or or devices. It includes any methods that use an awareness of the fertile time of the menstrual cycle, so that a woman can then avoid sexual intercourse to prevent pregnancy. These methods require education from experts and can be much less reliable than other forms of contraception.

Emergency contraception

This is not a type of contraception that is used as a woman’s regular contraception but can be used if a woman has unprotected sex and wants to avoid becoming pregnant.

The emergency contraception pill contains the hormone progestogen and can be bought at a chemist without a script from the doctor. It can be taken up to 5 days after unprotected sex but it is most effective if taken in the first 24 hours. If it is taken in the first 72 hours (3 days), it prevents about 85% of expected pregnancies. It can still be taken up to 96 days after unprotected sex but won’t be as effective.

The emergency contraception pill can make women feel sick so they may need tablets for nausea.

It is important for a woman to use a reliable form of contraception to prevent unplanned pregnancy.

Permanent contraception

Tubal ligation (tying) is often known as ‘getting your tubes tied’. It’s a surgical procedure for women, usually done under general anaesthetic, which blocks the fallopian tubes so that the egg cannot get from the ovary to the uterus and the sperm can’t get to the egg. It doesn't affect the periods, menopause, libido or sexual desire. Pregnancy is possible (for about 5 women in every 100 who have had their tubes tied) but it is very unlikely.

Risks of a laparoscopy (surgery through small incisions in the abdomen) are: damage to the bowel, bladder or blood vessels, infection of cuts in the skin and anaesthetic risks.

Who is it not good for?

Vasectomy is a surgical procedure for men; it blocks the tube (the vas) that carries sperm from the testicles to the penis. The chances of pregnancy after having a vasectomy are around one in 1,000. The operation doesn’t interfere with a man’s sexual desire or his ability to reach orgasm. This is a quick procedure that can be done under local anaesthetic or with the man asleep.

References and further reading

Jean Hailes for Women’s Health (2013) Contraception. Retrieved 7 October 2013 from http://www.healthforwomen.org.au/sexual-health/contraception
Jean Hailes for Women’s Health (2013) Contraception across your lifespan. Retrieved 7 October 2013 from http://jeanhailes.org.au/magazine/2012-magazine-vol-2/2-contraception-across-your-lifespan
Jean Hailes for Women’s Health (2012) Contraception for young people. Retrieved from http://jeanhailes.org.au/health-professionals/medical-observer/1437-contraception-for-young-people-27-july-2012
Sexual Health & Family Planning Australia (2013) Sexual Health & Family Planning Australia: leading the way in in sexual and reproductive health. Retrieved 7 October 2013 from http://www.shfpa.org.au

 
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