Contraception FAQs

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.

A full medical history is essential prior to taking the combibed pill, as this pill is not suitable for women who have certain conditions such as high blood pressure, circulatory disease, and diabetes. Women over 35 years who smoke or are very overweight may be advised to use another method of contraception. 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.

The POP or mini pill, unlike the combined pill contains only one hormone - progestogen. It works by acting on the cervical mucus, encouraging it to form a thick barrier to stop sperm entering the womb, and makes the lining of the womb thinner, to prevent it accepting a fertilised egg.

Good for women who are breast feeding, older women, smokers and those who can’t use the combined pill. It can also help with PMS and painful periods.

It has to be taken at the same time each day, or at least within three hours of that time. It is not reliable if taken over three hours late or if you have any vomiting and diarrhoea, in which case extra precautions will be required on the advice of your doctor. It can cause irregular bleeding, or periods may cease altogether during the time you take it. The POP offers no protection against sexually transmitted infections and HIV.

If taken correctly the progestogen-only pill is 98% effective.

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.

Known as Depo-Provera® in Australia, 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.

99% effective.

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.

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.

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 throught 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.

Th 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.

98% - 99% effective.

Commonly known as Mirena in Australia, 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.

Female sterilisation is performed by laparoscopic surgery, where a small incision is made in the lower abdomin in a position where any scarring will be virtually invisible. A portion of the fallopian tubes, which carry eggs from the ovaries to the uterus, are then either removed or clamped with a clip, preventing the sperm from getting through to fertilise an egg. The whole procedure takes about 15-20 minutes.

Female sterilisation does not interfere with sex and there are no hormonal side effects. While it is a very safe procedure, there are some very small risks associated with it, which your doctor will discuss with you.

Some doctors are not happy to sterilise young and/or single people who do not have children.

Sterilisation offers no protection against sexually transmitted infections and HIV.

Over 99% effective.

A permanent surgical technique in which the vas deferens (tubes which carry the sperm) are sealed, so that sperm are no longer present in semen when a man ejaculates. Sperm continues to be produced by the testicles but its passage to the penis is blocked, so it is re-absorbed by the body. Vasectomy has no effect on orgasm, ejaculation, the production of male hormones or sex drive.

The procedure takes 10 - 15 minutes.

Sperm can take a few months to disappear from the ejaculatory fluids altogether, and you should use another method of contraception until tests indicate you no longer have sperm present.

Vasectomy offers no protection against sexually transmitted infections and HIV.

Over 99% effective.

Emergency Methods:

If you have had unprotected sex (without contraception), missed contraceptive pills or a condom has split or come off, you can take 'emergency contraception' up to 3 days (72 hours) after sex to help avoid pregnancy. It is most effective the earlier it is taken after unprotected sex.

It is always best to use a reliable method of contraception and to be aware of the risk of sexually transmitted infections and HIV from unprotected sex. Remember to have a check up and pregnancy test within four weeks of using emergency contraception to ensure that it has worked and you are not pregnant.

Postinor-2® is the first pre-packed morning-after pill in Australia and prevents 95 per cent of pregnancies if taken within 24 hours of intercourse. It is a pack of two single tablets, each containing the hormone progestogen.

You take one of these tablets as soon as possible after unprotected sex and another tablet 12 hours later.

Progestogen-only emergency contraception works in two ways:

1. It can delay ovulation (the release of an egg from a woman's ovaries).
2. If ovulation has already taken place, it may stop a fertilised egg from implanting in the womb.

Since January 2004, Postinor-2® has been available in Australia over the counter at pharmacies, from your doctor or Marie Stopes International centre.

Although most women have no side effects, they can occur. The most commonly reported side effects are nausea and vomiting. Less common effects include breast tenderness, vaginal bleeding and headache.

Emergency contraception is not 100% effective. The key factor in its effectiveness is how much time has lapsed since you have had sex. It is most effective if taken soon after unprotected sex. It is most likely to fail if:

• you take it later than 72 hours;
• you have already had unprotected sex at other times since your last period;
• you vomit within 2 hour of taking the pills; or
• you have unprotected sex after taking the pills.

If you take Postinor-2® up to 24 hours after sex, it is 95% effective. If you take it 24-48 hours after sex its effectiveness is reduced to 85%. Leaving it 48-72 hours after sex reduces its effectiveness to 58%.

There is also another emergency contraceptive pill method using progesterone pills. This method has a higher failure rate.

The IUD can be fitted after unprotected sex to prevent pregnancy occurring. It must be fitted within five days of unprotected sex or five days after ovulation. It can be left in as a form of contraception or removed after a normal period.

It may stop an egg being fertilised or implanted in the uterus.

The IUD is not suitable for all women. A doctor will discuss whether this method is suitable for you.

The IUD is 98% - 99% effective.

For more information, download a copy of the Marie Stopes International Contraception Fact Sheet .

(if you do not have Adobe Acrobat Reader, you may download it from www.adobe.com).

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 wrapperas 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.