Download PDF - Children by Choice

Contraceptive options
If you have had unprotected sex, your condom broke, or you missed taking your contraceptive pill during the
last 72 hours, you should access emergency contraception as soon as possible if you haven't already.
Although the most commonly used methods of contraception in Australia are condoms and the pill, there are
many other options now available.
Implant | Injections | Intrauterine device (IUD) | Vaginal Ring | Contraceptive pill | Condoms | Diaphragm
| Sterilisation | Natural family planning
The method you choose might be influenced by a variety of things, including your general health, your lifestyle,
your childbearing intentions, your risk of contracting a sexually transmitted infection, any intolerances or
allergies you might have, and others.
If you're in a committed relationship it's important to talk about contraception with your partner. If you are
taking sole responsibility for contraception (for example, you're using an IUD or taking the pill), you might like
to talk about how he can help share the financial burden.
Sometimes you might need to try different methods before you find one that works well for you, or you may
find that different methods are more suitable at different stages of your life. It can help to talk to your GP or a
specialist sexual health doctor or nurse about your contraceptive options.
If you'd like a better idea of what options might be available for you, The Family Planning Alliance Australia
website also has a very useful overview of the effectiveness of all available contraceptive methods - it's
available to view or download as a pdf.
Long Acting Reversible Contraceptives (LARCS)
LARCs are also sometimes referred to as 'set and forget' contraceptive methods. They last for 3 weeks to 10
years once they are inserted, depending on the method chosen. However, these methods do not protect against
Sexually Transmitted Infections (STIs), so a barrier method may also be needed depending on your lifestyle or
partner/s.
While LARCS are generally very cost effective over the lifetime of the device, the upfront cost for the device
itself and its insertion can make them out of reach for some women. We have a No Interest Loan Scheme that
may be able to help if you are struggling to afford the cost of a LARC - check here for more details.
LARC methods available in Australia are the Implanon (implant), Depo Provera (injection), the hormonal or
copper IUD (intrauterine device), and the NuvaRing (contraceptive vaginal ring).
Implanon
Implanon is the brand name for the contraceptive implant available in Australia. The implant is small flexible
rod slightly smaller than a matchstick, which is inserted under the skin. It is usually inserted in the upper arm
but other placement options may be able to be negotiated with your provider. The implant slowly releases the
hormone progesterone to prevent pregnancy. Progesterone is one of the hormones used in the oral contraceptive
pill. The implant lasts for three years once inserted and is more than 99% effective.
Injection
The contraceptive injection is sold as Depo-Provera and Depo-Ralovera in Australia. It contains a hormone
similar to progesterone, and each injection protects against pregnancy for up to 12 weeks. It is 94% - 99%
effective.
Hormonal IUD
Mirena is the name of the hormone-releasing IUD available in Australia. It is a small T-shaped plastic device
which releases the hormone levonorgestrel for up to five years. The Mirena is inserted into the uterus and has a
nylon string attached to it which comes out through the cervix; this allows women to be able to self-check the
device is still in place (if the string can be felt) and also assists a doctor to remove it. The Mirena is suitable for
women who have not had children as well as those who have, and can also be used while breastfeeding. It is
over 99% effective.
Copper IUD
Copper IUDs are small plastic devices with copper wire wrapped around the stem. A copper IUD is inserted into
the uterus and has a nylon string attached to it which comes out through the cervix; this allows women to be
able to self-check the device is still in place (if the string can be felt) and also assists a doctor to remove it. Like
the Mirena, a copper IUD can be used by women who have or haven't had children, and who are breastfeeding.
There are two types of copper IUD available in Australia (one which lasts for five years and one which lasts for
up to ten); both are over 99% effective.
Vaginal ring
The contraceptive vaginal ring is sold as NuvaRing in Australia. It is a soft plastic ring which releases low doses
of oestrogen and progesterone (the two hormones used in the combined oral contraceptive pill). It is selfinserted into the vagina and remains there for three weeks, after which point you can remove it yourself and
replace it with the next ring a week later. It is around 91% effective.
Other methods
Oral contraceptive pill
There are two types of oral contraceptive pill marketed in Australia: the combined oral contraceptive pill, which
contains the hormones oestrogen and progesterone; and the progesterone-only pill, sometimes called the 'minipill'. The combined oral contraceptive pill works by stopping your ovaries from releasing an egg each month,
thereby preventing pregnancy. The progesterone-only pill makes the mucus at the entrance to the uterus thicker
so sperm cannot get through to fertilise an egg.
Used perfectly oral contraceptive pills are about 99% effective, but in reality user error or other factors mean it
is around 91% effective. The pill must be taken at the same time every day, so may not be suitable if you work
shift work, travel a lot, or have an erratic or unpredictable schedule. It may also not be appropriate for you to
take if you have a history of blood clots or stroke, if you are breastfeeding, or have some other medical
indicators - see the True website for further information or talk to your GP or a sexual health clinic if you are
concerned.
Condoms
Female and male condoms are available in Australia. Male condoms are one of the most commonly used forms
of contraception by Australians.
Male condoms are most commonly made of latex (although polyurethane condoms are also available if you or
your partner have allergies to latex), and are a thin sheath which fits over the penis during sex to contain any
ejaculate and thereby prevent pregnancy. Female condoms are also thin sheaths of polyurethane that act as a
barrier between the penis and vagina during sex, but they are inserted into the vagina instead of over the penis.
Female condoms have a soft flexible ring at each end, with one closed end and one open. The closed end is
inserted into the vagina and contains any ejaculate.
Male and female condoms are also barrier methods, so they help prevent Sexually Transmitted Infections (STIs)
as well as pregnancy. They are only able to be used once, so they are thrown away after use. They have failure
rates of 2%-20% depending on how they are used, so some couples may want to consider backing them up with
a hormonal contraceptive to decrease their risk of pregnancy.
Diaphragm
A diaphragm is a silicone cap which is inserted into the vagina prior to sex, and covers the cervix. This acts as a
barrier to sperm entering the uterus, thereby preventing pregnancy. It is 84-94% effective at preventing
pregnancy but provides little protection against sexually transmitted infection. It can be inserted well before sex,
so doesn't have the disruptive impact some people report with condoms. Side effects are rare and it is safe to use
while breastfeeding as it's non-hormonal. Diaphragms are available from family planning clinics, who can also
show you how to insert it and ensure it is fitted correctly.
Sterilisation
Both males and females can undergo sterilisation procedures. These procedures are permanent so if you are
considering sterilisation you need to be sure of your decision. If you think there is any chance you may want to
have a child (or another child) in the future - for example, if your relationship status changes - then sterilisation
is not for you. Although reversals can be attempted in some cases, their success rate is low and even then there
is no guarantee that pregnancy will result.
Both male and female sterilisation is more than 99.5% effective.
Male sterilisation is known as vasectomy. It is a simple and straightforward procedure which involves the
cutting and tying of the vas deferens, the tubes which carry sperm, to prevent sperm being carried from the
testes into the semen. The procedure does not affect the production of semen or impact on sexual function; men
who have had a vasectomy should still experience sex and ejaculation in the way they did before the procedure.
Vasectomies are usually performed under a local anaesthetic but can be carried out under sedation or general
anaesthetic. It can be performed by a specialist or through the public health system; some GPs and private health
clinics may also provide vasectomies. Ask your GP or a sexual health clinic for more info.
Female sterilisation can be performed in two different ways. The first involves one or two incisions into the
abdomen, inserting a laparoscope (a small telescope), and closing off the fallopian tubes with clips or by cutting
and tying them. The second method involves inserting small flexible inserts into the fallopian tubes, which
cause scar tissue to form and thus block the fallopian tubes. In either method, the end result means sperm cannot
travel up the fallopian tubes to fertilise an egg, so pregnancy is no longer possible. Female sterilisation can be
performed in the public health system or by a private gynaecologist. Talk to your GP or a sexual health clinic
for more info.
Fertility awareness based methods (FABM)
Fertility awareness based methods (FABM) involve tracking the menstrual cycle and avoiding sex on the days
when pregnancy could result. There are different methods that are used to do this which are all classified as
FABM. They require women to calculate 'fertile days' by counting the length of their cycle over time or by
following signs that indicate ovulation (for example, temperature or mucous changes). As no barrier or
hormones are used and individual cycles differ, sex may need to be avoided for 7 to 14 days each cycle.
Effectiveness of FABMs differs according the method and how long a woman has been using it, but is generally
between 75% and 99% effective. FABMs require committment and consistency of use, and it can be difficult to
predict ovulation even if you are confident with the method. It does not offer any protection against sexually
transmitted infections.
Lactational amenorrhea method (LAM)
The lactational amenorrhea method can be an effective form of contraception when used correctly. If you are
solely breastfeeding an infant less than 6 months old (ie, your baby isn't receiving any supplementary feeding
through formula), and menstruation has not recommenced since the birth, this may provide up to 98% effective
contraceptive coverage.
Last modified on: 04 July 2016