Contraceptive Advice

The oral contraceptive pill

The combined hormonal contraceptive pill (the Pill) is made up of two hormones, an oestrogen and a progestogen. These hormones are similar to the ones made in your ovaries. Many brands of the Pill are available which all have different types and doses of these two hormones.

The two hormones work together to prevent pregnancy mainly by stopping the ovaries from releasing an egg each month. The Pill also makes the mucous in the cervix thicker so that sperm can't get into the uterus. When you take the non-hormone pills you will get a withdrawal bleed like a period.

If there are no medical reasons not to take the Pill, women can safely use the Pill up to the age of 50. There are some medical reasons where taking the Pill is not recommended. Make an appointment with one of our women’s health GPs at The Bubble to find out if you are a suitable candidate for the Pill.

If it's used correctly, the Pill is 99.5% effective. In real life it can be less effective (93%) if you forget to take it or you run out of pills. The Pill might not work if you have vomiting or severe diarrhoea or if you are taking some medications including some epileptic medications or herbal remedies. Talk to your doctor if you start any new medications.

Intrauterine Device (IUD)

There are two types of hormonal intrauterine devices (IUDs) available in Australia. We are not allowed to name the brands due to advertising restrictions so let's call them the M IUD (52mg levonorgestrel) and K IUD (19.5mg levonorgestrel) . They are small plastic T-shaped devices with a hormone called levonorgestrel in their stem. K is slightly smaller than M and contains a slightly lower amount of hormone. It's placed inside the uterus to prevent a woman from becoming pregnant. A fine nylon thread is attached to the IUD - the thread comes out through the cervix into the top end of the vagina. Both types of hormonal IUD lasts for 5 years.

The IUD is placed inside the uterus by a trained doctor. The hormonal IUD:

  • stops sperm from fertilising the egg
  • makes the mucus in the cervix thicker so that sperm can't get into the uterus
  • changes the wall of the uterus, making it hard for an egg to attach to the wall

Hormonal IUDs are perfect for women who want a reliable, long-term contraceptive.

Both types can be used by women who have heavy periods but M IUD is proven to be very effective at reducing bleeding during your period. Both types usually makes bleeding much lighter and sometimes periods stop all together (this is more likely with M IUD than K IUD).

Fertility goes back to normal once the IUD is taken out and is suitable for both women who have had children and women who have not had children.

Only a specially trained doctor can put in an IUD.

You will typically need three visits.

The first visit will be your assessment in which you will be assessed in terms of your suitability for an IUD. All risks and side effects will be discussed and consent form signed. A script will be provided and appointment for insertion arranged. This appointment is between 20-30 minutes.

The second visit will be for your insertion. The insertion takes about 10 mins but you will be in the clinic for 20-30 minutes. We can also do your cervical screening test (previously known as pap smear) if this is due.

The third visit will be a 6 week followup to check the IUD strings and see how you are doing. This is typically a 10 minute appointment.

The hormonal IUD can stay in for 5 years but it can be taken out sooner. Your usual doctor can take it out. The doctor will remove the IUD by gently pulling on the string. This only takes a couple of minutes. Some people find it a little uncomfortable. If you want another hormonal IUD, the old one can be taken out and a new one put in at the same visit.

Both types of hormonal IUD are very effective. The M IUD is 99.9% effective; the K IUD is 99.7% effective.

Contraceptive Implant

The contraceptive implant is a small, flexible rod about the size of a match stick. The implant is put under the skin of the upper arm. It can stay there for up to 3 years. The implant slowly releases a progestogen hormone into the blood stream. This can prevent pregnancy for up to 3 years.

The implant prevents a woman's eggs from being released from her ovaries (ovulation) and it thickens the mucus in the cervix (the neck of the uterus) so that the sperm cannot enter the uterus.

Most women can use the contraceptive implant. It can be used by women who cannot use contraception that has the hormone oestrogen in it. Talk to one of our doctors at The Bubble if you are interested in the contraceptive implant.

The contraceptive implant is very effective at preventing pregnancy. It is 99.95% effective.

Contraceptive injection

The contraceptive injection is a hormone injection that prevents pregnancy. The injection works for 12 weeks. The injection contains depot medroxyprogesterone acetate (DMPA). DMPA is a hormone similar to progesterone.

DMPA is slowly released into the body - the DMPA stops your ovaries from releasing an egg. It also makes the mucus in the cervix thicker so that sperm can't get into the uterus. Each injection protects you from pregnancy for 12 weeks.

Most women can use the contraceptive injection.

The contraceptive injection is very effective at preventing pregnancy. It is 99.8% effective if you have an injection at the correct time every 12 weeks but in real life or in "typical" use it can be lower (96%).

Vaginal Ring

The vaginal ring is a soft plastic ring which contains two types of hormones - an oestrogen and a progestogen. These hormones are similar to the ones made in your ovaries and are like the hormones that are in the contraceptive pill.

You put the vaginal ring into your vagina. The vaginal ring releases hormones. The hormones are absorbed through the walls of the vagina. It mainly works by stopping your ovaries from releasing an egg (ovulation) and it also makes the mucous in the cervix thicker so that sperm can't get into the uterus.

The vaginal ring stays in your vagina for 3 weeks. After 3 weeks you take the ring out. You leave it out for 1 week. During this week you will have a withdrawal bleed like a period. You put a new ring in at the end of the ring-free week.

Most women cannot feel the vaginal ring once it is in place.

Most women can use the vaginal ring. The vaginal ring can be a good choice for women who find it hard to remember to take a pill every day. There are some medical reasons which mean that using a vaginal ring is not recommended. Talk to one of our GP's about whether the vaginal ring is recommended for you.

If it's used correctly, the vaginal ring is 99.5% effective, however in real life it can be less effective (93%) if you forget to take it out or put it back on time. Some medications might stop it working properly, like some epileptic medications or herbal preparations. Talk to your doctor before you start any new medications as you might need to change to a different contraceptive method.