Contraception - choices | Better Health Channel

Summary

Several methods of contraception are available. The method you choose will depend on your general health, lifestyle and relationships. Contraceptives available include physical barriers and devices, hormonal (oral, implant and injectable) methods, sterilisation, emergency and ‘natural’ methods.

Download the PDF version of this fact sheet

There are several methods of contraception available in Australia, including barrier methods (male and female condoms and diaphragms), hormonal methods (pills, vaginal rings, implants and injections), intrauterine devices (IUDs or coils), female and male sterilisation, emergency contraception and ‘natural’ methods.

Choose the method that suits you

Choosing the method of contraception that is right for you requires accurate information and the ability to communicate openly with your partner. Issues such as effectiveness, safety and adverse effects need to be weighed against convenience, cost and issues of trust and control.

The method you choose will depend on a range of factors, such as your general health, lifestyle and relationships, your risk of contracting a sexually transmissible infection (STI) and how important it is that you don’t become pregnant.

Some methods require more motivation than others. You need to think about what best suits you. For example, you need to remember to take the pill every day whereas an implant can last up to three years.

You need to consider the pros and cons and think about how these methods meet your current and future needs. You can discuss your options with your doctor, reproductive health nurse or trained staff at Family Planning Victoria.

Protect against STIs

It is important to practice safe sex as well as to protect yourself against pregnancy. Not all methods of contraception provide protection against STIs. The best way to reduce your risk of STIs is to use barrier protection such as male and female condoms and dams (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 infections.

Physical barrier methods

Barrier methods of contraception stop sperm from getting into the womb (uterus). Options include:

Male condom
Female condom
Diaphragm.

Male and female condoms also decrease the risk of STIs. Barrier methods can be very effective if used correctly. However, they can have high failure rates if they are not used consistently and correctly.

Male condom

This is a latex (or polyurethane) sheath that covers the erect penis and prevents semen entering the vagina. This is an effective (98 per cent) form of contraception when used correctly. This means using a condom every time you have sex and putting it on before there is any contact between the penis and vagina. Male condoms are relatively cheap and are available over the counter from supermarkets, pharmacies and sexual health clinics.

Female condom

This is a loose polyurethane sheath with a flexible ring at each end that sits in the vagina and collects semen. It can be inserted several hours before intercourse and is stronger than the male latex condom, though insertion and use may take some practice. If you use a female condom correctly every time you have sex, they are 95 per cent effective. Female condoms are available from Family Planning Victoria (via mail order) and some retail outlets and sexual health clinics.

Diaphragm

This is a soft, shallow rubber dome that fits in the vagina, covers the cervix and stops sperm from entering the uterus. The diaphragm must stay in place for at least six hours after intercourse and is 94 per cent effective if used, fitted and positioned correctly. Diaphragms must be fitted by a suitably trained doctor or nurse. They may decrease the risk of STIs, but should not be relied on for this purpose.

Intrauterine devices (IUD)

An IUD, sometimes known as a coil, is a small plastic device with added copper or hormones (Mirena) which is inserted into your uterus by a doctor. It can stay in the uterus for five to ten years (depending on the type used) and can easily be removed earlier if you want to become pregnant or are having problems.

Both types of IUD are more than 99 per cent effective. They work by changing the lining and environment of the uterus, effectively killing off sperm. If any sperm survive and fertilise an egg, the egg is unable to stick to the wall of the uterus, preventing a pregnancy from continuing.

The hormonal (Mirena) IUD also slowly and continuously releases a small amount of progestogen, which can thicken the mucus made by the cervix to further block sperm. This may also cause minor effects on the hormones controlling your menstrual cycle. The hormonal IUD (Mirena) is occasionally removed because of hormonal symptoms such as headache, breast tenderness, acne and increased appetite. It does, however, generally result in very light periods. The copper IUD tends to make periods heavier, but doesn’t cause hormonal side effects.

Hormonal contraceptives – pills and vaginal rings

Hormonal contraception for women is available by prescription in the form of a pill (oral contraceptive) or a vaginal ring. These methods are highly effective (99.7 per cent) if used correctly but, allowing for missed pills or days of ring use, may only be 92 per cent effective. Hormonal contraception may produce side effects and doesn’t protect against STIs.

Combined pill

This is made up of synthetic forms of the hormones oestrogen and progesterone. The combined pill prevents ovulation, thickens cervical mucus to make it harder for sperm to enter the uterus and changes the lining of the uterus to make it less suitable for a fertilised egg to stick.

There are many types of combined pills with different dose and hormone combinations. This form of contraception is generally not recommended for women who are at risk of heart disease, such as smokers aged over 35 years.

Vaginal ring

This contains similar hormones to the combined pill and works in the same way. A ‘one size fits all’ ring is inserted into the vagina and stays in place for three weeks. During that time, it slowly releases hormones that pass from the vagina into the bloodstream. It’s then removed and a new ring is inserted a week later. The vaginal ring is low dose and saves remembering to take a pill every day. It’s also as easy to insert as a tampon and, like the combined pill, is 99.7 per cent effective if used correctly.

Mini pill

This contains only a synthetic form of the hormone progesterone. It makes the cervical mucus thicker, which prevents sperm from entering the uterus. The mini pill must be taken every day at the same time and is not as effective as the combined pill. It’s usually suitable for women who either experience side effects from oestrogen or shouldn’t take it for health reasons.

Hormonal contraceptives – implants and injections

Hormonal contraceptives for women are also available as implants and injections. These methods are more effective than other hormonal methods, but may produce side effects and don’t protect against STIs. Male injectable contraceptives are currently being trialled.

Implanon

This is a hormone implant that is inserted under the skin at the inner side of the upper arm. It contains etonogestrel, a progesterone-like hormone that prevents ovulation and hinders sperm from entering the cervix by changing cervical mucus. Implanon lasts for three years, is close to 100 per cent effective and is suitable for most women who can’t tolerate synthetic oestrogens. The device is inserted by a doctor under local anaesthetic.

DPMA injections (Depo-Provera/Depo-Ralovera)

These are long-acting (12 to 14 weeks) injectable contraceptives containing the hormone progestogen. They prevent ovulation, block sperm by thickening the mucus made by the cervix and cause changes in the lining of the uterus to make it unsuitable for a fertilised egg to stick. DPMA injections are highly effective and provide a very private method of contraception.

Sterilisation

Sterilisation is a permanent surgical procedure that requires referral to a specialist. Female and male sterilisation are highly effective methods of contraception, but don’t protect against STIs.

Female sterilisation

This procedure blocks the fallopian tubes, preventing an egg from passing down the tube and being fertilised. The two common surgical methods used are:

Tubal ligation (having your tubes tied) – performed under general anaesthetic
Essure (having small coils inserted) – performed under local anaesthetic.

Vasectomy (male sterilisation)

This involves blocking sperm by cutting the tubes they pass through from the testes to the penis.

Emergency contraception

Sometimes it is necessary to prevent pregnancy after sex, rather than before: for example, when a pill is forgotten or a condom breaks, or in the case of rape. Emergency contraception, also known as the ‘morning after pill’, is a hormonal method of contraception that prevents or delays ovulation in that cycle. It may also stop a fertilised egg from sticking to the wall of the uterus. It prevents 85 per cent of pregnancies that would have otherwise occurred.

There are different types of emergency contraception available. The most commonly used form, a single pill containing the hormone progestogen, can be prescribed by a doctor or purchased over the counter at most pharmacies. Emergency contraception is best used within 72 hours of unprotected sex – the sooner within the 72 hours it is taken, the more effective it is. It can be taken up to 120 hours after unprotected sex, but will be less effective.

Natural methods

Natural family planning is based on an understanding of the menstrual cycle. Methods include monitoring cervical mucus changes, body temperature changes and rhythm or cycle calculations to help determine when a woman is most likely to be fertile each month.

The effectiveness of natural family planning varies in relation to whether one or a combination of methods is used. Confidence, correct use and effectiveness improve the longer the method is used. Natural family planning methods, however, do not protect against STIs.

Where to get help

Your doctor
Family Planning Victoria Tel. 1800 013 952 or (03) 9257 0100 or the Action Centre (for young people under 25) Tel. 1800 013 952 or (03) 9660 4700
Melbourne Sexual Health Centre Tel. (03) 9347 0244 or 1800 032 017 or TTY (for the hearing impaired) (03) 9347 8619
Women’s Health Information Centre (WHIC) Tel. (03) 8345 3045
Community health centre
Reproductive specialist
Pharmacist

Things to remember

Discuss your options with your doctor, reproductive health nurse or reproductive health service.
Different methods may suit you at different times in your life.
Methods of contraception available include physical barriers and devices, hormonal methods, sterilisation, emergency and ‘natural’ methods.
Condoms provide the best available protection against sexually transmissible infections (STIs).

Want to know more?

Go to More information for support groups, related links and references.

This page has been produced in consultation with and approved by:

(Logo links to further information)

Family Planning Victoria

Fact sheet currently being reviewed.
Last reviewed: July 2011

Content on this website is provided for education and information purposes only. Information about a therapy, service, product or treatment does not imply endorsement and is not intended to replace advice from your doctor or other registered health professional. Content has been prepared for Victorian residents and wider Australian audiences, and was accurate at the time of publication. Readers should note that, over time, currency and completeness of the information may change. All users are urged to always seek advice from a registered health care professional for diagnosis and answers to their medical questions.

If you would like to link to this fact sheet on your website, simply copy the code below and add it to your page:

<a href="http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Contraception_choices_explained?open">Contraception - choices - Better Health Channel</a><br/>
Several methods of contraception are available. The method you choose will depend on your general health, lifestyle and relationships. Contraceptives available include physical barriers and devices, hormonal (oral, implant and injectable) methods, sterilisation, emergency and ‘natural’ methods.

Content on this website is provided for education and information purposes only. Information about a therapy, service, product or treatment does not imply endorsement and is not intended to replace advice from your qualified health professional. Content has been prepared for Victorian residence and wider Australian audiences, and was accurate at the time of publication. Readers should note that over time currency and completeness of the information may change. All users are urged to always seek advice from a qualified health care professional for diagnosis and answers to their medical questions.

For the latest updates and more information, visit www.betterhealth.vic.gov.au

Copyight © 1999/2013 State of Victoria. Reproduced from the Better Health Channel (www.betterhealth.vic.gov.au) at no cost with permission of the Victorian Minister for Health. Unauthorised reproduction and other uses comprised in the copyright are prohibited without permission.

Contraception - choices