Written by Rhiann McNally
Illustrations by Haley Kigbo
Contraceptives are supposed to make our lives easier. And of course, that is true in the grand scheme of things. But finding the right contraceptive is still a frustrating process, inequitably shouldered by people with uteri.
To get the low down on birth control, we spoke to Kathleen McNamee, Medical Director at Family Planning Victoria.
They provide “broad based reproductive sexual and health services,” from contraception, to dealing with STIs and common gynaecology problems, and medication abortions.
In this article we look at the different kinds of contraception on offer, where to get it, and how it can help you. We also take a look at the advances in male contraception.
the various kinds of contraception
McNamee says the most popular kind of contraception in Australia is the Pill and condoms. She adds that in other countries the IUD has taken the top spot. McNamee explains that the implant is the most effective method of reversible contraception, while the IUD comes in second.
Whether you want to fit and forget, plan your cycle or avoid hormones, there are a lot of contraceptives to choose from.
The combined pill contains synthetic hormones (oestrogen and progestogen). The mini pill contains only progestogen. These hormones prevent eggs from being released and thickens mucus in the cervix so sperm can't get in. The combined pill is on average 92% effective and the mini pill is 91% effective.
The Implanon™ is a four-centimetre long implant that is inserted under the skin on your arm. It is a Long Acting Reversible Contraception. It contains the hormone etonogestrel and lasts 3 years. It is 99.9% effective.
There are two kinds of IUDs, hormonal and copper. The hormonal one contains progestogen, so it has a similar effect as the Pill. IUDs stop sperm from reaching the ovum and make it hard for fertilised eggs to stick to the uterus lining. They last between 5 and 8 years and are more than 99% effective. The copper IUD can act as emergency contraception if it is inserted within the 5 days after unprotected sex.
The contraceptive injection, or Depo shot, contains the synthetic hormone progesterone that prevents eggs from being released. It wears off over a period of 12 weeks. The Depo shot is on average 94% effective.
Like the Pill, the vaginal ring, also known as the NuvaRing™, contains synthetic hormones oestrogen and progestogen. So it prevents pregnancy in a similar way to the Pill. This soft, flexible ring is inserted into the vagina. One ring lasts you an entire menstrual cycle. Much like the Pill, when used correctly it is above 99% effective.
The Morning After Pill
Emergency Contraception is often confused with the abortion pill. The Morning-After Pill does not cause an abortion. Instead, it prevents the release of an egg by giving you a big dose of the same hormones that are in the Pill. The emergency contraceptive pill prevents around 85% of pregnancies if taken within three days of having sex.
Natural Family Planning
Natural Family Planning is the practice of observing physical changes in a menstrual cycle and avoiding sex during times when most fertile. When done correctly it can be 99% effective, but miscalculations can mean it only works 75% of the time.
why use contraception?
Preventing pregnancy is the main reason people use contraception. Being able to choose when to start a family has had a myriad of benefits for women.
Contraceptives can not only prevent unexpected bundles of joy and poop but can also make women’s lives more comfortable.
Common issues like heavy flows, acne and painful periods, can sometimes be solved using hormonal contraception.
Period Pain or Heavy Flow?
Try using; IUD, injection, ring, implant or the pill.
Try using; ring, the pill or sometimes implant.
Want to alter your menstrual cycle?
Try using; ring or the pill.
Finding the right contraceptive is all about trial and error because women’s bodies react differently to different hormonal contraceptives.
McNamee says “There are 16 different pill formulations available in Australia. The difference between women is greater than the differences between pills.”
She explains that sometimes “a medical condition, risk factor or medication might cause different issues with methods.”
So, where can we get contraception?
Hormonal contraception, like the Pill and the implant, is available by prescription from the pharmacy.
You can visit a specialist for the IUD, or family planning organisations in each state can make it easy and affordable.
The hormonal IUD can cost under $30. Because it lasts so long, it is the most affordable contraceptive available.
McNamee says “The diaphragm can be bought online or from a chemist, but it’s recommended the fit is checked by a doctor or nurse.” You can find condoms everywhere.
how to get emergency contraception in a pinch
You can get the Morning-After Pill from the chemist without a prescription. It can be a little intimidating asking a pharmacist for it, but hold your head high, because a lot of women use it.
McNamee says, “The copper IUD is the most effective method [and] is inserted by a doctor.” Contact Family Planning Victoria for more information.
what about male contraception?
It is unsurprising that there is a dearth of contraceptive products for men. Contraception has, for the longest time, been seen as a women's issue.
Most commonly men use condoms, however, there has been an incline in men relying on the withdrawal method. This is a little risky, for one thing, it does nothing to protect your ding-dong from disease. The pull-out method when used by a seasoned professional works 96% of the time.
But for others less practiced, it results in 27 pregnancies out of a hundred a year. So, it's best not to rely too heavily on this method.
So, what about fancy space-age methods yet to be available in Australia? Vasalgel is the US brand name of a method currently being developed.
It’s a reversible, non-hormonal injection of polymer into the vas deferens. It has been found to be very effective (thus far) and is cheaper than the syringe it came in.
McNamee says there have been lots of studies supporting the efficacy of male hormonal contraception, but so far none are marketed here.
She says that contraception is an issue both partners should think about as it is something you do together.
“Studies show a number of men would like to be able to control their fertility with an effective reversible method,” she says.
Safe sex isn’t all about preventing unwanted pregnancies, so be sure you’re protecting your bits in risky and frisky situations.
The only 100% effective method to prevent pregnancy is abstinence. Or homosexual sex. Choose your contraception method wisely.
If you have any further questions about contraception, visit FPV.org.au or talk to your GP.