Contraception

Contraception options available include: 

• The combined hormonal contraceptive pill is made up of two hormones, an oestrogen and a progestogen.  These hormones are similar to the ones that are made in your ovaries.  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 to the uterus.  When you take the “sugar” non-hormonal pills you will get a withdrawal bleed like a period.

• If taken correctly the pill can be 99% effective, however in real life it can drop to 93% (ie if you forget a tablet).

• If there are no medical reasons not to take the pill women can safely use the pill up until the age of 50.

• There are some medication conditions where taking the pill is not recommended ie smoking and >35yrs, migraines with aura, high blood pressure. 

• There are also progestogen only pills available.  These are recommended for people unable to take the oestrogen contraceptive pill.  The efficacy is very similar at 99% with “perfect use” and 91% with “typical use”. 

• They can be safely taken whilst breastfeeding.

• Is a hormone injection with DMPA (depot medroxyprogesterone acetate) that prevents pregnancy.  It is administered every 12 weeks.

• It is very effective >99% with perfect use, but drops down to 96% with typical use.  It does however have side effects which include weight gain and mood issues.  With prolonged use for more than 2 years it can also lead to a decrease in bone mineral density ie osteoporosis.

Implanon is a small flexible rod that is placed under the skin of the upper arm (about the size of a match stick).  It can stay there for up to 3 years.  The implant slowly releases progestogen hormone into the blood stream.  The implant works by preventing ovulation, thickening the mucus in the cervix so that sperm cannot enter the uterus.  It can however cause side effects such as irregular bleeding symptoms.

• T shaped device that sits in the uterus. 

• The spermicidal effect of the copper provides the contraception

• It can last from 5-10 years depending on the brand. 

• It is a good choice if you want to avoid hormone based contraception and not suffering overly with heavy periods. 

• It can also be used as an emergency contraception. 

• T shaped device that sits within the uterine cavity

• Works as a barrier, but the progesterone hormone also thins the lining of the uterus and thickens the cervical mucus to prevent pregnancy

• It can stay in for up to 5 years

• Can be inserted in the rooms (with N20 gas) or under an anaesthetic as a day procedure.

• Can reduce bleeding by 93%, so very useful for women who also suffer from heavy and painful periods.  90% of women have very light periods. 

• Side effects: pain at time of insertion, irregular spotting for the first 3 months following insertion.

• Pros: no delay in fertility following removal of the mirena.

Other methods not discussed:  The nuvaring, diaphragm, fertility awareness methods