Contraceptive Choices
Dr Sarah McDonnell
Contraception: what suited you at one stage of life, or what suits your friends, won’t necessarily be the best option for you right now. Our bodies like to change things up and keep us on our toes as we transition from puberty, to childbearing (or choosing not to have kids) and then into perimenopause and beyond. Available contraceptive options also differ from country to country.
It can be tricky to balance convenience, reliability and easy reversibility with your preferences, priorities and medical concerns. Sometimes avoiding pregnancy is very important – and sometimes less so. It’s worth remembering that women can conceive right up to the menopause, which may be as late as 55 for some women!
Whether you are just starting to use contraception or are looking for something to space pregnancies or provide a long term reliable solution, there are several options to consider:
- Barrier methods such as condoms, which are about 90% effective overall.
- Combined hormonal contraceptives (contain both estrogen and progesterone, mostly as pills but also as a vaginal ring changed weekly). With perfect use, these are about 99% effective, and can provide control of problematic periods, but are not suitable for women with certain medical conditions. Women can react very differently to different pills due to the variation in dose and ingredients.
- Progesterone only pills – previously called the “mini pill” as these contain progesterone only. Until recently only one version (Microlut) was available in Australia, which was 97% effective and has to be taken at the same time every day within a small time window (3 hours). A new version has recently become available (Slinda), which is more expensive but also more reliable.
- Long acting reversible contraception including the contraceptive implant (which lasts up to 3 years)
- Intrauterine devices including Mirena, Kyleena and copper devices (most last up to 5 years).
- Contraceptive injections.
- Surgical methods such as removal of the tubes connecting the womb and ovaries for women, or vasectomy for men.
It’s crucial to source reliable advice and information, which can be tailored to your unique situation. There are pros and cons to each method of contraception. In particular, conditions such as migraine, endometriosis and polycystic ovarian syndrome will impact on which options are best for you.
Most of the GPs at providing medical services at Neighbourhood Medical can discuss these options with you. Dr Sarah Mc Donnell and Dr Louisa Gilles are trained in insertion of intrauterine devices such as the Mirena (keep an eye out for more information to come regarding these services).
Medicare rebates are available for both face to face and video consultations regarding sexual and reproductive health for new patients.
Useful information on the various contraceptive options available in Australia can be found here.
