Family Planning Services by Dr Caroline Hoggenmueller
When thinking about birth control and contraception, it’s important to always select the method that’s right for you and your body.
Choosing the right birth control can be a stressful and confusing mission for many of us. There are dozens of options out there, and it can be overwhelming to know which one is safe, reliable and affordable.
But it doesn’t have to be that way. The key is to educate yourself as much as possible about what options are available and to seek professional guidance when necessary to ensure you’re on the right path.
Below, we’ll outline some information about contraception that we hope can help you determine the different kinds of family planning methods out there
What is Contraception?
Contraception, also known as family planning or birth control, refers to the use of various techniques to prevent becoming pregnant. It, therefore, involves a direct interference with the human body’s natural process of reproduction. There is a whole range of different contraceptive options available in today’s market, some of which we’ll outline on this page.
What birth control options are there?
Each method of contraception is different and has varying levels of interference with the body’s natural process of conception, ovulation and implantation.
Intrauterine devices (IUDs) contraception.
Intrauterine devices are small devices that you can insert into your uterus (i.e., your womb) in order to prevent pregnancy. The two main types of IUDs are the copper IUD and hormonal IUD (the latter being sold as IUD Mirena or “mini Mirena” called Kyleena IUD). These devices are highly effective and can stay in the same place inside your body for up to 5 years (for the Kyleena), up to 7 years (for the Mirena) and up to 10 years (for the copper IUD).
The copper IUD is designed to release copper into your womb, while Mirena IUD continually releases progestogen (a hormone that is created by the ovaries). The Kyleena IUD releases progestogen as well, however in a much lower dosage than the Mirena IUD.
All three are very useful to prevent pregnancy, with the IUD failure rate being about 0.1%. The Mirena IUD will also help if you have heavy periods as it makes periods much lighter and more manageable. You can remove each of these devices at an earlier time if required. They don’t need to stay in your body for the full 5 or 10 years.
Birth control pills.
Oral contraception, commonly known as birth control pills, the combined pill or simply ‘the pill’, is another highly effective contraceptive method. They are tablets containing both progestogen and oestrogen which you take every day, and they work by stopping ovaries from releasing an egg every month.
When taken correctly, birth control pills are 93% – 99.5% effective at preventing pregnancy. However, they might not work if you miss a pill, take it over 24 hours late, vomit within the first few hours after taking it, have diarrhoea or if you’re taking some other medication.
The mini pill is another kind of oral contraception, but it only contains progestin. It does not contain estrogen. It acts by thickening the cervical mucus in your body and thinning the womb lining and thereby stopping sperm from reaching your eggs. You will need to take most mini pills exactly at the same time every day to boost their effectiveness as much as possible. Newer generation Progesterone only pills like Slinda (Drospirenone), a recent addition in Australia, are more reliable than older generation progesterone only pills.
You may need to use the mini pill instead of the traditionally combined pill if you are breastfeeding, have experienced certain health problems (such as a history of blood clots) or are generally worried about taking estrogen.
Note that oral contraception (including both the mini pill and combined bill) does not protect against sexually transmitted diseases (STDs). For that, barrier protection is more effective which we will discuss below.
There are a range of methods that involve creating a literal physical barrier to stop sperm from entering the uterus. It’s important that these methods are used correctly during sexual intercourse.
Barrier methods of conception include using:
- Male condoms. This involves placing a thin layer of rubber or plastic around the erect penis during sex. This is not only effective to prevent pregnancy but also useful to protect against STDs.
- Female condoms. This is a thin pouch made of plastic that lines the vagina. It’s held firmly in place by a ring at the cervix (an ‘inner ring’) and at the vagina’s opening (an ‘outer ring’). Female condoms offer some protection against STDs.
- Diaphragms are small devices shaped like a dome. They are made of latex and silicone and are designed to fit inside the vagina and cover up the cervix. They are to be used with spermicide (a substance that kills sperm). There is only one type of diaphragm available in Australia, known as Caya. The diaphragm does not protect against STDs.
- Contraceptive sponges. Commonly referred to as simply the ‘sponge’, these are round devices made from a soft foam that also have spermicide on them. You insert them into the vagina, covering the cervix and thereby preventing the sperm from entering into the womb. You are to place this up to 24 hours before sexual intercourse and leave it in about 6 hours after sex.
- Cervical cap. This is a small dome made of plastic that can fit over your cervix and stay there through suction. Once again, this is to be used with spermicide.
Implantable birth control
A contraceptive implant like the Implanon, is a form of long-term and so-called ‘set and forget’ type of birth control. It is a flexible rod or bar that is placed into your upper arm and is typically no larger than a matchstick. It releases Progesterone continuously and is effective for up to 3 years, but it can also be removed at any stage before then.
However, while convenient, they are not for everybody. You should speak to your medical professional prior to selecting this option. They may warn against it if you are allergic to any of its components, have had blood clots, heart attacks, strokes, liver diseases, or have a history of breast cancer.
You should inform your doctor if you have a history of diabetes, high blood pressure, seizure, high cholesterol, gallbladder disease or depression.
Vaginal ring (NuvaRing)
The vaginal ring is a soft plastic ring that contains two hormones – oestrogen and progestogen – similar to the ones used in the contraceptive pill. The soft plastic ring is inserted into the vagina and stays there for 3 weeks. It is then removed and a new one inserted 7 days later. It prevents pregnancy when properly used with up to 99% efficacy. It is the lowest dose double hormone contraceptive. Most women cannot feel the small ring. However, it does not prevent STDs.
This is a permanent option for those couples who intend never to have children. A vasectomy for men involves blocking the vas deferens, which are the tubes the sperm travel through in order to find their way to the egg. Tubal ligation for women is where the fallopian tubes are blocked or removed, meaning eggs cannot be carried to the uterus.
Withdrawal method (‘pulling out’)
This is the act of the man withdrawing his penis from the vagina during sex just before ejaculating. This is not the most effective form of contraception given that sperm can still be in pre-ejaculation fluid (i.e., ‘pre-cum’). Withdrawal may therefore only really be 80% effective. There is also a risk that the male simply won’t ‘pull out’ in time.
This means not having sex. It is (unsurprisingly) 100% effective at preventing pregnancy and also STDs.
Your Obstetrician & Gynaecologist can help with all family planning decisions.
Making the right contraceptive decision will depend on your age, health, how many sexual partners you have, whether you intend to get pregnant in the future and how often you have sex.
It is always the best idea to speak with a medical professional such as a Gynaecologist about what birth control option is best for you. An Obstetrician & Gynaecologist is an expert in all aspects of a woman’s reproductive health and pregnancy, including all different methods of contraception.
Dr Caroline Hoggenmueller is a specialist Obstetrician & Gynaecologist in Melbourne well-versed in all types of family planning options. Armed with a passion for women’s health, she is dedicated to helping you determine which birth control option is right for you. Book now and get your appointment this week.