Contraception 101

Words by Georgia Cameron 
Art by Rinjia Pradhan

Since 1550BC, people have been trying to enjoy sex while limiting the possibility of having a child. Back in Ancient Egypt, they used honey, acacia leaves and lint placed in the vagina to block sperm. But we know that pregnancy isn’t the only concern – sexually transmitted infections (STIs) are also a major risk to people engaging in sex. We wanted you to know what options are available to you and those you’re having sexy times with.  

Hormonal methods

THE PILL

A pill taken at the same time each day containing progestogen or estrogen and progesterone. These hormones prevent the egg being released from the ovaries. This is currently only an option for those who have a vagina and a prescription from a doctor. A male version of this is still at least five years away from being available to the public.  

Effectiveness: 92-99%

Pros: Can regulate menstrual cycle, reduce PMS and period pain.

Cons: Not suitable for some medical conditions. If they are taken 3-24 hours late, they are ineffective. They do not provide protection from STIs.

CONTRACEPTIVE IMPLANT

A small rod containing the hormone progestogen which is inserted under the skin in the upper arm. It prevents ovulation and thickens the cervical mucus so that sperm cannot enter the uterus. The implant lasts for three years.

Effectiveness: 99.9%

Pros: Cost effective over time

Cons: Not effective against STIs and if it’s cracked while it’s in place, it can become less effective. Not all doctors and nurses are trained to do insertions.

CONTRACEPTION INJECTION

The contraceptive injection (also called Depo) is a three-monthly injection of the hormone progesterone. Similar to the implant, it prevents ovulation and makes it difficult for sperm to enter the uterus.

Effectiveness: 99.9%

Pros: Lasts 3 months, no medication stops it from working.

Cons: Bleeding can be unpredictable to start with, return to fertility may be delayed once usage stops and has been linked with weight gain and lowered bone density. Does not protect against STIs.


Intrauterine methods

HORMONAL IUD

Known as Mirena in Australia, it is a small T-shaped plastic device inserted into the uterus, with a nylon string attached to it which comes out through the cervix. Requires a prescription and a doctor to insert. Lasts five years and works like other progesterone-based options.  

Effectiveness: 99%

Pros: One of the longest lasting options, good for those who aren’t good with needles or remembering to take pills. Is relatively cost effective and covered by the PBS.

Cons: Not effective against STIs.

COPPER IUD

Similar to the Mirena but does not contain any hormones. Instead the copper wire stops  the sperm from fertilising the egg. The copper also makes the lining of the uterus unsuitable for a pregnancy.

Effectiveness: 99.9%

Pros: Reliable, long-term and an option for those who cannot use hormonal methods

Cons: Irregular bleeding for up to 6 months after insertion, not listed on the PBS so it may be expensive to insert.


Barrier methods

“MALE” CONDOM

A latex or polyurethane sheath that slips over the penis and prevents sperm entering the vagina during sex. It is the most widely used contraceptive in Australia and is sold  almost everywhere from supermarkets to health clinics.

Effectiveness: 85-98%

Pros: It protects against STIs, is cheap and is often given out freely at health clinics, and can come in fun colours or flavours/scents.

Cons: They can be easily damaged or tampered with.  

FEMININE CONDOM

Much like the male condom, the feminine condom is made of latex or polyurethane. It has a soft flexible ring at each end, with one closed end and one open. The closed end is inserted into the vagina.

Effectiveness: 80-95%

Pros: Protects against STIs and doesn’t need a medical professional to insert it. Only needs to be used during sex.

Cons: Not as readily available as the male condom and can be tricky to know if you’ve inserted it correctly.

DIAPHRAGM

A silicone cup which is inserted into the vagina prior to sex and covers the cervix which prevents sperm from going beyond that point. Diaphragms are available from family planning clinics, where medical workers can show you how to insert it and ensure it is fitted correctly. To be its most effective, it’s advised one adds spermicide for extra caution.

Effectiveness: 85-95%

Pros: It can be inserted well before sex, so it doesn’t have the disruptive impact some people report with condoms, such as ‘ruining the moment’.

Cons: No protection against STIs, must remain inserted for 6 hours in conjunction with spermicide to maximise effectiveness.


Permanent Options

STERILISATION

Sterilisation is the act of permanently clipping, blocking, or tying the fallopian tubes surgically so the eggs and sperm cannot meet. While there is the possibility of reversal, it doesn’t always work.

Effectiveness: Over 99%

Pros: It is a one-time procedure.

Cons: Small surgical risks, doesn’t protect from STIs, can be expensive and sterilisation reversal involves risks and doesn’t always work.  

VASECTOMY

This minor surgical procedure cuts the tubes that carry the sperm from the testicles to the penis. Much like the sterilisation of the vagina, this carries the same risks and is permanent.

Effectiveness: Over 99%

Pros: It is a one-time procedure.

Cons: Small surgical risks, doesn’t protect from STIs and takes three months to work so other options must be put in place until sperm runs clear.

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