The Ins & Outs of Contraception

Why use contraception?

A girl can get pregnant anytime, including the first time she has sex, so if you don’t want to get pregnant, it’s important to use contraception every time.

Fact:

A girl can get pregnant even when she has just finished or has her period
Sperm can stay alive in a girl’s body for up to 5 days after sex
‘Pulling out’ is not a safe form of contraception
Condoms are the only form of contraception that also reduce the risk of getting or passing on a sexually transmissible infection (STI)

There are many different types of contraception, some of which you might have heard of and others which may be new to you. The information in this brochure will help you decide the best method of contraception for you.

Common methods of contraception

Condoms

Male condoms

Condoms Condoms are made of rubber or polyurethane and fit closely over an erect penis. They collect semen and stop it from entering the vagina. Condoms are up to 98% effective at preventing pregnancy if used correctly - this means using a new condom every time you have sex (or when switching between vaginal and anal sex), putting it on and taking it off correctly and using water-based lubricants with condoms eg Wet Stuff. Oil-based lubricants, such as baby oil, massage oil, Vaseline and sunscreen increase the risk of condom breakage. Condoms need to be kept in a dry cool place. If exposed to heat they are less effective, so don’t keep them in your car or wallet. Always check the expiry date before use.

Advantages

Condoms reduce the risk of getting or passing on STIs
They are widely and cheaply available from supermarkets, pharmacies, service stations, sexual health clinics and FPWA
Condoms have no health risks (polyurethane condoms are available for people who are allergic to the latex in rubber condoms)

Disadvantages

They must be put on before any penis/vagina contact occurs for them to be effective, as sperm can leak from the penis before ejaculation
Sensitivity can be slightly reduced
Some people are allergic to lubricant

Female condoms

A female condom fits inside the vagina to stop semen from getting into the vagina. When used correctly, they are up to 95% effective at preventing pregnancy. Female condoms are available from sexual health clinics, FPWA and some pharmacies.

Advantages

Female condoms reduce the risk of getting or passing on STIs
They can be bought without a prescription
They can be inserted well before sex if preferred

Disadvantages

They are more expensive than male condoms and are not as widely available

Some things you should know about safe sex

STIs can be passed on through vaginal, oral or anal sex. Most STIs are transmitted through an exchange of body fluids, but some can be passed on through skin to skin genital contact.
Condoms and dams stop body fluids like semen, blood and vaginal fluids from being exchanged (a dam is a thin latex square held over the vaginal or anal area during oral sex). As some STIs can be passed on through skin to skin contact, it’s important to remember that condoms and dams only protect the area of skin they cover.
STIs can cause a wide range of health problems, from mild irritation to serious illness. Some STIs are easily cured with antibiotics if detected early, but can have long-term consequences if left untreated. While other STIs can’t be cured, treatments are available to ease symptoms.
Remember that some STIs have no symptoms, so it’s possible to have one and not know it. If you’ve had unprotected sex in the past, get tested by a doctor or at FPWA or another sexual health clinic.

The oral contraceptive pill

The combined pill (usually called ‘the Pill’)

The combined pill contains the hormones oestrogen and progestogen. It prevents the release of an egg from the ovaries each month. If taken every day the Pill is over 99% effective at preventing pregnancy. Taking medications such as antibiotics or anti-epileptic drugs, or taking herbal medicines such as St John’s Wort can stop the Pill from working (always check with your doctor or pharmacist). Vomiting or having diarrhoea can also make the Pill less effective.

Advantages

The Pill is very effective
It can make periods lighter and more regular, and allows a girl to choose when to have her period, or not to have it at all
It can improve acne and premenstrual symptoms
The Pill helps reduce period pain
It can be very inexpensive, depending on the type of pill

Disadvantages

The Pill can cause a change in appetite/moods
Some girls experience sore breasts, nausea and fluid retention when taking the Pill
The Pill can be affected by some medications
It can cause spotting or bleeding between periods

If any of these side effects bother you, speak to a doctor - a change of pill may be all that is required. Serious health risks with the Pill are rare, but smoking increases the risk of harmful effects. You shouldn’t take the Pill if you suffer from certain types of migraines or if you have ever had a deep vein thrombosis, a stroke or a heart attack. The Pill doesn’t cause breast cancer, nor does it cause infertility.

The progestogen only pill (POP) (sometimes called the ‘mini pill’)

The progestogen only pill contains one hormone - progestogen. If taken at the same time each day it is 96-99% effective at preventing pregnancy – if it is taken more than 3 hours late the risk of pregnancy increases. The POP prevents pregnancy by changing the mucus in the cervix (the entrance of the womb) so that sperm cannot pass through it to fertilise the egg. As with the combined pill, vomiting or having diarrhoea can stop the POP from working.

Advantages

Girls who can’t take oestrogen or who suffer from migraines can use the POP
It has no serious side effects and is not affected by most commonly used antibiotics

Disadvantages

The POP needs to be taken at the same time each day to be effective
It can change menstrual patterns

Emergency contraception (sometimes known as the ‘morning after pill’ or ‘after sex pill’)

Emergency contraception can be used to prevent pregnancy when sex has occurred without contraception or when contraception may have failed (eg condom breakage). It is most effective at preventing pregnancy when taken within 24 hours of having sex (the sooner it is taken the more effective it is). There is some effectiveness for up to 120 hours (5 days) after intercourse, however effectiveness decreases as time passes and is significantly reduced 72 hours (3 days) after sex. EC is available over the counter at some pharmacies, so you don’t need to see a doctor to get a prescription.

Injectables and implants

Implanon Injectables and implants are both progestogen-only forms of contraception, meaning they contain only one hormone – progestogen. They are given directly into a girl’s body by injection or a plastic rod inserted under the skin by a doctor, and work like the Pill to stop the release of an egg each month. Implants last for up to three years, while injections (Depo) last for 12 weeks. Injectables and implants are suitable for girls who can’t tolerate or shouldn’t take oestrogen for medical reasons, such as if they suffer from certain types of migraines or are at risk of blood clots.

Advantages

They are even more effective than the Pill and are not affected by medication or vomiting/diarrhoea
You don’t have to remember to take a pill every day
They can make periods lighter, or make them stop altogether
The implant can be removed at any time

Disadvantages

Possible small weight gain
Some girls get irregular bleeding, headaches and acne
Once an injection has been given it cannot be removed – it has to wear off

Vaginal rings

Nuva Ring Vaginal rings are made of soft plastic and contain the hormones oestrogen and progestogen. They are inserted inside the vagina for three weeks out of four and work in a similar way to the combined pill by preventing ovulation. When used correctly, vaginal rings are around 99% effective at preventing pregnancy.

Advantages

They contain a lower dose of hormones than the Pill and side effects such as nausea, sore breasts and spot bleeding may be less likely
They are very effective and are not affected by vomiting/diarrhoea
You don’t have to remember to take a pill every day

Disadvantages

It is unclear whether the vaginal ring’s effectiveness is lowered when taking commonly-prescribed antibiotics (as is the case with the Pill). As a precaution, it is recommended that another form of contraception (eg condoms) be used when taking antibiotics, and until you have had the ring inserted for seven days in a row after finishing the medication
They are more expensive than many other methods of contraception

Other methods of contraception

Diaphragms and caps

Diaphragms and caps are soft latex domes that sit inside the vagina and prevent sperm from entering the uterus (womb). They are inserted into the vagina every time a couple has sex and need to be left in place for 6 hours after intercourse. Diaphragms and caps come in a range of sizes and need to be fitted by a doctor or nurse.

Spermicides can be used with diaphragms and caps. These are creams, gels or foams which are placed in the vagina before sex. When used by themselves spermicides do not prevent pregnancy.

Advantages

Diaphragms and caps don’t interfere with hormone levels
They can be inserted at a convenient time prior to sex
They can be used to hold back bleeding during sex when a girl has her period

Disadvantages

Some girls find diaphragms and caps difficult to put in and take out
The risk of pregnancy is higher than for some other methods of contraception
Some people are allergic to the latex in the rubber of diaphragms and caps

Intrauterine devices and systems

IUD An intrauterine device (IUD) is a small plastic and copper device which is inserted into the uterus (womb) by a doctor to prevent sperm from reaching the egg. Intrauterine systems (IUSs) work in a similar way, but also contain a hormone which helps reduce heavy bleeding. They are both more than 99% effective for 5-8 years. IUDs are generally used by women who have already had children.

Advantages

IUDs and IUSs are very effective and safe forms of long-term contraception
They are fairly cheap considering how long they last
You don’t have to do anything about contraception at the time you have sex
IUSs can make periods lighter

Disadvantages

Periods may be longer and heavier with a copper IUD
IUDs and IUSs may increase the risk of pelvic infection which in rare cases can lead to infertility

Sterilisation

Sterilisation is a permanent method of contraception. Female sterilisation involves blocking the tubes which bring the sperm and egg together. Male sterilisation (vasectomy) cuts the tubes which carry the sperm to the penis.

Some contraception myths

If you’ve heard of a way of preventing pregnancy that isn’t in this brochure, chances are it doesn’t work. You can ring the Sexual Health Helpline on 9227 6178 (1800 198 205 country callers) if you want to check out a method.

There are many myths about what is a ‘safe time’ to have sex. The reality is that there is no time in a girl’s menstrual cycle when it is completely ‘safe’ to have sex, and a girl can get pregnant at any time. If a guy withdraws (‘pulls out’) his penis before ejaculating, it is still possible for the girl to get pregnant as sperm can ‘leak’ from the penis before ejaculation.

I think I might be pregnant!

If a girl’s period is late or much lighter than usual then she may be pregnant. Other signs of pregnancy are sore breasts, breasts getting larger, nipples getting darker, weight gain, nausea (feeling like vomiting), unusual tiredness and peeing more often. A girl should have a test if she thinks she might be pregnant and if her period is more than one week late. Urine pregnancy tests are quick and generally accurate. Home tests are available from pharmacies and supermarkets, but results should be confirmed by a health professional.

If you think you might be pregnant and you would like more information you can phone the Sexual Health Helpline on 9227 6178 (1800 198 205 country callers) for a confidential chat.

Page last updated Tue, 03 Jul 2007 15:38