Information & Support
Contraception Options
The method you choose might be influenced by a variety of things, including your general health, your lifestyle, your childbearing intentions, your risk of contracting a sexually transmitted infection, whether you’re living with any intolerances or allergies, and others.
It’s important to talk about contraception with sexual partner/s. If you are taking sole responsibility for contraception (for example, you’re using an IUD or taking the pill) and you are in a relationship/s you might like to talk about how they can help share the financial burden.
Sometimes you might not want others to know you are using contraception or might want a method that you feel others cannot mess/interfere with. The long acting reversible contraceptives may fit best for you. Find out more about these options below.
Sometimes you might need to try different methods before you find one that works well for you, or you may find that different methods are more suitable at different stages of your life.
Long Acting Reversible Contraceptives
LARCs are also sometimes referred to as ‘set and forget’ contraceptive methods. They last for 3 weeks to 10 years once they are inserted, depending on the method chosen. However, these methods do not protect against Sexually Transmitted Infections (STIs), so a barrier method may also be needed depending on your lifestyle or partner/s.
Implanon
What it is
Implanon is the brand name for the contraceptive implant available in Australia. The implant is a small flexible rod slightly smaller than a matchstick, which is inserted under the skin – usually in the upper arm.
How it works
By slowly releasing the hormone progesterone to prevent pregnancy. Progesterone is one of the hormones used in the oral contraceptive pill.
How long it lasts
Three years once inserted.
Side effects
Some users can experience unpredictable bleeding patterns.
How effective it is
99% effective.
Is it detectable
The bandaging after insertion can make it obvious that it’s been done, and it’s possible to feel the rod under the skin. It’s usually inserted in the upper arm but you may be able to ask your doctor to insert it somewhere less detectable.
Can it be tampered with
If it’s cracked while it’s in place it could become less effective, so it may not be suitable for people living with physical violence.
Additional considerations
Cost effective over time in comparison to other methods; no potential for user error or interference; not all doctors and nurses are trained to do insertions; does not provide protection against sexually transmitted infections.
Injection
What it is
The contraceptive injection is sold as Depo-Provera and Depo-Ralovera in Australia and is a three monthly injection of hormone by a nurse or doctor.
How it works
By preventing the egg from being released and the sperm from reaching the egg.
How long it lasts
Twelve weeks.
How effective it is
94% typical use; 99% perfect use.
Typical use is how the method of contraception is generally used, taking into account mistakes that can happen (e.g. forgetting to take a pill, the condom tearing). Perfect use is when the method of contraception is used correctly 100% of the time.
Side effects
Bleeding can be unpredictable to start with. Return to fertility may be delayed for a period once usage stops.
Is it detectable
The only signs of use are the injection site on the day of each injection, and the end of regular menstruation. Users experiencing high levels of surveillance or monitoring may have issues due to things like Medicare records showing three-monthly visits and changes in menstrual patterns.
Can it be tampered with
Once injected it cannot be tampered with for that twelve week period.
Additional considerations
Lasts three months each injection, does not provide protection against sexually transmitted infections.
Hormonal IUD
What it is
Mirena or Kyleena are the hormone-releasing IUDs available in Australia. They are small T-shaped plastic devices inserted into the uterus, with a nylon string attached to it which comes out through the cervix. This allows users the ability to self-check if the device is still in place (if the string can be felt) and also assists a doctor to remove it. It can be used by people who have not had children as well as those who have, and can be used while breastfeeding.
How it works
By slowly releasing a low dose of hormones that prevent pregnancy. This changes the lining of the uterus, making it unsuitable for a pregnancy, and prevents sperm from reaching the egg.
How long it lasts
Five years once inserted.
How effective it is
99% effective.
Side effects
Changes in bleeding, missed menstrual periods, cysts on the ovary (usually disappear on their own within 2-3 months), headaches, acne, mood changes. It can take 6 months to adjust to the hormone.
Is it detectable
The strings may be detectable inside the vagina, but can be trimmed shorter by a doctor (although this may make it more difficult to remove). Menstruation patterns may also be disrupted.
Can it be tampered with
It could be potentially forcibly removed, especially if the strings are not cut off at the opening of the cervical canal.
Additional considerations
Cost effective over time, no potential for user error, not all doctors and nurses are trained to do insertions, upfront costs for insertion can be a barrier for some people, does not provide protection against sexually transmitted infections.
Copper IUD
What it is
Copper IUDs are small plastic devices with copper wire wrapped around the stem. A copper IUD is inserted into the uterus and has a nylon string attached to it which comes out through the cervix; this allows women and people with the ability to become pregnant to be able to self-check the device is still in place (if the string can be felt) and also assists a doctor to remove it. Like the Mirena or Kyleena, a copper IUD can be used by people who have not previously given birth as well as those who have, and can be used while breastfeeding. There are two types of copper IUD available in Australia.
How it works
Copper IUDs do not have any hormones, but the copper makes the lining of the uterus unsuitable for a pregnancy and hostile to sperm.
How long it lasts
Five to ten years once inserted.
How effective it is
99% effective.
Side effects
Your periods can become heavier and last longer. Can take up to 6 months to regulate menstrual bleeding patterns.
Is it detectable
The strings may be detectable inside the vagina, but can be trimmed shorter by a doctor (although this may make it more difficult to remove). Menstruation patterns may also be disrupted.
Can it be tampered with
It could be potentially forcibly removed, especially if the strings are not cut off at the opening of the cervical canal.
Additional considerations
Cost effective over time, no potential for user error, not all doctors and nurses are trained to do insertions, not listed on the PBS so insertion can be expensive, does not provide protection against sexually transmitted infections.
Vaginal Ring
What it is
The contraceptive vaginal ring is sold as NuvaRing in Australia. It is a soft plastic ring self-inserted into the vagina, which remains there for three weeks, after which point you can remove it yourself and replace it with the next ring a week later.
How it works
By releasing low doses of oestrogen and progesterone, these hormones are absorbed through the vagina walls (the two hormones used in the combined oral contraceptive pill).
How long it lasts
Each ring lasts three weeks.
How effective it is
91% typical use; 99% perfect use.
Typical use is how the method of contraception is generally used, taking into account mistakes that can happen (e.g. forgetting to take a pill, the condom tearing). Perfect use is when the method of contraception is used correctly 100% of the time.
Advantages
Can help regulate the menstrual cycle, reduce PMS and period pain; easier to use correctly than the combined pill).
Disadvantages
Not suitable for women with some medical conditions; not listed on the PBS so more expensive than other combined contraceptive methods.
Side effects
Headaches, nausea, breast tenderness, bloating, changes in your periods.
Can it be tampered with?
Easily removed so may not be suitable for women and people with the ability to become pregnant who have little control over if, when or how sex happens.
Is it detectable
It’s easily detected, although it can be removed for short periods of time (up to three hours) without becoming less effective, so it could be discreetly removed just before sex and reinserted immediately afterwards.
Additional considerations
Can help regulate the menstrual cycle, periods return to normal immediately once removed, reduce PMS and period pain, not suitable for women and people with the ability to become pregnant with some medical conditions, not listed on the PBS so more expensive than other combined contraceptive methods, does not provide protection against sexually transmitted infections.
Other Methods
Combined Oral Contraceptive Pill
What it is
Pill containing the hormones oestrogen and progesterone, taken every 24 hours.
How it works
The hormones prevent the egg from being released.
How long it lasts
It must be taken at the same time each day.
How effective it is
91% typical use; 99% perfect use.
Typical use is how the method of contraception is generally used, taking into account mistakes that can happen (e.g., forgetting to take a pill, the condom tearing). Perfect use is when the method of contraception is used correctly 100% of the time.
Side effects
Headaches, nausea, breast tenderness, bloating, changes to periods (your body can take up to 6 months to adjust to the hormones).
Is it detectable
Pills in their packaging can be easily recognisable. They could be removed from their packaging and hidden elsewhere to reduce this risk but this could alter their effectiveness if they’re exposed to heat, light or moisture.
Can it be tampered with
Pills can be easily disposed of by anyone with access to them. Instructions about what to do if a pill is missed are easily available online if it’s unsafe to keep that information in printed form.
Additional considerations
Can help regulate the menstrual cycle, reduce PMS and period pain, not suitable for women and people with the ability to become pregnant with some medical conditions, if pills are missed, extra contraceptive methods may be necessary as a backup, does not provide protection against sexually transmitted infections.
Progesterone Only Contraceptive Pill (Mini Pill)
What it is
Pill containing the hormone progesterone, taken every 24 hours.
How it works
The hormone prevents the egg from being released and thickens the cervical mucus, making it harder for the sperm to reach the egg.
How long it lasts
It must be taken at the same time each day.
How effective it is
91% typical use; 98% perfect use.
Typical use is how the method of contraception is generally used, taking into account mistakes that can happen (e.g., forgetting to take a pill, the condom tearing). Perfect use is when the method of contraception is used correctly 100% of the time.
Side effects
Changes in patterns of bleeding, headaches, acne, mood changes. Can take up to 6 months to adjust to the hormones.
Is it detectable
Pills in their packaging can be easily recognisable. They could be removed from their packaging and hidden elsewhere to reduce this risk but this could alter their effectiveness if they’re exposed to heat, light or moisture.
Can it be tampered with
Pills can be easily disposed of by anyone with access to them. Instructions about what to do if a pill is missed are easily available online if it’s unsafe to keep that information in printed form.
Additional considerations
Alternative to the combined pill for women and people with the ability to become pregnant who can’t take oestrogen because of some medical conditions, not suitable for women and people with the ability to become pregnant with some medical conditions, if pills are missed or taken more than three hours late, extra contraceptive methods may be necessary as a backup, does not provide protection against sexually transmitted infections.
Internal Condoms
What it is
Internal condoms are also a barrier contraceptive method and are thin sheaths of polyurethane that act as a barrier between the penis and vagina during sex, they are inserted into the vagina instead of over the penis. Internal condoms have a soft flexible ring at each end, with one closed end and one open. The closed end is inserted into the vagina.
How it works
Internal condoms prevent sperm from entering the vagina by trapping ejaculate.
How effective it is
79% typical use; 95% perfect use.
Typical use is how the method of contraception is generally used, taking into account mistakes that can happen (e.g., forgetting to take a pill, the condom tearing). Perfect use is when the method of contraception is used correctly 100% of the time.
Side effects
Some people can be allergic to the plastic used to make condoms.
Is it detectable
Condoms are an obvious form of contraception and are visible during sex.
Can it be tampered with
Condoms may be damaged or removed.
Additional considerations
As internal condoms are a barrier method, they help prevent Sexually Transmitted Infections (STIs) as well as pregnancy, only needs to be used during sex, can be used as a backup for other contraceptive methods, one off use.
External Condoms
What is it
External condoms are a barrier contraceptive method and are most commonly made of latex (although polyurethane condoms are also available if you or your partner have allergies to latex). External condoms are a thin sheath which fits over the penis during sex.
How it works
External condoms prevent sperm from entering the vagina by trapping ejaculate.
How effective it is
82% typical use, 98% perfect use.
Typical use is how the method of contraception is generally used, taking into account mistakes that can happen (e.g., forgetting to take a pill, the condom tearing). Perfect use is when the method of contraception is used correctly 100% of the time.
Side effects
Some people can be allergic to the plastic used to make condoms.
Is it detectable
Condoms are one of the most obvious forms of contraception and are visible during sex.
Can it be tampered with
Partners with a penis can easily take control of this method so it is very open to sabotage, condoms may also be damaged or removed.
Additional considerations
As external condoms are a barrier method, they help prevent Sexually Transmitted Infections (STIs) as well as pregnancy, external condoms are readily available in Australia, only need to be used during sex, can be used as a backup for other contraceptive methods, one off use.
Dental Dams
What is it
A dental dam is a thin, flexible piece of latex that protects against direct mouth-to-genital or mouth-to-anus contact during oral sex. The thin barrier reduces the risk of transmitting common sexually transmitted infections (STIs) including; chlamydia, gonorrhea, syphilis and HIV.
How it works
Latex acts as a physical barrier between the persons mouth and their partners genitals, minimising the risk of transmitting a STI.
How effective is it
When used correctly, dental dams are effective in reducing the risk of transmitting common STIs.
Side effects
Some people can be allergic to the latex used to make dental dams.
Is it detectable
Dental dams are visible as they are used externally.
Can it be tampered with
A dental dam could be tampered with and broken, leading to unprotected sexual activity.
Additional considerations
Non-invasive; dental dams can be made out of condoms if a dental dam cannot be purchased/is not available; one off use.
Diaphragm
What it is
A diaphragm is a silicone cap which is inserted into the vagina prior to sex, and covers the cervix.
How it works
As a barrier to sperm entering the uterus.
How effective it is
82% typical use, 95% perfect use.
Typical use is how the method of contraception is generally used, taking into account mistakes that can happen (e.g., forgetting to take a pill, the condom tearing). Perfect use is when the method of contraception is used correctly 100% of the time.
Side effects
Side effects are rare and it is safe to use while breastfeeding as its non-hormonal. Can increase the risk of urinary tract infections.
Is it detectable
It may be detectable during sex, particularly by fingers but less so by penile penetration; shape is fairly distinguishable due to the lipped rim, so may be obvious to others when it’s not in use.
Can it be tampered with
Needs forward planning so may be not suitable for people who have little control over if, when or how sex happens; can easily be removed by another person before or during sex.
Can it be tampered with?
Needs forward planning so may be not suitable for women who have little control over if, when or how sex happens; can easily be removed by another person before or during sex.
Additional considerations
It can be inserted well before sex, spermicide may be needed to ensure effectiveness, needs to be left in place for at least six hours after penetrative sex.
Sterilisation (Tubal Ligation)
What it is
Surgical procedure to permanently clip, block, or tie the fallopian tubes so eggs and sperm can not meet.
How it works
By preventing the egg and sperm from meeting.
How long it lasts
Permanent.
How effective it is
More than 99% effective.
Side effects
Anaesthetic that is used throughout the operation can sometimes cause side effects.
Is it detectable
Depending on the method, there may be a need for incisions and anaesthesia, and/or a follow-up at three months, which may make it difficult to have done discreetly. Menstruation is maintained and there’s no ongoing signs once the incision scars have healed.
Can it be tampered with
No.
Additional considerations
Permanent, cost effective over time, doesn’t interfere with hormones, expensive to have done privately and not widely available, public waiting lists are long and often have strict eligibility criteria, including age and childbearing history, does not provide protection against sexually transmitted infections.
Fertility Awareness Based Methods
What it is
Tracking the menstrual cycle and avoiding sex on the days when there’s an increased chance pregnancy could result. There are different methods that are used to do this which are all classified as FABM. They require women and people with the ability to become pregnant to calculate ‘fertile days’ by counting the length of their cycle over time or by following signs that indicate ovulation (for example; temperature or mucous changes). A number of apps have become available and gained popularity to assist in the menstrual cycle tracking process.
How it works
By avoiding penis-in-vagina sex or using a barrier method during fertile days.
How effective is is
Varies from 75-99% effective.
Side effects
N/A
Is it detectable
These methods, when used properly require record keeping about cyclical changes. These could be concealed in code on your phone, in a diary or on a fertility app but may still be risky for women and people with the ability to become pregnant experiencing high levels of surveillance.
Can it be tampered with
May not be suitable for people who have little control over if, when or how sex happens.
Additional considerations
Doesn’t require any device or access to medical care (however, apps are often used to track the menstrual cycle), requires training and practice for greatest effectiveness. FABMs require commitment and consistency of use, and it can be difficult to predict ovulation even if you are confident with the method, it does not offer any protection against sexually transmitted infections.
Can it be tampered with?
May not be suitable for women or people with the ability to become pregnant who have little control over if, when or how sex happens. Emergency contraception may need to be accessed in these circumstances.
Lactational Amenorrhea Method
What it is
The lactational amenorrhea method can be used by people who are breastfeeding, when menstruation has not yet recommenced following the birth of their baby.
How it works
If you are solely breastfeeding an infant less than 6 months old (ie, your baby isn’t receiving any supplementary feeding through formula), and menstruation has not recommenced since the birth, this can be a form of contraception when used correctly.
How effective it is
75% typical use, up to 98% with perfect use.
Typical use is how the method of contraception is generally used, taking into account mistakes that can happen (e.g., forgetting to take a pill, the condom tearing). Perfect use is when the method of contraception is used correctly 100% of the time.
Side effects
No side effects
Is it detectable
Discreet.
Can it be tampered with
No.
Additional considerations
It does not offer any protection against sexually transmitted infections.
