Contraception
Our doctors have considerable experience in the provision of women’s health services, including contraceptive advice and emergency contraception. Dr Sarah Horniblow is also trained in implanon and IUD insertion and removal.
The Pill
The combined oral contraceptive pill (COCP) remains one of the safest contraceptives for women, both in terms of side effects and prevention of unplanned pregnancies. As a group, the COCPs also protect against acne, some (such as diane) more so than others.
A number of new formulations are available, including super low dose pills such as femme tab 20, and pills with newer progesterones. Some of these, such as zoely and yaz, only have a 4-day break in hormone, achieving even lighter periods and better protection against breakthrough ovulation.
There are a number of medical conditions that may mean the COCP is not suitable for use, and it is important to discuss these with your doctor.
LARCs
The long acting reversible contraceptives (LARCs) have become very popular and are also a very safe option for women of all ages.
These are especially useful for women who are not able to take the COCP because they suffer from migraine or thrombosis.
Implanon is a small plastic rod impregnated with progesterone. The rod is inserted in the upper arm, just under the skin, and slowly releases progesterone over 3 years. At the end of 3 years, it is removed as a simple surgery procedure.
The intrauterine contraceptive device (IUCD or IUD) is a small device that is inserted through the cervix and into the uterus. Again, this is done as a simple office procedure. In Australia, two devices are available: the mirena IUD, which is impregnated with progesterone, and the copper IUD.
The mirena needs to be replaced after 5 years have elapsed, and the copper IUD after 10 years have elapsed. The mirena IUD is particularly useful in controlling heavy bleeding and can be used following menopause and in older women to protect against cancer of the uterus.
The nuvaring is a newer product that consists of a silicon ring impregnated with oestrogen and progesterone. It is inserted into the vagina and the hormone is released over a 3-week period. The ring is then removed and replaced with a new ring, either immediately if the woman wants to avoid a period, or after 7 days have elapsed (allowing time for a period).
Other useful contraceptives include the progesterone only pill, or minipill, and condoms. There are particular situations where these remain the best options for contraception.
Emergency Contraception
This is contraception that is provided following unprotected sexual intercourse where it is believed that there is a risk of conception.
Most commonly, a hormonal product is used. Two products are available in Australia.
Postinor contains levonorgestrel and needs to be taken within 72 hours of unprotected intercourse.
EllaOne contains ulipristal and can be effective up to 120 hours after unprotected intercourse.
The earlier they are taken following intercourse, the more protective these products are likely to be.
The copper IUD can also be used for emergency contraception.
