CONTRACEPTION

An integral part of our service is setting you up with contraception going forward. We strongly recommend a LARC (long acting reversible contraception) which covers the most effective forms of contraception and includes the contraceptive implant (a.k.a. rod or bar), depo or intrauterine contraceptive devices such as the Intrauterine System (containing progesterone) or intra-uterine device (containing copper). 

Contraception is important but doesn’t protect you against sexually transmitted infections, for this reason we always promote condom and dam use as well. Free condoms are available via family planning Tasmania and youth services such as The Link. Additional sexual health services are available from Clinic 60 and Family planning Tasmania

This summary by the Family Planning Alliance Australia is a great overview of your different options.

Summary

Types of contraception

We would suggest considering a contraceptive implant as this is the most effective form of contraception. The Intrauterine System (IUS) and Copper IUD run close second and third in effectiveness. Not only is the implant very effective, but we can arrange for this when you attend your assessment, whereas we need to wait a few weeks before inserting an IUS or copper IUD. Your fertility will return very quickly after the termination and we want to make sure you have effective contraception in place. LARCs are generally suitable for women of any age even those with significant health concerns, they tend to be well tolerated and are generally easily reversible with removal by your Doctor. 

Contraceptive implant

The contraceptive implant is a small plastic rod which is inserted by your doctor just under the skin containing a form of progesterone, it is 99.95% effective. It has an effective life of 3 years and can usually be removed easily by your Doctor. It is possible to remove it earlier at your request. The implant works by preventing ovulation with a backup effect of changing the cervical mucous to inhibit sperm. 

Your periods may change, you may have no periods (this is not a problem, many women enjoy this unexpected benefit!), occasional spotting or for about 1 in 5 women more frequent or prolonged bleeding. If you experience troublesome bleeding please see your Doctor as we can frequently manage this and improve things for you. Other possible side effects (in common with other forms of hormonal contraception) include effects on your mood, skin and breast tenderness.

There are very few people who cannot use the implant for medical reasons, we can insert it when you attend for the abortion assessment appointment. 

Intra-Uterine System

This is a small plastic device that is inserted into the womb through the cervix, it is generally considered 99.8% effective. It contains a form of progesterone and has an effective life of 5 years, it can usually be removed easily by your GP. The IUS will act by thinning the endometrium (lining of the womb) to prevent implantation, and changes to your cervical mucous which inhibit sperm. You will often still ovulate even if you don’t get periods. There are few people who can’t have an IUS but we are unable to insert it immediately. It is possible to arrange for this to be fitted at your follow up appointment. Women frequently have lighter periods but not uncommonly have no period or occasionally scantly light spottin only (again, not a problem!). Some women do have persistent or troublesome bleeding particularly in the first 6 months, there are things your Doctor can do to help but frequently it will settle with time. Other possible side effects are mood disturbance, skin changes and breast tenderness. Whilst the IUS is very effective there is a higher chance of ectopic pregnancy if you are unlucky enough to fall pregnant. 

More in depth info here.

 
 

Copper intrauterine device

The Copper IUD has been around in various forms for 40+ years. It is a small plastic and copper device inserted into the womb via the cervix and lasting 5-10 years (depending on which version). Not only is it very effective at 99.7% effective but unlike all the other reliable reversible forms of contraception it doesn’t contain hormones. Very few women are not able to have a copper IUD but if you already have heavy periods we probably wouldn’t recommend it as it can make your periods heavier. Very occasionally it can come out unintentionally and similar to the IUS if you were unlucky enough to fall pregnant you have a slightly higher chance of an ectopic pregnancy. 

More in depth info here.

Contraceptive injection

The contraceptive injection is about 94% effective, an injection of progesterone  is given into the arm or buttock, usually every 12 weeks. Unlike the options previously mentioned the main drawback is once given is not easily reversible, and you will need to wait for the effects to wear off which for some women can take many months. It has similar side effects to the other options already mentioned with possible irregular or annoying bleeding, mood, skin and other hormonal effects. An additional positive is that it can be commenced straight away when you attend for your assessment appointment.

More info here.

The Pill

We are starting to drop down the effectiveness scale now, at 91% effective, for both the combined and progesterone only pills. The combined pill contains oestrogen as well as a form of progesterone and also enables you to have control of your periods. Unfortunately, the combined pill is not recommended for a significant number of women as it can have some higher risks, most commonly related to high blood pressure and blood clots in the arteries or veins. Often, we will use a form of the pill as bridging contraception whilst we are waiting to insert a IUS or copper IUD for example. Otherwise they have similar hormonal side effects to other options already mentioned. The different pills can be very effective if taken correctly but the biggest risk is user error and that means missing pills or taking pills late, how do you think this fits in with you and your lifestyle?

Helpful Links

Contraception is important but doesn’t protect you against sexually transmitted infections, for this reason we always promote condom use as well. Free condoms are available via family planning Tasmania and youth services such as The Link. Additional Sexual health services are available from Clinic 60 and Family planning Tasmania.