The world of family planning.

It never ceases to amaze me the differences and gaps in education of my patients about family planning. There isn’t day goes by in my clinic that I am confronted my misguided information about the choices available to us, and sometimes I am even horrified at what so called health professionals advise my patients.

Yes there are many, many horror stories about the differing types of hormonal contraceptives. But the negative stories always get the headlines don’t they, never the “wow I feel so much better, I can actually cope now Dr, thank-you” stories.

I would never dream of enforcing hormonal manipulation on a patient, my role is to educate and fully inform so the choice made is the right one for all involved. Yet as GP’s we can often be vilified in the media as making out that birth control is something necessary and fertility is a burden to be controlled. Some would go as far to say that birth control causes children to become sexually active earlier!

Now choices are actually limited to hormonal or non hormonal methods. You either take a pill everyday, pop a plastic rod under the skin, have an injection every 3 months, insert an intrauterine device, use a vaginal ring, barrier methods or use the calendar method of natural family planning. Boys and girls please make note none of the above include the withdrawal method!

There are endless side effects listed in all the prescribed contraceptive boxes and this can scare alot of people away, but they can be minimal and for only a short period of time. Your Dr also needs to take into consideration your own medical and family history to determine if there are any reasons you can’t have contraception.

So to recap and refresh your memory here is a list of the current choices available;

• 99% effective

1.  Implanon – progestogen only plastic rod under skin on upper arm. Lasts for 3 years.
2. IUD or coil – device that is inserted into the womb. Can be either copper with no hormones or the Mirena which has progestogen embedded on it.
3. Sterilisation – male or female surgical operation to block your tubes, and is irreversible.

• 91% effective

1. Contraceptive injection – progestogen only injection every 3 months.
2. Combined contraceptive pill – oestrogen & progestogen tablet, taken everyday.
3. Progestogen only pill – single hormone daily tablet.
4. Contraceptive vaginal ring – combined hormones on rubber ring, inserted every 4 weeks.

• 76% effective

1. Condoms.
2. Diaphragm – rubber cap placed inside vagina.
3. Fertility awareness or calendar method – tracking your cycle and not having sex during your fertile time.

Useful links:

https://www.healthdirect.gov.au/contraception-options

https://www.fpnsw.org.au/health-information/contraception/contraception-choices