There are many different types of contraceptives, and each have their own pros and cons. When choosing a contraception, make sure to research and speak with your doctor or reproductive and sexual health clinic about available options. Here are some of the common types of contraception, and a little bit about them:
Condoms are the only type of contraception that protects you against sexually transmitted infections (STIs). They are often worn by males during sexual activity, but you can get female condoms (they are more expensive and not as widely available). Condoms prevent the sperm and egg meeting by providing a physical barrier between them. They also stop body fluids from passing between sexual partners. Condoms should be used with all other forms of contraception. If a condom breaks or slips, emergency contraception can be used to prevent pregnancy and it’s a good idea to have a sexual health check-up for STIs. Condoms should always be used with a generous amount of a water-based lubricant, especially for anal sex. It is important to not use oil-based lubricants like Vaseline or baby oil, because they weaken the condom.
The Combined Oral Contraceptive Pill (more commonly known as ‘The Pill’) is an oral contraceptive containing hormones. It is taken daily to prevent pregnancy and is about 92 – 99.7% effective with proper use but does not protect you against STIs.
The pill contains low doses of oestrogen and progestogen which prevents ovulation and thickens the mucus of the cervix to prevent sperm entering the uterus. There are some side effects which tend to settle within the first 3 months of starting the pill such as nausea, mood changes, breakthrough bleeding, skin changes, weight gain, breast tenderness or enlargement, and change in sexual response. Users of the pill may experience health benefits including:
- Lighter periods,
- Less period pains,
- Improved acne,
- Assistance with symptoms of perimenopause and Polycystic Ovary Syndrome,
- And reduced risk of some cancers.
The cost of the pill varies by each type, a doctor must be seen for prescriptions, there are some risks associated with Pill use in a number of health conditions, and the efficacy depends on your ability to take the pill as directed.
Mental health & fertility issues can be linked to the pill. There is evidence that suggests both oestrogen and progesterone influence brain function, which may be responsible for the negative mood changes and depression that women often experience while on the pill4. Newer oral contraceptive pills may be less likely to cause mood changes5. If you think you may be experiencing mental health issues whilst on the pill, talk to your doctor or mental health professional.
Long-term use of the pill can affect your fertility within the first 12 months after stopping taking the pill. Your fertility should return to normal within or after a 12 month period6, but for most women, it can be as short as 3 to 6 months7. If you are experiencing fertility issues after you stop taking the pill, consult your doctor or medical professional.
The Morning After Pill (Emergency Contraception)
If you’re sexually active, there will probably come a time when you need to know how to get the morning after pill.
The morning after pill can be taken up to 5 days after unprotected sex, but it is more effective the earlier it is taken. There are a number of situations that might cause you to consider the morning after pill, which include:
- You had unprotected sex and want to protect yourself against unwanted pregnancy
- You missed your contraceptive pill and want to prevent pregnancy
- You have been vomiting or have diarrhoea, which may stop your usual contraceptive pills from working
- You were the victim of a sexual assault
- Your condom split or fell off during sex
You can get the morning after pill from pharmacies without a prescription in Australia. The exception to this is if you’re under 16, in which case you may need a prescription. So, no matter how old you are or what the situation is, you can walk into a pharmacy and ask for the morning after pill. Men are unable to get the morning after pill alone as the pharmacist or doctor will need to speak with the woman to confirm she is aware of the side effects and outcomes of the medication, check that it won’t interfere with any other medication, and make sure that she isn’t being coerced into taking the morning after pill.
Other places you can get the morning after pill in Australia include:
- A sexual health clinic
- A family planning centre
- A doctor
You will be asked a series of questions, which may include:
- Why do you need the morning after pill?
- Do you use contraception normally?
- When did you last have unprotected sex?
- Have you started your period?
- Were you a victim of sexual assault?
- Are you pregnant?
- What medications are you taking?
- Do you have any health symptoms or underlying health conditions?
The emergency contraceptive pill prevents or delays the ovaries releasing an egg. If you have unprotected sex again you may need another dose. Emergency contraceptive pills may:
- Change the amount of bleeding for your next period,
- Or make your period late or earlier.
If your period is more than 7 days late, lighter than usual or unusual in any other way, take a pregnancy test as soon as you can.
If you find that you are pregnant after taking the morning after pill, it is safe to continue the pregnancy or to end it by having a medical or surgical abortion.
If you need further support, you can get help from your doctor, sexual health clinic, or family planning centre. You can also access free counselling and advice from Children by Choice, a Brisbane-based organisation that offers Queensland-wide information and support for all pregnancy options that is confidential and non-judgemental.
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Intrauterine Contraceptive Device (IUD)
Intrauterine Contraceptive Devices (known as IUDs) are long acting reversible contraceptives that are fitted inside your uterus, where it can remain for 5 to 10 years (depending on which device is inserted). They are not felt if inserted correctly, and have nylon strings that extend through your cervix into your upper vagina so you can check that it is still in place. IUDs are highly effective and relatively inexpensive, but do not protect you against STIs
Mirena and Kyleena are brand names for IUDs which release progestogen in small amounts directly into the uterus. Kyleena has a lower dose and is smaller than Mirena, and both are effective for 5 years. Hormonal IUDs work by thickening cervical mucus to prevent sperm penetration, inhibiting sperm migration, interfering with egg survival, causing endometrial changes, and sometimes preventing ovulation. These IUDs may cause irregular and unpredictable bleeding and spotting in first 3-5 months. Hormonal side effects are rare but may include:
- Benign ovarian cysts,
- Mood changes,
- Weight gain,
- Breast tenderness,
- Loss of libido,
- And acne.
They are generally mild and should improve with time.
Copper IUDs are made of plastic and copper. Copper IUDs work by inhibiting sperm migration, interfering with egg survival, and preventing implantation.
The insertion and removal of the IUDs can only be done by a trained Health Practitioner, and insertion into the uterus requires a procedure can be uncomfortable and painful. If you aren’t given an option of anaesthetic or sedation, you should consider consulting with another health professional who can to minimise the pain you might experience. If you haven’t had a vaginal birth, the insertion procedure might be more painful than those who have. Prior to insertion, the practitioner will measure the depth of your uterus, which must be more than 6cm (the average depth is 8cm).
Side effects from using IUDs can include:
- Period-type cramping after insertion (which usually settles after a few days),
- Changes to your bleeding,
- Sometimes it can fall out within 3 months,
- And in some people it can cause headaches, skin changes, sore breasts and mood changes.
Possible risks using IUDs as a contraceptive option include abdominal pain, perforation, expulsion, pelvic inflammatory disease, miscarriage, or ectopic pregnancy.
The contraceptive implant (commonly referred to as the brand name, ‘Implanon’) is a small rod placed under the skin (usually in your non-dominant arm) that releases hormones into your blood stream to prevent ovulation and thickens the mucus of the cervix so that sperm cannot enter the uterus. The implant lasts 3 years unless it is taken out and is about 99.8% effective but does not protect you against STIs. Changes to the pattern of vaginal bleeding is the most noticeable result of using the implant, due to the ovulation suppression. Most women can safely use the implant.
Possible side effects of the implant include:
- Changes to your bleeding,
- Stomach cramping,
- Vaginal irritation,
- Mood changes,
- Weight gain,
- Breast tenderness,
- Low libido,
- And new onset or worsening of acne
Depo Medroxyprogesterone Acetate (also known as DMPA or the Depo shot) is a hormonal contraceptive given by injection into your arm or buttock every three months. DMPA is about 94% effective but does not protect you against STIs. DMPA contains a progestogen, similar to the hormone progesterone naturally produced by your body. DMPA works by preventing ovulation, and thickening the mucus of the cervix so that sperm cannot enter the uterus. Most women can use DMPA, and it is suitable if you can’t take contraceptives that contain oestrogen.
Women with heavier periods are likely to have no periods or lighter bleeding, and women with period pain experience less or no pain when using DMPA as their contraceptive option. Some side effects when using DMPA include:
- Small weight gain in some women,
- Change in libido,
- And mood swings.
Because the hormones in each DMPA shot lasts 3 months, unfortunately your body can’t get rid of them naturally if you don’t react well to it. You may have to wait up until the 3 months is up until the side effects go away.
The Billings Method is a fertility awareness- based method that relies on the observation of patterns of fertility based on vulvar sensations and appearance of vaginal discharge. If used and followed correctly, this Method is highly effective at avoiding pregnancy, but does not protect against STIs.
Your cervical mucus changes throughout the month. Straight after your period, your vagina may feel quite dry, and then around the time of ovulation, the mucus becomes clear and stretchy, similar to raw egg whites. After you have ovulated, it becomes thicker and cloudier. The five days before ovulation (including the day you ovulate) are when you are most likely to conceive. After ovulation, your egg can only live for 12 to 24 hours. Sperm can live up to five days inside your body, so if you have sex five days before you ovulate, you can get pregnant.
As the Billings Method is a natural method of contraception and fertility management, there are no artificial hormones or prescriptions involved, and it teaches you to recognise your body’s natural signs of fertility. This method does, however, depend on how strictly you use this method. It can take time and patience to get this method right, and some women can still find it difficult to predict when they are ovulating.
The Billings Method isn’t suitable for everyone. For example, if you have abnormal bleeding, inflammation in your cervix or vagina, if you’re taking medicines (including antibiotics, antihistamines or thyroid medicines). It is also not suitable if you’ve just finished using a hormonal method of contraception, you have irregular periods, are getting close to menopause, or your partner doesn’t fully cooperate. Getting sexually aroused or having semen in your vagina can also make it harder to tell what your mucus is like.
Other methods of contraception include the Progestogen Only Pill (POP or Mini-Pill), Nuvaring and diaphragm.