What is contraception?

Contraception, also sometimes referred to as ‘birth control’, is something people can use when they want to have sex that can result in pregnancy, but do not want to become pregnant or have a baby. 

Understanding contraception and figuring out the best contraceptive method for you is an important part of looking after your sexual and reproductive health. But, with so many different options out there, it can feel a little overwhelming. 

Remember, no matter what contraceptive option you choose, you need to make sure that you’re protected against STIs which means using condoms or dental dams every time you have sex.

Types of contraception

Barrier methods

When used consistently and correctly, barrier methods stop body fluids being passed from one person to another during sex. Condoms, dental dams, and diaphragms are all examples of barrier methods, but only condoms provide protection against both pregnancy and sexually transmitted infections (STIs).

Condoms (external):
External condoms are made of latex or polyurethane (a latex free material) and are rolled onto an erect penis before sex. You need to use a new condom every time you have sex or switch partners if you’re having sex in a group. When , they are 82-98% effective in preventing pregnancy and can be used alongside other contraceptive methods for extra protection.

Condoms come in a range of shapes, sizes, textures, and flavours so it can be fun to try different types and brands until you figure out your faves. You can buy condoms at any supermarket, chemist/pharmacy, or sex shop as well as at most convenience stores and petrol stations. You do not have to show your ID or provide any information about yourself when you purchase condoms. 

Are you under 30? There’s a bunch of places that provide free condoms to anyone 30 years old in NSW. 

Internal condoms:
Internal condoms are made from thin latex or polyurethane (a latex free material) and has two rings at each end. Internal condoms can be inserted into the vagina before sex. When used correctly, internal condoms are 79-95% effective in preventing pregnancy and can be used to prevent STIs when having vaginal or anal sex. 

Diaphragms:
Diaphragms aren’t very common in Australia and can be hard to get (especially when other options are more effective). A diaphragm is a soft, dome-shaped silicone cup that can be inserted into the vagina before sex. It prevents pregnancy by stopping sperm from entering the uterus. Sperm can live for several hours in the vagina so the diaphragm must be left in place for at least 6 hours after sex until the sperm in the vagina die. When used correctly, and properly fitted, diaphragms are 82-86% effective.

Hormonal methods 

Hormonal methods of contraception prevent pregnancy by slowly releasing the hormones oestrogen and/or progestogen into the body through tablets or a device. A doctor’s prescription is needed for all hormonal contraception methods. 

None of these methods provide protection against STIs so make sure you use condoms every time you have sex to make sure you’re protected.

Oral contraceptives

Oral contraceptives are a type of contraception that comes in the form of a small tablet that uses hormones to prevent pregnancy. There are two types of oral contraceptives, the combined oral contraceptive pill (often referred to as ‘the pill’) and the progestogen-only pill (sometimes referred to as the mini-pill’). They must be taken at the same time every day and are usually about 93-99% effective when used correctly.

Combined oral contraceptive pill (the pill):
The combined oral contraceptive pill uses both oestrogen and progestogen to prevent pregnancy. The oestrogen prevents ovulation the ovaries from releasing an egg) and the progesterone thickens the cervical mucus, presenting sperm from entering the uterus. There’s a lot of different brands of the pill that contain different amounts of each hormone but work to prevent pregnancy the same way. 

Progestogen only pill (the mini pill):
The progestogen-only pill uses a hormone named, you guessed it, progestogen and prevents pregnancy by thickening the cervical mucus so sperm can’t get into the uterus.

Vaginal ring (NuvaRing):
The vaginal ring is a soft plastic ring which slowly releases low doses of two hormones, oestrogen, and progestogen. The ring is self-inserted and remains in the vagina for three weeks. After three weeks, the ring is self-removed, and a new ring is self-inserted a week later. 

Long-acting reversible contraception (LARC) 

LARC are contraceptive methods that last a long time but aren’t permanent. LARC are “set and forget” methods which means that you don’t have to remember to do something every day or every time you have sex. This makes them the most effective form of contraception.

Birth control implant or contraceptive implant (Implanon NXT):
A contraceptive implant, also known as ‘the rod’ or ‘the implant’, is a small rod placed under the skin of the upper arm by a doctor or nurse that provides contraception for up to three years. It works by continuously releasing a low dose of a hormone (progestogen) into the blood stream which prevents ovulation (eggs being released from the ovaries). Implanon NXT® is the brand name of the implant that is available in Australia. 

Implants need to be replaced every three years but like IUDs, can be removed earlier if needed. The implant can cause changes to the menstrual cycle, which vary from person to person. Some people may not get any bleeding at all, others may experience lighter periods and 1 in 5 people experience irregular or long-term bleeding. Implants are 99.9% effective in preventing pregnancy.

Intrauterine devices (IUDs):
Intrauterine devices (IUDs) are small, T-shaped devices are inserted into the uterus (womb) to prevent pregnancy. They offer long-term contraception (between 5-10 years) but can be removed at any time by a doctor or nurse. There are two types of IUDs available including the hormonal IUD (Mirena/Kyleena) and the non-hormonal IUD (copper). 

The hormonal IUD (Mirena/Kyleena):
The hormonal IUD, also known as the Mirena, is a small T-shaped device that is fitted inside the uterus (womb). It works by slowly releasing a very low dose of the hormone levonorgestrel and can prevent pregnancy for up to five to seven years, depending on which one you get. Periods usually become lighter or may stop when using a hormonal IUD. The hormonal IUD is 99.8% effective in preventing pregnancy. 

Copper intrauterine contraceptive device (Cu-IUD):
The copper IUD is a small T-shaped device made from plastic and copper that is fitted inside the uterus. They have no hormones and therefore don’t typically impact a person’s menstrual cycle as much as hormonal alternatives, but some people do find that their periods may become heavier when using a copper IUD. Copper IUDs are 99.2% effective in preventing pregnancy. 

Contraceptive injections (Depo Provera):
The contraceptive injection is given every 12 weeks and prevents pregnancy by stopping ovulation. In Australia, it’s sometimes referred to as ‘the injection’ or ‘Depo’. Periods may stop while using DMPA and there may be a short delay (Rough estimate) in return to usual fertility after stopping the injections. The contraceptive injection is 94-99.8% effective. 

Emergency contraception

Emergency contraception, often known as the “morning-after pill or “Plan B” can be taken after having unprotected sex to reduce the risk of pregnancy. There are two types of emergency contraception, the emergency contraception pill (ECP) and the intrauterine contraceptive device (Cu-IUD).

Emergency contraception pill (ECP):
ECP can be taken up to 5 days after unprotected sex, but it is most effective if taken in the first 24 hours. When taken in the first 72 hours (3 days), it prevents about 85% of pregnancies but it’s a good idea to do a pregnancy test a few weeks later to make sure you’re not pregnant. In Australia, you do not need a prescription to get the morning after pill. Simply head to a chemist and ask for it at the pharmacy counter. 

Oral emergency contraception pills are often confused with those used to have a medical abortion. They are not the same thing and taking emergency contraception is not the same thing as having an abortion. You can read more about ECP here. 

Copper intrauterine contraceptive device (Cu-IUD):
A copper IUD can also be used as emergency contraception when inserted in the first 120 hours (5 days) after sex, it prevents about 99% of expected pregnancies. Keep in mind that these need to be inserted by a trained doctor or nurse but could be a good option if you’re looking for immediate and ongoing contraception.

Fertility awareness methods (cycle tracking, period tracking etc.)

The fertility awareness method, also referred to as period tracking or cycle tracking, is when a person monitors their period cycle and/or any fertile signs (cervical mucus, body temperature etc.) to see when they are most fertile. A person would need to avoid having sex during their fertile period (the week before ovulation until a day after ovulation occurs) to reduce their chances of becoming pregnant.

There are a number of apps that can be used to monitor and record this information but it’s worth noting that the effectiveness of this method in preventing pregnancy is dependent on how each individual does this. You can read more about pros and cons of this method here. 

Withdrawal method (pull out method)

The withdrawal method, also known as ‘the pull out method’ or ‘pulling out’, is when the penis is removed from the vagina during sex, before ejaculating (orgasming/cumming). It’s typically only about 78% effective in preventing pregnancy because it requires expert timing to ensure the penis is fully removed from the vagina before ejaculating. This includes both cum AND pre-cum.

How much does contraception cost?

The below table will give you an idea of how much each type of contraception costs. These are not exact prices and the actual cost of each will vary based on the brand you buy, where you live, whether you have a Medicare card/concession card/private health insurance or not, where you get your contraception advice (GP, sexual health clinic, doctor etc.) and how much you pay to see your doctor. 

How do I get on contraception?

Now that you’ve read about all the different contraceptive options available in New South Wales, Australia, you might be wondering how you actually ‘get on’ contraception. 

Our advice is to always speak with a healthcare professional, such as a doctor or nurse. They can help you choose the most suitable contraceptive method based on your needs and circumstances. Any doctor should be able to provide you with judgement-free contraception advice and all conversations are 100% confidential if you’re over the age of 15. 

Once you’ve spoken with a health professional and together you’ve figured out the best contraceptive option for you, they will also help you figure out where to get it. Some options may require another doctor’s appointment and involve a minor procedure (IUD, contraceptive implant), others may mean you need to visit a chemist/pharmacy to fill a script (the oral contraceptive pill) and if you’re only going to be using condoms, it could be as simple as ducking out to your local shops. 

Remember, no matter what contraceptive option you choose, you need to make sure that you’re protected against STIs which means using condoms every time you have sex (oral, vaginal or anal) and getting regular STI tests every 6-12 months.

What do I say in the appointment?

It’s really important that you’re open and honest with the doctor or nurse about what you’re looking for when it comes to contraception. Keep it simple and say something like “I’d like to discuss contraception with you and figure out the best option for me.” 

To help figure out the best contraceptive option for you, they will need ask you some personal questions about your body and sexual history. It’s important that you’re 100% honest with them so they can give you the best possible care and advice.

Don’t be afraid to ask questions during the appointment or let them know if you’re worried about anything at all. It’s their job to help you. 

How do I pay for the appointment? Will my parents know?

If you have a Medicare card, we suggest finding a doctor that can bulk-bill your appointment which means you don’t pay anything for the appointment. 

If you are still on your parents Medicare card, but don’t want to ask them for your Medicare card/number, the doctor’s receptionist can help you get the number by contacting Medicare directly. Although your parents/guardians may be able to see that you saw a doctor, if you’re 14 or older, Medicare won’t disclose your medical information to your parents without your consent.

If you’re worried about this, you can get your own Medicare card once you turn 15. With your own Medicare card, only you will be able to see your medical records. Read more about getting your own Medicare card.      

How to avoid STIs after having unprotected sex

There’s no way to protect yourself against all STIs after the fact, but if you’ve had unprotected sex and are concerned about STIs, you can call our free sexual health advice line on 1800 451 624 and speak directly with a sexual health nurse who can help you figure out what to do next. 

If you think you might have been exposed to HIV, consider getting started on PEP as soon as possible. PEP is a medicine you can take after being exposed to HIV to reduce your chance of being infected. PEP must be taken within 72 hours after a potential exposure, but the sooner you can start taking PEP, the better. PEP is available at most public hospital emergency departments, all sexual health clinics and some GPs. Wherever you choose to go, it’s a good idea to call ahead to make sure they’re open, and to tell them that you need to access PEP so they can help you get started on PEP as soon as possible. Find a PEP provider near you.  

If you’re not sure if you need to take PEP, you can call the NSW PEP Hotline on 1800 737 669 (1800 PEP NOW) or if it’s after hours, visit your local emergency department for advice.