Contraception is a highly personal choice that every woman should be informed about. No method will suit everyone, however it’s important to dispel any misinformation about contraception, so that you can make a safe and effective choice.
At Norwest Obstetrics & Gynaecology, Drs Gerges and Wilson pride themselves on providing you with the most up-to-date scientific information about contraception and your reproductive health, so that you can make an informed decision.
Although Intra-uterine Devices (IUDs) are a safe and very effective form of protection from pregnancy, only 7% of Australian women use an IUD. This compares to 21% of Swiss women and 17% of French women.
An IUD is a small copper or plastic object that is inserted into a woman’s uterus to prevent sperm from fertilising an egg.
The IUD is a cheap, safe and effective method of contraception that has been around since the 1970’s. However, Australian research has found that there are a number of myths that have prevailed in the community about the safety of the IUD, which have historically made this an unpopular contraception choice.
Several high profile cases in the U.S. 30 years ago, of pelvic infection and subsequent infertility, were related to the strings of one type of IUD. However modern devices don’t increase the risk of infection. Yet this myth about the safety of IUDs continues to live on.
One 2010 study of 996 women by Family Planning Queensland found that 95% of all IUD insertions were successful, with 90% of these insertions reported as being easy by the doctor.
Although it’s important to remember that an IUD won’t protect you against getting a sexually transmitted infection.
The most popular form of contraception in Australia is the combined oral contraceptive pill. Worldwide this is also the case with around 100 million women taking the pill.
The “pill” switches off a woman’s natural production of the hormones, progesterone and oestrogen. These are replaced by synthetic versions of both hormones. These synthetic hormones inhibit the release of eggs from the ovaries and alter the lining of the womb, so that implantation of the fertilised egg is less likely.
Although the pill is effective in preventing pregnancy, there are also other prescribed benefits and reasons why women take it. The pill can be used to regulate your periods and reduce severe menstrual pain. It can also be effective in reducing the symptoms of conditions like polycystic ovarian syndrome and endometriosis.
One pervasive myth about the pill, is that it will reduce a woman’s ability to conceive a child, after she’s taken the pill for a long period of time. Research shows that most women want to return to their pre-pill fertility levels when they cease taking the pill.
Yet some women find it difficult to fall pregnant after stopping the pill. This leads women to conclude that the contraception affects their long-term fertility. However, the factors that affect a woman’s fertility are far more complex than this.
It’s challenging to assess the effects of the pill on a woman’s fertility, when many other factors are at play. Fertility is affected by a woman’s age, concurrent illnesses, weight, exercise levels, cigarette smoking and stress levels. A review of studies found that between 79% and 96% of women were able to get pregnant after 12 months of actively trying and ceasing taking the pill.
There is limited evidence to suggest that using the pill for contraception has a long-term impact on fertility. Although it is very effective for women wanting to prevent pregnancy in the short term.
Research indicates that on average, women will take the pill for three to five years. Although this average duration will vary from country to country.
Recent studies from Australia and the U.S. have found that many women worry that taking the pill will lead them to store up hormones in their bodies, leading to problems. This erroneous idea has led to the common misconception that women should take a break from the pill every once in a while.
Some women attribute the side effects of breast tenderness, headaches, nausea and bloating to the pill itself. Although these symptoms occur as a result of the hormone free interval. This interval allows the withdrawal bleed to occur, mimicking the natural menstrual cycle.
The reproductive health specialists at Norwest Obstetrics & Gynaecology will make a detailed medical assessment of your health to establish whether or not you would be suitable for the contraceptive pill, and if so, what kind. The pill is not suitable for everyone and so an individualised assessment is essential. Drs Bassem Gerges and Matthew Wilson will be able to help you find the right pill that suits your needs.
Many medications have a small risk of serious side effects associated with them. This is also the case with the contraceptive pill. The risk of adverse side effects is highest when you resume taking the pill after a break and also in the first few months of taking it.
Whilst research has shown that there is a slightly elevated risk of cervical cancer associated with taking the pill, there has also been evidence that it reduces your risk of endometrial and ovarian cancer.
One of the most serious side effects associated with the pill is an increased risk of thrombotic complications such as stroke, myocardial infarction, and venous thromboembolism (VTE). These are also known as blood clots in the heart, brain, limbs and groin. These risks are more serious for women who smoke or who are in mid-life and have a risk of heart disease.
Although these risks are serious, the risk of blood clots is low. The risk is marginally higher compared to women not taking the pill. To put the research into perspective, when you take the pill, your risk of blood clots is lower than the risk of blood clots during pregnancy, delivery and post-partum.
There are other forms of effective contraception aside from the pill, known as Long Acting Reversible Contraception (LARC). Although Australian media stories in recent years have focused on isolated cases of women who have experienced adverse side effects from using LARC such as contraceptive implants (Implanon) and IUDs (Mirena).
These media stories failed to show how the majority of women who use a LARC, find these methods reliable, effective and easy. Adverse side effects and complications arising from the use of Implanon affect less than 1 in 1,000 women.
One U.S. study involving 10,000 women found that when they were provided with evidence based information about the LARC and when financial barriers to purchase were removed, that over 70% of the women chose LARC.
A large study in the U.S. (the CHOICE study) involving more than 7,000 women showed, when provided with evidence-based information, more than two-thirds of women chose a LARC over other methods.
One reason to support the use of LARC is that these methods don’t require daily adherence to be effective. This makes these contraception methods ideal for young women who have high fertility and are susceptible to unwanted pregnancy.
It’s vital that you have regular checks with an Obstetrician/Gynaecologist. Your contraceptive needs will change as you grow older. This is particularly the case as you reach milestone points in your reproductive life such as becoming sexually active, getting into a long-term relationship with someone, trying to conceive, after having a child and when you’ve completed your family. No matter what stage you are at, the team at Norwest Gynaecology & Obstetrics are always here for you! Call us on 02 8883 5143 or request an appointment on our website.
American Journal of Obstetrics and Gynaecology (2010) The Contraceptive CHOICE Project: reducing barriers to long-acting reversible contraception.
Monash University (2012) Monday’s medical myth: the pill affects long-term fertility. Professor Sonia Davison, The Conversation.
La Trobe University (2018) No, women don’t need to ‘take a break’ from the pill every couple of years, Professor Jayne Lucke, The Conversation.
La Trobe University (2012) IUDs safe, effective but myths live on The Conversation.
The University of Sydney (2017) Reporting a few cases of negative side effects from long-acting contraceptives is alarmist and damaging, Professor Kirsten Black, The Conversation.