Australian women got access to the birth control pill in 1961, and to say that it was a game changer would be putting it lightly. For women, having the choice about if and when to have children meant they could make decisions about their future. But medical science didn’t stop there, and since the 60s has been continuously innovating and improving on contraceptive methods.
Sadly though, not all of us are taking advantage of the vast array of choices available. Culturally, we often think of contraception as a conversation for young people. It’s a key component of sex education, along with learning about STIs. But often we don’t revisit the topic after we’ve decided on a birth control method at around 18.
However, life changes pretty drastically between 18 and 48. Our body, our lifestyle, our wants and our needs are all vastly different at different ages, and our contraceptive choices should reflect that. After all, what you wore at 18 probably isn’t what you want to be wearing at 28, or 38 is it? So why should your contraception be any different! Here are some questions to consider to help you work through your contraceptive needs.
What kind of sex are you having?
Same-sex – If you’re in a same sex relationship, you’re most likely not too concerned about pregnancy. But that doesn’t mean that contraception can’t help you or your partner with other issues such as painful periods, bad acne, or menstrual regularity. It’s also important to remember that while pregnancy might not be a risk, STIs still can be. Always make sure you’re using Condoms or dental dams if you and your partner haven’t been tested, or if you’re in a non-monogamous relationship.
Multiple heterosexual partners – If you’re enjoying sex with multiple opposite-sex partners, you can and should be considering a reliable birth control method to prevent an unplanned pregnancy. But it’s also important to remember that the only thing that can help prevent the spread of STIs are male and female condoms and dental dams. Don’t be afraid to double up, because there’s no reason you can’t combine Condoms with LARC, dental dams with The Pill, or any combo that suits your needs and keeps you safe.
Monogamous heterosexual partner – If you’re in a committed relationship, now is the time to start having the contraception conversation with your significant other. It takes two to make a pregnancy, so it’s important that both of those people are on the same page about what’s happening to prevent that. Luckily we’ve prepared a conversation guide for you here.
How do you feel about pregnancy?
Soon – If you’re aiming to get pregnant in the next 12 months, you will probably want to consider short term contraception options. Although long-acting reversible contraception (LARCs) are highly effective and reversible, they become less cost efficient when being used for less time. Because they have to be inserted by a trained doctor, it may also not be as convenient for you if, say, you’re only looking for a method to use for 4 months. And remember, if you’re using the Contraceptive Injection, it can take up to 18 months for your body to begin ovulating again after your last shot.
Not yet – For many people, especially younger people, it can be hard to make a decision with absolute certainty about children. You might know that you don’t want kids for at least the next 3, 5 or 10 years, but you want the option to reconsider after that. If that’s the case then LARC is definitely a great option. Copper IUD, Hormonal IUD and Implants are a group of “set and forget” methods, where you don’t need to do or remember anything for between 3-10 years depending on the option you choose. They can be removed at any point that you decide you’d like to start a family, and have no impact on your fertility rates. They’re also extremely cost-effective when you take into account how long they last. IUDs, in particular, can be more cost-effective than The Pill, or even Condoms, if you keep them for the full duration.
Never – More and more people are making the decision to live a childfree life. For people who are confident in the knowledge that they don’t ever want kids, there’s the option of Tubal Ligation or a Vasectomy. Both are safe, effective and permanent methods of contraception that mean you don’t have to spend time worrying about an unplanned pregnancy for the rest of your life.
How do you feel about periods?
My periods are awful – If your periods tend to be long, heavy, painful or emotional it’s worth considering hormonal birth control options, as these have been proven to help minimise the symptoms of periods. Have a chat with your doctor about what your symptoms are and which method is right to help manage them.
My periods don’t bother me – One of the most effective methods of contraception on the market is the Copper IUD. It doesn’t use any hormones, just some really cool science. However, it can make periods heavier or more painful for some women, so if you already struggle with your period, the Copper IUD may not be your best option.
My period gives me migraines – If you find that you suffer from migraines during your menstrual cycle, you’ll need to speak to a healthcare professional before considering contraception. Depending on the specifics of your migraine symptoms, certain types of birth control could make it better, or it might create serious problems for you. Best to discuss with your doctor before making a decision.
How do you feel about hormones?
I would prefer not to use hormones – If you’ve made the decision not to use any kind of hormonal birth control, and are looking for a contraceptive method with high efficacy, you can’t go past the Copper IUD. If you’re not after something long term you can always double up a couple of short-term methods, to ensure a higher efficacy rate. Using Barrier Methods with Fertility Awareness Methods and/or Withdrawal for instance. There’s no wrong way, as long as you understand the effectiveness of your method and your risks.
I would like to be taking fewer hormones, but they’re helpful for some issues – Hormonal contraception can be useful for controlling irregular periods, acne and cramps, but if you’re looking to lower your dose then a Hormonal IUD might be for you. It delivers small doses directly to your reproductive system. There is also the option of the Mini Pill, which does have fewer hormones than the Combined Oral Contraceptive Pill. However, it requires you to be incredibly vigilant, taking it at the same time every single day, within 3 hours (and it has a slightly higher dose of progestogen than the Hormonal IUD).
I don’t mind using hormones – If hormones aren’t an issue for you, then you can select from a broad variety of both short and long term reversible contraception, including The Pill, Contraceptive Implant, Contraceptive Injection, Hormonal IUD and more!
What’s your lifestyle like?
We lead lives that don’t necessarily fall into a neat pattern or routine, so taking a tablet at the same time every day could be quite challenging for some. For others, it could be an issue to get an injection every three months or to pick up a script. If you’re travelling a lot, or like to swim regularly for sport, all these things can play a part in determining what method might work best for you. It’s important to consider any lifestyle factors that you think might be a barrier to the efficacy of your contraception or that might make you not want to use it anymore. Our contraception pages list the routine for each method, to help you understand what you’d be committing to for each one.
There’s a lot there to consider, so don’t feel bad if you’re a bit overwhelmed. We’ve designed a handy little quiz to help guide you through some contraception considerations. Check it out here.