Contraception plays a large part in the sexual and reproductive lives of most women. And with so many different options available, it can be overwhelming trying to figure out which method is going to be the perfect fit.
Conversation guide for you
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.
Conversation guide for your partner
Relationships are an important part of our lives; and open and honest communication within relationships is the best way to ensure that they succeed. We all know that it take two to create a pregnancy, but surprisingly few of us are making the time to talk to our partners about birth control. So if you haven’t had a deep and meaningful about safe sex and unplanned pregnancies with your significant other, then here’s a helpful guide to get you started.
How do you feel about kids?
Obviously there’s different kinds of relationships, and this isn’t the kind of question that you’re going to ask a one night stand. However if you’re in a long term relationship, or you feel like the person you’re dating is someone you could see yourself with for the long run, it’s definitely a subject you need to broach. Aside from anything else, it’s good to know whether or not you’re both on the same page. But more importantly, it can help to determine what kind of contraceptive method might be best.
Soon – If it turns out you’re both ready to start a family, or commit to another kid, then congratulations! If you’re both thinking about children, but not quite ready yet, then you could consider some short term contraceptive options to tide you over until you’re ready.
Not sure – If you’re both on the fence about whether or not you want children, that’s okay. You can use a short-term method of contraception until you figure things out, or you can have the peace of mind that comes with long acting reversible contraception (aka LARC) and knowing that if you decide to try for kids these methods can be reversed at any time.
Never – If you’re both committed to never having kids, that’s a great opportunity to discuss either LARC or permanent contraception methods such as tubal ligation or vasectomy.
How do you feel about taking responsibility?
Protecting the Uterus – For the person who is at risk of getting pregnant, there are a huge variety of options on the table, as you can see from our method explorer [LINK]. The important part of this conversation though, is that both people in the relationship understand what’s being committed to.
While we wouldn’t want to live without it, contraception does have the capacity to be expensive, time consuming, frustrating and sometimes even a bit painful. In a relationship, it’s not fair to expect one person to bear the burden of that alone, just because they’re the one who risks becoming pregnant.
So if one person is going to get an IUD, the other person has the opportunity to accompany them and provide emotional or financial support. If one person is taking the pill, the other person can help by filling scripts, or setting reminders about taking it. Contraceptive conversations are important, because it allows everyone involved to be as supportive and understanding as they can be for their role in it.
Stopping Sperm – If the partner with the penis is happy to take responsibility for all things contraception, that’s fantastic; the only downside is the lack of options available!
Preventing a pregnancy through sperm management means there’s three options available; condoms, withdrawal and a vasectomy [LINKS].
Shared Responsibility – Another contraception option is to combine the responsibility and the methods used. For instance, using condoms and the pill gives you that much more peace of mind as well as providing both parties with their own responsibility. Alternatively the Fertility Awareness Method is an option that requires open and constant communication about where one person is at in their cycle, and combined with the withdrawal method or condoms, it becomes much more reliable.
How do you feel about different methods?
Even though it might come down to one person taking the contraceptive responsibility in terms of a device or method, it’s still important to have a discussion about everyone’s feelings regarding different methods. Our partner’s opinions are important (after all, we wouldn’t be with them if we didn’t think they mattered), so it’s good to be on the same page about what level of risks and potential side-effects everyone is comfortable with.
It’s important that no one in the relationship feels like they’re in a position where they might be involved in an unplanned pregnancy against their will, particularly where it could have been avoided by using a more effective or reliable method of contraception. If you’re in a relationship where your partner is taking away your bodily autonomy around birth control or pregnancy, this is reproductive coercion and it’s a form of abuse. This can include being coerced into becoming pregnant, being denied access to reliable contraception, being financially controlled to the point where you can’t access birth control, or having your partner sabotage existing birth control.
How do you feel about side effects?
Most methods of contraception contain varying levels of hormones, which come with a variety of side effects. Some of them are positive, such as minimised period pain, clearer skin, or removing periods altogether. However for some people, their preferred method of birth control comes with some less desirable side effects. Each person is different and will know what their own threshold is when it comes to their reactions to contraception; for some people a little bit of weight gain with one method is preferable to the unpredictable periods that come with a different method.
The important thing here is to have an open and honest conversation within your relationship about what the offshoot issues might be and to make sure you’re both on the same page about how they’ll be managed. Giving a partner a heads up that your contraception can cause bad period pain means giving them the opportunity to be there with pain killers and a hot water bottle when needed. Likewise, having your spouse tell you when to expect wild mood swings and how they’d like you to handle them can be an opportunity to be a more empathetic partner.
What do you want to do if contraception fails?This conversation must come with the caveat that the person who becomes pregnant is the one who ultimately has the final say. However, as a way to clarify what people want when it comes to having kids, it’s definitely worth discussing. Helping a partner understand what your decision would be in the case of an unplanned pregnancy could be a deciding factor in the method of birth control chosen.
Having an open and honest conversation about the consequences of an unexpected pregnancy can help to reiterate the importance of a reliable contraceptive method. Alternatively, discovering that both partners would greet an unexpected pregnancy happily can indicate that you might both be ready to start trying for a family and only need to consider short-acting or barrier methods. But regardless of the outcome, it’s a crucial conversation to have for everyone involved.
Conversation guide for your doctor
Many of us rely on our doctor for prescriptions, check ups, and telling us whether we’ve got the flu or just a cold. But your doctor is also a great place to start with help about making reproductive health decisions. This includes giving contraception advice and helping you decide on the right method of birth control for your needs.
To get the most out of your consultation though it’s important to highlight any relevant concerns and considerations that you want to discuss when it comes to contraception. So here’s our conversation guide to help you cover your bases when you’re talking to your doctor about your options.
What contraception have you used in the past?
Perhaps you’ve used contraception before, but stopped that method because of adverse side effects. It’s important to tell your doctor about what you were on, and any issues you had that you’d like to avoid. This could include things like cramps, spotting, wild mood swings or weight gain. Lifestyle issues are a perfectly legitimate reason to switch to a different method and you shouldn’t be embarrassed to raise concerns about things like remembering to take a pill every day. The more information your doctor has, the better they’ll be able to advise you on what might work best for you.
What’s your lifestyle like?
Certain lifestyle factors can dictate which contraception methods you should avoid. Things like smoking, sexual activities, breastfeeding, and even frequent air travel can all factor into what contraception your doctor might recommend. So if your doctor starts asking about your sex life or how often you travel for work, don’t worry, there’s a good reason for it!
What are your periods and PMS like?
Your period can tell your doctor a lot about what’s going on with your body. For instance, pain in your pelvic area, super long periods and periods with a whole heap of stress or sadness, can all be symptoms for different health issues. Different types of contraception can either alleviate or exacerbate these symptoms.
Many of these conditions can be treated, or the symptoms minimised with the use of specific hormonal birth control (as long as your symptoms aren’t caused by a health issue that prevents you from using certain contraception).
Do you have any pre-existing medical conditions?
Certain medical conditions are incompatible with some methods of contraception, so if you don’t think your doctor has a complete medical history for you, give them one. This can include certain medical conditions that you have a family history of, but might not have experienced yourself. Things like a family history of ovarian cancer or breast cancer are worth mentioning.
What medications are you on?
It’s uncommon for hormonal contraception to interact with medication, vitamins and supplements. But it’s always better to be safe than pregnant if you’re not ready; so make sure you give your doctor a comprehensive list of all the medications, drugs and supplements that you take regularly.
What to do if something goes wrong with your contraception
Modern medicine and science are pretty amazing, but nothing is absolutely foolproof. If you feel like something isn’t working the way it should, or if you’re experiencing side effects that coincide with your uptake of a new type of contraception you’re using, don’t hesitate to have a conversation with your doctor. Also remember that some contraception might take a month or two to settle in.
Your contraception shouldn’t be causing you enough pain or discomfort that you miss work. It shouldn’t be making you so depressed that you can’t get out of bed. Contraception is meant to be a modern convenience, and if it’s not making your life more convenient, then it’s not the right one for you.
How to tell your doctor you’re unhappy with your contraception
Your doctor is there to ensure that you’re the healthiest you can be; your health is their number one priority. If you’re unhappy with your chosen contraception, don’t be afraid to talk about changing it. Explain what side effects you’re experiencing and your doctor should work with you to try and find an alternative. You’re not asking too much to have your concerns taken seriously, but if you do find resistance to providing comprehensive contraception counselling, it might be time to seek another opinion or speak to a specialist.
What to do if your doctor refuses to change or remove your contraception
Doctors are human beings, and because of this they come with their own unique set of opinions and biases. Sadly, some doctors have been known to think that women are exaggerating or even lying about the pain they’re in, or the health issues they’re experiencing. If this happens to you, and your doctor is refusing to provide you with a different script, help with finding you another method, or remove a contraceptive implant or IUD that you no longer want, it’s time to get a new doctor.
If your doctor won’t prescribe contraception that you’re requesting because they think you’re too young or you don’t know what you want, it’s time to find a new doctor.
If your doctor isn’t listening or responding to you telling them about symptoms you’re experiencing, it’s time to find a new doctor.
They might have been your family GP for the last 25 years, but if they’re not putting your wellbeing first, then they’re not doing their job.
One last thing
Don’t be afraid of seeking second opinions. If you have issues with contraception and your current doctor isn’t helping you, seek out a service provider that specialises in contraception or women’s health.