It is advisable to plan when you have children. A number of factors will impact on your decision to have children, such as relationship stability, your own health and wellbeing, financial stability, other family members. You are able to manage your fertility by using contraception. There are many different types of contraception and the doctors at Gynaecare will offer you expert advice as to which is right for you, and your partner. Contraceptive methods are divided into non-hormonal, hormonal and permanent.
Intra-uterine system (IUS)
The IUS is a revolution in womens health. It is an intrauterine device which releases tiny amounts of progesterone locally into the uterus (womb) where it is held in place by the design of the device and the natural shape of the uterus.
Not only does it provide highly effective contraception for up to 5 years, but also tends to reduce the amount and length of periods which usually means less painful periods. It can be inserted early in the menstrual cycle after a termination of pregnancy (TOP ) and in women who have had a baby at least 4 weeks previously, and in breastfeeding women. We are happy to insert IUS for you at Gynaecare with or without sedation. If you have had a recent vaginal delivery it may be possible to insert the IUD without anaesthetic. If not or if you don’t want to be awake for insertion of an IUD/IUS, you will be more comfortable having a brief anaesthetic. Gynaecare can provide sedation (inhaled or intravenous) on one of our procedural days when there will be 2 doctors looking after you. An IUD or IUS can be taken out easily without anaesthetic in the clinic, provided that the threads are still visible at the cervical os. If the threads are not visible (lost threads), it may be necessary to have a sedation to remove the device.
The IUS can also be used to provide the progestogen component of Hormone Replacement Therapy during the menopause.
The IUS immediately stops working when it is removed and thus is a type of contraception called “long acting reversible contraceptive” (LARC). You will be able to fall pregnant straight away after having the IUS removed, provided there are no other reasons why you might have difficulty conceiving.
Most women really like their IUS devices, as they provide extremely reliable contraception as well as lightening periods. However, a few unlucky women experience hormonal side effects and choose to have their device removed early, though we recommend that you persevere with the device for at least 6 months to allow it to settle in. It is not usually possible to predict which women will get side effects from an IUS, as everybody is different, though we do suggest that if a woman has had serious depression, then another form of contraception might suit them better. Even women who are very sensitive to hormonal side effects, are pleasantly surprised with the IUS, as it has the smallest amount of hormone compared with other hormonal contraception, and risk of side effects are reduced.
Oral contraception (the pill or minipill)
There are many different types of contraceptive pill available. Sometimes, it is necessary to change pills to find one that is suitable. Some women find that certain pills may have side effects eg, headaches or skin breakouts. However, there can also be non contraceptive benefits to taking the pill such as menstrual control, improvement in acne and pre menstrual syndrome. Pills can either be combined (oestrogen and progesterone) or progesterone alone. Taken correctly the pill can provide excellent contraception and cycle control. Some pills are subsidised by the pharmaceutical benefits scheme ( PBS) which make them more affordable than those which are not subsidised.
If a condom breaks or unprotected sexual intercourse occurs, it is possible to reduce the chances of pregnancy occurring. This is in the form of a single pill that is available over the counter at pharmacies, or by prescription from your doctor. The copper IUD can also be used for emergency contraception, provided it is inserted within 5 days of the episode of unprotected sex.
The vaginal ring is a thin silicone ring which is placed in the vagina. The ring releases hormones which are absorbed into the blood supply giving contraceptive cover in the same way as the pill. Neither you nor your partner should feel the ring in place, though it can be removed for intercourse, provided it is replaced immediately afterwards. The benefit is that a woman using the ring does not need to remember to take contraceptive pills on a daily basis like the pill. A new ring is used every month.
The side effects of the contraceptive ring can be similar to those of the combined oral contraceptive pill such as headache, fluid retention and breast tenderness, though the amount of hormones contained and released by the vaginal ring are smaller, as the medication doesn’t need to be absorbed through the stomach, or be processed by the liver. So, the hormonal side effects are generally less. The contraindications, ( reasons for not taking it) for the vaginal ring are the same as for the combined oral contraceptive pill. The vaginal ring is more expensive than the oral contraceptive pill.
The contraceptive implant is a tiny rod which is inserted under the skin in the upper inner arm. It slowly releases a form of progesterone into the blood stream and lasts for 3 years. We can insert the implant for you at Gynaecare under local anaesthetic on any day of the week. The implant can also be inserted at the time of medical or surgical termination of pregnancy. The best time to have the implant inserted is during a menstrual period. About 20% of women get unpredictable bleeding with the implant, and if it gets really annoying, some women ask to have the implant removed, which is also straightforward (usually), and is done under local anaesthetic at our Gynaecare clinic. Generally, you will know after 3 months of use, whether the implant will suit you or not.
Depot contraceptive injection
The depot injection is given every 3 months into the buttock or upper arm. It is an effective form of contraception, but it may take time for its effects to wear off after use. The depot injection can cause suppression of ovulation (with associated hormone suppression), and therefore it is not recommended for use long term due to risks of bone density deterioration.
Intra-Uterine Device (IUD)
The non hormonal IUD is placed in the uterus with or without sedation at Gynaecare. If you have had a recent vaginal delivery it is likely we can insert the IUD without anaesthetic. If not or if preferred, Gynaecare can provide sedation (inhaled or intravenous). The non-hormonal IUD contains a small amount of copper which provides contraception. In some women it can make periods longer/ or heavier. The IUD lasts for 5-10 years depending on which type is used. It is easily removed and immediately reversible.
Condoms are a good form of barrier contraception. They provide protection against sexually transmitted infection, as well as unplanned pregnancy. If a condom breaks, it is advisable to use emergency contraception ; either medication or have a copper IUD fitted.
Whilst not the most effective form of contraception, the diaphragm offers a drug free barrier form of contraception which suits some women, ie those who cannot use any hormonal methods or those with naturally reduced fertility. There is no need to use spermicides. There is only one type of diaphragm available in Australia, and does not need to be fitted.
Natural family planning
Awareness of a woman’s fertility can help couples plan their families without the assistance of any medication or device. Through the understanding and observance of natural physiological changes, couples can avoid pregnancy or enhance the chances of conception. Our expert doctors at Gynaecare can train you regarding awareness of your natural fertility to avoid or maximise the chances of pregnancy.
Permanent forms of contraception
Vasectomy is a permanent form of contraception for men. It requires a simple procedure to block the passage of sperm into semen. It is popular in men who feel they do not want to father further children and do not want to rely on other forms of contraception.
This is a permanent form of contraception, for women, requiring a laparoscopy , and insertion of small clips across the fallopian tubes, blocking the passage of the eggs down the fallopian tubes so that they cannot be fertilized. It is performed in hospital under general anaesthetic.
It is popular in women who do not want to have further children and other forms of contraception are not suitable. We do not offer this procedure at Gynaecare’s Chatswood (Sydney lower north shore) clinic but will refer you to an appropriate gynaecologist ( private or public) if it is your choice to have this procedure.
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