CONTRACEPTION PROGRAM

Contraception is any method used to prevent pregnancy. Both males and females can use contraception, although there are more options available for females.

There are many different contraceptive options available, and what suits one person may not be suitable for another. Understanding the options is the key to choosing the right method and using it effectively.

Each month, the ovaries release an egg. During ejaculation, semen contains millions of sperm, and it only takes one sperm to fertilise an egg for pregnancy to occur. Using contraception helps prevent this process, with different methods working at various stages.

To understand how contraception works, it will help us to know how pregnancy occurs and how it can be interrupted at one or more of these steps.

Pregnancy occurs when:

• A sperm fertilises an egg
• The fertilised egg travels to the uterus 
• The egg implants into the uterine lining

Each of the contraception options can interfere with any of or all of the above steps

There are several types of contraception, and each works differently. The right options depend on your individual needs, preferences, and medical history. 

Female contraceptive options vary and should be selected in consultation with a doctor who can discuss suitable options based on your needs and health.

These methods may work by:

• Preventing ovulation
• Thickening cervical mucus to block sperm
• Altering the uterine lining
• Physically preventing sperm from reaching the egg

Barrier methods

There are two barrier options for both women and men. 

Female Barrier Methods 

There are two options: the female condom or the diaphragm. Both physically prevent the sperm from reaching the egg. 

The female condom is a plastic sheath that is placed into the vagina before sex. This method is up to 95% effective when used correctly. This method is also effective in preventing STIs. The drawback for these is the same as male condoms; they can tear during use, which accounts for the last 5%.

The diaphragm is a silicone dome that is placed over the cervix, which does not allow sperm to pass. These need to be fitted initially by a doctor or nurse to ensure they are a correct fit. When used correctly, the diaphragm is up to 94% effective.

Fertility Awareness Method

This method is centred around knowing where you are in your cycle and being aware of when ovulation is happening, and avoiding sex around this time.

 If this method is going to be used, it is recommended to seek specific education from family planning experts first. This method is around 75-88% effective; however, ovulation times can vary in some women, making this method unreliable at times. For greater effectiveness, it is often recommended to use a more reliable method if possible.

Surgical Contraception

This surgery is called tubal ligation, or more commonly known as getting your tubes tied, and is a more permanent form of contraception. For this reason, it should only be used once a person is sure that they do not wish to have any/or more children.

This is keyhole surgery where the surgeon blocks the fallopian tubes with a tie or clip to prevent sperm and eggs from meeting. This method is over 99% effective and is only ineffective if a tie or clip fails and a fallopian tube becomes unblocked.

Barrier Contraceptives

Perhaps one of the most well-known contraceptive methods is the use of condoms. This involves placing a latex or latex-like sheath over the erect penis. This keeps the sperm inside the barrier, preventing pregnancy and STIs. If used correctly, condoms are up to 98% effective, meaning around 2 out of 100 people may still experience pregnancy over one year of use. However, with typical use, which accounts for incorrect or inconsistent use, effectiveness drops to around 82%, meaning approximately 18 out of 100 people may experience pregnancy within a year.

Common reasons for reduced effectiveness include:

• Not using a condom every time during sex
• Putting the condom on incorrectly or too late
• Breakage or slipping during use
• Using oil-based lubricants with latex condoms can weaken and break the material

The Withdrawal Method

The method is where the man takes his penis out of the vagina before ejaculation. This method varies in success from 80-96%. The variance comes from a failure to withdraw before ejaculation or enough pre-ejaculate to cause impregnation. For this reason, it is only recommended as a secondary method of contraception.

Surgical Contraception

This surgery is known as a vasectomy. A vasectomy involves cutting or blocking the tube that carries sperm from the testicles to the urethra. This prevents sperm from being present in the ejaculate.

This method is one of the most effective methods of contraception, at 99.98% effective. This method is close to permanent, with reversal being possible in some cases, although not ideal. This should only be used by men who are sure they do not want children.

Each individual responds differently to contraception. Some contraceptive methods may not be suitable for everyone. A health professional consultation can help

• Access suitability
• Discuss risks and benefits 
• Provide personalised recommendations

If you're considering contraception or reviewing your current method, taking the first step to understand contraception can be a useful starting point.

Early discussion can help you better understand and explore appropriate management approaches suited to your individual circumstances.

Connect with a clinical team for a professional assessment and, where appropriate, begin building a plan to help manage your wellbeing.