A Guide to Contraception Options in Australia

Contraception plays a crucial role in family planning and allows individuals and couples to make informed decisions about when and whether to plan pregnancies and have children.

In Australia, a variety of contraception options are available to people. This comprehensive guide will explore the different types of contraception, how they work and where to obtain them.

Female Contraception Methods

There are a wide range of hormonal and non-hormonal contraception options available to individuals assigned female at birth.

Hormonal

1. Oral Contraceptives (The Pill): There are two types of oral contraceptives; Combined Oral Contraceptives (COCs) and Progestogen-Only Pills (POPs). Oral contraceptives are taken daily at the same time and contain synthetic hormones (estrogen and progestin) that inhibit ovulation, making it difficult for sperm to fertilize an egg. They also alter the cervical mucus, preventing sperm from reaching the egg. The Pill can only be acquired with a prescription after consulting a healthcare professional.
2. Contraceptive Implants: This is a small, flexible rod that is inserted under the skin of the upper arm. It contains progestin to prevent ovulation and thicken cervical mucus. Implants require a prescription and insertion by a healthcare provider. They last 3 years but can be removed earlier.
3. Contraceptive Injection: These injections contain progestin to prevent ovulation and thicken cervical mucus. They are administered by a healthcare professional every few months and require regular medical visits.
4. Contraceptive Patch: Patches release hormones through the skin to prevent ovulation. Patches require a prescription and are applied to the skin once a week for three weeks.
5. Hormonal Intrauterine Devices (IUDs): Hormonal IUDs, such as Mirena, are T-shaped devices that release a small amount of progestin into the body. IUDs are fitted into the uterus by a healthcare professional and work for up to 8 years.
6. 'Morning after' pill: The 'morning after' pill (also known as 'Plan B') is an oral emergency contraception method. It works by delaying or preventing ovulation, blocking fertilisation or preventing a fertilised egg from implanting in the uterus. They can work 3-5 days after unprotected sex, depending on the brand, but are most effective when taken within 72 hours (preferably 24 hours). It can be used if you have missed taking your oral contraceptive pills, are taking oral contraceptive pills but have experienced diarrhoea or vomiting, if a condom has broken during intercourse or if you have been sexually assaulted. Emergency contraception pills are available at pharmacies and sexual health clinics

Non-Hormonal

1. Female Condoms: While less common than male condoms, internal female condoms are another barrier method. They are inserted into the vagina before intercourse and also prevent sexually transmitted infections (STIs). Female condoms are available at some pharmacies and some sexual health clinics.
2. Copper IUDs: Like hormonal IUDs, copper IUDs are T-shaped devices fitted into the uterus by a healthcare professional however they do not release hormones. Instead, the device has thin copper wire wrapped around the frame which is toxic to sperm preventing fertilisation of the egg. Copper IUDs last 5 to 10 years.
3. Diaphragm: A diaphragm is a shallow dome that is inserted before intercourse. It covers the cervix and prevents sperm from entering the uterus. It is left in place for 6 hours after intercourse, by which time the sperm have died and it is recommended it be used in conjunction with a lactic acid-based gel. 
4. Tubal ligation or female sterilisation: A tubal ligation, commonly referred to as "getting your tubes tied", is a surgical procedure where the fallopian tubes are tied, cut or blocked to prevent the egg from travelling from the ovaries to the uterus. This procedure does not affect the menstrual cycle but prevents pregnancy and must be performed by a gynaecologist. Tubal ligations can not always be reversed to allow for pregnancy again if the tube was damaged or if there is insufficient tube remaining to reconnect.

Male Contraception Methods

Current contraception options for individuals assigned male at birth are non-hormonal however there are some interesting developments in male hormonal contraception too.

Non-Hormonal

1. Condoms: Condoms are worn over the penis during intercourse and provide a physical barrier, preventing sperm from reaching the egg. They are widely accessible and can be purchased in grocery stores, pharmacies and some service stations. Condoms also protect against sexually transmitted infections (STIs) in addition to preventing pregnancy.
2. Withdrawal Method: This is a natural form of contraception (also known as "pulling out") whereby the penis is withdrawn from the vagina before ejaculation. The effectiveness of the withdrawal method varies as it is dependent on the individual's self-control.
3. Vasectomy: A vasectomy is a surgical procedure whereby the vas deferens, which are the tubes that carry the sperm, are cut and blocked to prevent sperm from reaching semen. Vasectomies are permed by doctors and most vasectomies are reversible with sperm progressively returning after 3 months for 90% of people.

Trials for Male Hormonal Contraception

Whilst not available in Australia as yet, there are some advancements in the male hormonal contraception; 

1. Contraceptive Gel: With this method a a gel is applied to the upper arms and shoulders daily to inhibit sperm production. This method of contraception is currently undergoing clinical trials in Australia so not yet widely available.
2. Injectable Male Contraceptive: A new gel is being trialled by 25 men. It is injected into the tube that carries the sperm and is believed to provide "temporary" contraception for up to 2 years.
3. Oral Pill: Like the female pill, a daily oral pill for men is currently being trialled in Britain.

References:

1. Family Planning New South Wales. (n.d.). Retrieved from https://www.fpnsw.org.au/
2. Family Planning Victoria. (n.d.). Retrieved from https://www.fpv.org.au/
3. Better Health Channel - Contraception. (2021). Retrieved from https://www.betterhealth.vic.gov.au/health/healthyliving/contraception
4. Marie Stopes Australia. (n.d.). Retrieved from https://www.mariestopes.org.au/
5. Australian Government Department of Health. (2021). Sexual and reproductive health. Retrieved from https://www.health.gov.au/health-topics/sexual-and-reproductive-health
6. IVFAustralia https://www.ivf.com.au/treatments/male-treatments/vasectomy-reversal
7. ABC News - Male contraceptive being trialled in Melbourne dubbed a game changer by researchers https://www.abc.net.au/news/2022-11-11/male-contraceptive-implant-trial-melbourne-epworth/101642056
8. The Guardian - Scientists are on the verge of a male birth control pill. Will men take it? https://www.theguardian.com/commentisfree/2023/dec/18/male-birth-control-will-men-take-it