We celebrate World Health Day on 7 April.
Being able to control if and when you have children is a big part of maintaining your health. So is choosing the right contraceptive method for you.
This month we compare the effectiveness of different contraceptive methods in preventing pregnancy. Different methods suit different people according to their age, life stage, finances and personality.
With no method of contraception, 85% of women in their 20s will become pregnant within one year.
We specifically look at effectiveness of preventing pregnancy here. Only condoms and diaphragms provide protection against both pregnancy and STIs.
Perfect use vs typical use
Many contraceptive methods are affected by human error such as forgetting to take your pill. They may be very effective with “perfect use” but the effectiveness of certain methods as “typically used” is likely to be lower.
Perfect use of a contraceptive method is when it is used correctly all the time.
Typical use is what generally happens in real life. It takes into account human error.
As you can see below, for long acting reversible contraception (LARCs) the perfect use is the same as typical use. This is because you don’t have to remember to take anything or get the condom on correctly. This is why more and more women are choosing LARCs.
Effectiveness of different contraception methods
Contraception effectiveness is measured by how many women will get pregnant within a year of using that method.
For example, the effectiveness of male condoms with perfect use is 98%. This means out of 100 women using condoms correctly all the time, two will become pregnant within one year.
Sometimes the effectiveness is quoted for the first year of use when people are learning how to use a method correctly. These figures below quote the first year use.
Barrier Methods
Male Condoms
- Perfect use: 98% effective
- Typical use: 85% effective
Diaphragm
- Perfect use: 94% effective
- Typical use: 84% effective
Oral Contraceptive Pill
Combined oral contraceptive, aka The Pill
- Perfect use: over 99% effective
- Typical use: 92% effective
Taking the pill continuously (i.e. skipping your period) is likely to be safer.
Progestogen-only pills, aka The Minipill
- Perfect use: over 99% effective
- Typical use: 92% effective
Long-Acting Reversible Contraception Methods (LARCs)
Mirena
- Perfect use: over 99% effective
- Typical use: over 99% effective
Copper IUD
- Perfect use: over 99% effective
- Typical use: over 99% effective
Jadelle
- Perfect use: over 99% effective
- Typical use: over 99% effective
Implanon
- Perfect use: over 99% effective
- Typical use: over 99% effective
Others
Depo Provera Injection
- Perfect use: over 99% effective
- Typical use: 97% effective
Nuva Ring
- Perfect use: over 99% effective
- Typical use: 92% effective
Emergency Contraception
Emergency contraception pill (ECP)
- Within 4 days of unprotected sex: 98-99% effective
- After 4 days: not effective
Research shows the ECP may not work for women with a BMI over 30. The copper IUD is a good option for these women.
Copper IUD
- Within 5 days (120 hours) of unprotected sex: over 99% effective
- After 5 days: not effective
Sterilisation
Vasectomy
- Failure rate: 1 in 1,000 (after waiting for two sperm-free semen tests)
Tubal ligation
Some information sourced from Contraception: your questions answered. 6th edition, 2013. Guillebaud J, MacGregor A. Churchill Livingstone Elsevier.
Key facts
- Using contraception allows people to have sex while preventing an unplanned pregnancy.
- Many different methods of contraception are available.
- It’s important to discuss contraception with a new partner before you decide to have sex.
- Contraception affects both you and your partner, so you are both responsible for it.
- The type of contraception you use is your choice — your doctor can help you understand the benefits of each type to help you decide.
Someone can get pregnant when a sperm released during sex fertilises an egg, which then implants in the uterus (womb). Contraception prevents pregnancy, so people can have sex while preventing an unplanned pregnancy.
There are many different forms of contraception. No form is 100% effective, but some methods are more effective than others. Aside from preventing pregnancy, some — but not all — methods of contraception can also prevent transmission of STIs.
Your choice of contraception might be an individual one, or a decision you make with your partner. In either case, it’s important to discuss contraception with a new partner before having sex, so you can choose a method that works for you. Contraception affects both you and your partner, so it the responsibility of both.
What types of contraception are available?
There are many different types of contraception available:
A male condom is a thin rubber or plastic covering worn on the penis during sex. A female condom is inserted into the vagina before sex. A condom stops body fluids mixing during sexual activity. This reduces the chance of pregnancy, as well as the likelihood of catching a sexually transmitted infection (STI). Condoms are the only contraceptive method that also help prevent STIs. Read more about the pros and cons of condoms
The combined oral contraceptive pill, also known as ‘the pill’ or OCP, is a tablet taken daily by women to prevent pregnancy. The pill contains a combination of hormones that stops the ovaries from releasing an egg each month. They also alter the mucus at the entrance of the uterus, making it harder for sperm to get through. Read more about the pros and cons of the combined oral contraceptive pill.
The vaginal ring is a flexible plastic ring inserted high into the vagina. It contains the same hormones as the pill and works in the same way. It stays in place for 3 weeks, so some women find it easier to use than the daily pill. Read more about the pros and cons of the vaginal ring.
The progestogen-only pill, or ‘mini-pill’, is another tablet that women take daily to prevent pregnancy. It contains the hormone progestogen, which changes the mucus at the entrance of the uterus to make it harder for sperm to get through. Read more about the pros and cons of the progestogen-only pill.
The contraceptive injection is a hormone injection given to women every 12 weeks. It works in a similar way to the pill. Read more about the pros and cons of the contraceptive injection.
The contraceptive implant is a small plastic rod inserted by a doctor into a woman’s upper arm. It contains the same hormone as the contraceptive injection but is more easily reversible since it can be removed. Read more about the pros and cons of the contraceptive implant.
The hormonal intrauterine device (IUD) is inserted by a doctor into a woman’s uterus through the cervix. It releases a hormone that prevents pregnancy in a few different ways, similar to the OCP. It can stay in position for up to 5 years. Read more about the pros and cons of hormonal IUDs.
The copper IUD is inserted into the uterus in the same way as the hormonal IUD. It does not contain hormones. The copper in the device makes it more difficult for sperm to fertilise the egg and prevents any fertilised eggs from implanting in the uterus. It can stay in place for 5 or 10 years, depending on the type of device used.
A diaphragm is a soft, reusable silicone cap placed in the vagina before sex to cover the cervix. It prevents pregnancy by stopping sperm from entering the uterus. Read more about the pros and cons of diaphragms.
The ‘withdrawal method’ is when the penis is removed from the vagina before ejaculation. This prevents sperm from being released into the vagina where they may swim up to the uterus and fertilise an egg. It is less effective than other methods because:
- There is sperm in the fluid released before ejaculation (pre-ejaculate or ‘pre-cum’).
- If ejaculation occurs at the entrance of the vagina, sperm can swim inside the woman’s body and this can result in pregnancy.
- It can be difficult for the man to withdraw in time.
‘Fertility awareness’ is when you avoid sexual intercourse during the times of the month when the woman is most fertile (most likely to conceive). This method involves keeping track of a woman’s periods and other indicators, such as cervical mucus and body temperature. This method can be tricky to use if a woman’s cycle is not regular.
Sterilisation is a medical procedure that can permanently prevent a pregnancy. In women, this involves blocking the fallopian tubes with an operation called a tubal ligation or occlusion. This prevents the egg from being released into the uterus where it may be fertilised. In men, the operation is called a vasectomy. It blocks sperm from being released into the ejaculate (cum), meaning the sperm cannot enter the woman’s body. Read more about the pros and cons of tubal ligation and vasectomy.
Any medicine or medical device can have side effects. Many are unwanted, but some can actually be beneficial.
The hormones used in contraceptive pills, implants, injections and intrauterine devices can have effects that include:
- irregular periods or bleeding between periods
- lighter or skipped periods
- less painful periods
- mood changes
- nausea
- headaches
- clearer skin
Ask your doctor or pharmacist for more information about any side effects that you should expect due to your contraceptive method.
What is emergency contraception?
Emergency contraception — sometimes called the ‘morning-after pill’ — is taken by a woman after having sex to reduce the risk of a pregnancy.
You might decide to use emergency contraception if:
- you had sex without using any contraception
- you had sex using a condom, and it broke
- you forgot to take your daily contraceptive pill, or have severe diarrhoea or vomiting after taking it
- you were sexually assaulted
The ‘morning-after pill’ contains hormones that stop ovulation. Two types of morning-after pill are available in Australia. Both can be bought from a pharmacy without a prescription. They can be used up to 72 hours (3 days) or 120 hours (5 days) after unprotected sex, depending on the pill you buy. Both pills are more effective the sooner they are taken. Your pharmacist can give you more information and advice about the best pill for you.
The emergency contraceptive pill reduces your chance of pregnancy from any unprotected sex that happened a few days before taking it. It will not prevent pregnancy from future unprotected sex — and it doesn’t protect you from catching an STI.
Another option for emergency contraception is having a copper IUD inserted within 5 days of unprotected sex. A copper IUD affects sperm movement, making fertilisation less likely and can also reduce the chance of a fertilised egg implanting in the uterus. The IUD can also provide long-term contraception.
Which type of contraception is best for me?
There are many things to think about when choosing which method of contraception is right for you.
Consider the following when making your contraceptive choice:
- Is it easy to use?
- How effective is it?
- Is it reversible?
- Does it protect against STIs?
- What is the cost?
Some options aren’t suitable for everyone. Some types of hormonal contraception are not recommended for people with a history of blood clots or other health problems like migraines or high blood pressure.
The type of contraception you use is your choice. Your GP or local family planning clinic can give you more information and suggestions about which options might be right for you.
When should I see my doctor?
It’s a good idea to see your doctor if you’re considering your options for contraception. They can advise you on which options might be right for you depending on your health and lifestyle. Many methods, such as the oral contraceptive pill, need to be prescribed by a doctor.
If you are interested in getting an IUD or a hormone injection, ask your doctor about the process.
ASK YOUR DOCTOR — Preparing for an appointment? Use the Question Builder for general tips on what to ask your GP or specialist.
What are family planning clinics?
Family planning clinics offer a range of reproductive and sexual health services to the general public. These include information and advice about contraceptive options. Clinic staff may also be able to prescribe contraceptive medicines, insert IUDs or contraceptive implants and refer people for sterilisation procedures.
Clinic services may have a cost so be sure to ask when you book an appointment.
Resources and support
For more information and support, try these resources:
Other languages
Do you prefer to read languages other than English? Family Planning NSW has fact sheets on Women’s Health and Contraception in many languages.