Contraception prevents unplanned pregnancy. It is an important part of having a healthy and fulfilling sex life, but with so many choices available, it can be overwhelming for a young person to know where to start. If a young person you’re working with has questions about contraception options, preventing pregnancy and safe sex, this article will help guide your discussion.
What is contraception?
Contraception is used to prevent pregnancy. It’s sometimes referred to as birth control and includes various options, including the pill, implants, and injections.
Anyone who is sexually active and can get pregnant should consider if they need contraception – it’s a personal choice that provides people with autonomy over their body and their future.
It’s important to remember that contraception protects against pregnancy, but only condoms protect against sexually transmissible infections (STIs).
Types of contraception available
There are many methods of contraception that work in different ways. The type of contraception a young person uses is their choice. A doctor can help them to understand the benefits and side-effects of different options and work out the one that best suits. There are four main ‘types’ of contraception:
- Hormonal methods (the Pill or the mini-pill, vaginal ring): Hormonal contraception uses hormones such as oestrogen and progestogen to make changes to the body to prevent pregnancy.
- Long-acting reversible contraception (the hormonal IUD, the copper IUD, the Implanon and the contraceptive injection): Contraceptive methods that last a long time but aren’t permanent. Some use hormones while others don’t.
- Barrier methods (the internal and external condom): Barrier methods stop the transfer of bodily fluids. These types of contraception also work to prevent STIs as well as pregnancy.
- Other methods (fertility awareness method, withdrawal method): These methods do not involve hormones or barriers to stop the transfer of bodily fluids and are usually less effective.
Below, we explore these options in more detail.
A GP is the best person to discuss contraception options with a young person. Another excellent resource for young people is Family Planning NSW’s free and confidential Talkline service.
Hormonal methods
Hormonal contraception methods operate by gradually releasing either estrogen, progestogen, or both into the body via tablets or a device. A doctor’s prescription is required for all hormonal contraception options.
Hormonal methods do not offer protection against STIs, so it’s important that young people know they still need to use condoms as part of a healthy and safe sex life.
- The contraceptive pill: The combined oral contraceptive pill, commonly known as ‘the Pill’, contains two hormones (oestrogen and progestogen) and is taken daily, preferably at the same time each day. The oestrogen prevents the ovaries from releasing an egg and the progesterone thickens the cervical mucus, preventing sperm from entering the uterus. When taken correctly, the pill can be up to 99% effective at preventing pregnancy. There’s a lot of different brands of the pill that contain different hormone levels. Each work to prevent pregnancy in the same way.
- The minipill: The minipill is also known as the Progestogen-Only Pill (POP). The minipill contains only one hormone, progestogen, and prevents pregnancy by thickening the cervical mucus so sperm can’t get into the uterus. Sometimes it also stops the ovaries from releasing an egg too. It must be taken at the same time every day to be effective. When taken correctly, the minipill can be up to 99% effective at preventing pregnancy.
- Vaginal ring: The vaginal ring is a soft plastic ring which slowly releases low doses of two hormones, oestrogen, and progestogen. The ring is self-inserted and remains in the vagina for three weeks. After three weeks, the ring is self-removed, and a new ring is self-inserted a week later.
Long-Acting Reversible Contraception (LARC) methods
LARC are contraceptive methods that last a long time but aren’t permanent. They’re a ‘set and forget’ option, which means young people won’t need to remember to do something every day. This also means they’re the most effective form of contraception.
Just like hormonal methods, LARC methods do not offer protection against STIs, so it’s important to remind young people to always use condoms anytime they have oral, vaginal or anal sex.
- The Contraceptive Implant (Implanon): The contraceptive implant is also known as ‘the rod’ or the Implanon. It is a small plastic rod inserted beneath the skin on the upper arm, which releases progestogen slowly into the blood stream and can remain effective for up to three years. This is one of the most effective contraceptive options at 99.9% effective to prevent pregnancy.
- Hormonal IUD: The hormonal IUD, also known the Mirena or Kyleena, is a small ‘T’ shaped plastic device inserted into the uterus by a specially trained healthcare provider. It works by slowly releasing a very low dose of the hormone levonorgestrel and can prevent pregnancy for up to five years and is 99.9% effective at preventing pregnancy.
- Copper IUD: The copper IUD is a small t-shaped device made from plastic and is wrapped in a small copper wire. It is inserted into the uterus by a specially trained healthcare provider. The copper on the IUD is toxic to both the egg and sperm which prevents the sperm from fertilising the egg. Copper IUDs are 99.2% effective in preventing pregnancy and can also be inserted as an emergency contraception method.
- The contraceptive injection: The contraceptive injection, also known by its brand name Depo Provera, is given every 12 weeks and prevents pregnancy by stopping ovulation. In Australia, it’s sometimes referred to as ‘the injection’ or ‘Depo’ and is between 94-99.8% effective.
Barrier methods
Condoms are a barrier method of contraception and prevent the exchange of body fluids during sex. They offer protection against both pregnancy and STIs when used consistently and correctly.
- External (male) condom: Made of latex rubber or non-latex polyisoprene and rolled onto an erect (hard) penis, condoms can be up to 98% effective if used correctly.
- Internal (female) condom: Made of pre-lubricated nitrile, the internal condom is inserted into the vagina before sex. With perfect use, it’s up to 95% effective.
Other methods
There are a range of other non-permanent methods that can be used to prevent pregnancy. These include:
- Fertility awareness methods: The fertility awareness method, also referred to as period tracking or cycle tracking, is when a person monitors their period cycle and/or any fertile signs (cervical mucus, body temperature etc.) to see when they are most fertile. A person would need to avoid having sex during their fertile period (the week before ovulation until a day after ovulation occurs) to reduce their chances of becoming pregnant. Read more about pros and cons of this method here.
- Withdrawal method: The withdrawal method, also known as ‘the pull-out method’ or ‘pulling out’, is when the penis is removed from the vagina during sex before ejaculating (orgasming/cumming). It’s typically only about 78% effective in preventing pregnancy because it requires precise timing to ensure the penis is fully removed from the vagina before ejaculating. It’s important to know that there may be some sperm in the fluid that comes out of the penis before ejaculation occurs too.
Emergency contraception
Emergency contraception, commonly referred to as the ‘morning-after pill’ or ‘Plan B,’ can be used after unprotected sex to lower the risk of pregnancy. It comes in two forms: the emergency contraceptive pill (ECP) and the copper IUD.
- Emergency contraceptive pill (ECP): This can be taken up to five days after unprotected sex, but it is most effective if taken in the first 24 hours. In Australia, you do not need a prescription, but can simply ask at the pharmacy counter. When taken in the first 72 hours (three days), it prevents about 85% of pregnancies, but doing a pregnancy test a few weeks later is recommended. It’s important to know that the ECP is not an abortion pill. The ECP can be between $5-40 per pill and shouldn’t be relied on as ongoing contraception.
- Copper IUD: A copper IUD can also be used as emergency contraception. When inserted in the first 120 hours (five days) after sex, it prevents about 99% of pregnancies. Keep in mind that these need to be inserted by a trained doctor or nurse but could be a good option if someone is looking for immediate and ongoing contraception.
We hope this has helped shed some light on the contraceptive choices available in Australia but if a young person you’re speaking with wants specific advice, always direct them to their GP or a family planning clinic.
Choosing the right contraception
There are many contraception choices available, so it can take some time for a young person to research and understand the different options.
If you’re chatting with someone about contraception, you can help them to research the different options available to them and support them to chat with a GP, who will be able to advise on:
- Effectiveness
- Ease of use
- Any side effects
- Reversibility
- Cost and availability
- Benefits and disadvantages
- Impact of any existing health issues on contraception choice
Before going to their GP, you can encourage young people to read through the fact sheets on Family Planning NSW’s website or Body Talk, along with the latest blog about contraception on the Play Safe website. These are fantastic resources that provide an overview of the different types of contraception, how it works, the pros and cons, where to get it, and how to take it.
Reading these ahead of their appointment will help them feel prepared and also get a better understanding of their circumstances and preferences. They could even start thinking about things like:
- What is their lifestyle like? Is taking a pill every day tricky, or manageable?
- What are their periods like? Some hormonal contraception can positively impact painful or heavy periods – this may be something they wish to consider.
Thinking about these upfront will help them prepare for their appointment and prepare any questions they might have for their GP.
Whose responsibility is contraception?
One question that might come up in conversation is whose responsibility contraception is. Although the person taking the contraception is the one who can get pregnant, if they’re in a relationship, fostering a sense of shared responsibility in contraceptive choices is important.
As Body Talk says: “It’s important to consider all the contraception types available and pick one that best suits you and your partner’s health and lifestyle needs”.
How to talk to young people about contraception
If someone is seeking specific advice on contraception, always direct them to a GP or Family Planning NSW’s Talkline service.
As with any conversation about sexual health, it’s important to create a safe, confidential and open environment.
Be aware of the person’s cultural and religious background:
Some cultural and religious backgrounds may influence thoughts, attitudes and beliefs around contraception. These may show in someone experiencing shame or stigma discussing contraception or sexual health. Always be aware of these sensitivities, have youth-led conversations and ensure the young person you’re working with is comfortable with the conversation.
Consider LGBTQI+ inclusivity:
When chatting with young people, be aware of using language that is inclusive of the LGBTQIA+ communities (lesbian, gay, bisexual, transgender, queer, intersex, and asexual).
Use age-appropriate language:
Tailor your language and explanations to the age and comprehension level of the young person you’re speaking to. Avoid medical jargon and use simple, clear terms.
Practice active listening:
Listen actively to young people’s questions and anxieties, validate their feelings, and alleviate fears through accurate information.
Address concerns honestly:
Provide transparent information about contraception, its benefits, and potential risks, but always direct to a GP for further information.
Helpful external resources
If you want to learn more about contraception to guide your discussions with young people, or someone in your service wants to know more, check out the links below.
