Types of contraception

Barrier methods prevent sperm from reaching an egg in a person’s uterus. There are several types of barrier methods, including the condom and the diaphragm. As mentioned, only latex condoms are the only form of contraception that are also effective for STI prevention. However, if you have a latex allergy, you can use polyurethane condoms.

• Condom
  There are two types of condom:
  - External condom, to be put on the penis;
  - Internal condom, also known as the ‘female condom’, to be put inside the vagina. You can also use an internal condom off-label for anal sex.
  
• Diaphragm
  A diaphragm is a device that is placed inside the vagina, so that it covers the cervix, and acts as a barrier to prevent sperm from reaching the uterus.

Some condoms or diaphragms can also be used with spermicidal gel, which effectively kills off the sperm in semen. Spermicidal gel can improve the effectiveness of barrier methods for contraception. Spermicidal gel is not common in Australia, though many people obtain it from overseas.

Hormonal contraceptives are an option for people with a uterus. Two hormones tend to be used, oestrogen and progesterone.

These hormones are delivered in a number of ways:

• A pill (or 'the Pill')
• Contraceptive ring
• Implant
• Injection
• Hormonal intra-uterine device (hormonal IUD)

In addition to preventing pregnancy, these hormonal methods can also have other effects and be used in other ways. These include slowing or stopping your period, preventing acne, or reducing symptoms of endometriosis and polycystic ovarian syndrome (PCOS).

It is best to speak more with a medical professional about the use, risks, and benefits of different hormonal methods.

A copper intra-uterine device, or copper IUD, is another option for people with a uterus. Copper IUDs work by thickening cervical mucus, to block and trap sperm so they can’t reach the egg to fertilise it. Some can also change the lining of the uterus, to prevent a fertilised egg from attaching to the wall of your uterus. The copper IUD needs to be inserted into your body by a trained medical professional, such as a doctor or nurse.

One extra use of copper IUD is asemergency contraception (see below).

There are many types of surgery as contraception: Vasectomy (for a person with testicles/balls) and Tubal ligation (for a person with ovaries and uterus).

• Vasectomy
  A vasectomy involves surgically cutting the vas deferens, or the tubes that carry sperm from the testicles to the penis. The surgery itself can be done with a local anaesthetic, and would involve a small cut into your scrotum to access the vas deferens.
• Tubal ligation
  Tubal ligation involves surgically ‘clipping’ the fallopian tubes that bring eggs from the ovaries into the uterus. This is a fairly major surgery, which requires general anaesthetic, cutting into your belly to access the correct area, and recovery time.

Many doctors are reluctant to provide surgical contraceptive options to young people, because many of these methods are either irreversible, or very difficult to reverse.

The emergency contraceptive pill, also known as the ‘morning after pill’, can be taken up to 72 hours after sex (three days). However, for most people it's still effective up to four days after sex. It's not as effective if you weigh more than 70kg. It's also free at some pharmacists (you would need to check in your area), but can cost up to $40.

⚠️ Important!

The emergency contraceptive pill is meant as a last resort, or as an ‘emergency’ form of contraception, as it says in the name. It’s not a reliable contraceptive method to use long-term. If you are sexually active and can get pregnant, talk to your doctor or a relevant health professional to find other suitable contraceptive options that can be safer for you in the long term.

An emergency copper IUD can be inserted up to 120 hours (five days) after unprotected sex, or within five days of your earliest expected date of ovulation. This method is also known to be more effective than the emergency contraceptive pill, but it requires a more invasive procedure (you need a trained professional, usually a doctor or nurse, to insert the IUD for you) and it's not quite as easy to access. Compared to the emergency pill, a copper IUD is recommended if you weigh more than 70kg.