Although over two-thirds of Australian women of reproductive age use contraception, it is estimated that over half of Australian women experience an unplanned pregnancy. Currently the most commonly used methods of contraception in Australia are the contraceptive pill (27-34%) and condoms (20-23%), the efficacy of which can be easily affected by human error. Experts suggest that the number of unplanned pregnancies could be reduced if more women used long-acting reversible contraception (LARC) methods, however currently they have one of the lowest uptakes.
Family Planning NSW's 'Reproductive and sexual health in Australia' resource states:
"Very few women used long acting reversible contraception (LARCs) with injectable contraception accounting for 0.9 to 2.1% of contraceptive use with similar proportions of use for the implant (1.1 to 3.6%) and intrauterine contraceptive methods (IUDs) (1.2 to 3.2%).”
Improving the public's understanding of LARCs will not only allow women to have more choices of contraception, but also decrease the risk and rate of unplanned pregnancies.
What are LARCs?
LARCs are the most effective forms of contraception after abstinence and are considered to be on par with sterilisation. Unlike other methods of contraception, human error generally has very little impact on LARCs as they do not require action to prevent pregnancy on a daily basis or prior to each incidence of sexual intercourse. The long-acting nature of LARCs often gives them the tag line 'fit and forget' as once they've been inserted they will be effective for a number of years. LARCs need to be inserted and removed by a doctor, and are fully reversible allowing a quick return to full fertility after removal.
There are three main types of LARC:
Implant
What is it?
The implant is a 4cm plastic rod that is inserted under the skin in your upper arm by your doctor. It continuously releases a synthetic hormone similar to progesterone into the bloodstream and lasts up to three years. Fertility returns very quickly upon removal of the implant by your doctor.
Efficacy
The implant is one of the most effective contraception options available with a rate of 99.95% protection with typical use (how most people use it).
Side effects
Some women may experience dramatic changes to their menstrual cycle, or other hormone-related side effects, and are recommended to trial the implant for three months and discuss issues with a doctor before considering removal.
Intrauterine devices/systems (IUD/IUS)
Early forms of IUD/IUS had a bad reputation, but modern types of IUD/IUS have greatly improved and are an excellent choice for women who have completed their families or younger, childless women. There are two types currently available – hormonal (IUS) and copper (IUD).
Hormonal IUS
What is it?
A small, T-shaped piece of plastic is inserted into the uterus by your doctor, and the attached fine threads protrude through the cervix to assist with removal. The hormonal IUS slowly releases the hormone levonorgestrel (similar to progesterone) for up to 5 years and fertility returns to normal very quickly following removal.
Efficacy
The hormonal IUD has a protection rate of 99.8% for typical use.
Side effects
A small number of women (~5%) may experience an unexpected expulsion of the hormonal IUS. Women can check whether their device is still in place by feeling for the fine threads that protrude through the cervix. The hormonal IUS can also alter a women's menstrual cycle, usually by causing periods to become lighter and less frequent so are particularly useful in women with heavy menstrual bleeding.
Copper IUD
What is it?
A small, T-shaped or U-shaped plastic device wrapped with copper wire is inserted into the uterus by your doctor, and the attached fine threads protrude through the cervix to assist with removal. The copper IUD inhibits the movement of sperm (sperm motility) and also creates an unsuitable environment for implantation. Different types of copper IUD last for up to 5 or 10 years and fertility returns to normal very quickly following removal.
Efficacy
The copper IUD has a protection rate of 99.2% with typical use.
Side effects
A small number of women (~2-3%) may experience an unexpected expulsion of the copper IUD. Women can check whether their device is still in place by feeling for the fine threads that protrude through the cervix. The copper IUD can also alter a women's menstrual cycle, usually by causing periods to become heavier, with up to 50% more bleeding. The copper IUD is a suitable choice for women who cannot, or prefer not to use a hormonal form of contraception.
The 'in-between'
Contraceptive injections
The contraceptive injection falls somewhere between short-term contraceptive methods and LARCs. Contraceptive injections last between 8-13 weeks so require more human input than other LARCs and therefore have a lower efficacy rate. Unlike the implant or IUD/IUS, the injection does not offer an immediate return to fertility.
What is it?
A synthetic hormone similar to progesterone is injected into the buttock or upper arm by a doctor or nurse every 8-13 weeks depending on the type. It takes 7 days to become effective and is not immediately reversible, with women taking up to two years to return to full fertility.
Efficacy
The injection has a protection rate of 94% with typical use.
Side effects
The contraceptive injection effects bone density and is not recommended as a first choice for women under 18 or over 45 years of age. However, this reduction in bone density is reversible after injections are ceased for women in their mid-reproductive years. The injection can also effect a woman's menstrual cycle, with ~50% of women having no bleeding after one year.
Family Planning NSW's 'Reproductive and sexual health in Australia' resource states:
"Very few women used long acting reversible contraception (LARCs) with injectable contraception accounting for 0.9 to 2.1% of contraceptive use with similar proportions of use for the implant (1.1 to 3.6%) and intrauterine contraceptive methods (IUDs) (1.2 to 3.2%).”
Improving the public's understanding of LARCs will not only allow women to have more choices of contraception, but also decrease the risk and rate of unplanned pregnancies.
What are LARCs?
LARCs are the most effective forms of contraception after abstinence and are considered to be on par with sterilisation. Unlike other methods of contraception, human error generally has very little impact on LARCs as they do not require action to prevent pregnancy on a daily basis or prior to each incidence of sexual intercourse. The long-acting nature of LARCs often gives them the tag line 'fit and forget' as once they've been inserted they will be effective for a number of years. LARCs need to be inserted and removed by a doctor, and are fully reversible allowing a quick return to full fertility after removal.
There are three main types of LARC:
Implant
What is it?
The implant is a 4cm plastic rod that is inserted under the skin in your upper arm by your doctor. It continuously releases a synthetic hormone similar to progesterone into the bloodstream and lasts up to three years. Fertility returns very quickly upon removal of the implant by your doctor.
Efficacy
The implant is one of the most effective contraception options available with a rate of 99.95% protection with typical use (how most people use it).
Side effects
Some women may experience dramatic changes to their menstrual cycle, or other hormone-related side effects, and are recommended to trial the implant for three months and discuss issues with a doctor before considering removal.
Intrauterine devices/systems (IUD/IUS)
Early forms of IUD/IUS had a bad reputation, but modern types of IUD/IUS have greatly improved and are an excellent choice for women who have completed their families or younger, childless women. There are two types currently available – hormonal (IUS) and copper (IUD).
Hormonal IUS
What is it?
A small, T-shaped piece of plastic is inserted into the uterus by your doctor, and the attached fine threads protrude through the cervix to assist with removal. The hormonal IUS slowly releases the hormone levonorgestrel (similar to progesterone) for up to 5 years and fertility returns to normal very quickly following removal.
Efficacy
The hormonal IUD has a protection rate of 99.8% for typical use.
Side effects
A small number of women (~5%) may experience an unexpected expulsion of the hormonal IUS. Women can check whether their device is still in place by feeling for the fine threads that protrude through the cervix. The hormonal IUS can also alter a women's menstrual cycle, usually by causing periods to become lighter and less frequent so are particularly useful in women with heavy menstrual bleeding.
Copper IUD
What is it?
A small, T-shaped or U-shaped plastic device wrapped with copper wire is inserted into the uterus by your doctor, and the attached fine threads protrude through the cervix to assist with removal. The copper IUD inhibits the movement of sperm (sperm motility) and also creates an unsuitable environment for implantation. Different types of copper IUD last for up to 5 or 10 years and fertility returns to normal very quickly following removal.
Efficacy
The copper IUD has a protection rate of 99.2% with typical use.
Side effects
A small number of women (~2-3%) may experience an unexpected expulsion of the copper IUD. Women can check whether their device is still in place by feeling for the fine threads that protrude through the cervix. The copper IUD can also alter a women's menstrual cycle, usually by causing periods to become heavier, with up to 50% more bleeding. The copper IUD is a suitable choice for women who cannot, or prefer not to use a hormonal form of contraception.
The 'in-between'
Contraceptive injections
The contraceptive injection falls somewhere between short-term contraceptive methods and LARCs. Contraceptive injections last between 8-13 weeks so require more human input than other LARCs and therefore have a lower efficacy rate. Unlike the implant or IUD/IUS, the injection does not offer an immediate return to fertility.
What is it?
A synthetic hormone similar to progesterone is injected into the buttock or upper arm by a doctor or nurse every 8-13 weeks depending on the type. It takes 7 days to become effective and is not immediately reversible, with women taking up to two years to return to full fertility.
Efficacy
The injection has a protection rate of 94% with typical use.
Side effects
The contraceptive injection effects bone density and is not recommended as a first choice for women under 18 or over 45 years of age. However, this reduction in bone density is reversible after injections are ceased for women in their mid-reproductive years. The injection can also effect a woman's menstrual cycle, with ~50% of women having no bleeding after one year.
No comments:
Post a Comment