Contraception

Long-acting reversible contraception (LARC) is an umbrella term for highly effective contraceptive methods that provide ongoing pregnancy prevention and can be removed if pregnancy is desired in the future. LARC methods include:

• Hormonal intrauterine devices (IUDs)
• Copper intrauterine devices (IUDs)
• Contraceptive implants

These methods require little ongoing maintenance and may provide contraception

Intrauterine devices, commonly called IUDs, are a type of LARC. They are small devices inserted into the uterus. There are two main types.

Hormonal IUD

Hormonal IUDs release a small amount of progestogen within the uterus. Depending on the device selected, potential benefits may include:

• Highly effective contraception
• Reduced menstrual bleeding
• Improvement in heavy periods
• Reduced period pain for some women

Copper IUD

Copper IUDs do not contain hormones. Potential benefits may include:

• Long-term contraception
• A hormone-free option
• Rapid return to fertility following removal

Copper IUDs are not suitable for everyone as they can worsen period bleeding and cramps in someone who already experiences heavier or more painful periods.

The contraceptive implant is a small, flexible rod inserted under the skin of the upper arm. It releases a progestogen hormone and provides longer-term contraception. Potential benefits include:

• Effective pregnancy prevention
• Long duration of action
• No need to take daily medication
• Rapid return to fertility after removal

Some women may experience changes to their bleeding pattern when using the implant.

The combined oral contraceptive pill contains oestrogen and progestogen hormones. When taken correctly, it is an effective contraceptive option for many women. Its benefits may include:

• Effective contraception
• More predictable menstrual cycles
• Lighter or less painful periods
• Improvement in acne for some women

The combined pill is not suitable for everyone, especially women with certain medical conditions or risk factors.

The progestogen-only pill, sometimes called the mini pill, contains progestogen without oestrogen.

It may be suitable for some women who cannot use combined hormonal contraception. Suitability depends on your health, medications and individual circumstances.

The contraceptive injection provides pregnancy prevention through hormone injections given at scheduled intervals.

It may suit some women who prefer not to take daily medication. Its potential advantages, side effects and impact on the return to fertility should be discussed with a gynaecologist, such as Dr Lanziz Homar.

Barrier methods work by preventing sperm from reaching the egg, like external condoms, internal condoms and diaphragms.

Condoms are the only contraceptive method that also helps reduce the risk of sexually transmitted infections (STIs) and can be used alongside other contraceptive methods.

Permanent contraception may be considered by individuals or couples who are certain they do not want children in the future.

Female Sterilisation
Female sterilisation involves a surgical procedure to block or remove the fallopian tubes.

Vasectomy
A vasectomy is a procedure performed on the male reproductive tract and is generally considered a highly effective permanent contraceptive option.

Permanent contraception should be considered carefully, as reversal procedures may not always be successful.

Natural family planning involves identifying fertile and non-fertile times within the menstrual cycle. Methods include:

• Fertility awareness and cycle tracking
• Basal body temperature monitoring
• Cervical mucus monitoring

Effectiveness varies and depends on accurate, consistent monitoring. Menstrual irregularity, illness, travel and other everyday factors can also make fertile periods more difficult to predict.

Emergency contraception may help reduce the risk of pregnancy following unprotected intercourse or contraceptive failure, such as a missed pill or broken condom. Options include:

• Emergency contraceptive pills
• Copper IUD insertion

Emergency contraception is most effective when used as soon as possible after unprotected intercourse.

Most reversible contraceptive methods do not have a long-term effect on fertility, and for most, fertility returns after contraception is stopped or removed. Sometimes though, the timing varies based on the method.

If you are considering a future pregnancy, speak to your OBGYN, Dr Lanziz Homar, to discuss the expected return to fertility associated with each option.