Doctors Need To Think Beyond The Pill For Contraception

There are plenty of cheaper, more effective options that don't mess with your body.

05/10/2016 2:59 PM AEDT | Updated 05/10/2016 3:02 PM AEDT
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All you need is a carefree contraceptive that doesn't mess with your body.

The pill revolutionised society when it was introduced in Australia 55 years ago but now scientists are lobbying GPs to offer women alternative and more effective options.

Family Planning NSW senior medical officer Mary Stewart said there were cheaper, more effective long-term options that women weren't always hearing about.

"The pill is almost a rite of passage," Stewart said.

"Women are generally comfortable with it and and doctors know about it. We know that women are often not getting information on long-term reversible contracteptives when they go to the doctor asking about the pill."

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The pill's effectiveness depends on the person taking it.

While the pill is 99 percent effective in theory, studies showed that human error brought it down to 91 percent, and one Choice study even showed 60 percent of women who had an unexpected pregnancy were on either condoms or the pill at the time.

"If you're a perfect pill taker then it's very effective," Stewart said.

"In a real-world situation though, we know that most women will sometimes forget to take the pill every day and that reduces its effectiveness.

"You don't need to remember to do something daily for long acting, reversible contraceptives."

Stewart and University of Sydney clinical associate director Deborah Bateson have co-authored a report on long-term reversible contraceptive options in Australian Prescriber.


Intrauterine devices

These devices are implanted in your uterus and two common options are made from copper and an alternative that slowly releases hormone levonorgestrel (like Mirena). They can stay in the body for long periods of time and don't affect overall fertility once removed. They do, however carry a small risk of infection when implanted. While in the uterus, sperm generally cannot make its way to an egg and if an egg is fertilised, it cannot survive.

The contraceptive implant

This is a small rod about 4cm long containing a small amount of a hormone called progestogen etonorgestrel and can last for multiple years. The hormone stops eggs from leaving the ovaries.

The contraceptive injection

This injection puts hormone progesterone directly into the body's muscle and stops eggs being released from the ovaries. It lasts for three months.

These alternatives have become more popular in the last decade but Stewart said there were a few reasons why the pill was still prescribed more often.

"There are many factors: I think women do like a method they have control over. They can stop and start the pill without having to go to a health professional to get anything removed.

"We're also all familiar with taking a pill for medicine, whereas an implant or IUD means having a procedure, which often requires two consultations.

"There are different factors that matter to different women and that's why we want to make sure they've got all the information they need to make the right choice."

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