Permanent and Temporary Contraception
Contraception is a broad term used to describe intervention for the prevention of pregnancy. Contraceptives can take a variety of forms, including hormonal medication, barrier contraceptives (such as condoms or diaphragms), implants and injections, intrauterine devices and more.
When you are choosing the right type of contraception for you, it’s important to be fully informed about your choices so you understand how well each method works, as well as possible side effects, costs, and ease of use.
At Northside Gynaecology, our team of female gynaecologists provide a range of contraceptive services to women across Brisbane. We understand that each women is different, and we aim to help you make the best choice for your body and lifestyle.
Let’s look at some options to consider.
Also known as ‘having your tubes tied’, tubal ligation is a permanent form of contraception that involves blocking the fallopian tubes. It’s a minimally-invasive surgical procedure where your fallopian tubes are clipped, cut and tied, or sealed shut.
When you ovulate, an egg is released from one of your ovaries, and travels down the fallopian tube into your uterus. There it stays, waiting to be fertilised until it’s broken down and reabsorbed by the body during menstruation.
Tubal ligation stops any eggs from travelling from your ovaries into your uterus by blocking the path altogether. As the procedure doesn’t affect the ovaries at all, you’ll still get your period as normal. The only difference is that there’s no egg in your uterus waiting for sperm to fertilise it each month.
It’s important to note, that tubal ligation doesn’t protect you from getting an STD. Safe sex is always the best option to be 100% confident you’re not going to pick up an infection from your partner.
Getting your tubes tied might be a good option for you if:
- You are finished having children;
- You are unwilling or unable to use other forms of contraception, and;
- You are in a monogamous relationship and have both been cleared of STDs.
Tubal ligation is 99% effective in preventing pregnancy. However, it’s considered a permanent procedure, so careful consideration is needed before deciding to go ahead.
If you think you might want children later, it’s best to consider another contraceptive option.
At Northside Gynaecology, we perform tubal ligation via laparoscopic surgery. Laparoscopic procedures are minimally invasive, and offer faster recovery times and less risk of infection than more traditional open surgical procedures.
Tubal ligation is performed as day surgery under anaesthetic. During the procedure, a few small cuts are made in your abdomen. Small specialised instruments are inserted through these cuts, as well as a tiny camera that allows your surgeon to see your abdomen on the inside.
Using video from the camera to guide her, your surgeon carefully closes off your fallopian tubes, using clips or a band to seal them shut. You can choose to have your tubes sealed using other methods (such as cauterisation or cut-and-stitch) - your gynaecologist will discuss your wishes with you when planning your laparoscopy.
When the procedure is done, the instruments are gently removed and you’re off to recovery. Most women go home the same day, and are back to normal activities after a couple of weeks.
We do offer single cut laparoscopy too, which means that the procedure is performed through only one cut about 2cms long. That means less time for your body to heal, and a barely noticeable scar.
It is possible to repair fallopian tubes after a tubal ligation. But it’s not an advisable procedure, as only about 50% of women over 40 years of age fall pregnant after a reversal. The cost of a tubal ligation reversal can be expensive. Also, the risk of an ectopic pregnancy is higher.
Tubal ligation costs vary depending on a number of factors, including whether you have private health insurance, what your policy covers, and any special considerations regarding your surgery.
Endometriosis is a condition in which cells that usually line the uterus grow in other parts of the abdomen or pelvis.
These cells form a type of tissue called ‘endometrium’. Endometrium responds to hormonal changes that happen as part of the menstrual cycle. It’s the tissue that thickens, breaks down and bleeds when you have your period. The problem is, during your period, endometrium usually leaves the body through the vagina. But when it’s growing elsewhere in your abdomen, it has nowhere to exit the body. So instead it thickens, bleeds, becomes inflamed and painful, and then heals. Over time, this cycle creates scar tissue, and can cause reproductive organs to stick together or to the abdominal wall. The result is often very long and painful periods, and sometimes debilitating pain at other times of the month too.
This condition can be difficult to diagnose, because it presents differently in different women. Endometriosis can also appear in a variety of forms depending on where it is occurring and which organs it’s affecting. Sometimes, women suffering from endometriosis aren’t even aware of it until they try to have a baby, and have trouble conceiving. Endometriosis can make getting pregnant difficult for up to 50% of women with the condition.
The contraceptive implant works in a similar way to the Pill. The implant itself is a small, flexible 4cm long tube that’s inserted just under the skin in your upper arm.
It sits there for up to three years, slowly releasing the hormone progesterone into your bloodstream to help block ovulation, which prevents pregnancy. Progesterone also thickens mucus at your cervix, making it harder for sperm to get through to the uterus and potentially meet an egg.
When the contraceptive implant’s three year lifecycle is done, it can simply be taken out by a medical professional.
In Australia, the contraceptive implant’s brand name is Implanon NXT™. Implanon NXT™ is available with a prescription from the pharmacist, but needs to be inserted by a medical professional. The procedure for insertion is quick and only requires a local anaesthetic.
The contraceptive implant is suitable for most women of any age. However, women with a history of breast cancer, unexplained vaginal bleeding, or those who are taking certain medications might want to give it a miss. Your gynaecologist will discuss your suitability with you.
Many women choose this method of contraception because it’s so convenient. Instead of having to remember to take an oral contraceptive pill at the same time each day, the contraceptive implant only needs to be maintained every 3 years.
Implanon NXT™ is cost-effective too. It costs between $5-$25, plus the cost of your GP visit to insert it. Compared with the oral pill which can cost $20+ every 3 months, it’s a much better option for your budget.
The contraceptive implant is more than 99% effective in preventing pregnancy. It begins to work after 7 days (or immediately if inserted during the first 5 days of your period). After its removal, women regain their normal level of fertility the first month.
However, this form of contraception does not protect against STDs. If you’re unsure about your partner’s sexual health, always use a condom to protect yourself from potential infection.
The most common side effect is a change in your periods. Some women experience heavier bleeding and spotting during the month, but most women actually report less heavy periods.
Some other side effects may include:
- Acne development
- Weight gain
- Breast pain
- Mood changes
Some bruising and soreness may hang around the insertion site on your arm for a couple of weeks too.
In Australia, the hormone-releasing IUD available is Mirena™. Mirena™ is an intrauterine device is a small, T-shaped device that is placed into the uterus to prevent pregnancy. It is a long term hormonal contraceptive option, as it’s designed to stay in place for 5 years. That being said, you can choose to have it removed sooner if your circumstances change.
Mirena™ works in two ways:
- Thickening mucus in the cervix to stop sperm from reaching an egg
- Thinning the lining of the uterus to partially suppress ovulation
Inserting a Mirena™ is a quick and simple non-surgical procedure that can be done at our gynaecological suites in Brisbane.
During the procedure, a speculum is inserted into your vagina to open your cervix. Then the Mirena™ is folded down and gently inserted into your vagina, through your cervix, and into your uterus. It then expands and sits in place.
A thin string hangs down into your vagina, so you can check that the IUD is still in place at any time. This string also makes removing Mirena™ easy.
Mirena™ is over 99% effective in preventing pregnancy. As with the other contraceptive options discussed on this page, it does not protect against STDs. So make sure to use condoms to be fully protected from infection.
Mirena™ is listed on Australia’s PBS, so the government subsidises the cost if you have a Medicare card. If you have a Healthcare card, it costs around $6.40. If you’re paying full price, it will still only cost around $40, plus the cost of your visits to insert and remove it.
Many women choose Mirena™ because it’s long lasting, low maintenance, and suitable for nearly every woman.
Advantages of using an IUD include:
- It can be used when breastfeeding
- It still works no matter which other medications you’re taking
- It’s long lasting (5 years)
- It’s cost-effective
- It’s low-maintenance
- Women return to their normal fertility quickly after its removal
- It can help reduce heavy periods
However, if you could be pregnant, have a current pelvic infection, are being treated for a gynaecological cancer, or have abnormal bleeding, Mirena™ is not suitable for you.
Some women might experience cramping for the first few days after Mirena™ has been inserted. Spotting or irregular bleeding might also occur, as well as breast tenderness, skin changes and mood changes.
These usually settle over time, but it’s important to see your gynaecologist if you are concerned about any of these symptoms.
The procedure for removing Mirena™ is simple, yet does need to be performed by a health professional. To remove Mirena™, your gynaecologist will use an instrument to grasp the device’s strings, then gently pull. The IUD’s arms will fold up as its removed from the uterus.
Removal of an IUD can be done at any time during your menstrual cycle, and can actually be a bit easier when you’re on your period.