Contraception Sydney
Sydney gynaecologist Dr Anu Mahadik for contraceptive advice
Contraceptive advice
Contraception, or birth control, can help you prevent pregnancies and implement family planning – that is controlling the number of children that you chose to have, and the duration of time between their births. There are many different contraceptives that are available to you. No method is 100% effective – there is always a chance that you could still get pregnant even when using birth control.
Some contraceptives also protect against Sexually Transmitted Infections (STI). You may be prescribed contraceptives for other purposes such as acne; PMS; migraines; painful, irregular or heavy periods; endometriosis; PCOS; or to cut back on bleeding if you have severe anemia.
There are four categories of birth control that are available:
- Barrier contraceptives
- Daily contraceptives
- Long-acting reversible contraceptives
- Emergency contraceptives
We will help you find birth control that is right for you. You may find some types don’t work as well for you, or cause side effects.
Barrier contraceptives Sydney
Barrier contraceptives
Barrier contraceptives act as an obstacle between sperm and eggs – preventing the sperm from getting to the egg. Some act as a barrier between genital contact and can be effective in preventing the spread of STIs. Barrier contraceptives include:
- Male condoms
- Female condoms
- The diaphragm
Male condoms
Condoms are 98% effective with perfect use. Reasons that a condom may fail, and allow sperm to pass through, include:
- Passed expiry date
- Incorrect size
- Torn or punctured
- Stored in hot places for a long period of time
Female condoms
A female condom is similar to male condoms in the way they work and the materials which they are made from. Female condoms are typically more expensive than male condoms and they can be more difficult to find in stores.
Female condoms are inserted into the vagina of a woman and prevent sperm from entering the uterus. They can be inserted a few hours before a sexual encounter. They fit a variety of women. The female condom is also effective in reducing the spread of many STIs.
Female condoms are 95% effective at preventing pregnancies when used properly. Reasons the female condom may fail includes:
- Torn or punctured
- Passed expiry date
- Not inserted correctly
Diaphragm
- Incorrect fit
- Not inserting it correctly
- Taking it out too soon after sex (less than 6 hours)
- Torn
- Passed expiry date
- Not used with the gel

Contraceptive pills Sydney
Daily contraceptives
Daily contraceptives are hormone-based birth control that need to be administered every single day. If you forget to take a dose you risk pregnancy. There are two main kinds of contraceptive pills: the combined oral contraceptive pill and the mini-pill.
Combined Oral Contraceptive Pills (COCP)
The COCP, simply ‘the pill’ is a daily tablet that contains both oestrogen and progesterone hormones. You should try and take the pill at the same time every day. A script is required to purchase the pill from a pharmacy. The price of the pill varies by brand, and whether or not you purchase a generic. The pill does not prevent STIs so you should use condoms to prevent STI’s.
The pill typically comes in 28-day packs which include both hormonal pills and sugar pills. When taking the sugar pill you will typically have a period. You can skip the sugar pills and instead continue straight onto hormone pills to skip your periods.
There are many different brands of pills which may give you different side effects. Common side effects include:
- Weight gain or bloating
- Skin changes
- Mood changes
- Nausea
- Headaches
- Tender or sore breasts
- Irregular bleeding
Some side effects subside over time.
The pill is over 99% effective. Efficacy can be reduced if:
- You miss a pill
- You vomit or have diarrhoea (making the pill leave your system)
- You are taking medications or natural remedies (e.g. St John’s Wort)
The Mini Pill
There are many different brands of pills which may give you different side effects. Common side effects include:
- Skin changes
- Mood changes
- Headaches
- Tender or sore breasts
- Irregular bleeding
Some side effects subside over time.
The pill is over 99% effective. Efficacy can be reduced if:
- You take a pill more than 3 hours late
- You vomit or have diarrhoea (making the pill leave your system)
- You are taking medications or natural remedies (e.g. St John’s Wort). Ask your doctor if any medication you are prescribed will interfere with the pill.
IUD Sydney
Long acting reversible contraceptives
Some women forget to take the pill, or simply don’t like having to take a tablet daily. Longer active reversible contraceptives are another option that may suit you better. These birth control options last for longer length of time – few years. These include:
- Intrauterine Devices (IUDs)
- Subdermal contraceptive implants (Implanon)
Intrauterine devices (IUDs)
IUDs are small devices that are placed into the uterus to prevent pregnancy. IUDs can be copper or hormonal (Mirena). You will need a prescription to buy an IUD and you need a qualified GP or specialist to insert it. Both IUDs are small ‘T-shaped’ devices inserted into the uterus. Both have strings that hang down out of the cervix so that you can check the device is still in situ and so it can more easily be removed later. The strings do not hang outside of the body and cannot be seen. Neither IUD is effective in protecting against STIs. You should use condoms with new partners.
The Copper IUD works by continually releasing a small amount of copper into the uterus. This is toxic to both the egg and the sperm and stops them from meeting. It also changes the lining of the uterus so that if an egg were fertilized it would not be able to ‘stick’ to the lining and start a pregnancy. It can also be used for emergency contraception (within 5 days of unprotected sex).
The hormonal IUD works by slowly releasing progestogen (hormone) into your uterus. This prevents the sperm and egg from meeting. It also thickens the mucus around the cervix to prevent sperm from entering the uterus. It changes the lining of the uterus so that a fertilised egg cannot stick to it to start a pregnancy. Sometimes it can also stop the ovaries from releasing eggs.
You may experience some cramping for a few days when it is first inserted. Spotting and frequent bleeding is common in the first 3 months following insertion. Most women find this settles with time and their regular menstrual cycle returns; however, some women may find their periods heavier with the copper IUD.
You may experience cramping for a few days after your Mirena is first inserted and may have spotting or frequent bleeding for the first 3-6 months. Some women also experience headaches, tender breasts, mood changes or skin changes. These nearly always settle with time. While the Mirena is in situ many women do not have periods or only a light regular period.
The Copper IUD starts working immediately.
Mirena is effective immediately after insertion if it is inserted in the first 7 days of the menstrual cycle, if inserted after that then it starts working after 7 days, so you should additional contraception in that time.
It is more than 99% effective and lasts between 5 and 10 years. The Copper IUD may stop working if it falls out or is in the wrong position. It will also be less effective if it has been in longer than 5-10 years.
The hormonal IUD is more than 99% effective and lasts up to 5 years. The hormonal IUD might not work if it falls out, is in the wrong position or has been left in for longer than 5 years.
If you suspect your IUD has moved, use condoms until you can have it checked by a doctor. They may perform an ultrasound to do so.
Subdermal contraceptive implants
This is a subdermal contraceptive implant that is inserted into the upper arm. It is a soft plastic stick which is approximately 4cm long – similar to a matchstick. You must have a prescription to purchase it and then need to see a trained doctor to insert it. The implant available in Australia is called Implanon NXT.
The implant contains progesterone which is slowly released into your body. This stops the ovaries from releasing an egg each month and also thickens your cervix mucus to prevent sperm entering the uterus.
Possible side effects include:
- Irregular bleeding
- Headaches
- Bloating
- Skin changes
- Tender breasts
- Mood changes
These often settle with time. For many women their period patterns will change. They may be more often or irregular. Some women will experience no bleeding at all while others may have frequent or prolonged bleeding that may get better over time. Some medications can help with this bleeding.
Contraceptive injection (Depo Provera)
Side effects of depo include:
- Weight gain (common)
- Bone mass density may drop. This will return once injections stop.
- Mood changes
- Skin changes
- Headaches
- Bloating
- Tender breasts
Your period patterns will change. It could either irregular or occur more often. 60% of women will have no periods at all. Prolonged or frequent bleeding may occur but will get better with him. Medications may be prescribed to reduce bleeding.
Contraception for emergencies | Sydney gynaecologist Dr Anu Mahadik
Emergency contraceptives
If you have had unprotected sex, missed a pill or suspect a barrier method of breaking you may need to use an emergency contraceptive. This is not a replacement for regular contraceptives, but is a backup plan to help you prevent pregnancy.
As mentioned earlier, the Copper IUD can be used as an emergency contraceptive. The other option for emergency contraception is using the morning-after pill. There are two kinds of pills: LNG pill and Ella One
Emergency contraceptive pills may change the amount of bleeding you have in your next period. It can also make your next period late or early. If your period is more than 7 days late, take a pregnancy test as soon as you can. Other side effects include:
- Headaches
- Nausea
- Bloating
- Tender breasts
Contraception Sydney FAQs
Frequently asked questions about contraceptives
The efficacy (how well they work) of different contraceptives varies. They are also less effective if you do not use them perfectly, or do not take them on time.
With perfect use:
- Condoms are 98% effective
- Female condoms are 95% effective
- Diaphragms are 86% effective
- The pill is 99.5% effective
- The Mini Pill is over 99.5% effective
- Both the copper and hormonal IUDs are 99.5% effective
- Implanon is 99.95% effective
- Depo injections are 99.8% effective
This again depends on which method you are using:
- Condoms (male and female) are single use.
- Diaphragms can last up to 2 years, but are only inserted for a maximum of 24 hours at a time.
- The pill must be taken every day to work. It typically comes in a pack of 28
- The Mini Pill must be taken every day at the same time for it to work. They typically come in packs of 28
- IUDs last between 5 years (Mirena) and 10 years (Copper IUD)
- Implanon lasts 3 years
- Each NuvaRing lasts 3 weeks
- Depo injections last 12-14 weeks
Barrier methods (condoms and the diaphragm) work immediately as they prevent the sperm and egg from joining. Other contraceptives take longer to start working. You will need to use barrier methods (or abstain) until then if you do not wish to fall pregnant. The time it takes for different contraceptives to start working when you first use them, or after a period of not using them, varies:
- The pill can take 7 days to start working
- The Mini pill can take 3 days to start working
- Copper IUDs start working immediately, while the Mirena takes 7 days
- Implanon takes 7 days to start working
- NuvaRing takes 7 days to start working
- Depo takes 7 days to start working
Breastfeeding may delay your period returning, but you can still get pregnant so you should use contraceptives. Oestrogen-based contractions can reduce your supply of breastmilk. Depending on your personal circumstances, you should be able to use:
- Condoms
- The Mini Pill
- Diaphragms
- Depo-Provera
- Implanon
- IUDs
Sydney Gynaecologist at Norwest and St George Private Hospitals
Consulting at Norwest and Kogarah
My consulting rooms are at Burbank Place, Norwest which is near Norwest Private Hospital. If you live northwest of the Sydney CBD, or near the M2 or M7, you may find my practice in Norwest the best location for all your women’s health consultations.
If you live in the Sydney CBD, or south of Sydney, you may be best served by coming to my rooms in Kogarah, at St George Private Hospital Medical Suites.
I am affiliated with Norwest Private Hospital, St George Private Hospital and Westmead Private Hospital. Westmead patients are welcome for consultations at my Norwest or Kogarah rooms.
