This scene might sound familiar to you…

You visit the doctor with the intention of going onto some form of contraception. There are so many options and information out there that you’re not too sure which method is best for you nor what the differences are. The doctor takes your blood pressure, asks about your medical and sexual history and what contraception you currently use.

After asking a few more questions they ruffle around in their desk drawer and hand you a pamphlet about the Oral Contraceptive Pill, also known as the Pill. You trust the doctor, so you don’t ask about other options, you just take the script and go.

The Pill is the most common method of contraception in Australia, followed by the condom, and then vasectomies. The Pill is a hormonal birth control method which is taken daily in tablet form. It comprises the hormone’s progesterone and estrogen, which are naturally occurring in the body. By taking the Pill daily, these two hormones prevent your body from making and releasing an egg each month, thereby circumventing any pregnancy.  

The Pill also thickens the fluid around the cervix which prevents sperm from entering the uterus. The Pill’s use follows a normal menstrual cycle, with the oral contraceptive pill taken daily for three weeks, this is followed by one week of sugar pills (placebo pills). The sugar pills trigger bleeding, this is not your real period but instead breakthrough bleeding which is induced by a drop in the hormones. When you are on the Pill you don’t menstruate naturally because there is no uterus lining to shed due to the absence of ovulation.

Taken the way it should, the Pill is over 99% effective at preventing pregnancy. But many of us know that human error means it’s hard to take it the way you should every day. Also, if you miss a Pill, vomit within two hours of taking it, have severe diarrhoea or take certain medication, such as antibiotics, the effectiveness can decrease to 93%.

Taken the way it should, the Pill is over 99% effective at preventing pregnancy. But many of us know that human error means it’s hard to take it the way you should every day. Also, if you miss a Pill, vomit within two hours of taking it, have severe diarrhoea or take certain medication, such as antibiotics, the effectiveness can decrease to 93%.

According to NSW Family Planning some of the advantages of taking the Pill include:

• Highly effective when taken correctly
• Fertility returns to normal when you stop taking it
• Can skip monthly bleeding
• Reduces heavy menstrual bleeding
• Can reduce period pain and symptoms of endometriosis
• Regulates monthly bleeding in people with irregular periods
• May improve premenstrual syndrome (PMS)
• Can improve acne
• Reduces the risk of some cancers including ovarian, bowel and uterine cancers.

The disadvantages include:

• Doesn’t protect against sexually transmissible infections (STIs)
• Has to be taken at the same time each day
• Can’t be used by people who cannot use oestrogen for medical reasons
• Small risk of blood clots (deep vein thrombosis)
• Extremely small risk of heart attack and stroke (risk can increase if you smoke, have diabetes or high blood pressure)
• Potential for spotting or breakthrough bleeding
• Can have hormonal side-effects like headaches, nausea or bloating, breast tenderness, acne, mood changes, lowered sex drive and weight gain

Currently in Australia there is a large gap in the knowledge GPs hold around contraception options. GPs are over-prescribing the Pill which is not a “one shoes fits all approach”. Professor Danielle Mazza, head of general practice at Monash University, explains that many women aren’t aware of the existence of other contraceptives such as intrauterine devices (IUDs) or contraceptive implants and may have never been offered these options by their healthcare practitioner.

Long Acting Reversible Contraception (LARCs), such as IUDs and implants, are more than 99% effective and are not affected by human error unlike the Pill. Despite LARCs being highly effective and safe the uptake of LARCs in Australia remains low, sitting at 5% use for the contraceptive implant and 4.5% for IUDs. 

Education around contraception options needs to improve. This will not only allow thousands of young women to feel empowered but also to make better informed decisions about the contraceptive option best for them, their body and their sexual health.

In the meantime, next time you’re French kissing, grab a Frenchie when it gets hot and heavy to ensure you’re protected against STIs and unintended pregnancies (most effective when used in conjunction with oral contraception or LARCs).