Methods offered (in order of effectiveness) include:
[a] Very effective methods:
- Vasectomy -a new method with less pain and suffering!!
- Referral for Tubal Ligation -modern methods using a laporoscope make this a less traumatic precure than in the past.
- The Mirena System -a hormonal intrauterine system which lasts for five years. It is very useful for women with heavy periods.
- Depo Provera -an injection of progesterone lasting 3 months (we will recall you each 12 weeks)
- Combined oral contraceptives -a variety are available. The "third generation" pills remain the best tolerated and have THE SAME low risk of DVT (clots) for low risk women as the less well tolerated "second generation" pills and a lower risk than women not taking the pill.
- Multiload Cu375 IUCD -a well tolerated Intra-uterine Contraceptive Device, also lasting 5 years. Only available if you have had at least one vaginal delivery AND you are in a stable relationship. Can provide post-coital protection if fitted within 5 days!
- Minipills -these progesterone only pills are a good alternative for breast feeding women, those near the menopause who want to stop the combined pill but don't want to risk a pregnancy and those who shouldn't take oestrogen (as in the combined pill).
- Breast Feeding -believe it or not, FULLY breast feeding (feeding on demand, at least one night feed and no bottles, solids or dummies) is associated with a failure rate of 1-2%. I suggest adding another method (eg the minipill) as soon as these conditions are no longer true.
[b] Less effective methods:
- The Diaphragm -this requires an individual fitting. It only suits those women who are comfortable checking themselves internall. The failure rate (about 5%) reduces to about 1% after 5 years as women not suited to the method "drop out" or get pregnant.
- The Condom -this should primarily be seen as a barrier to STDs (sexually transmitted diseases) and a "back-up when normal contraception is unavailable or unreliable (such as forgotten pills or taking an antibiotic) as on-going reliance for contraception eventually leads to failure in many women because the failure rate is approximately 10% per annum.
- The "morning after pill" -this is available as an emergency service (up to 72 hours after exposure) and is combined with a review of contraceptive needs and methods.
[c] Very unreliable methods:
- Natural Family Planning -as 1 in 4 become pregnant in New Zealand using the "fertility awareness" method, I don't advise it unless there is no alternative. In that case I would recomend (a) attending a Natural Family Planning advisor and (b) a lifestyle compatible with a healthy pregnancy ie no smoking, no alcohol, no drugs etc, good stress management and high folic acid intake (tablets or never overcooking the greens which you eat in abundance!)
- Coitus Interuptus (Withdrawal) -an absolute waste of time (60% failure rate) and dangerously portrayed on porn flicks as sensible (if one has intercourse with a porn star or a prostitute without a condom, one in f***ing crazy, and the porn star or prostitute has a death wish.)