All about hormonal contraception
The Pill – Combined progestogen and oestrogen
How: Taken orally, the combined pill contains synthetic versions of both hormones.
What happens: This increase in hormones indicates that a pregnancy has already happened, which stops eggs being released from the ovaries. It also makes the lining of the womb thinner, so any Houdini eggs won’t find a footing to stick around.
When: It must be taken daily, preferably at around the same time each day. Each month, seven days of placebo pills will enable your period to take place as usual, although some women opt to skip these and continue on without a period. The combined pill is effective after seven days of starting to take it and typically provides a 8 in 100 chance of pregnancy, but less than 1 in 100 if used perfectly.
What else: Some women find the increase in hormones can cause moodiness. It can also help to manage painful or heavy periods, causing a more reliable and easy flow. It may also help with other complaints, such as acne. There is no protection from STIs when using the pill.
The Pill – Progestogen only (aka the ‘Mini Pill’)
How: Like the combined pill, this version is taken orally, but unlike its older sister it skips the oestrogen. This makes it safer for women who are breastfeeding, have heart or liver conditions, and those who have a family history of cancers or heart conditions.
What happens: The mucus thickens around your cervix, making it difficult for sperm to get through to eggs. It will also sometimes stop ovulation. The mini is used for those who cannot take oestrogen for health reasons and for those who suffer from side effects when using the combined pill. Chances of becoming pregnant on the mini pill are typically 8 in 100 but less than 1 in 100 if used perfectly.
When: The pill must be taken at the same time, within a 3 hour window, each day. It works after seven days. If a pill is missed, there is a higher chance of pregnancy happening.
What else: For those looking to control their periods, a progestogen-only can be less effective than the combined pill. There is no protection from STIs with the mini.
The Pill – Progestogen only (aka the ‘Mini Pill’)
How: Like the combined pill, this version is taken orally, but unlike its older sister it skips the oestrogen. This makes it safer for women who are breastfeeding, have heart or liver conditions, and those who have a family history of cancers or heart conditions.
What happens: The mucus thickens around your cervix, making it difficult for sperm to get through to eggs. It will also sometimes stop ovulation. The mini is used for those who cannot take oestrogen for health reasons and for those who suffer from side effects when using the combined pill. Chances of becoming pregnant on the mini pill are typically 8 in 100 but less than 1 in 100 if used perfectly.
When: The pill must be taken at the same time, within a 3 hour window, each day. It works after seven days. If a pill is missed, there is a higher chance of pregnancy happening.
What else: For those looking to control their periods, a progestogen-only can be less effective than the combined pill. There is no protection from STIs with the mini.
Hormonal Intrauterine Device (IUD)
How: A ‘fit and forget’ method of contraception, this little T-shaped device is implanted into the uterus by a specially trained medical professional such as a doctor, nurse or midwife. There are two types available in New Zealand: Mirena and Jaydess.
What happens: Small amounts of progestogen are released over time, which thickens the mucus in the cervix, preventing sperm from breaking through to ovaries. The hormone may also prevent eggs from being released. It provides a less than 1 in 100 chance of getting pregnant.
When: It is effective immediately and can last for 3-5 years without needing to be refitted.
What else: IUDs offer no protection against STIs. As it emits only small amounts of progestogen, most women will have no side effects, although it can cause irregular bleeding or prevent periods from happening altogether. It is entirely reversible and women are able to get pregnant immediately after it is removed.
Implant
How: Two matchstick-sized, flexible plastic rods are implanted under the skin of the upper arm by a trained medical professional. Although it can be a little painful after being fitted, the implant is an easy way to gain long term protection from pregnancy. In New Zealand, the implant used is called Jadelle.
What happens: Progesterone is released from the implant, working in a similar way to the mini pill and the IUD by preventing sperm from getting to the eggs for fertilisation. It provides a less than 1 in 100 chance of getting pregnant.
When: After it is fitted, the implant will be effective in preventing pregnancy after one week and will last up to five years.
What else: Again, there is no protection from STIs. Some people suffer side effects, such as changes in menstruation patterns and longer lasting periods for around six months after the implant is fitted. While fertility returns immediately after the implant is removed, it can sometimes be challenging to remove, especially if it has been in for some time.
Injection
How: The injection used in New Zealand is called Depo Provera. It is given by a medical professional in the upper arm or buttocks.
What happens: Containing progestogen, the injection is another relatively forgetful-proof way of preventing pregnancy by stopping sperm from getting to the ovaries. It does this by thickening the mucus around the cervix, preventing ovulation and making the lining of the womb thinner. Provided it is given on time, the injection provides a 1 in 100 chance of pregnancy. For most people, this is typically a 3 in 100 chance as injections are not always given promptly.
When: It lasts up to three months and is effective after up to seven days, depending on your cycle.
What else: Periods may be interrupted and can be irregular or heavier than usual. And, you guessed it – there is no protection from STIs with the injection.
