For nearly half a century the Pill has been one of the most effective forms of birth control. And while we may think we know all there is to know about the variety of contraceptives available, it pays to stay well informed in order to make the best, most suitable personal choice – and exercise a degree of caution.

Answering the most frequently asked questions about birth control and sexual health is Dr Terri Foran, sexual health practitioner at the Sydney Menopause Centre at the Royal Hospital for Women.
 

I find it hard to remember to take the Pill. do I have any other choices?
‘Longer-acting contraception is increasingly popular for this reason,’ Dr Foran says. ‘Options containing only the hormone progestogen have been available for years: the progestogen injection, implant and progestogen-coated intra-uterine device. There isn’t the need to comply at the same time every day, but some women experience irregular bleeding patterns that may be hard to manage initially.

‘The good news is newer, longer-acting methods of contraception, which contain both oestrogen and progestogen, have been developed, and although they have very low doses of hormone, irregular bleeding is still uncommon. They include the contraceptive patch (not yet available in Australia) and the contraceptive vaginal ring. The ring is a soft plastic device worn high up inside the vagina for three weeks, then taken out for a week, at which time the woman gets a light period.’

Is it better to take my pill in the morning or at night?
The choice should be a personal one as scientifically there’s not a better or worse time. ‘The trick is to simply pick a time that’s most convenient,’ Dr Foran says. ‘And even if you miss a Pill you have up to 24 hours to take it before you lose contraceptive cover.

‘Occasionally women will complain of nausea after taking the Pill, especially when they first start it,’ Dr Foran adds. But this tends to be less of a problem if the Pill is taken at night. 'When using Minipills (pills that have only progestogen and are mainly used by breastfeeding mums), timing is more critical since it must be taken within three hours of the usual time before you lose contraceptive cover.

‘It’s not a good idea to take this Pill just before bedtime, because the chances of remembering to take it if forgotten are slim.’

If I have unprotected intercourse with someone I’m with for the first time, what are my odds statistically of contracting an STD?
‘The only reliable safeguard against sexually transmitted infections – and even it isn’t 100 per cent – is safe sex every time with every partner… which means using a condom,’ Dr Foran says.

I bought a packet of condoms several years ago. Will they still be safe to use?
Barrier methods of contraception such as the condom are the most used techniques in the world, and couples of all ages swear by them. To be safe, always check the use-by date on the condom pack. Condoms with spermicide have a shelf life of two to three years, and those without spermicide can last up to five years. ‘Check condoms are certified by the Australian Standards Mark on the pack, featuring five ticks,’ Dr Foran adds.

Reliability of use-by dates depends on how condoms have been stored. Hot places such as bathrooms, the boot or glovebox lead to fast deterioration. The wallet’s also out, as body heat and friction weaken the condom, and purses or bags expose them to sharp edges, which may puncture and weaken them. If in doubt, buy some more.

I had my diaphragm fitted around 10 years ago. Will it still fit me properly or should I just get a new one?
‘Update immediately and throw the old one out!’ Dr Foran says. ‘Diaphragms last a maximum of two years even with proper care, which means keeping them in a cool dry place, dusting with cornflour and regularly checking for holes by holding them up to strong light.

‘Even if it’s less than two years old, the diaphragm size that you need may change if you lose or gain more than 5kg or have a baby.’

I have heard about a new type of contraceptive pill that means you take less of
the sugar pills. can you tell me more about it?
This relatively new low-dose oral contraceptive has 24 active (hormone) tablets and four inactive sugar tablets, compared with the traditional 21 active tablets and seven inactive tablets of other Pills. Therefore, you take the active (hormone) tablets for three more days than other contraceptive Pills. This may allow for less hormonal fluctuation throughout the length of the menstrual cycle.
 

The good news now for fertile women of all ages is there have never been so many choices. If you feel like you need a change, talk to your family doctor and decide what’s the best method of contraception for you.