April 28, 2020

10 Contraception Myths with Dr Bronwyn

Contraception. It is essential part of life unless you are planning on having a baby or three! What you may not know is there are plenty of old wives’ tales out there that aren’t totally true…

Myth #1: The Combined Oral Contraceptive Pill (COCP)will make you gain weight!
The research does not support this. However, some women will experience some fluid retention due to the hormones in the pill however once the pill is stopped this will go away. There are some pill formulations specifically designed to reduce fluid retention however depending on the type of progesterone/progestin they contain. Have a chat with your GP about the different types of Pill available if fluid retention is an issue for you.

Myth #2: The Pill may lead to issues with fertility long term.
This is not true. We know that most women will regain regular cycles within 3 months of coming off the COCP. I usually say wait a month or two after coming off the pill if you are trying to conceive to allow the lining of the uterus to become nice and healthy as the pill can make the lining quite thin (this is one of the ways it works to prevent pregnancy).

Myth #3: If I’m not good at remembering to take Pills and I don’t like condoms there are no other options for contraceptive options for me!
There are many long acting reversible contraception (LARC) options such as IUDS (Intrauterine Devices) namely Progesterone containing IUD (Mirena) and Copper IUDS; Progesterone implants; Progesterone injections; and Hormone vaginal rings (Nuvaring). Make a time to see your GP to discuss the best option for you.

Myth #4: An IUD cannot be placed in women who have not had children.
We now know that IUD’s can be used by women of all ages and in particular can be used by women who haven’t yet had children. They are a very safe and effective form of contraception and often have a lower side effect profile than the combined oral contraceptive pill and are great in that they are >99% effective and you don’t have to rely on remembering to take a pill each day! Some women choose to have these placed in the clinic setting or if they prefer can have these placed whilst asleep whilst sedated or under general anaesthetic. They are also great in that they last for 5 years in most cases! The copper IUD can also be used as emergency contraception if it is placed within 5 days after unprotected intercourse.

Myth #5: An IUD may cause infertility.
In particular, the progesterone (Mirena) IUDs have a great safety profile for women who are yet to start a family. The Copper IUDs make the uterus hostile to sperm and in a low percentage, can be associated with infection inside the uterus as the Copper IUD does not protect against spread of STDs (eg Chlamydia) into the uterus and pelvis unlike the Progesterone containing IUD which prevents spread of STDS (by thickening the cervical mucous and reducing spread of infection through the uterus). Use of barrier contraception in addition to an IUD for new partners is a must!

Myth #6: Emergency contraception is only effective the day after unprotected intercourse.
There are two types of ‘morning after pill’ which can be taken within 120 hours of unprotected intercourse. They are more effective if taken immediately or within the first 24 hours after intercourse however. The Copper IUD can also be inserted up to 5 days post unprotected intercourse to prevent an unwanted pregnancy.

Myth #7: Washing out your vagina/douching after intercourse can be an effective form of contraception.
WRONG! This is bad for the health of your vagina (it upsets the delicate pH and balance of good bacteria in your vagina!). It may even be linked to ovarian cancer so please avoid doing this!!

Myth #8: Natural methods of contraception are effective.
The two main methods rely on watching your cervical mucous ‘Billings method’ and watching the calendar for your most fertile days of the month. The problem with ‘natural methods’ is they aren’t always effective, as your fertile days can change from month to month if you have a shorter or longer cycle. It also takes practice to identify these fertile periods and takes motivation to avoid intercourse on these days. So a slight change in your cycle for the month could easily lead to a pregnancy.

Myth #9: ‘Withdrawal method’ ‘AKA Quickdraw Mcgraw’ is an effective method of contraception.
This also falls into the natural category and is also not greatly effective as there is a chance there can be sperm in the pre-seminal fluid prior to ejaculation and it also relies on meticulous timing on the male partner’s behalf! It only takes one egg… and one sperm to conceive!

Myth #10: You can’t get pregnant whilst on your period.
Not true! Sperm can last in the vagina and uterus for up to 5 days! Particularly women with short cycles (less than 28 days) need to be cautious that if they ovulate prior to day 14 then it is possible that the sperm are still swimming around until such time that an egg is released!

References
https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD003987.pub2/abstract
https://www.ncbi.nlm.nih.gov/pubmed?term=24477630
https://www.ncbi.nlm.nih.gov/pubmed?term=17855280
https://www.ncbi.nlm.nih.gov/pubmed?term=20802021
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5141580/
https://www.fpv.org.au
https://jeanhailes.org.au/health-a-z/sex-sexual-health/contraception

Dr Bronwyn Hamilton