Drugs for Female Contraception

Fun fact #2
Did you know the myth about implants? A good thing about implants is that they in fact can NOT move to another part of your body. (4)

About Us:

On this page ‘Drugs for Female Contraception’, our aim is to educate the Australian public on a variety of commonly used forms of female contraception including the IUD, Implant, the Pill, contraceptive injections, patches, and rings.

When looking at the rates of unintended pregnancies, the data is confounding. In Australia, 1/3 of women experience an unintended pregnancy in their lifetime. A study (1) of contraceptive use at the time of unintended pregnancy found that out of the women enrolled into the study, 21.1% of women had been pregnant with 84.6% reporting their pregnancies being accidental. The majority (73.4%) had used a form of birth control at that time, mainly being the pill in conjunction with condoms or the withdrawal method. However, these methods are dependent on the user, and experience higher failure rates than Long-Acting Reversible Contraception (e.g. Contraceptive injections) or non-user dependent methods (e.g. IUD). In particular, up to 60% of users of the pill report skipping a dose (2).

The consequences of unintended pregnancy are severe. Therefore, at ‘Drugs for Female Contraception’ we hope to provide information on the different forms of contraceptives, so that women can make the best decision for themselves.

Adherence to the oral contraceptive pill: a cross-sectional survey of modifiable behavioural determinants - PubMed The present data point to a number of key modifiable psychological determinants of OCP use. Future work will establish whether changing these variables results in better adherence to the OCP.

Fun fact of the day

Here is a short video on the different methods of contraceptives available to the general public!

J. Robinson, Johns Hopkins Medicine. Female Birth Control Options | Family Planning. 2021 July 21. Available from:
https://youtu.be/EcQSwtMR55E

🟢🟢🟢 PILL 1/4: INTRODUCTION
The pill is a daily tablet and works by stopping the ovaries from releasing an egg each month.

The pill contains two hormones (2)
1. oestrogen
2. progestogen

💊 It also thickens the fluid around the cervix to prevent the s***m from entering.

💊 When you start the pill for the first time, or after a break from the pill, it can take up to 12 days to start working to prevent pregnancy.(1)

😱 OMG FACT
Can the pill change your PERSONALITY 😱❓❓

Mood-related issues like anxiety and depression are very common among women 💁‍♀️ on the pill.
💊 Almost half of all women who go on the pill stop using it within the first year because of intolerable side effects 🙅‍♀️, and the one most frequently cited is unpleasant changes in mood❗

🟢🟢🟢 PILL 2/4: EFFECTIVITY AND PRICE 🎯💸
If you use it perfectly, the pill is 99% effective❗ (1)

But people aren't perfect and it's easy to forget or miss pills — so in reality the pill is about 91% effective 🙃
That means about 9 out of 100 pill users get pregnant each year.
Also if you vomit 🤮 within 2 hours of taking a pill, have severe diarrhoea 🧻, or take certain medications💊 it might only be 93% effective. (1)

The pill on average costs between $70 and $90 for a three-month supply. (3)

💫 That's about $1 a day❗

🟢🟢🟢 PILL 3/4: HOW TO ADMINISTER 👩‍⚕️

💊 Women take the pill orally (by mouth) once a day.
The pill is most effective when you take it consistently at the same time each day ☀️. (2)

💊 The standard way to take the pill is to take 1 every day for 21 days, then have a break for 7 days, and during this week you have a bleed like a period.

💊 You start taking the pill again after 7️⃣ days.

🟢🟢🟢 PILL 4/4: PROS, CONS, AND SIDE EFFECTS 📈📈📉📉🩺

PROS (3)
✅ Can be used to skip your period
✅ Periods become lighter, more regular, and less painful
improve acne
✅ Reduce your chance of getting cancer of the uterus (womb), ovaries and bowel
help with symptoms of polycystic o***y syndrome (PCOS) and endometriosis.

CONS (3)
❌ irregular va**nal bleeding
❌ nausea, bloating, headaches
❌ changes to your skin and mood changes
❌ small risk of deep vein thrombosis (blood clot), heart attack/stroke.
❌ does not protect against STIs
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UNSUITABLE if you: (3)
💥 find difficulty remembering to take a daily tablet
💥 are taking certain types of medication which might stop the pill from working (check with your doctor, nurse or pharmacist)
💥 have had some health conditions such as high blood pressure, heart or liver disease (check with your doctor, nurse or pharmacist)
💥 are over 35 years and smoke

🌸🌸🌸 RING 1/4: INTRODUCTION 💍💍💍

🗣🗣🗣 The Intra-va**nal ring is a combined hormonal contraceptive (1) that is marketed in Australia under the name NuvaRing. (2) It is a small plastic non-latex ring that is inserted into the va**na and works by releasing hormones to prevent pregnancy! 🤰 Progesterone and oestrogen are steadily released over the course of 3 weeks that the ring remains inserted in the va**na. (3) These hormones are absorbed through the walls of the va**na and passively enter the blood stream where they begin to act. (4) 💯

They prevent pregnancy as they stop the ovaries from releasing eggs every month during ovulation, whilst also thickening cervical mucus and thinning the uterus lining to prevent the s***m from fertilising the egg and falling pregnant. 🥚(5) After the three weeks of having the ring inserted, it is removed, and the absence of these hormones will trigger your period! (3) 🩸🩸🩸

DID YOU KNOW 🧐🧐🧐

The 2 hormones released by the ring mimic those produced by our bodies. These are etonogestrel and ethinyl estradiol, their counterparts being estrogen and progesterone respectively. Over the course of three weeks etonogestrel and ethinyl estradiol are released slowly at tiny rates of 0.120mg/d and 0.015mg/d 😲 (3). At these rates, the dose is high enough to prevent ovulation and menstruation, but small enough to minimise unwanted side effects!! WOAH, so consistent!

🌸🌸🌸 RING 2/4: EFFECTIVITY AND PRICE 🎯💸

Effectivity: 🎯
The ring is most effective if inserted correctly, a study found that "If 100 women use the va**nal ring for 1 year, about 9 will still likely become pregnant". 😱😱😱(2) Also, from a review article it found that overall satisfaction with the ring was around 95%, and even the 60% who discontinued using the contraceptive after the clinical trial, 75% of them were more likely to recommend it to others. 🤯🤯(6) Overall, the ring has high satisfaction amongst women and is a reliable form of contraceptive. 👌👌

Price: 💸
Each ring costs around $30 (4), so it would sum up to $400 per year which is quite expensive. (4,7) 💰

🌸🌸🌸 RING 3/4: HOW TO ADMINISTER 👩‍⚕️

As implied by the name, for this contraceptive to work, it needs to be inserted into the va**na! 💁‍♀️💁‍♀️💁‍♀️

The ring 💍 is a self-administered contraceptive and should sit high up the va**na, close to the cervix, once inserted. For the duration of the 3 weeks, the ring should not be removed under any circumstances, otherwise it will not work. ❌❌❌ (2)

In the 4th week of having the ring inserted, you simply remove it and you period will start 🩸. This will last for one week, so it will be a 7-day ring-free period, and then on the 8th day a new ring is inserted again 💍. (2)

If you desire to not have your period at all, it is possible to insert a new ring instantly after the 3 weeks and completely skip the ring-free week. It is advised to consult a doctor 👩‍⚕️ before doing so. (2)

❗️❗️❗️❗️NOTE: If the ring is taken out under any circumstances within the 3-week period, it must be rinsed in lukewarm water and reinserted within 3 hours of it falling out. The ring may be out of the va**na for 3 hours before it stops working as efficiently as it normally would. (8 )❗️❗️❗️

🌸🌸🌸 RING 4/4: PROS, CONS, AND SIDE EFFECTS 📈📈📉📉🩺

The Intra-va**nal ring is a good alternate contraceptive as it has a lot of advantages and has fewer side effects in comparison to other contraceptives.

Pros 📈📈📈📈

✅Safe to use
✅Self-administered - does not require to be fitted by a doctor (4)
✅Offers the option to not have a period at all (2)
✅Does not interrupt sexual in*******se - 75% of partners have never noticed it and 94% have not minded the use of the ring as a contraceptive (6,8 )
✅Avoids the digestive system (2) - its' effectivity will not be affected by any vomiting or diarrhoea (9)
✅Assists the management of pre-menstrual syndrome and acne whilst also having good cycle control (8 )
✅Has a lower discontinuation rate than the pill - 17%-32% (8 )

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CONS 📉📉📉📉

❌The ring needs to be inserted correctly and sit close to the cervix; some women may have issues maintaining it there for the course of 3 weeks. (2)
❌Must be removed and replaced on the same day every 3 weeks (2)
❌The ring itself is quite expensive to maintain summing up to $400 yearly, so there are cheaper contraceptives available (4,7)

Side effects of the ring include:
❌Headache (2)
❌Bloating (2)
❌Nausea (2)
❌Tender breasts (2)
❌Mood changes (2)
❌Decreased libido (2)
❌Breakthrough bleeding (2)
❌Acne (2)

The most experienced side effects are headaches, vaginitis, leukorrhea, and nausea. (9) The more serious yet rare side effects that may occur include. 👀👀
❌Heart attacks (2)
❌Stokes (2)
❌Blood clotting (2)

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You cannot use the ring as a contraceptive if.
💥You are pregnant (1)
💥You have diabetes with associated complications (1)
💥You are overweight or obese - the effectivity of the ring decreases as weight increases (1,10)
💥You are currently taking epilepsy medications that induce hepatic enzymes (1)
💥You have a history of blood clots (1)
💥You have a heart condition that affects the circulatory system (1)
💥You experience migraines with aura (1)
💥You smoke and are over the age of 35 (1)
💥You have lupus (1)
💥You have hypertension (1)

If you have any concerns, it is always best to check with your local GP to see if the intra-va**nal ring is suited for you!

🟣🟣🟣 PATCH 1/4: INTRODUCTION 🩹🩹🩹

The patch contraceptive is beige transdermal adhesive sticker (1), much like a band aid🩹, that works to release hormones consistently over a period (2). These hormones are absorbed through the skin, and passively enter the blood stream, taking effect after 48 hours of application. 🕒 (1) Like the pill and most other contraceptives, it releases oestrogen and progestogen (2) to prevent ovulation from occurring, so there is no egg is released each month. 🥚🗓 (3) They also thicken cervical mucus and thin the womb lining to further prevent pregnancy as not only does it limit how far the s***m will move through the cervix, but also prevents a fertilised egg from implanting itself, overall reducing the chance of becoming pregnant. ❌🤰(4)

🟣🟣🟣 PATCH 2/4: EFFECTIVITY AND PRICE 🎯💸


EFFECTIVITY:🎯
The patch has found to be more than 99% effective at preventing pregnancy when used correctly! (4)

The patch is a fast-acting contraceptive and starts working instantaneously (1) if it is applied in the first 5 days of your period. ⏳ (4) So, it is a suitable contraceptive for those who need it immediately if it is timed right. If the patch is applied after this period, it is advised to use another form of contraceptive for a week after application to ensure a pregnancy does not occur. 💊 (3)

Some doctors recommend using another contraceptive alongside the patch for the first month just to ensure pregnancy does not occur as your body may release the egg early and its' effects would be useless. 😨😨(3)

PRICE: 💸
The patch is not yet available in Australia. However, an average cost of the patches is found to be between $0-$85 per month. 💰💰💰(3)

🟣🟣🟣 PATCH 3/4: HOW TO ADMINISTER 👩‍⚕️

The patch is self-administered much like the intra-va**nal ring. So, the first patch is applied and worn for 7 days, it is replaced with a new patch on the 8th day. For example, if the first patch were applied on Monday, it would be replaced with a new patch the following Monday. 🗓 (3) This is maintained for 3 weeks, and then no patch will be applied for the fourth week, this will induce your period. 🩸 (4,6)

Within the patch-free week, there may be withdrawal bleeding, and this will be your period. This may not occur every single time, but there must be a patch-free week. ❌🩹(4) After 7-days, apply a new patch and this will restart your menstrual cycle. (4) The patch must be applied even if there is still bleeding, or the contraceptive will fail to work. 😲 (4) If you stop using the patch for any reason, an alternative contraceptive will be required 24 hours after removal as it will no longer work. (3,4)

For the patch to work it must be stuck on correctly so here are some tips to ensure that it is working to its' full potential!
✅ Ensure that the skin is clean, dry, and not very hairy - so it does not affect how well the hormones are absorbed. (4)
✅ Change the location of each new patch to minimise the amount of skin irritation. (4)
❌ Avoid areas such as sore or irritated skin, an area that will get rubbed off with clothing, and your breasts. (4)
❌ Do not use creams, oils, powders, lotion at the site of application as it will affect the adhesiveness of the patch and it will not adhere properly. (5)

❗️❗️❗️NOTE: The patch is very sticky and should not come off under any circumstances such as swimming 🧜‍♀️, bathing 💆‍♀️, after gym 🏋️, etc. (3) However, in the case that it does come off it is important to reapply that patch instantly (6) or apply a new patch if the adhesive will not stick. This will work up to 48 hours of removal. If the patch is removed for over 48 hours, apply a new patch, and continue the initial cycle that you were following. ⏳⏳ (3) For example, if I reapplied it on Wednesday, and my normal application day was Monday, I would apply the next patch on the following Monday. Alongside, for the following 7 days after the patch is reapplied after removal, an additional contraceptive must be used to prevent pregnancy. (3)❗️❗️❗

🟣🟣🟣 PATCH 4/4: PROS, CONS, AND SIDE EFFECTS 📈📈📉📉🩺

PROS 📈📈📈📈

✅ Non-invasive in comparison to other contraceptives. (2,4)
✅ Easy to use and does not affect sexual in*******se. (2,4)
✅ Easy to manage as it only needs to be changed once a week. (2,4)
✅ As the hormones are absorbed through the skin and do not go through the digestive tract, any vomiting and diarrhoea will not affect how well the patch will work. (2,4)
✅ It assists in regulating the menstrual cycle by making the flow of your period lower, decreasing any pre-menstrual symptoms. (2,4)
✅ Helps to control hormonal acne. (2,4)
✅ Reduces the risk of ovarian, womb, and bowel cancer. (2,4)
✅ Reduces the risk of fibroids, ovarian cysts, and non-cancerous breast disease. (2,4)

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CONS 📉📉📉📉

❌ Aesthetically the appearance of the patch is not desirable. (4)
❌ Prolonged use may lead to skin irritation, itching, and soreness. (4)
❌ May be tedious to change every week and might look for a long-term contraceptive like the IUD
❌ Certain medications interact with the patch to it is important to consult your doctor before making the decision to use this contraceptive. (4)

Side effects associated with the patch are like any other contraceptive and they include.
❌ Nausea (2,4,6)
❌ Headaches (2,4,6)
❌ Mood swings (2,4,6)
❌ Breast tenderness (2,4,6)
❌ Weight gain (2,4,6)
❌ Loss of libido (2,4,6)
❌ Spotting and breakthrough bleeding (2,4,6) - it is common within the first few cycles of the patch however is just a nuisance if anything, as you will still be protected from pregnancy despite this. (4)

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Furthermore, not everyone is able to use the patch as a contraceptive. You may not be able to use the patch if:
💥 You are pregnant. (4,6)
💥 You are breastfeeding a baby that is less than 6 weeks old. (4,6)
💥 You are taking medicines that interact with the contraceptive and these include some antibiotics, St John's Wort, epilepsy medication, Tuberculosis medication, or HIV medication. (4,6)
💥 You are over 35 and smoke, or you have stopped smoking less than a year ago. (4,6)
💥 You are overweight (4,6) - studies have shown that with increased weight and obesity there is an increase failure in contraceptives. (7)

If you have had or have any of these medical issues you are also unable to use the patch:
💥 A history of blood clots or a family member with a history of blood clots before the age of 45 (4,6)
💥 A heart condition affecting the circulatory system (4,6)
💥 Lupus (4,6)
💥 Breast cancer (4,6)
💥 Migraines with aura (4,6)
💥 Liver and/or gallbladder disease (4,6)
💥 Diabetic with complications (4,6)

If you have any concerns, it is always best to check with your local GP to see if the transdermal patch is suited for you!

🔵🔵🔵 SHOT 1/4: INTRODUCTION

Depo-Provera ® (depot medroxyprogesterone acetate DPMA) (1) is a contraceptive injection given every 3 months which contains a hormone progestin, similar to progesterone. It works by supressing ovulation and thickens the cervical mucus to prevent s***m cells reaching the egg. (2)

Depo-Provera is a contraceptive of choice for many women due to its convenience, benefits, and minimal risks. It was introduced in Australia in 1994 (3) and since 2019 has been used by over 74 million women in over 114 countries worldwide (4).

Let's take a break, and break some myths!

Did you know, that parental consent is not required for most young people to obtain birth control as long as the doctor in charge deems that they are competent of sound decision making.

For more information, visit: https://lsc.sa.gov.au/cb_pages/young_people_and_health.php

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Reference: Australia, L., 2021. Young People and Health Factsheet - Legal Services Commission of SA. [online] Legal Services Commission of South Australia. Available at: [Accessed 21 July 2021].

Young People and Health Factsheet - Legal Services Commission of SA Health Disclaimer: The material in this factsheet is a general guide only. It is not legal advice. For legal advice about your own particular situation we encourage you to call the Free Legal Helpline on 1300 366 424. The legal information was

🔵🔵🔵 SHOT 2/4: EFFECTIVITY AND PRICE 🎯💸

Effectivity: 🎯
Depo-Provera is 99.8% effective when given every 3 months. 6% of women will still get pregnant when using Depo-Provera, however, this is lower than other forms of birth control drugs. (1)


Price: 💸
In Australia, each injection costs about $26-$30 or $7 with a concession card. They can be purchased from a pharmacy once prescribed by a doctor. (5) Since each dose lasts for around 3 months, at $0.33 a day Depo-Provera is more affordable than other forms of birth control such as the pill.

🔵🔵🔵 SHOT 3/4: HOW TO ADMINISTER 👩‍⚕️

Depo-Provera is a prescription-only drug and is administered by your doctor into muscle of the buttock or upper arm.
💉 The injection is usually administered within the first five days of your menstruation to enable it to work immediately.
💉 Upon injection, Depo-Provera will reach full efficacy in around 7 days. (6)
💉 Each injection lasts for 12 weeks, meaning that repeated doses are necessary. (7)

As a progesterone-only contraceptive injection, it primarily works by preventing your body from ovulating. This is due to its inhibition of gonadotropin, which is responsible for follicular maturation and ovulation. (8 ) Other effects of such as uterine lining thinning prevents fertilised eggs from implanting and developing. The mucus of the cervix is also thickened, making it harder for s***m to reach the egg. (7)

🔵🔵🔵 SHOT 4/4: PROS, CONS, AND SIDE EFFECTS 📈📈📉📉🩺

Pros 📈📈
✅ Many women choose Depo-Provera for its positive effects on menstruation. Period bleeding significantly lessens, and periods may discontinue after the 2nd and 3rd shot. Irregular and light bleeding (nuisance bleeding) may occur. Heavy bleeding may occasionally occur, but this can be regulated by hormone treatments.
✅ Period side effects will also lessen, including period pain
✅ The long effect time of 3 months makes the shot convenient as opposed to methods such as the birth control pill
✅ Possible reduction in risks of ovarian cancer, endometrial cancer, pelvic infection
✅ Can be used by women who cannot take the combined pill (1)
✅ Safe to use when breastfeeding (7)

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Cons 📉📉
Nausea
❌ Breast soreness, swelling
❌ Small weight gains. Most women will experience little to no change
❌ Mood changes, headaches
❌ Abdominal pain
❌ The progestin hormone cannot be removed once injected. This means that women must wait for effects to wear off. Periods will return from 6-12 months. Pregnancy is possible for 50% of women within 12 months of discontinuing the injections, and 90% of women after 2 years. (1)
❌ Does not protect against STD
❌ Can reduce bone density (osteoporosis) with extended use. This is reversible upon ceasing injections. (2)

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Who can’t use this? Women with 🩺🩺
Bleeding disorders, or on anticoagulant medication
💥 Already pregnant, or wishing to become pregnant in 12 months
💥 Cancer history
💥 Undiagnosed abdominal bleeding
💥 Other serious medical problems
💥 Not recommended for women suffering/ or at risk of reduced bone density (2)

Consult your GP or family planning clinic for your individual circumstance

🟡🟡🟡 IMPLANT 1/4: INTRODUCTION

Looking for a long-term reversible contraceptive? In Australia we have Implanon NXT which is a matchstick-size thin, flexible plastic rod inserted under the skin of the upper arm which prevents ovulation by releasing the progestogen hormone over 3 years (a 3 year duration).(1,5) Implanon contains approximately 68mg of progestogen etonogestrel (ENG) which is released into the body over 3 years.(7) This thickens the cervical mucus, limiting the mobility of s***m in the cervix, and thins the womb lining so that each month an egg is less likely to be fertilised, implanted then released. The pharmacokinetic mechanism responsible ensures that the released hormone causes serum/plasma levels of ENG rise to >90pg/mL within hours of insertion which may inhibit ovulation in 97% of women.(11) Four to six months after insertion, there is only a gradual decline in these levels. You can expect your hormone levels be gradually falling during this period but with the right management, you will not likely experience adverse side effects, and the GP will not prematurely remove the implant!!(9,11)