Two people in Australia have been diagnosed with the “super gonorrhoea” infection recently reported for the first time, which has highlighted growing concerns about antibiotic overuse.
Two people in Australia have been diagnosed with the “super gonorrhoea” infection recently reported for the first time, which has highlighted growing concerns about antibiotic overuse. A Queensland Health spokesperson on Tuesday confirmed two cases of gonorrhoea resistant to multiple antibiotics were detected in the past month; one in Queensland and one in Western Australia.
The contraceptive implant, often called ‘the rod’ is a small flexible plastic rod that contains a progestogen hormone. It is inserted under the skin on the underside of the upper arm where it slowly releases a small amount of this hormone over three years.
HOW DOES IT WORK?
The contraceptive implant mainly works by stopping the egg being released from the ovary (ovulation). This prevents pregnancy occurring. It also increases the thickness of mucus in the cervix which make it hard for any sperm to travel through and fertilise an egg.
HOW LONG DOES IT LAST?
The contraceptive implant is effective for three years, but can be removed earlier if you wish.
HOW EFFECTIVE IS IT?
The contraceptive implant is a very effective contraceptive method and is 99.95% effective at preventing pregnancy.
WHO CAN USE THE CONTRACEPTIVE IMPLANT?
The contraceptive implant is suitable for most women to use. Your doctor will be able to help you decide if it is suitable for you. There are some women for who it is not suitable, these include the following:
Women who might be pregnant.
Women who have had breast cancer or reproductive organ cancers.
Women with severe liver disease.
Women who have undiagnosed abnormal vaginal bleeding.
Women on certain medications which may interfere with the action of Implanon.
ADVANTAGES OF THE CONTRACEPTIVE IMPLANT
It gives you 3 years of highly effective contraception with no need to do anything on a daily basis.
It gives you contraceptive cover straight away if it is inserted in the first five days of your cycle.
It can be removed if side effects are not acceptable or if you wish to become pregnant.
Normal fertility returns quickly after removal.
It is a low-cost method of contraception.
It can be used by breastfeeding women.
DISADVANTAGES OF THE CONTRACEPTIVE IMPLANT
The disadvantages of the contraceptive implant are:
It requires a minor surgical procedure to insert and remove it.
It does not provide protection against sexually transmissible infections.
POSSIBLE SIDE EFFECTS
The most common side effect of the contraceptive implant are changes to menstrual bleeding, these changes can include:
No bleeding.
Infrequent spotting or bleeding.
Prolonged or frequent spotting or bleeding.
OTHER POSSIBLE SIDE EFFECTS INCLUDE:
Headache.
Breast discomfort.
Acne may develop or worsen, although some women may find that acne improves.
Local reactions at the site of the insertion (see possible risks).
Some women report weight changes or mood changes, but available evidence does not support the idea that the implant causes these.
Progestogen hormones can be associated with development of cysts on the ovary, but these types of cyst usually disappear spontaneously, and rarely cause symptoms or need treatment.
WHEN AND HOW IS IT INSERTED AND REMOVED?
The implant is inserted by a doctor or nurse who has been specially trained to do this procedure. The insertion is a simple procedure which involves a small amount of local anaesthetic to numb the skin, then the implant is inserted just under the skin in the inner aspect of your upper arm. A crepe bandage will be placed around that part of your arm for 24 hours to reduce swelling and bruising and also to reduce any risk of infection.
The implant is usually inserted in the first five days of your period but it can be inserted at other times if there is no chance that you could be pregnant. When it is inserted within the first 5 days of your period it is effective immediately. When it is inserted at other times in your cycle it will take 7 days to be effective. It is safe to have it inserted following the birth of a baby.
The implant can be left in place for three years, after this time it will need to be replaced. It can be removed earlier if desired. Removal is usually a simple procedure which involves a small amount of local anaesthetic to numb the skin before a very small incision is made and the implant removed.
POSSIBLE RISKS
Possible risks of insertion are unusual, and include:
Bruising, soreness, infection.
Possible scarring at the site of the insertion.
Possible difficulty removing the implant.
Allergy to the anaesthetic or to the implant itself.
WHERE CAN I GET THE CONTRACEPTIVE IMPLANT?
The contraceptive implant is available through family planning clinics, including SHFPACT, as well as through GPs and gynaecologists.
Hormone releasing IUDs are small plastic devices which are inserted into the uterus (womb) by a doctor and are used to prevent pregnancy. They contain a hormone called levonorgestrel in the stem. Levonorgestrel is a type of progestogen. A very small amount of this hormone is released continuously over 5 years. There are two types of hormone releasing IUDs: the Mirena® and the Kyleena®. The Kyleena® is slightly smaller and releases a lower dose of hormone than the Mirena.
The female contraceptive pill has helped millions of women take control of their fertility and reproductive health since it became available in 1961. Yet a male equivalent has yet to be fully developed. This effectively leaves men with only two viable contraceptive options: condoms or a vasectomy.The idea of creating a male contraceptive has been around almost as long as the female contraceptive. In theory, targeting the production of sperm should be a simple process. The biology of sperm production and how they swim towards the egg are well understood.
A new birth control pill for men appears to be safe when used daily for a month, with hormone responses consistent with effective contraception, study researchers say.
A new birth control pill for men appears to be safe when used daily for a month, with hormone responses consistent with effective contraception, study researchers say. Their study results, in 83 men, will be presented Sunday at ENDO 2018, the Endocrine Society's 100th annual meeting in Chicago, Ill.
Contraception is essential for planning the size of your family and spacing children optimally for your individual family unit. A pregnancy that occurs within twelve months of giving birth can place extra stress on the mother and baby, and carry more risks of complications, so having effective contraception during this time is particularly important. It can be a good idea to talk to your doctor about this even before giving birth as some contraceptive methods can be started very soon after childbirth.
Contraception is not needed in the first three weeks following childbirth, but ovulation (the release of an egg from the ovary) can occur from as early as three weeks postnatal.
Your choice of contraception will depend on many factors, such as how effective the method is, suitability for your personal and medical circumstances, your personal preference, and whether or not you are breastfeeding.
CONTRACEPTIVE OPTIONS IN THE POST-NATAL PERIOD:
THE CONTRACEPTIVE IMPLANT (THE ROD)
The contraceptive implant (Implanon) is a small plastic rod which is inserted beneath the skin on underside of the upper arm. It contains progestogen which prevents ovulation.
It is over 99% effective.
It can be inserted at any time after birth. Although the product information advises three weeks afterwards, evidence-based guidelines by contraception experts advise that it can be safely inserted earlier.
The contraceptive implant can be used when breastfeeding.
INTRA-UTERINE DEVICES (IUDS)
An IUD is a small plastic device that is inserted into the uterus. There are two types: the hormonal IUDs (Mirena® and Kyleena®) that last five years, and the copper IUD that lasts for five or ten years depending on the model. IUDs work in several ways: by stopping the egg and sperm meeting, by changing the lining of the uterus so it cannot support a fertilised egg, and hormonal IUDs also thicken the mucus in the cervix.
Both types of IUDs are over 99% effective.
An IUD can be inserted at four or more weeks following birth, but it is possible to insert earlier in some situations, and it can be removed at any time.
Both the hormonal IUD and the copper IUD can be used when breastfeeding.
THE CONTRACEPTIVE INJECTION
The contraceptive injection is a hormonal contraceptive containing a progestogen, which is given into the muscle of the buttock or arm every twelve weeks. It works by preventing ovulation.
It is 96% effective.
There can be a delay in return to fertility after stopping the contraceptive injection, therefore this method may be less suitable for anyone considering a pregnancy within two years.
It can be started any time after delivery.
The contraceptive injection can be used when breastfeeding.
THE PROGESTOGEN-ONLY PILL
The progestogen-only pill (mini pill) is a pill which must be taken at the same time every day and works mainly by changing the mucus in the cervix
The minipill is 93% effective at preventing pregnancy.
It can be started immediately after delivery.
The minipill can be used when breastfeeding.
THE COMBINED ORAL CONTRACEPTIVE PILL
The combined oral contraceptive (‘the pill’) contains two hormones, oestrogen, and a progestogen. It works by preventing ovulation.
The pill is 93% effective.
It can be started six weeks after birth.
The pill can be used when breastfeeding from 6 weeks after delivery.
CONDOMS: External Condoms
A condom is a thin sheath that is placed over the penis during sex. They work as a barrier method, preventing sperm entering the vagina. Condoms are an effective method of contraception when used correctly and can be a good temporary choice following childbirth, especially if you are waiting to start another contraceptive method.
Condoms are about 88% effective.
They are readily available at chemists and supermarkets. Use of water-based lubricant is advised to make sex more comfortable and to reduce the risk of the condom breaking.
They can be used as soon as you resume sex.
CONDOMS: Internal Condoms
The internal condom is a thin pouch that is inserted into the vagina where it remains during intercourse. Internal condoms work as a barrier method preventing sperm entering the vagina.
Female condoms are 79% effective.
They are available to order online.
Internal condoms can be used as soon as you resume sexual intercourse.
Diaphragm
A diaphragm is a silicone dome which is placed into the vagina before intercourse and left in for a minimum of six hours afterwards. It is a barrier method that covers the cervix and prevents sperm entering the uterus.
The diaphragm is 82% effective.
It is advised that diaphragms are individually fitted by a specially trained nurse (e.g., at SHFPACT). You will then need to purchase a diaphragm of the correct size via online suppliers.
The diaphragm can be used from six weeks after childbirth. If you were using a diaphragm before your pregnancy, you will need a check for the correct fit as sizing can change after the birth of a baby.
EMERGENCY CONTRACEPTION (EC):
Emergency contraception (EC) can be used to reduce the risk of pregnancy when unprotected intercourse has occurred, for example when no contraception was used, a condom broke, a diaphragm slipped, or a pill was taken late.
There are three types of emergency contraception available in Australia:
Levonorgestrel EC.
This is an oral pill that contains progestogen and works by stopping or delaying ovulation (release of an egg). It needs to be taken within three days (72 hours) of unprotected sex. The sooner it is taken the better. It is available over the counter at most pharmacies, the Walk in Centres in the ACT, SHFPACT, Canberra Sexual Health Centre and The Junction Youth Health Centre. It is safe to use while breastfeeding.
Ulipristal EC.
This is an oral pill that contains a progesterone blocker and works by stopping or delaying ovulation (release of an egg). It needs to be taken within five days (120 hours) after unprotected intercourse. The sooner it is taken the better. Ulipristal acetate EC has been shown to be more effective than the Levonorgestrel EC. It is available over the counter from pharmacies. If you are breastfeeding, you cannot breastfeed for a week after taking Ulipristal -EC and will need to discard any breastmilk expressed during this time.
The Copper IUD
A copper IUD can be used as emergency contraception and is 99% effective at preventing pregnancy. It needs to be inserted by a specially trained doctor within five days of unprotected intercourse and can be used from four weeks after childbirth. It can also be used as ongoing contraception.
STERILISATION
The two sterilisation methods available are vasectomy for people with a penis and tubal ligation for people with a uterus. They are both over 99% effective. As sterilisation is regarded as a permanent method, it is advisable to take the time to thoroughly consider all aspects before deciding. This includes consideration of whether a sterilisation decision may be regretted if the loss of partner or children through illness or accident were to occur. If you are interested in sterilisation talk to your GP or a doctor at the SHFPACT Clinic. You will need a doctor’s referral for tubal ligation.
LACTATIONAL AMENORRHOEA (FULLY BREASTFEEDING AS A CONTRACEPTIVE)
Lactational amenorrhoea is when breastfeeding is used as a method of contraception. It is very effective (98%) when used correctly. To use it correctly the following three criteria must be met:
Your baby must be less than six months old.
Your periods must have not returned.
You must be fully breast feeding your baby. (This means no bottle feeds, and no longer than four hours between feeds during the day and six hours between feeds at night. If your baby misses any feeds or begins to sleep long periods at night your risk of pregnancy will increase, and you should use an additional method of contraception if you wish to avoid pregnancy).
Once your periods return, even if you are fully breastfeeding, contraception should be used if you wish to avoid pregnancy. Contraception is also advised once your baby turns six months old.
If there are any difficulties in establishing breastfeeding, if you are using complimentary feeds, or if you decide to bottle feed, you will need to use contraception as soon as you resume sexual intercourse.
WHEN CAN I RESUME SEXUAL INTERCOURSE?
There is no set time to resume sexual intercourse after having a baby, it is really an individual decision. You may or may not feel like having sex for a while after the birth of your baby. Be guided by your own emotions and how you feel physically.
You can find other ways to be intimate and sexually close with your partner until you feel ready to have sexual intercourse again. It’s important to talk to your partner and let them know how you are feeling about it.
WILL SEX BE UNCOMFORTABLE?
Many people worry that sex will be uncomfortable after giving birth. Discomfort may occur because vaginal lubrication is often decreased due to the hormonal changes of birth and breastfeeding. Discomfort may also be related to an episiotomy or tear which is still healing after a vaginal delivery.
Recovery usually takes place over a few weeks to months. It is a good idea to use lubricant to make sex more comfortable. This can be applied to the penis or the vaginal entrance before intercourse. Do not continue intercourse if it is painful or uncomfortable, wait a few days before attempting it again.
If sexual intercourse continues to be uncomfortable over an extended period, you should see a doctor to discuss it.
FOR OTHER HEALTH SERVICES AND INFORMATION This email address is being protected from spambots. You need JavaScript enabled to view it. OR CALL 02 6247 3077
The POP (sometimes also called the mini pill) is an oral hormonal contraceptive pill which contains a low dose of progestogen. The POP is taken continuously and at the same time every day in order to prevent pregnancy. It is different to the combined pill (‘the pill’) which contains two hormones, oestrogen and progestogen.
HOW DOES IT WORK?
The POP works by making the mucous produced by the cervix thicker, so that sperm cannot get into the uterus (womb) and fertilise an egg.
HOW EFFECTIVE IS IT?
It is thought to be between 91% - 99% effective in preventing pregnancy. This means that if 100 women were using the POP for a year, between 1 and 9 women would get pregnant. Effectiveness is very dependent on how well the pill is taken. The POP is more effective in women over 40 years.
WHAT ARE THE ADVANTAGES OF THE POP?
It is a low dose oral contraceptive.
It has minimal side effects.
It is easily reversible on stopping.
It can be used while breastfeeding.
It can be used by women who cannot take oestrogen.
It will not mask menopause symptoms.
WHAT ARE THE DISADVANTAGES OF THE POP?
It needs to be taken strictly at the same time every day.
It doesn’t protect against sexually transmissible infections.
Taking the POP can change your periods, some women may experience regular periods, while others experience irregular bleeding.
WHEN DO I START TAKING IT?
You will need to discuss starting the POP with your prescribing doctor. The POP needs to be taken strictly at the same time every day. Choose a time that it is easiest for you to remember. It can be helpful to use an alarm or reminder system to help you remember to do this.
WHAT DO I DO IF I MISS A PILL?
If you are more than three hours late taking the POP you could get pregnant. You should take the late pill as soon as you remember and then take the next pill at the correct time. Use additional contraceptive precautions (condoms) or avoid sex for the following 48 hours.
If you had sex when you were not protected you should consider using the emergency contraceptive pill, available at pharmacies without a prescription (see our information brochure on Emergency Contraception).
WHAT SHOULD I DO IF I AM VOMITING?
If you vomit within two hours of taking the POP you should take another pill straight away. If you vomit the second pill you will need to use condoms or avoid sex until you have taken the next three pills at the correct time. If you have severe diarrhoea you should follow the missed pill advice.
WHAT IF I’M TAKING OTHER MEDICATIONS?
Some medications and herbal preparations may stop the progestogen only pill working, this should be discussed with your prescribing doctor.
WHAT SIDE EFFECTS MIGHT I EXPECT?
The POP has very few side effect. The main side effect which may occur is a changed bleeding pattern. This might be irregular bleeding, missed periods or sometimes no periods. Some women who take the POP report mood changes and weight gain but there is no current evidence that the POP causes these side effects.
IF YOU WOULD LIKE TO KNOW MORE
Contat us on 02 62473077 or make an appointment from the link below.
FOR OTHER HEALTH SERVICES AND INFORMATION This email address is being protected from spambots. You need JavaScript enabled to view it. OR CALL 02 6247 3077
The combined oral contraceptive pill, usually simply called ‘the pill’, is a contraceptive pill taken by mouth which contains two hormones, oestrogen and a progestogen.
HOW DOES IT WORK?
The pill works by preventing ovulation, which means it stops the ovaries from releasing an egg each month, which in turn means that fertilization cannot occur and a pregnancy cannot begin.
HOW EFFECTIVE IS IT?
The pill is approximately 93% effective.
HOW IS IT TAKEN?
The pill is taken by mouth every day. Most pill types come in a box of three to four sachets with each sachet containing a month’s supply of pills.Each pill sachet contains hormone pills that you usually take for three weeks, and inactive or sugar pills (which help you to keep the habit of taking the pill every day) that you take before starting the active pills again.You can also take the hormone pills for longer than three weeks so that you skip periods. If you think you would like to do this discuss it with your doctor.
WHO CAN TAKE THE PILL?
The pill is suitable for most contraceptive users.
There are some medical conditions that make the pill unsuitable; these include the following:
A history of deep venous thrombosis (blood clot), stroke or heart attack.
Severe liver problems.
Migraine with aura (visual or other disturbances starting just before the migraine).
Breast cancer.
Some autoimmune conditions that increase the risk of blood clots.
The pill may also be unsuitable:
If you have high blood pressure, diabetes, gall bladder disease, active liver disease, kidney disease, some blood problems, or you are on some other medications which may interact with the pill.
If you have a history of breast cancer or cervical cancer.
If you are over 35 and smoke.
If you have unexplained bleeding from the vagina.
If any of these conditions apply to you, let your doctor help you decide if the pill is suitable for you.
ADVANTAGES OF THE PILL?
It is very effective with correct use.
It is readily accessible.
It is easily reversible.
It gives you a predictable bleeding pattern and allows you to skip periods if you want.
It can be useful in controlling heavy or painful periods and managing Premenstrual Syndrome.
It can improve acne.
DISADVANTAGES OF THE PILL?
It must be taken every day.
It is less effective if not used perfectly (for example if pills are missed).
Some pill types can be expensive.
Effectiveness may be reduced by vomiting or diarrhoea.
THE PILL AND YOUR HEALTH
Serious health problems caused by the pill are very rare — the most significant of these is blood clotting. Symptoms of this are severe sudden chest pain, severe pain or swelling in one leg, sudden blurred vision or loss of sight, slurring of speech or sudden severe headache.
If you have any of these symptoms contact your doctor immediately.
Your risk of developing a blood clot is increased when you are not mobile for an extended period of time e.g. sitting in a car or airplane on a long trip, or if you are planning to have surgery. Please talk to your doctor if you are planning any of these.
As well as being a contraceptive, the pill has other health benefits. When on the pill you are less likely to develop a serious pelvic infection, cancer of the ovary, cancer of the endometrium (lining of the womb), cancer of the bowel, anaemia, non-cancerous breast lumps, and cysts of the ovary.
When you are taking the pill, periods are generally less painful, the bleeding is usually lighter and more regular, and there is often less premenstrual tension. Acne may also improve.
Most people feel fine on the pill, but it is common to have some minor side effects initially. You might get some bleeding in between periods, sore breasts and mild nausea (feeling sick) for the first couple of months. These side effects usually settle by themselves.
Some people report weight changes, reduced desire for sex, and mood changes, however, there is no scientific evidence to show that the pill causes these effects, other aspects of life may be contributing factors.
Very rarely the oestrogen in the pill can cause a patchy brown discolouration of the skin on the face called melasma. This is more noticeable if you spend a lot of time in the sun. If melasma does occur it usually does so in the first few months after starting the pill. If you notice this discolouration starting to appear on your face see your doctor.
TYPES OF PILLS AVAILABLE
There are quite a few different types of the pill available. There are some differences between them and it may take a few trials to find the one most suitable for you. Don’t be afraid to discuss the different options with your doctor.
PROGESTOGEN ONLY PILL (SLINDA®)
Slinda® is a new progestogen only pill. Unlike the combination oral contraceptive pills, it does not contain any oestrogen. However, it works in a similar way by preventing ovulation. It is quite different to the mini pill which works by thickening mucus in the cervix. Slinda® is approximately 93% effective.
Advantages:Slinda® is very effective with correct use; easy to get with a script from your doctor; easily reversable; can reduce menstrual bleeding over time; and can be used by people who cannot take pills that contain oestrogen.
Disadvantages:Slinda® needs to be be taken every day; may be less effective if not used properly; may cause light irregular bleeding(spotting); and is more expensive than some of the combined oral contraceptive pills.
STARTING THE PILL
As long as you are absolutely certain that you are not pregnant, you can start the pill at any time of your menstrual cycle. If you start with a hormone pill on Day 1 to Day 5 of your cycle (Day 1 if your first day of bleeding), you are immediately protected from pregnancy.
If you start on any other day of your menstrual cycle, you will need to use additional contraception, such as condoms, or abstain from intercourse, until you have taken 7 of the hormone pills.
WHAT TO DO IF YOU MISS A PILL
Is it more than 24 hours since the pill should have been taken? (This means more than 48 hours since you last took a pill.)
FOR OTHER HEALTH SERVICES AND INFORMATION This email address is being protected from spambots. You need JavaScript enabled to view it. OR CALL 02 6247 3077
Two people in Australia have been diagnosed with the “super gonorrhoea” infection recently reported for the first time, which has highlighted growing concerns about antibiotic overuse.
The female contraceptive pill has helped millions of women take control of their fertility and reproductive health since it became available in 1961. Yet a male equivalent has yet to be fully developed. This effectively leaves men with only two viable contraceptive options: condoms or a vasectomy.The idea of creating a male contraceptive has been around almost as long as the female contraceptive. In theory, targeting the production of sperm should be a simple process. The 
A new birth control pill for men appears to be safe when used daily for a month, with hormone responses consistent with effective contraception, study researchers say.
