Transcript generated automatically by AI and may contain errors.
Chapter 1: What contraceptive options are available in Australia?
As women's bodies are different, everyone's body is different, your experience of side effects of a specific contraception will be different to my experience of that side effect. And even my life is different to your life, so what I'm willing to tolerate is different to yours.
One, two, three, four.
Hi, Jackie. Hi, Steph. Thanks for having me. Thank you for coming on. I feel like this episode, questions around contraception and sex and stuff comes up so much. And I feel like there was not enough education for us when we were younger on maybe some of the options. And also, I know... And I'm intrigued to learn more.
But I also know that there's been quite a development on those options probably. Or we've learned more about them maybe since we were, you know, teenagers or early 20s. So very keen to learn from you. And I think for me as well, personally... Because I've been on a couple of different ones, really interested to learn more about those and, yeah, just hear your thoughts on it.
But I think where I'd love to start, and this is an interesting one for me because, like, we've heard you speak about IUDs and the use of them within Australia being quite low. Yeah. So interested to know why that is. I do know that there is a lot of stories shared about like maybe what's gone wrong with those kind of contraceptions.
And I feel like for me, I've had two experiences, one with Copper IUD, one with Marina. Copper IUD didn't actually even... Like go in. Oh, God, you poor thing. It was very painful. This was years and years and years ago. Didn't happen. My body was just like not having it and it was very painful and so we just gave up. Yeah. And then I actually got the IUD, the Mirena. Yeah.
three or four months postpartum after my first. And that was purely just because I was like absolutely sure I do not want to accidentally fall pregnant right now. And for me, like I had it for like two and a half years and I think it worked really well in so many ways.
But I just felt like I could feel it, like it was a bit uncomfortable or that I could maybe feel it in sex, which I know is not the case for everyone. I've got friends who have had it and they're like, I forgot it was there. So, yeah, it's really interesting and I'm keen to hear your thoughts on, I suppose, both different types. Is there more than two? Yeah. in IUD? There is.
So there's a third one called the Kylena, which is a hormonal IUD. It's like the Mirena. It's just a smaller one. And it lasts for three years instead of up to eight years. It's very similar. Same, basically same side effects and that sort of stuff. I think it came on to the market in Australia in 2020. So it's much newer than the other ones.
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Chapter 2: How effective are different contraceptive methods?
It lasts for a long time. Most women who use the Mirena ID say, won't have a period or if they do, it'll be very light. They're super effective at preventing pregnancy. There's lots of really good things about them. And I think the insertion procedure scares people off, understandably. Yeah. But there are things that you can do to find your ways around that.
So finding a clinician who does them regularly helps. Finding a clinician who has the pain relief options that you're interested in all help with reducing that pain threshold.
Yeah.
And can you explain maybe if someone was kind of thinking, oh, copper, marina, what was the other one you mentioned? Kylena. I don't know who names them. Why are there the three? Like what's the difference between the three?
Yeah, so the copper IUD is non-hormonal, so it's just got some copper around it and that is its mechanism of action, so how it prevents pregnancy, while the marina and the kylena are both hormonal-based, so they have synthetic hormones in them. I guess the main difference is the copper IUD, so it's non-hormonal. They're all kind of super effective, more than 99% effective at preventing pregnancy.
The Mirena and the Kylena to a slightly lesser extent because it has a lighter hormone in it will reduce your period. The copper IUD will increase it. Okay. So around 50% ā no, it's most women who use a copper IUD will experience a period that is 50% heavier ā Mm-hmm.
Oh, 100%. I think that was why it was really interesting when I was in my early 20s and I was trying to learn all this stuff about my hormones and like coming off the pill that I'd been on for like such a long time. And, you know, at the time, the internet completely demonized the pill and what it was doing to me and everything. And I got fully sucked into it. And that's why I
chose the copper IUD because I was like, oh, there's no hormones. I don't want any more hormone stuff and whatever. Yeah. But I know also the hormones with it, like the IUD, it's very different as well to the hormone, I suppose, hormones from pills and everything like that. Can you explain that difference as well in case people are ā I suppose, which I don't want, I want to get into the pill.
I would really love to get into the pill because I do think that there is a lot of misinformation out there. And so for someone who obviously it's like what you do to research and everything like that, I'm really keen to hear your thoughts. But for those who maybe, yeah, have come off the pill or they don't want something like...
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Chapter 3: What should you expect during an IUD insertion?
Um, the NuvaRing, it's like a small circle. It looks like a hairband. Okay. Um, and it's like kind of squishy. It's plasticky. I'm not sure if it's actually made of plastic, but it's like kind of squishy. You insert it into your vagina, leave it there for three weeks and then take it out. Have a period, put a new one in. Oh. Yeah, so it works.
It's the same kind of hormones as a pill, so it works like the pill. It's a good option for if you like the pill but don't like taking it every day. Really, really, really, really good. It's just been listed on the PBS. So before it was around like more than $70 or something for three months, which is just so much money. But now it's $25. Wow, for three months. For three months, which is so good.
So that can be a really good option for people. The other method that people try sometimes is a contraceptive implant or implanon. So it's the small rod that gets inserted into your upper arm, under the skin in your upper arm. You can feel it if you get one. It kind of looks like a matchstick. Yeah, actually, now that you've said that, I remember a few older girls in school.
Yes, same, having them and letting everyone feel them, yes. So that's another option, lasts for three years, super effective at preventing pregnancy. It has similar hormones to an IUD, so it's different to the pill. So it's a good option if you can't tolerate the pill or the NuvaRing. It can cause, I think the main side effect or the main reason people don't love it is its impact on bleeding.
It can just make your bleeding, what's the word, like unpredictable, I suppose. Like you might not quite know when your next period might be or if you'll be spotting for how long and that sort of stuff. And then less used methods that are available are the contraceptive injection.
So that's an injection you get from your healthcare provider every 12 to 14 weeks, relatively effective at preventing pregnancy. It does have some side effects that are concerning for people. So it can lead to a little bit of weight gain. It reduces your bone density while you're using it. And your return to fertility after using it takes a while.
So with something like the pill or the IUD, you stop using them, your return to fertility is quite quick.
for the um injection it's called depo usually people refer to it as um it yeah it takes a little while for that to come back that's so interesting yeah so i guess when you're thinking about what contraceptive method is right for you it's partly thinking about what you want right now but also what you want in the future as well so if you for example were you know thinking i want something to cover me for a few months before me and my partner start trying the injection is probably not for you
Yeah. Yeah, I feel like that's why I was so drawn to the IUD because I ā Knew that I didn't necessarily want to go back. I hadn't been on the pill since I was like 20. Yeah. And I didn't necessarily want to go there again. I was definitely open to it.
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Chapter 4: What are the side effects of various contraceptives?
Yeah. I was, yeah, we just need to do better. And what do you think, like, why do you think the pill is the most common, I mean, next to condoms, like the most common?
There's a few different reasons. It's been around for a while. So it's been around since the 1960s. It's very likely that either you have used it, your mom has used it, your friend has used it. If you haven't used it, someone you know has used it. It's something very easy that you can talk about with people. Everyone's got an experience of it. It's very easy to access.
You go to your GP and ask for a script and they'll give you a script basically. And even actually now in Victoria and New South Wales, you'll be able to get the pill at a chemist without a script from a GP. Yeah. Actually, I think I heard that. Yeah, it's been really recent. Yeah. So it's going to become even more accessible for people.
And then I think the process of taking the pill is super normal. So it's a tablet, right? We take tablets all the time. It's like taking a vitamin. Exactly. Exactly. You have headache, you take a tablet. You have a cold, you take a tablet. You have whatever, you take a tablet. And so that's very normal. It's not this big logistical step of... an IUD, for example, and having to get it in.
So I think that plays a big role as well.
With that, I remember, you know, these like little horror stories of like, I still fell pregnant on the pill. Yeah. Is that mostly just from misuse of it?
Yes. Yes, kind of. So when we talk about efficacy for contraceptive methods, we talk about efficacy in two ways. So there's perfect use and that's how that method is used perfectly. And it's usually in a lab environment. It's not really representative of real life. And then we talk about typical use, so how it's actually used in real life.
So for a method like the IUD, we only have perfect use rates of ID because once it's in, there is nothing you, the person, can do that will stop it working, which is why they're also super effective. It doesn't rely on you doing anything. So the pill, and I've got it in my notes so I didn't get this wrong, so the pill under perfect use conditions is more than 99% effective.
Typical use conditions, 93% effective. So that means in a year of use, seven women will get pregnant while using it. And that doesn't mean that they stuffed it up. It might mean they took it and then they got gastro and they had diarrhea or they were vomiting. You know, there's all sorts of reasons why. Maybe you forgot to take it on time.
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Chapter 5: How does the pill compare to long-acting methods?
I don't know if you've watched Friends or not. Yes. So there's an episode when I think when Rachel gets pregnant and they all come into the room and Ross is like, you know, condoms aren't 100% effective. And What? What are you talking about? They are not 100% effective. Yeah, this is what I always think about when I look at the efficacy.
So under perfect use conditions, they're 88% effective at preventing pregnancy. What? Yeah. That's so... What? Yeah. Under perfect use? No, typical use.
Oh, sorry.
Did I say that wrong? Typical use. 98% under perfect, 88% under typical use conditions. Yeah.
Is that like, again, when we say typical use, because as we said, life happens, is that like condom broke or maybe it was old or there was a hole in it or like it wasn't actually, I don't know. It falls off. Yeah, okay. Yeah, things like that. When you mentioned the Implanon, I actually remembered one of my friends did have it. She didn't have it for long, though.
I think someone that she knew had an incredible experience with it, hence why she got onto it. But she did experience really heavy bleeding, and it kind of didn't stop. I remember her explaining it to me. I honestly had a three-week period. And I think after two months, she just wasn't for her, which is fair enough.
Yeah.
Is there a reason why like someone might experience that and someone else doesn't or is it just kind of not luck of the draw but everyone's just very different or, you know, is there a reason why someone might decide that those symptoms are, you know, that that's kind of still the direction for them?
Yeah.
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Chapter 6: What is the process for obtaining the morning-after pill?
So at that initial appointment, you'll get the script for it. Then you need to go to the chemist and pick it up. On the day, so at that appointment when, so if your GP inserts, can insert the IED and you've decided, yes, you want an IED, have a chat with them about what the pain relief options are, what that looks like, what the day will look like for you, what insertion looks like.
If you need to go see somebody else to get it inserted, have an appointment with them and have that same chat. ask them how often they insert IEDs. You want to go to somebody who does them fairly regularly because they'll have all the systems set up. They'll be pretty familiar with doing it. and then talk about pain relief options and how you get it.
So I mentioned earlier that Penthox or the green whistle is becoming an option. So some places have that available on site. So that's just an option for you to then have. Some people have mentioned or have spoken about how you actually have to get that as well as the IUD when you go to the chemist for a script. So have a talk through what that looks like.
And then on the day of the insertion, make sure you take the full day off. I was chatting to a friend about this a little while ago about how like if you went to the dentist and you had a tooth out, would you go back to work? No. No, you would not. You would go home and you would lay on the lounge and whatever. Same goes. When you have an IUD inserted, take the day off.
Obviously, people have lives and, you know, you can't always, you've got kids, whatever. But as much as possible, take the day off. Don't do anything. It is a procedure. You need to rest. So go to your appointment, take the IED with you. If you go to a clinic that does them fairly regularly, it should be set up in a nice room. You'll have stirrups, whatever.
If you're getting the green whistle, they will give that to you immediately. kind of just before they start the procedure so that you can, you know, kind of get it into your system. And the green whistle is like, it makes you feel a bit woozy and kind of like out of body type experience. Good for pain relief. They use it a lot in the emergency department, like for people in pain.
So that could make you feel a bit woozy. If you're using something else, there's like sprays and creams and stuff they can apply to the cervix. They'll do that. Some clinicians advise that you take some pain relief, like Neurofen or Panadol a few hours before. So make sure you do that.
And then, yeah, they'll, you know, ask you to undress and you'll get up on the bed, up into the stirrups and then they'll commence doing it. There's a few little different instruments that they need to use. They need to stabilise the cervix, measure, making sure they get the marina in the uterus in the right spot and then they need to cut the strings.
Mm-hmm.
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Chapter 7: What considerations should be made for choosing contraception?
Yeah.
I guess it depends what pack and what pill you get. And they're not all $25, just the ones listed on the PBS. So if you're on a more expensive one, it's more expensive. But I guess the long-term cost-wise, the IUD is more cost-effective. There's no upkeep. You don't really have to do anything. It's just that upfront cost that can be a lot.
Yeah, but I guess the other thing when we think about cost, so that is the financial cost. But what about the physical cost and the emotional cost and all that stuff as well which comes into it? when you're thinking about, yeah, what contraceptive method you want to do. It comes in to it for all contraceptive methods.
So the one thing that has not really come up that my mind has gone to, particularly with all the mentions of high school, and I don't know if I've ever mentioned this on the podcast, but I've taken the morning after pill when I was younger. And it was because I had been sexually active and I knew I'd forgotten to take. It was when I was on the pill, but I was reckless with taking it. Yeah.
And I took the morning after pill. Is that ā I mean, I'm sure it's still around. Yeah. But, like, what's the process of having something like that? And is there, like, a limit? Because I remember ā I feel like I remember people talking about, like, oh, no, you can't take that more than a couple of times or something like that. I know.
And obviously we don't want, I don't want people to think like, okay, take the morning after pill like every week or whatever. Like it's a routine thing. Yeah. But yeah, I would love to learn more about how accessible it is and yeah, if there is anything to watch out for with something like that.
Yeah. So I guess it's not a routine form of contraception. You don't want it to be the main thing you rely on. Yes. But yeah, absolutely is accessible. So I guess the main thing is that you can go to a chemist to get the morning after pill, also called emergency contraception, whenever you need it. You don't need a script. You don't need to go to your GP.
Just rock up to your chemist and say, hey, I need it. And they should be able to give it to you. You need to get it as soon as possible. So as soon as you realize that something has happened, go and get it. because it's more effective the sooner, the closer to unprotected sex or sex that wasn't as protected as you had hoped it had been. So do that as soon as possible.
The other thing that people don't know, and it's a little bit trickier to do, but you can also use the copper IUD as emergency contraception. So if you can get access to that within, I think it's within five days of unprotected sex, that is a really good form of emergency contraception as well, and then is ongoing contraception. Whereas the morning after pill, you take it and that's it.
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Chapter 8: What are the implications of vasectomies in family planning?
Like, did it not work? And it's like, well, yeah. No, it did work, but it takes a while for that sperm to clear and for it to work. So I think it's around three months.
Yeah. They said that similar time. And then they also said... It was almost like clearing out the pipes. That's how Josh said it. But, like, he had to basically ejaculate a certain amount of times. Yes. And then after, like, that amount of times, send off his sperm to confirm that, yes, in fact, it had worked.
But it was so funny because, like, when he said the amount and, yeah, after obviously that first initial break because things aren't exactly comfortable for them, I would say. Yeah, yeah. You know, you kind of looked at me and I was like, well, you're going to have to help yourself out there, dude.
Because that's so not happening. It's a lot. It was like... It was something like 30 ejaculations or something. Yes. I was like, what? Yes. It's like twice a week or more than twice a week or something.
It's a lot.
Yeah.
Especially when people are getting vasectomies postpartum.
Yeah. And it's like, really?
Yeah. Do we really? Yeah.
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