Contraception 101: Permanent Methods of Contraception

Many patients come to see me for advice about contraception. There’s never one right answer as everyone has different needs, and most patients first discuss the options with their mums, friends and of course Dr Google!

In this third and final part of the Contraception 101 series, I'll present an overview of the permanent methods of contraception.

“Permanent Methods of Contraception”

For patients who want permanent contraception, surgical options are sometimes a solution. 

Female sterilisation can usually be performed through key hole surgery and involves either small clips being placed across the fallopian tubes (which connect the ovary to the uterus), or complete removal of the fallopian tubes. These procedures require general anaesthetic. Both are permanent and irreversible procedures, and are usually requested by women who have no desire for fertility and who don’t want to or are unable to use other forms of contraception. Some recent studies suggest that ovarian cancer may actually arise from the fallopian tube, so removal of the fallopian tubes may have this additional benefit compared to use of sterilisation from clips.

In the Contraception 101 series, I've outlined the most common types of contraception I discuss with my patients. It's important that you find a contraceptive that is convenient and reliable, and suits your needs. There are other options available and these can be discussed with your GP or gynaecologist.

Contraception 101: Intra-Uterine Devices, Implants and Injections

Many patients come to see me for advice about contraception. There’s never one right answer as everyone has different needs, and most patients first discuss the options with their mums, friends and of course Dr Google!

In this second part of the Contraception 101 series, I'll present an overview of intra-uterine contraceptive devices (IUDs), implants and injections.

“Intra-Uterine Devices, Implants and Injections”

IUDs are devices that are inserted through the cervix and sit inside the uterus. The implanon is an implant that is inserted just under the skin of the upper arm and Depo Provera is given by an intra-muscular injection. These are useful contraceptives as they are long-acting (IUDs and implants last 3-5 years), reversible and also very reliable, as the user doesn't have to remember to take a tablet or do anything else once the IUD or implant is inserted, or following their injection.

The Mirena is a commonly used IUD.  Apart from being a contraceptive, the Mirena is also very useful for helping to manage heavy and painful periods. The Mirena can be inserted during an appointment with local anaesthetic, however some patients prefer or require insertion of the Mirena under a general anaesthetic in day surgery. After insertion, irregular bleeding is quite common initially, however this usually settles within 3-6 months.

The Implanon is a rod that is inserted just under the skin in the upper arm. It lasts for three years after insertion and, like the Mirena, is a reliable and reversible form of contraception. It also has the side effect of irregular bleeding. The Implanon may be an option for you if you simply need contraception, and prefer not to have the initial discomfort associated with insertion of an IUD.

The Copper IUD is another type of intra-uterine contraceptive device, however it does not contain any hormones. Patients who request a Copper IUD may wish to avoid contraceptives containing hormones for various reasons, but at the same time want a reversible and reliable contraceptive option. Sometimes periods can seem a little heavier after insertion of a Copper IUD.

Depo Provera is given by an intra-muscular injection every 12 weeks. Some women cease having periods after using Depo, but it may also cause irregular bleeding. After discontinuation of Depo Provera, some women experience a delay in return to fertility of up to 18 months.

You should seek advice from your GP or gynaecologist before making a decision about whether IUDs, implants or injections are the right contraceptive for you. IUD insertion can be accompanied by some minor discomfort, so if you plan to have an IUD inserted, you may wish to take some Panadol and Nurofen two hours prior to your appointment.

In the next and final Contraception 101, I'll provide an overview of permanent (surgical) methods of contraception.

Contraception 101: Oral Contraceptives

Many patients come to see me for advice about contraception. There’s never one right answer as everyone has different needs, and most patients first discuss the options with their mums, friends and of course Dr Google!

In this three part series, Contraception 101, I'll present an overview of some of the options for contraception I discuss with my patients, and explain when I usually recommend each. Today's post covers oral contraceptives.

“The Pill”

'The Pill' is probably the most common type of contraceptive for women and is often credited as helping to improve the status of women by offering simplicity and effectiveness in birth control. 'The Pill' refers to the combined oral contraceptive pill, which contains synthetic forms of estrogen and progesterone (the hormones produced by the ovaries). The pill is a reliable contraceptive if it is taken daily, at the same time each day. I often recommend the pill as a contraceptive option for women who also want to regulate their periods. There are many different types of the pill (Levlen, Yaz, Diane to name just a few). Some types of the pill may have additional effects such as improved mood or reduced acne. 

The 'mini pill' is a progesterone only pill. It is less reliable as a contraceptive than the combined pill, but is often used in women who are breast feeding or are unable to take estrogen due to problems with blood clots. 

Pros and cons? The pill is non-invasive and can be easily stopped at any time if you experience side effects. Taking the pill also often causes periods to be lighter and less painful. The main drawback is that you have to be able to remember to take a tablet every day.

What works well for one person, may have different effects for another. If you are thinking about starting the pill, you should seek advice from your GP or gynaecologist.

In part two of Contraception 101, I'll cover intra-uterine devices (IUDs), implants and injections.

Adult Acne – Why? What can I do to fix it?

Unfortunately, skin problems are not something limited to adolescence.  Breakouts can plague us well into adulthood. Adult acne may be lifestyle related, but may also be associated with hormonal fluctuations and conditions such as poly-cystic ovarian syndrome. Being time poor and chronically stressed may put our adrenal glands into overdrive, which may increase the oil flow from our skin follicles. This sets the stage for congestion in the form of blackheads, pimples and pustules. Once started, the cycle can be self-perpetuating. Seeking advice regarding what skin treatments to use is important, as products used to conceal imperfections may aggravate the problem spots rather than aiding them to heal or normalise.

Help your skin help you

1.    Don’t squeeze pimples!  Squeezing will most likely cause more damage by prolonging healing time, increasing the likelihood of scarring and the incidence of a pimple reoccurring in the same place.  Consider applying a spot treatment product instead.

2.    Eat a low GI diet.  There is evidence to suggest that regular consumption of high GI foods elevates insulin production, increases sebum (oil) production and may be associated with hormonal changes, all of which contribute to acne.   

3.    Take time to decompress and relax, which will help keep stress hormones in balance.  Additionally, having some time to focus on yourself can help you review your diet and your skin routine.

4.    Have an appropriate skin routine in place.  At a minimum, cleanse and moisturise twice a day.  Unless you’ve been advised against it, regularly exfoliating will also help promote a clear complexion.  Blemishes are often the result of excess dead skin cells binding with oil and debris to clog follicles.  Exfoliating will help shed the old skin cells and promote the generation of fresh, new cells.

5.    If your breakout levels are closely linked to your menstrual cycle, you may benefit from hormonal intervention in the form of the oral contraceptive pill.

At GAALS we are able to provide advice for conditions such as poly-cystic ovarian syndrome and can make recommendations about who to consult regarding your skin problems.  If you have a gynaecological problem or would like an appointment, please call us on 1300 242 257 or click Contact on our web page.

New Year’s resolutions every woman should make (and keep!)

Now that it’s February, 2016 is well and truly underway.  January seems to go by in a bit of a blur, so now it’s time to get serious about your new year’s resolutions.

As women we often have so many things to juggle. However, our health should never be neglected. The following are three resolutions I think every woman should make:

1.     Keep up to date with your pap smears

Let’s be honest, as women, we really don’t like having pap smears.  The procedure may be uncomfortable and some women may feel embarrassed.  However, having regular pap smears is really important, as it is a screening test for cervical cancer.  Pap smears can detect abnormal cells on the cervix, and these can then often be easily treated.  The pap smear registry will remind you when your next pap smear is due, so if you receive a reminder, don’t put it off. 

2.     Fit some exercise into your daily routine

It is very easy to make excuses for not doing any exercise.  Many health concerns may be lifestyle-related, so it is important that we make time for regular exercise.  The easiest way to do this is to try to fit some exercise into your daily routine, such as taking the stairs or walking to work.  That way it won’t seem like something extra to ‘fit in’. 

3.     Don’t put off those annoying female problems, such as heavy or painful periods, any longer

If you find yourself dreading ‘that time of the month’, then it’s important you do something about it.  Many women suffer from period problems such as very heavy or painful periods.  There are treatments available to help manage your periods, including hormonal or surgical options.  So if you find your periods are problematic, please see your doctor about it.

At GAALS these are all common conditions we see everyday and we would be happy to help you with any of your gynaecological concerns.  If you have a gynaecological concern and would like to see us, please call 1300 242 257 or click Contact on our website for further information.