From the Guidelines
The most effective contraceptive options available in Australia, according to the Australian Medical Council guidelines, include long-acting reversible contraceptives (LARCs) such as the levonorgestrel intrauterine system, copper intrauterine devices, and etonogestrel implants, which have the highest efficacy rates (>99%) due to minimal user error. When considering contraceptive options, it is essential to take into account the medical eligibility criteria, including age, smoking status, BMI, personal/family history of VTE, migraine with aura, breast cancer history, and drug interactions 1. Some of the available contraceptive options include:
- Hormonal contraceptives: combined oral contraceptive pills (COCPs) and progestogen-only pills (POPs)
- Long-acting reversible contraceptives (LARCs): levonorgestrel intrauterine system, copper intrauterine devices, and etonogestrel implants
- Injectable medroxyprogesterone acetate (DMPA)
- Barrier methods: male condoms, female condoms, and diaphragms with spermicide
- Emergency contraception options: levonorgestrel and ulipristal acetate
- Permanent methods: vasectomy for men and tubal ligation for women It is crucial to note that the efficacy of these methods varies significantly between perfect use and typical use, with LARCs having the highest effectiveness due to minimal user error 1. When switching from another contraceptive method, such as an intrauterine device (IUD), it is essential to consider the timing and need for back-up contraception to prevent unintended pregnancy, as outlined in the U.S. selected practice recommendations for contraceptive use, 2013 1. Healthcare providers should advise women to retain the IUD for at least 7 days after combined hormonal contraceptives are initiated and return for IUD removal, or use alternative methods such as barrier contraception or emergency contraceptive pills (ECPs) to ensure effective contraception.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Contraceptive Options
The available contraceptive options according to Australian Medical Council (AMC) guidelines for Medical Council of Australia (MCA) multiple choice questions (MCQ) preparation include:
- Combined oral contraceptive pills (COCs) 2
- Progestin-only pills (POPs) 3, 4
- Long-acting injectable contraceptives, such as Depo-Provera 3, 4
- Implantable contraceptives, such as Implanon 3 and etonogestrel-releasing implant 4
- Intrauterine devices (IUDs), including the levonorgestrel-releasing intrauterine system (LNG-IUS) 4 and copper-releasing IUD 5
- Transdermal patch 5
- Vaginal ring 5
- Barrier methods, such as male condoms 5
Considerations for Specific Populations
When choosing a contraceptive method, considerations should be made for specific populations, such as:
- Women with underlying medical conditions, who may require alternative methods due to contraindications or interactions with other medications 3
- Lactating women, who may need to avoid hormonal methods that can interfere with milk production or infant growth 4
- Adolescents, who may benefit from long-acting progestogen-only methods or novel methods like the transdermal patch and vaginal ring, but may also experience higher discontinuation rates due to minor bothersome effects 5
Non-Contraceptive Benefits
Some contraceptive methods also offer non-contraceptive benefits, including: