With International Women’s Day on the 8th March, we pause to consider the advances in contraception for women. After 59 years the combined oral contraceptive pill remains a popular choice but in typical use would result in 10% of women taking the pill for 1 year experiencing an unplanned pregnancies. This is due to forgetfulness, or reduced effectiveness due to interactions with other medications or poor absorption during vomiting and diarrhoea illnesses. In addition, it increases the risk of breast cancer and deep vein blood clots particularly in overweight women.
Other contraceptive options have emerged to avoid these risks; in particular, the long acting contraceptives – Implanon and Mirena. They are more effective (99.8%) and cheaper in the long-term with few serious adverse effects. By releasing progesterone they prevent pregnancy by making the cervical mucous hostile to sperm. Mirena is an intrauterine device releasing hormone directly to the uterus therefore minimising the side effects caused by progesterone, including acne, breast tenderness, mood changes, or increased appetite.
It lasts for 5 years for the cost of one prescription. General Practitioners who have undergone training can insert Mirena in their Practice. It requires a consultation to assess your suitability which includes consent and swabs to screen for pre-existing infections. Mirena can be easily removed with fertility returning immediately. It is a popular choice both before and after childbearing with the additional advantage that it can control problematic menstrual periods.
Within a year of inserting a Mirena, most women safely achieve amenorrhea (experiencing no periods). In fact, Mirena is used to treat problematic bleeding in women not requiring contraception and to protect menopausal women from endometrial cancer when they are on oestrogen therapy. If you would like to find out more, please make an appointment to discuss with your local GP.
This article was written by Dr Lisa O’Rourke