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Green Whistle and IUD insertions

IUDs (intrauterine devices) are an increasingly popular method of contraception for many people – they are extremely effective at preventing pregnancy. They are small, T-shaped devices inserted into your uterus, with a fine nylon thread attached. There are hormonal and non-hormonal types of IUDs. IUDs must be inserted by a specially trained doctor or nurse. 

IUD insertion 

When you are having an IUD inserted, the painful part happens when the IUD is passed through the cervix into your uterus. This pain typically lasts for around 10-30 seconds. The amount of pain can vary from person to person, and is influenced by things like the position and angle of your cervix. Sometimes it’s less painful for people who have given vaginal birth. Different clinics offer different types of pain relief for IUD insertions, such as over the counter pain relief tablets, local anesthetic spray or full sedation. 

Diagram of a uterus with an IUD

About the green whistle 

A medication called ‘Penthrox’ (or the ‘green whistle’) is a form pain relief that is offered by some IUD clinics around Victoria. The green whistle is commonly given by paramedics, or in emergency departments when patients are in acute pain caused by things like fracture, burns, or large wounds. It contains a medication called methoxyflurane, which is vaporised in a green inhaler.  

Photo of a green whistle

To take the medication, you put the ‘green whistle’ in your mouth and are in control of how many times you breathe in. You typically take breaths for the 10 – 30 seconds that there is pain, then stop using it. Some of the side effects may include drowsiness, cough, dizziness, headache, nausea, and confusion. Side effects wear off in about 30 minutes. 

Green whistle and IUD insertions 

Studies in the UK and Europe have shown how easy and effective the green whistle is to use.  Feedback from IUD patients using the green whistle has also been positive, with most saying they would repeat the procedure when they are next due to change their IUD.  

Despite IUDs being extremely safe and reliable (over 99% effective at preventing pregnancy), only a small percentage of Australians actually use them (for example, only 6.3% of Australian women use hormonal IUDs 1). This means that people may be at risk of unwanted pregnancy, if they are reliant on other, less effective means of contraception. While there is growing awareness of contraceptive methods such as IUDs, there is also growing awareness of how uncomfortable IUD insertion procedures can be – which may discourage people from utilising them (for example, see ABC News 2022). 

The green whistle adds to the available pain relief options for anyone interested in an IUD. 

If you are interested in finding services that provide IUD insertions with different pain relief options, contact 1800 My Options (1800 696 784, weekdays 9am – 5pm) or online.  

 

  1. Grzeskowiak LE, Calabretto H, Amos N, Mazza D, Ilomaki J. Changes in use of hormonal long-acting reversible contraceptive methods in Australia between 2006 and 2018: A population-based study. Aust N Z J Obstet Gynaecol 2021;61(1):128–34. doi: 10.1111/ajo.13257. 

 

3 ways to prevent contraception FAILS

Contraceptive failure is one of the biggest causes of unplanned pregnancy.1 It’s estimated that over half of all Australians requesting an abortion were using some form of contraception at the time.2  So what causes contraception to fail, and what can we do about it?

“Perfect” vs “Typical” use

There are many different types of contraception, and each have different levels of efficacy. Unfortunately, no contraception is 100% effective all the time. However, there is also a difference between their level of efficacy given “perfect” use (when used correctly all the time), and “typical” use (what happens in real life), as seen in the chart below:

Basically, “typical” use can be much less effective than “perfect” use. This is mainly due to human error – or external factors, such as:

Practice makes perfect

One way you can reduce your risk of contraceptive failure is to try to address any areas for human error. For example, you could:

Two is better than one

Another way you can improve your chances of preventing unwanted pregnancies would be to use 2 different methods of contraception – a hormonal method with a non-hormonal method. For example, this could look like:

LARCs – typically perfect!

However, you can see above that there are some methods of contraception (aside from permanent sterilisation) where the “typical” use rate is nearly the same as the “perfect” use rate. These contraception methods are known as LARCs – Long Acting Reversible Contraception.
Once they are correctly installed, LARCs are not affected by user error. They last a very long time, and because they are so low maintenance, are often described as “set and forget” methods.
LARCs available in Victoria include:

LARCs are the most efficient way to prevent pregnancy. For information about LARC services near you, or all contraception and pregnancy options services – please contact 1800 My Options on 1800 696 784 (weekdays, 10am – 4pm) or email [email protected]

REFERENCES
Trussell J. Understanding contraceptive failure. Best Pract Res Clin Obstet Gynaecol. 2009;23(2):199-209. doi:10.1016/j.bpobgyn.2008.11.008
Marie Stopes International. Real Choices: Women, Contraception and Unp

What is stealthing, and why is it illegal?

What is stealthing?

Stealthing is the intentional non-use, removal or tampering of a condom without consent. In addition to violating consent, stealthing increases the risk of unwanted pregnancy and STI transmission. Like other forms of sexual assault, survivors can also experience psychological trauma.

Stealthing is also considered a form of reproduction coercion. Reproductive coercion is any behaviour that interferes with your right to make choices about your sexual and reproductive health. Reproductive coercion is a form of family violence and commonly happens in intimate partner relationships. Reproductive coercion can also occur in casual sexual relationships.

How common is stealthing?

There are no comprehensive estimates of how common stealthing is. Among some parts of the community, it may be quite common. A Monash University study in 2018 surveyed attendees of a sexual health clinic in Melbourne, finding 32% of women and 19% of men who have sex with men who responded to the survey had experienced stealthing. This study found that female sex workers are particularly at risk, almost three times more likely to have experienced stealthing than other women reporting to the sexual health clinic. Stealthing is largely unreported, only 1% of the Monash study respondents reported stealthing to police.

What are the laws around stealthing?

In July 2023, the Victorian government changed the existing laws around consent and adopted an affirmative consent model. Affirmative consent means if someone wants to engage in a sexual act with another person, they must actively gain consent, rather than rely on the other person to give their consent. This means if a sexual assault is alleged, the burden of proof of consent is the responsibility of the alleged perpetrator, not the alleged victim survivor.

Under these laws, sexual consent is NOT given if there is:

What can you do if you experience stealthing?

As stealthing is a crime, you have the right to report the assault to police.  Sexual assault cases are investigated by specialised teams in Victoria Police: Sexual Offences and Child Abuse Investigation Teams or the Sex Crimes Squad.

Making the decision about whether to report sexual assault can feel overwhelming. Being fully informed about what to expect during the legal process will help you to make a decision about how to proceed.  Sexual Assault services can provide counselling, support and advocacy. You never need to feel that you will go through the legal process alone.

If you would like some information, support or advocacy from a sexual assault or family violence service, you can contact:

If you are concerned about STI transmission, you should speak to a medical professional about STI testing.

If you are concerned about an unintended pregnancy, you can access emergency contraception from a pharmacist without a prescription. Emergency contraception works best as soon as possible after unprotected sex. 1800 My Options can talk you through this.  Contact us on webchat or 1800 696 784 (weekdays, 9am – 5pm).

Period tracking apps: What you need to know

Period tracking apps are easy to access via your app store on any smartphone. You might have heard of ones like Cycles, Glow, Eve, or Flo. Most period tracking apps get you to enter some information regularly, like the days that you are bleeding, and any other period-related symptoms you might have. After a few cycles, the app should show you information such as how long your cycles last, on average.

There are many ways period tracking apps can help you monitor your reproductive health:

Period tracking apps are growing in popularity, as people find it convenient to track their cycle with more precision, and know more about their bodies. However, some people are also using these apps to prevent pregnancy, possibly to avoid having to use contraceptive devices or medications.

Period trackers aren’t always great at preventing pregnancies.

Using a period tracking app for contraception is only 75% effective. This means that for every 100 women that use a tracking app to avoid pregnancy, 25 will become pregnant. For comparison, a contraceptive implant is over 99% effective.

Some apps will alert you in some way (eg. Highlight your calendar or change colour) to tell you to when you are fertile or not. These timeframes may not be inaccurate and you might become pregnant.  If you have an irregular period, are not an organised person, or become unwell, the app may not accurately track your cycle.

Even apps like Natural Cycles that make you record your ‘basal body temperature’ everyday are not always accurate. Your basal body temperature is your body temperature during rest; for many people, there is a slight increase in basal body temperature when you ovulate. However, using your body temperature to estimate your ovulation dates can be risky; accurate estimates require you to measure your temperature at exactly the same time every day, immediately as you wake up. Furthermore, your body temperature can also be affected by things like sickness, stress, smoking, alcohol, medications or the weather.

Some studies have found that ‘basal body temperature’ tracking methods are only 22% effective at tracking ovulation, which could have led to unplanned pregnancies. One hospital in Sweden found that 37 of 668 patients seeking abortion had been relying on Natural Cycles, and the UK advertising watchdog cautioned the company for having misled consumers, and “exaggerated the efficacy of the method as a form of contraception.”

Period tracking apps and your health data

Generally, health apps are a multimillion industry and period tracking apps are no exception. Some apps are free, while others might have a fee where you enter payment and a monthly fee thereafter. Because apps are big business for marketers and medical companies, consider the benefit of the app for your health and wellbeing before committing to a purchase. Remember to check what the app might do with your health information – will it be secure? (For example, in 2021, the period tracking app Flo ‘settled a complaint with the FTC which alleged that the company was selling users’ health data to Facebook and Google, as well as marketing and analytics firms’.) You can find out more about popular fertility apps and your privacy here.

The bottom line

Period tracking apps can be useful for lots of things, like predicting your next bleed or tracking your period-related symptoms. However, they are not the most effective form of contraception, and can’t protect you against STIs.

If you want discuss all your contraception options, contact our team on 1800 696 874 (weekdays, 9am – 5pm) or search for a contraception provider online.

Is it safe to skip periods?

The answer is YES!

If you think about it, your body is actually designed to ‘skip’ periods when needed – for example, if you’re breastfeeding, pregnant or stressed. This is something your body is able to do very easily. Compared to in the past, people now are having more periods than ever before – because on average, we have fewer pregnancies, and shorter breastfeeding periods. People are also getting their first periods at a younger age, and reach menopause at an older age than in the past.

Many people now use contraception for preventing unplanned pregnancies or to regulate their periods. There are many kinds of contraception.  Most of them cause some changes to when you get your period, and what the flow of bleeding is like. One of the things hormonal contraception does is thin the lining of your uterus, so there is no big build up if you skip a period. This is why hormonal contraception often makes your period lighter than usual. When you skip a period, your body simply reabsorbs the uterine lining.

The most common way to skip a period is to be on the combined oral contraceptive pill. This type of pill has eostrogen and progesterone in it. These are the hormones that are present throughout your monthly menstrual cycle. Most pill packets have around 21 days of active hormone tablets, and around 7 days of inactive ‘sugar pills’ when you get your ‘period’. Sometimes people “skip” the 7 days of inactive ‘sugar pills’ and continue on to their next pill packet.  This means they won’t get bleeding during this time.

Photo of a hand holding a pill packet

The inactive ‘sugar pills’ are often marked with a different colour on your pill packet.  

Other contraception that can change your bleed pattern, and lighten or stop your periods completely are hormonal IUDs (like Mirena and Kyleena), contraceptive implants (Implanon) and injections (Depot Provera) or the vaginal Nuva Ring.

Some people might still get bleeding in between their ‘periods’. This is called breakthrough bleeding. If this happens to you, see your GP or women’s health clinic to find out why this is happening. Don’t stop using contraception without medical advice, or you might become pregnant.

Skipping periods can work really well for people who have heavy periods, period pain, pelvic pain, iron deficiency, pre-menstrual tension or disabilities. There are also many social reasons why you might want to skip your period – such as travel, work, exercise, sex, or convenience.

Remember, it is your choice. Skipping your periods with hormonal contraception is safe – and won’t affect your future fertility or long-term health. 

If you want more information about what is right for you, see your GP or your local woman’s health clinic.

5 Vasectomy Myths

A vasectomy is an operation that prevents sperm travelling from the testicles to the penis.

It is done by cutting the tubes (vas deferens) that allow sperm to leave the testicles. It is more than 99.85% effective at preventing pregnancy! It’s a straightforward procedure that costs less and has less possible side effects than current contraceptive options for women and people with uteruses.

Digital illustration of anatomy testThe vas deferens are cut and tied, or sealed, to prevent sperm from travelling from the testicles to the penis. 

Despite this, it remains an underutilised form of contraception. This is demonstrated by higher rates of tubal ligation than vasectomy, even though vasectomy is a simpler, shorter and safer operation (and often, much cheaper!). This is probably because there are still many myths surrounding vasectomy. So, if know you don’t want to have children, we present some myth busting facts:

  1. Myth One: A vasectomy kills your sex drive / erections 
    False! A vasectomy will not change your sex drive, your sexual desires, or your ability to have erections and ejaculate! A vasectomy does not remove your testes, which is where testosterone is produced, so your testosterone levels will remain unchanged. It simply redirects sperm by cutting the vas deferens so that it can’t mix with semen. The only thing that will change is that your semen will no longer have any sperm in it. Erections are a result of good blood flow to the penis, so this is not affected by a vasectomy.
  2. Myth Two: It’s extremely painful, and so is the recovery 
    False! Vasectomies are generally not painful. The procedure itself usually only takes around 15 minutes. Each person is different, but after local anaesthetic it should only feel like slight tugging. You may feel a dull ache after the anaesthetic wears off, but icepacks and over-the-counter medication should do the trick. Recovery usually takes a week!
  3. Myth Three: I won’t have any ejaculation (cum) afterwards 
    False! Less than 3% of ejaculate (semen) is made of sperm, so you’ll pretty much ejaculate the same amount of fluid!
  4. Myth Four: Vasectomies fail anyway 
    False! With new technological advances and improved techniques, failure rates for vasectomies are around 0%. However, it usually takes around 10-20 ejaculations to clear sperm completely after the procedure. Vasectomy does not result in immediate infertility, so another form of contraception must be used, for around three months, until sterility is confirmed by semen analysis.
  5. Myth Five: If I change my mind, it’s not reversible 
    This depends! A vasectomy can be reversed by reconnecting the vas deferens. However, it is a difficult procedure. The success rate depends on how long it has been since the initial vasectomy, how it was done, and the person’s overall health. Regardless, a vasectomy would not be a recommended method of contraception if you are wanting children in the future.

If you’re still not convinced, there’s also evidence to suggest that once someone has had a vasectomy, sex is more enjoyable – because there’s no anxiety about possible pregnancy! So if you know you don’t want to parent, vasectomy could be the right permanent contraception option for you.

To search for vasectomy services near you, contact 1800 My Options on 1800 696 784 (weekdays, 9am – 5pm) or search our database online.

References: 

Healthy Male – Andrology Australia
Health Direct (Australian Department of Health and Aged Care)
Family Planning New South Wales
Better Health Channel (Department of Health, State Government of Victoria)

Is Emergency Contraception the same as Abortion Pills?

Emergency contraception and medical (medication) abortion are often confused, with many people thinking that emergency contraception is the same as an early medical abortion. But there’s a big difference between the emergency contraception pill and medication abortion pills.

Essentially, emergency contraception pills are used to prevent a pregnancy whilst the medication abortion pills are used to end a pregnancy.

Emergency contraception pills

The emergency contraceptive pill works by stopping or delaying when your ovaries release an egg. It is up to 85% effective. They are most effective if taken within 24 hours after unprotected sex. Emergency contraception pills may not work if you:

In Australia, there are two options available:

Ulipristal acetate is more effective than Levonorgestrel, but only Levonorgestrel is safe to take when breast or chest feeding.

Emergency contraception pills are directly available from pharmacists. You do not need a prescription.

Medication abortion pills

Medical (medication) abortion is a safe and legal non-surgical method to end a pregnancy. Before you can have a medication abortion, you will need to have a blood test and ultrasound scan to confirm the pregnancy.

Medication abortion is a two-stage process. The first stage involves taking a tablet (mifepristone) which blocks the hormone that is needed for the pregnancy to continue. This is followed by a second medication (misoprostol) which expels the pregnancy from the body.

The medication abortion pills have a high success rate of working – up to 98% effective in ending an early pregnancy. Medication abortion is only available up until 9 weeks of pregnancy. In Australia, surgical abortion is required after 9 weeks.

Medication abortion pills are available from (some) GPs, private abortion clinics, (some) public hospitals and (some) community health and sexual health clinics. A prescription is required for this medication.

If you’re worried about an unplanned pregnancy, or if you need support finding Emergency Contraception or Medication Abortion services, please call us on 1800 696 784 (weekdays, 9am – 5pm) or search for services online

15 years of World Contraception Day

Since 1960, people have had access to a variety of hormonal and non hormonal contraceptives. This has empowered women to more freely decide on the timing of their education, careers, relationships, pregnancies and parenting, as well as manage many health concerns.

However, unintended pregnancy rates continue to be high around the world. In countries with restricted abortion access, women may resort to unsafe practices that increase the maternal mortality rate each year. Contraception is a vital tool for global public health equity, and there is clearly unmet need for contraception access that must be fulfilled.

How many people need contraception internationally?

The History of World Contraception Day 26th September

23 September 2007

UN experts at the office of the United Nations High Commissioner for Human Rights in Geneva released a statement;

“Access to family planning and contraception services, free from coercion or impediment, is a component of the right to health that is central to women’s autonomy and agency and key in the realization of women’s right to equality and non-descrimination, life, sexual and reproductive health rights and other human rights.”

26 September 2007 

10 international family planning organisations joined together to raise awareness about contraception, working towards a vision where every pregnancy is wanted. The World Contraception Day mission is to:

“improve awareness of contraception and to enable young people to make informed choices on their sexual and reproductive health.”

The present day

There is a coalition of 15 NGO international government organisations and scientific medical societies spreading the right knowledge about sexual and reproductive health.

Remarks from Dr Alaka Singh, a WHO Sri Lanka representative on World Contraception Day 2021 detail the importance of contraception access in all aspects of contemporary society:

“Improved access to low-cost contraception and its uptake through family planning programmes has reduced high-risk pregnancies; maternal and child mortality; teen and unplanned pregnancies; and, improved child health and nutrition. Modelling exercises have found that contraceptive use may have reduced maternal mortality by over 40%…

It is important to note that the impact of family planning is beyond health. It is multisectoral and even intergenerational. It is well documented that improved child health and nutrition has the potential to positively influence academic performance and behavior. In turn, education is a key determinant of the uptake and consistency in use of family planning services. Estimates for the economic impact of family planning have found that $3.6 billion a year spent on providing contraception to all those who want them has a potential of an annual return of $432 billion. A return of $120 for every dollar spent. Further, family planning is increasingly being identified as a cost-effective approach in climate change resilience strategies.”

The future

By 2030, the United Nations’ Sustainable Development Goal Target 3.7 is:

“to ensure universal access to sexual and reproductive health care services, including family planning, information and education and the integration of reproductive health into national strategies.”

If you want to know more about your contraception options please review our website.
There are 10 choices that include hormonal or non-hormonal options, with long or short term methods available.

If you are looking for a contraception service, you can search for a provider in your local area or call 1800 696 784 for confidential, free and non-judgmental pro-choice advice.

Plan B. What is it and how does it work?

You may have heard the term Plan B on social media or in films or tv, but do you know what it is?

Plan B is an American brand name for the emergency contraception medication called Levonorgestrel.

Emergency contraceptive pills are available in Australia too, but ‘Plan B’ is not a brand name that is used here. So, to avoid any confusion always ask your pharmacist or doctor for the Emergency Contraceptive pill rather than Plan B. In Australia this medication can also be known as ‘The Morning After Pill’.

The two types of emergency contraceptive pills most commonly available in Australia are Levonorgestrel and Ulipristal Acetate.

The pills are around 85% effective, and work best if you take them within 24 hours of having unprotected sex.

Levonorgestrel, can be taken up to 3 days after unprotected sex. Ulipristal Acetate (sold as EllaOne) can be taken up to 5 days after unprotected sex. Ulipristal Acetate is more effective than Levonorgestrel. Both options are available from pharmacists without a prescription. 

These pills work by preventing or delaying ovulation (this is when a mature egg is released from the ovary). Despite what you might hear, use of the emergency contraception pill is NOT an abortion. Emergency contraception works by preventing pregnancy whilst abortion is a medical procedure used to end a pregnancy (via medication or surgery). If you are already pregnant before you take emergency contraception the pills will not work.

If you’re going to a pharmacist for the Emergency Contraceptive pill, they will need to ask you some questions. These questions might include:

Pharmacists, however, have NO right to ask you about your sexual partners, or – if you are a young person – if your parents know that you are having sex.

Emergency contraceptive pills will not harm a pregnancy. It is safe to continue the pregnancy or have an abortion.