Contraception - common issues and practical suggestions

General practitioners are usually the first point-of-contact for young people seeking sexual health and contraceptive advice. Although the combined oral contraceptive pill is still the most common choice for contraception by Australian women, there is an increasing drive to encourage the consideration and use of long acting reversible contraception.

This article focuses on common issues that may complicate contraceptive management and provides some practical suggestions for effectively managing the use of different contraceptive methods, particularly in young women.

If presented with information about the range of contraceptive choices, including long acting reversible contraception, young women will commonly choose a longer acting method. Good counselling is important before advocating either implant or depot injections as irregular bleeding can occur and is likely to be of particular concern to younger women. Clinicians are increasingly considering intrauterine devices in nulliparous women and in women aged less than 25 years. It is uncommon for women to have complications with intrauterine device insertion, the most significant potential problem being pelvic infection. The key to minimising problems in contraceptive practice is the consideration of sustainability (cost, efficiency, duration of action and suitability), making a careful choice and then counselling the patient well.