The goal of contraception is to prevent unintended pregnancy. Vasectomy has the lowest failure rate – but you must get an ‘all clear’ from the post vasectomy sample.
326 of Australian women were interviewed about unexpected pregnancy. The 2018 study found that 41% were using contraception at the time of the pregnancy of whom:
A quarter of the women interviewed said that the unintended pregnancy was ‘wanted.’
There was hope around ten years ago that a temporary form of vasectomy might be developed using a clip.¹ This procedure was associated with high failure rates and stopped. Another method of temporary vasectomy used a rod, and this got to the development stage only.²
So Guys essentially have a choice of Vasectomy or Condoms.
The following table gives an overview of female contraceptive options & failure rates³. Rather than being an exhaustive list of every possible benefit or risk, it’s a balanced overview of the most common issues affecting couples.
|Main Benefits||Main Risks||Practicalities|
|Combined Pill||Low Failure Rate, can reduce period bleeding, can have cycles back-to-back. Often Beneficial for conditions like acne or hirsutism.||Deep Vein Thrombosis & Cardiovascular Risk Factors to evaluate include Body mass index, Smoking, Migraine with aura, Family history, increasing age, high BP, Cholesterol, Diabetes, kidney disease etc.||Can forget to take the pill.|
|Progestogen Only Pill||Used as a 2nd line oral contraceptive when the combined pill is not recommended. No increased cardiovascular or thrombotic risks.||Australian licensed mini pills need to be taken in a 3 hour window each day.||The minipill is unforgiving when forgotten – failure rates are high.|
|Progestogen Injection||No increased cardiovascular or thrombotic risks. Periods often disappear completely within 12 months.||Progestogenic side effects are usually manageable but women may sometimes report weight gain, mood or changes. Periods often erratic to start with.||3 monthly visits to your doctor & practice nurse to get the injection. Need a pregnancy test if late for your next injection.|
|Progestogen Implant (rod)||Periods often disappear completely within 12 months.||Persistent bleeding beyond 6 months in around 15% of women may require the implant to be removed.||3 yearly implant in the inner side of the left upper arm.|
|Intrauterine Device – Mirena||Periods usually disappear completely within 12 months – often good for heavy or painful periods.||Risk of uterine perforation is around 1 in 1000. Rarely infection or migration of the device.||5 yearly re-insertion. Few GPs currently provide this service & most women need a referral to a gynaecologist.|
|Local Methods||Caps, Diaphgragm & Vaginal Ring.||no systemic risks. Higher rate of failure than many other methods of contraception.||Suits only a few women and couples – comes down to personal preference & guidance on use from a health practitioner.|
|Female Sterilisation||Low failure rate at around 1 in 200||Small risk from a General Anaesthetic & Infection.||Day Case in a hospital.|
|Vasectomy||The lowest failure rate at around 1 in 2000 after the all-clear. Hormone-Free. Men can step up.||Post vasectomy pain affects around 1 in 50 guys.||The most important thing is to continue contraception until you get the all-clear after the semen analysis.|