Family Planning

Family planning enables men and women to plan their desired number of children and the spacing and timing of their births while maintaining a normal sex life. Contraceptive methods, sexually transmitted disease testing and treatment, and the treatment of involuntary infertility help achieve this.

Family planning addresses three things:

1. to help avoid unintended pregnancies
2. to reduce the spread of sexually transmitted diseases (STDs)
3. to reduce the rates of infertility by addressing the problem of STDs.

The different types of birth control contraception for family planning comprise of:

• Barrier methods - include male and female condoms, the diaphragm, cervical cap and contraceptive sponge.
• Short-acting hormonal methods - include birth control pills, vaginal ring, skin patch and contraceptive injection (Depo-Provera). They are classed as short-acting methods as you have to remember to use them daily, weekly or monthly.
• Long-acting hormonal methods - include the copper intrauterine device (IUD), intrauterine system (IUS) and the contraceptive implant. They are considered long-acting methods because they last for three to ten years after insertion depending on the method or until you decide to have the device removed.
• Fertility awareness methods – uses monitoring and recording different fertility signals during the menstrual cycle to work out when you are most likely to get pregnant. Fertility signals include the length of your menstrual cycle, daily readings of your body temperature and cervical secretion changes (cervical mucus). Pregnancy is avoided by not having sex or using a barrier birth control on fertile days.
• Spermicide or vaginal gel - are non-hormonal methods for birth control. Spermicide kills sperm or stops it from moving. Vaginal gel stops sperm from moving so they cannot get to your egg to fertilise it. They are applied deep into the vagina before sex or combined with other barrier methods of birth control.
• Sterilisation - is a permanent method of birth control. It can include tubal ligation for women and vasectomy for men.
• Emergency contraception - is used after unprotected sex. It can be the copper IUD or the emergency contraceptive pill, called the morning after pill.

Fertility tests

If you have been trying to conceive for a while without success, you may wish to have some tests to help find out the cause of any infertility and assist you in choosing the right treatment options.

• Semen sample – to test male fertility. It tests sperm quality and its chances of conception, based. The analysis looks at the number of sperm (the ‘count’), the way the sperm are moving (motility) and the number of sperm that look normal (morphology).
• Hormone blood tests and ultrasound scans - to test female fertility. Hormone tests include FSH, LH, oestrogen, prolactin and anti-mullerian hormone. They can be combined with ultrasound scans to help identify female fertility issues such as ovarian reserve, PCOS and ovulation.

Modern family planning methods are categorised into three types:

• Short-term methods – include the pill, condoms, diaphragms, foaming tablets, jelly, the lactational amenorrhoea method (LAM), natural family planning, and the emergency contraceptive pill.
• Long-term methods- include injectables, implants and IUDs.
• Permanent methods - female and male sterilisation.

There are also traditional methods that consist of periodic abstinence, withdrawal, and various folk methods such as herbs.

The best type of family planning will depend on you and your partner and your lifestyles. Ramsay can give you advice on all the types of contraception available and what we think might be the best type for you based on our conversations during your consultation.

Some contraceptive methods are more effective than others. Some have the potential for user error such as remembering to take the contraceptive pill. Some contraceptive methods have side effects such as spotting or bleeding between periods, sore breasts, nausea, or headaches. The male condom gives the best protection against STIs and the female condom provides some protection.

Some people find they are not successful in getting pregnant and part of their family planning will focus on determining if there are fertility issues.

There are 15 types of contraception that support family planning.

1. Cap – is a circular, thin and soft silicone dome that is inserted into the vagina before sex. It covers the cervix to prevent sperm from getting into the womb. Spermicide is used with it to kill the sperm.
2. Combined pill – contains synthetic female hormones, oestrogen and progestogen. It stops a woman's ovaries from releasing an egg (ovulating) and makes it difficult for sperm to reach an egg or for an egg to implant itself in the lining of the womb.
3. Progestogen-only pill (POP, mini pill) - contains progestogen but not oestrogen. It thickens the mucus in your cervix to stop sperm from reaching an egg. It may also stop ovulation. You take a pill at or around the same time every day, with no break between packs of pills.
4. Male condoms – are made of very thin latex (rubber), polyisoprene or polyurethane. They aim to stop a man's semen from coming into contact with his sexual partner. Condoms are the most effective way of preventing sexually transmitted infections (STIs).
5. Female condoms – are made from thin, soft plastic called polyurethane. They are worn inside the vagina to prevent semen from getting to the womb. They help to protect against pregnancy and sexually transmitted infections (STIs).
6. Contraceptive implant - is a thin, flexible rod about 4cm long that is inserted under the skin of your upper arm by a professional. It stops eggs from being released from the ovary by slowly releasing progestogen into your body. Progestogen also makes it harder for sperm to move through your cervix and less likely for your womb to accept a fertilised egg. It typically lasts for three years.
7. Contraceptive injection - releases the hormone progestogen into your bloodstream to prevent pregnancy. Depending on the type of injection it will last for 8, 12 or 13 weeks so you don't have to think about contraception every day or every time you have sex.
8. Contraceptive patch - is a sticky 5cm by 5cm patch that delivers hormones into your body through your skin. It contains the same hormones as the combined pill, and it works in the same way. Each patch lasts a week and is changed every week for three weeks and then you have a week off without a patch. You'll still be protected against pregnancy during this week.
9. Diaphragm – is a circle of silicone that you insert into your vagina before sex and leave in place at least six hours after sex. It covers the cervix to prevent sperm from getting into your womb. You need to use spermicide with it. A diaphragm needs fitting by a trained doctor or nurse and is reusable.
10. IUD (intrauterine device, coil) – is a small T-shaped plastic and copper device that is inserted into your womb by a doctor or nurse. It releases copper to stop you from getting pregnant by stopping sperm and eggs from surviving in the womb or fallopian tubes and it may prevent a fertilised egg from implanting in the womb. An IUD works immediately and lasts for between five and ten years.
11. IUS (intrauterine system) - is a small, T-shaped plastic device that is inserted into your womb. It releases progestogen into your womb that thickens the mucus from your cervix and makes it difficult for sperm to move through and reach an egg. It also thins your womb lining so that it is less likely to accept a fertilised egg and it can stop ovulation in some women. Depending on the type, it works for three to six years and means you don't have to think about contraception every day or each time you have sex.
12. Vaginal ring - a small, soft plastic ring that you place inside your vagina and leave for 21 days when you remove it. Seven days later you insert a new one for the next 21 days. The ring releases oestrogen and progestogen to prevent ovulation and make it difficult for sperm to get to an egg. It also thins the womb lining, so it is less likely that an egg will implant there.
13. Vasectomy – is male sterilisation that involves cutting and sealing off the tubes that carry sperm from the testicles to the penis. Men who have a change in circumstances can have a vasectomy reversal that offers a chance to father a child.
14. Female sterilisation – known as tubal litigation. It is an operation to cut, tie or block your fallopian tubes (the tubes between the ovary and the uterus) with rings or clips. It is a permanent method of contraception. It is possible to have a female sterilisation reversal procedure, but it is a complex process and there is no guarantee that you will be able to have any more children after surgery.
15. Natural family planning (family awareness) – you learn when you can have sex without contraception during your menstrual cycle with a reduced risk of pregnancy.

The costs of family planning will depend on your chosen healthcare specialist and your preferred method of contraception or required STI or fertility testing.

You will receive a formal quotation price for your family planning following a consultation with one of our family planning specialists. This formal quote will be valid for 60 days.

Ramsay is recognised by all major medical insurers. Medical insurance policies often don’t cover family planning. We advise you to obtain written authorisation from your insurance provider before your family planning if you wish to pay this way.

We have a number of finance options if you are paying for your family planning yourself. We offer interest-free finance with 0% interest, no deposit and affordable monthly instalments, and pay-as-you-go payment plans.

The recovery process of family planning will depend on what type of contraception, STI or fertility testing you require.

There is no recovery time required for many contraceptives such as the pill and condoms. After the insertion of an IUD or IUS, you may feel some cramping and bleed, and these usually settle quickly. You should avoid sexual intercourse for 24 hours or until the bleeding settles, to prevent infection.

After a longer-term contraception surgery, such as a vasectomy, you may need to rest for a few days. You can usually go home the same day as your surgery. In the first few days, your testicles will probably ache. You should avoid sex for a week or so and use an alternative contraception until your surgeon has confirmed there are no sperm in your semen.