Gardasil  

The Gardasil government funded program has now ended however, we are still able to carry out the vaccinations but it will be privately funded on prescription. The average cost is $150 for each injection and it is a course of 3 over a 6 month period. 

For further information about the Gardasil vaccine or cervical cancer please visit http://www.cervicalcancer.com.au/

Your health is our greatest responsibility!  

Contraception and Hormone Replacement Therapy

Over the past 10 years there have been several advances in contraception and hormone replacement therapy. Some examples include the new Nuvaring (intravaginal hormone ring), Implanon (hormonal implant under the skin) and Mirena (intrauterine hormone rod).

Many women are finding that these newer options suit them better than taking of the traditional oral contraceptive pill. All of our doctors can discuss and prescribe any of these options for you.

Ask your Doctor today and do not worry about tomorrow!

Nuvaring

Nuvaring (intravaginal hormone ring) is a hormonal contraceptive for vaginal use. It is a flexible, transparent, almost colorless ring with an outer diameter of 54 mm and a cross sectional diameter of 4 mm. Each ring contains two female sex hormones, etonogestrel (a progestogen) and ethinylestradiol (an estrogen). The ring slowly releases these hormones into the blood circulation. Because of the low amount of hormones that is released, NuvaRing is considered a low-dose hormonal contraceptive. Since NuvaRing releases two different types of hormones it is a so-called combined hormonal contraceptive. 

Each ring is packed in a reclosable sachet. The sachet is made of aluminum foil and packed in a cardboard box together with this package leaflet. Each box contains 1 or 3 rings.

 Why use NuvaRing?                                                               

 To prevent pregnancy. NuvaRing, when used correctly, is an effective method of birth control.

How does it work?

NuvaRing works just like a combined contraceptive pill (the Pill). NuvaRing releases two female sex hormones that prevent the release of an egg cell from the ovaries. If no egg cell is released you cannot become pregnant. An advantage of NuvaRing is that you do not have to remember to take a pill every day.

NuvaRing is very reliable, but as for all contraceptive methods, protection is never 100%. If NuvaRing is used according to the directions, your chance of getting pregnant is less than 0.7% per year. For comparison purposes, if combined oral contraceptives are used diligently, the chance of getting pregnant is expected to be about 0.1% and if progestogen only pills ("mini pills") are used about 0.3%. Your chance of getting pregnant increases if NuvaRing is not used exactly according to the directions.

 For more information on Nuvaring and other contraceptive methods please visit: http://www.nuvaring.com/Consumer/index.asp 

Implanon

A hormonal implant under the skin is another contraceptive option available on the market today. It is a single small non-biodegradable semi-rigid rod, 4 cm in length and 2 mm in diameter, made of plastic (ethylene vinylacetate copolymer). It contains 68 mg etonogestrel, a hormone that is slowly released into the bloodstream for three years.

Although Implanon may be removed at any time, it must be removed after three years. Implanon is placed directly under the skin of the inner part of your upper arm in the groove between the biceps and the triceps.

How does it work?

As with Nuvaring, the etonogestrel in Implanon prevents the release of an egg cell from the ovaries (ovulation). In addition, Implanon causes changes to cervical mucus that make it difficult for sperm to enter the womb.

Before you have Implanon inserted or removed, confirm that your doctor is familiar with the technique. For uncomplicated removals, it is necessary that Implanon be inserted directly under the skin. Incorrect insertion may lead to complicated removals that may result in scarring.

Why use Implanon?

Implanon has several important advantages:

• It is one of the most reliable birth control methods. However, there is no birth control method that is 100% effective.
• It does not interfere with having sex.
• Once you stop using it you can expect your previous fertility to return quickly
• You do not have to worry about taking a tablet (The Pill) each day; Implanon need only be replaced every 3 years.
• Implanon can be used by women who do not tolerate oestrogens.
• Implanon may, in some circumstances, be used by lactating women (check with your doctor, as the safety of the use of Implanon when breastfeeding is still being investigated)

Disadvantages

• Vaginal bleeding may occur at irregular intervals during the use of Implanon. You also may not have any bleeding at all. It is important to have regular medical check ups, because while irregular bleeding is a common side effect of Implanon, it may rarely be caused by other medical conditions.
• On rare occasions, Implanon moves from its original position. This may complicate removal.
• Implanon must be inserted and removed by a doctor. A small scar may remain.

For more information on Implanon please visit http://www.fpv.org.au/pdfs/ImplanonApril06.pdf 

Mirena

Mirena (intrauterine hormone rod) consists of a small T-shaped frame made from a plastic called polyethylene. This carries 52 mg levonorgestrel, a hormone used in many contraceptive pills. The hormone is contained within a substance called dimethylsiloxane/ methylvinylsiloxane (cross-linked) elastomer. This is surrounded by a membrane (skin) made of dimethylsiloxane/ methylvinylsiloxane (cross-linked) elastomer. The T-shaped frame also contains barium sulfate so that it can be seen on X-rays. This structure provides a system for releasing the hormone gradually into the uterus (womb).
There are two fine threads, made of iron oxide and polyethylene, attached to the bottom of the frame. These allow easy removal and allow you or your doctor to check that the system is in place.

What is Mirena used for?

Mirena may be used as a long term and reversible method of contraception, for the treatment of excessive menstrual bleeding or for protection from endometrial hyperplasia (excessive growth of the lining of the womb) during hormone replacement therapy. It is placed inside the womb where it slowly releases the hormone (at an initial rate of 20 micrograms per day) over a period of five years or until it is removed.

How does it work as contraception?

• Controlling the monthly development of the womb lining so that it is not thick enough for you to become pregnant.
• Making the normal mucus in the cervical canal (opening to the womb) thicker, so that the sperm cannot get through to fertilise the egg.
• Preventing ovulation (the release of eggs) in some women.
• There are also local effects on the lining of the womb caused by the presence of the T-shaped frame (since Mirena is also an intrauterine contraceptive device).
• Affecting the movement of sperm inside the womb, preventing fertilisation.

How does it work as a Hormone Replacement Therapy?

Mirena also works in the treatment of excessive monthly bleeding and as protection in oestrogen replacement therapy by slowly releasing the progestogen hormone levonorgestrel, within the womb.  Levonorgestrel suppresses the response of the cells in the lining of the womb to oestrogen making the lining of the womb insensitive to circulating oestradiol. This stops the growth of the lining of the womb, which results in a reduction in the volume and duration of menstrual bleeding. This is the mechanism of action in the treatment of excessive bleeding (menorrhagia) and for protection against overstimulation of the lining of the womb in oestrogen replacement therapy.

Is Mirena suitable for me?

Not all women should use Mirena. All products have benefits and risks. If you are unsure if Mirena is suitable for you, discuss this with your doctor.

For more information on Mirena please visit http://www.mariestopes.com.au/contents/2.%20MSI%20Mirena%20Fact%20Sheet%20-%20Dec05.pdf