While age is one consideration, individual preferences and other factors such as the presence of medical conditions influence the choice of contraception for a woman. No matter what the woman's age, a comprehensive discussion with a family doctor or a gynaecologist will help identify the best choice of contraception for her.

The 30s: longer-term contraception preferred

Women in their 30s often look for longer-term contraception because they want to space out their pregnancies or have already completed their families. With longer-term methods, women don’t have to remember to take a pill or use a condom.

The two most popular methods at Singapore General Hospital (SGH), a member of the SingHealth group, are the following:

• a progesterone-hormone-containing intrauterine device (also called an intrauterine system or Mirena) and
• a progesterone-containing implant which is inserted under the skin of the arm (Implanon).

Mirena and Implanon have very low failure rates. A side effect of any progesterone releasing contraceptive method is light but often irregular bleeding, which is more apparent when the method is first used. Bleeding often settles with time.

In the longer term, these methods may cause an absence of periods, which is not harmful and will be corrected once either method is discontinued. Mirena is also very effective for heavy periods as it reduces menstrual blood loss by up to 80 per cent. Evidence has shown that using Mirena reduces the need to have a hysterectomy (removal of the womb) for heavy periods.

An array of contraceptive choices

Implanon, on the other hand, is an effective treatment for dysmenorrhoea (painful periods). Mirena and Implanon are effective for five and three years respectively, but they can be removed at any time, with fertility rapidly restored.

Other methods include the older copper intrauterine device (IUCD) and an injectable three-monthly progesterone hormone called Depo-Provera.

Unlike Mirena, the copper IUCD causes periods to become slightly heavier. Light, irregular bleeding is also common with Depo-Provera injections.

Ref: V10