Not your mother's contraception

Reading a popular women's magazine the other day, I was startled to discover that what looked like one of those peel-off make-up samples wasn't a make-up sample at all. It was "The Patch", a form of contraception that you put on your skin once a week. Of course, the magazine sample didn't actually contain the combination of oestrogen and progestogen that the real patch releases - it was just to demonstrate how thin and unnoticeable the real thing is.

A few pages later, I found an advert for a vaginal ring, an insertable hormonal contraceptive. After decades of very little exciting news in contraceptives for women, suddenly we're riding a wave of promising new contraception methods.

"This is really unprecedented", says Dr Stephanie Tiel, a clinical instructor of obstetrics and gynaecology, who points out that there are several new methods of contraception now on the market.

Tiel calls the new options "the best of both worlds" - they have the quick reversibility of the pill should you decide to get pregnant, but they're longer-acting systems that don't require busy women to remember to do something at the same time every day.

"You don't have to think about it"

First on the market was Mirena, an intrauterine system (IUS) that's been used in Europe for more than ten years. Like intrauterine devices (IUDs, commonly called coils), this T-shaped device is fitted in the womb. But unlike IUDs, Mirena releases levonorgestrel, a hormone commonly found in the pill, to create a "hostile uterine environment" and prevent pregnancy. Inserted (and removed) by a doctor, Mirena works for up to five years, with a failure rate of less than 1%.

"You don't have to think about it. Once it's in, it's in", says Tiel. "It's just as effective as having your tubes tied, only it's reversible." Another big plus: Mirena causes lighter periods for most women. In fact, some 20% of Mirena users don't menstruate at all. “It's totally normal,” Tiel explains. The hormone in the IUS thins the lining of the uterus so you still ovulate, but you don't bleed. Most of the other 80% experience 1-2 days of very light bleeding, a huge relief if you normally have problem periods.

Some women avoid the IUS because of fears of infection and infertility. But those problems were limited to a type of IUD that had a plaited string for the doctor to use in removing the device. The plaiting allowed bacteria to grow, unlike the single-filament strings used to remove current IUDs and the IUS.

As with any contraception method, there are some disadvantages. Mirena has to be inserted and removed by a doctor; it's a simple procedure, but not a do-it-yourself task.

Patching it up

Tiel predicts that the contraceptive patch will be immensely popular. Using the same hormones as in a contraceptive pill, the patch can be applied anywhere on the body - the buttock, the lower back, the abdomen - except directly over the breast. "It's discreet. People don't have to see it if it's under your underwear", she says. It's changed once a week, and has the same possible side effects as the pill.