Are there any other serious complications of Rubella?

For most people, Rubella is a mild illness. However, less commonly complications can occur, such as middle ear infections and encephalitis (inflammation of the brain).

How is Rubella diagnosed?

Rubella can be hard to diagnose, as the symptoms can be very mild, and the rash can look like other viral rashes. If your doctor suspects Rubella on the basis of your symptoms, they can arrange a blood test to confirm the diagnosis.

How long is Rubella contagious?

Rubella is contagious for about a week before the rash appears (so a person can spread it before they know they have it). The contagious period lasts for about 4 days after the rash appears.

How can you prevent Rubella?

Vaccination against Rubella is part of the National Immunisation Program Schedule in Australia. It is included in the MMR vaccine at 12 months and again in the MMRV vaccine at 18 months.

Rubella vaccination is particularly important for certain high risk groups including-

• travellers to and from areas where rubella is common
• childcare workers
• healthcare workers

If a woman is planning a pregnancy she can ask her doctor about having a blood test to check her immunity. If found to be non-immune, vaccination can be arranged. Pregnancy should be avoided for a month after having the MMR vaccine.

Is there any treatment for Rubella?

Unfortunately, there is no specific treatment (which is why prevention with vaccination is important). Fluids, pain relief and rest are usually recommended.

What should you do if you’re worried about Rubella?

If you are concerned about Rubella (particularly if you’re pregnant or planning a pregnancy), you should speak to a doctor as soon as possible.

Further Patient Resources

The Royal Women’s Hospital

The Mayo Clinic

What about antibiotics and the pill?

The standard advice given to women in the past was that antibiotics would stop the pill working properly.  This is now known to be untrue. Most antibiotics do not interfere with the pill, so no extra precautions are required.  Antibiotics used to treat chest infections, sore throat, skin infections, urinary tract infections and other common illnesses have no effect whatsoever on the pill. There are rare exceptions which include uncommonly used antibiotics used to treat meningitis and TB.

Can you get pregnant on the pill?

The pill is a very effective method of birth control if used correctly all the time- but in reality, most women tend to miss a pill now and then, which reduces the reliability. About 0.3% of women who use the pill perfectly become pregnant each year. However, approximately 9% of women will become pregnant if they take the pill correctly most of the time. As most women fall into this second category, it means the pill is generally 91% effective. Of course, it’s important to note that more than 80% of sexually active women will become pregnant within a year if they do not use any form of birth control.

Article Resources

Royal Children’s Hospital website

Mayo Clinic website

Clotting risk and the pill

• Women who take the pill have a slightly higher risk of developing a blood clot
• Clotting risk is further increased by smoking, obesity, long haul flights, major surgery, immobility and certain medical conditions such as lupus and cancer- an alternative form of birth control should be discussed with your doctor.
• Depending on where a clot forms in the body, it can lead to a stroke, heart attack, DVT (deep vein thrombosis) or pulmonary embolism (a clot in the lung). These conditions can be serious, and potentially life-threatening.
• Symptoms of a blood clot may include:
  • A painful/swollen leg (or arm)
  • Sharp chest pain which is worse on taking a deep breath
  • Unexplained shortness of breath or rapid heart rate
  • Coughing up blood
  • Numbness or weakness of an arm or leg
  • Sudden problems of speech or vision

• It’s also important to be aware that some pills have a higher clotting risk than others. Pills containing certain progesterones have a higher risk. If possible, it’s better to take a pill with lower risk ingredients. Ask your GP or pharmacist if you’re not sure.

The Pill and Cancer

Taking the pill appears to increase the risk of some types of cancer but may protect against others- overall, the risk of cancer is reduced in women who take the pill. The risk of breast cancer appears to increase slightly, so regular self-checking of the breasts is advised, and if any changes are noticed, it’s important to see a doctor. There may also be a slightly increased risk of other cancers, including cervical cancer. It’s therefore important to have regular cervical screening. Rates of cancer of the ovary, uterus and bowel appear to be lower in women who take the pill.

If you have concerns or questions about the pill, or about side effects of the pill, speak to your GP or pharmacist.

Further Patient Resources:

Contraception – the combined pill betterhealth.vic.gov.au

Contraceptive pills thewomens.org.au

Article Resources:

Grossman N. (2010). Managing adverse effects of hormonal contraceptives

Liao PV. (2012). Half a century of the oral contraceptive pill

How effective is the pill compared to other forms of contraception?

No method of contraception is 100% reliable, and some forms of birth control such as the pill are affected by how carefully a woman follows instructions for correct use. Effectiveness is usually stated as the percentage of women who become pregnant after one year of using that method.

• The mini pill or progesterone only pill (POP) is said to be 91% effective, based on typical, less-than-perfect use (i.e. about 9% of users will become pregnant per year). This is about the same as the combined contraceptive pill. Both forms of pill are 99% reliable if taken “perfectly”, but perfect use is not the reality for most women!
• The progesterone “depo injection” is a long acting option, which lasts 12 weeks. It’s said to be about 94% effective (i.e. about 6% of users will become pregnant each year).

• IUDs including the hormonal IUDs and copper coil are over 99% effective.
• The progestogen implant , commonly known as the “rod”, is more than 99% effective.
• The contraceptive vaginal ring  is about as reliable as the pill, at 91%.
• Condoms are about 82% effective.
• Tubal ligation or occlusion (forms of female sterilisation) are more than 99% effective.

For more information about different forms of contraception, check out our contraception hub page.

Do you smoke?

If you’re a smoker, this increases your risk of developing a blood clot. As the pill also increases your risk of a clot, it’s not advisable to smoke if you take the pill. If you are a smoker over 35 years of age, the pill is contraindicated, and a different form of contraception is required.

Do you suffer from migraine with aura?

If you suffer from migraine and have ever had an “aura”, you should not take the pill, as it puts you at a higher risk of stroke. Migraine is usually a severe throbbing headache that lasts between 4 and 72 hours. The pain is often located on one side of the head and may be worsened by movement. It is often associated with nausea, vomiting or an aversion to light (photophobia). An “aura” may happen in the hour before the headache- an aura typically involves a disturbance in vision which may include flashes of light, blind spots or shimmering lines. Less commonly, an aura may involve numbness or pins and needles of the arm or the face. Even less commonly, it may involve difficulty speaking. If you think you have had a migraine with aura, you should speak to your doctor as the pill is not suitable if this is the case.

There are other side effects and important health issues related to taking the pill. If you have questions or concerns about taking the pill, speak to your GP or pharmacist.

Further Patient Resources:

Get the facts: Contraceptive Pill getthefacts.health.wa.gov.au

Contraceptive Pill (The Pill) healthywa.wa.gov.au

Article Resources:

Combined Hormonal Contraceptives ranzcog.edu.au

How can you check your hormonal IUD is in place?

It’s recommended to check your hormonal IUD each month, after your period. You do this by inserting a finger into the vagina and feeling for the threads. Sometimes it can be hard to feel the threads because they’re curled up or are sticking to the wall of the vagina. If in doubt, your GP can check for you.

Does the hormonal IUD  make you gain weight?

So far, studies show that women who have a hormonal IUD are not more likely to gain weight. While some women who have an IUD may report weight gain, this is probably unrelated and caused by some other issue.

What are the side effects of the hormonal IUD?

Though the hormonal IUD is very well tolerated by most women, like any medication it can cause unwanted side effects. Side effects of the hormonal IUD include:

• Unscheduled or irregular vaginal bleeding
• Heavy bleeding or heavy periods
• Light periods or no periods (though many women consider this an advantage!)
• Headaches
• Pelvic or tummy pain
• Changes in vaginal discharge
• Irritation or inflammation of the vagina and vulva (vulvovaginitis)
• Hormonal side effects are uncommon because only very tiny amounts of progesterone are absorbed into the body

There are other less frequent side effects, which are listed on the drug information leaflet that comes with the pack.

How is the hormonal IUD removed?

The process of removing a hormonal IUD is usually very quick and straight-forward. The doctor or nurse will use forceps to pull firmly on the threads, and it will usually come out immediately. There may be a moment of discomfort just as it passes through the cervix.

If the threads are not visible or the hormonal IUD does not come out when the threads are pulled, you may need to see a specialist to get it removed.

Anything else you should know?

If you’ve more questions about the hormonal IUD, how it works or the side effects, speak to your GP or gynaecologist.

Do you take the mini pill every day?

• Yes, the mini pill must be taken within the same 3 hour period each day.
• If you are more than 3 hours late taking your pill, you may become pregnant.

What if you miss a pill, or if you have vomiting or diarrhoea?

• If even one tablet is late (more than 3 hours later than the timing of yesterday’s dose), or if a tablet is entirely missed, you may become pregnant.
• The next pill should be taken as soon as remembered (even if that means taking two at once), then continue to take one each day, but also use condoms for the next 7 days.
• If you’ve had sex in the 7 days leading up to the missed/late pill, you may become pregnant- the morning after pill/ emergency contraception may be required. It is advisable to speak to your pharmacist or doctor
• The more doses that have been missed, the higher the chance of pregnancy.
• If you vomit within 4 hours or have severe diarrhoea after taking a tablet, it may not have been completely absorbed. This is like missing a dose- see above

What does it mean if you miss periods or get irregular bleeding on the mini pill?

• Some women don’t get periods when they take the mini pill. If you have missed a period, but you have taken all your tablets correctly and have not taken any medications that interfere with your mini pill, then it is very unlikely that you are pregnant- continue to take the mini pill as usual.  If you have further concerns consult your doctor or pharmacist.
• If you miss two periods in a row, you may be pregnant even if you have taken your pill correctly – do a pregnancy test, and/or seek advice from your doctor.

• Irregular vaginal bleeding (spotting or breakthrough bleeding) between periods is common in the first few months of taking the mini pill. It’s usually advised to continue to take your tablets as usual. The bleeding often stops after a few months, once your body has adjusted to the
• If you have unexpected bleeding which is repeated, continuous, heavy or not settling after the first 2-3 months, you should see your doctor. If there is abdominal pain or abnormal vaginal discharge with the bleeding, you should also seek prompt medical attention.

What if I’m under 18?

It doesn’t matter- you are still entitled to go to your pharmacist and request it. They may ask you some health-related questions (in person, or on a questionnaire), but they are NOT entitled to ask about your religion, who you had sex with or whether your parents know about it.

Are there any side effects of the morning after pill?

• Side effects are uncommon- these include breast tenderness, nausea or headaches.
• It may also cause your menstrual cycle to be out of its normal pattern in the following month or so.
• If your next period is late or lighter than usual, you should do a pregnancy test, as the morning after pill does not work 100% of the time.
• Ectopic pregnancy is rare, but is a very serious condition that happens when a pregnancy forms outside the uterus- it most often presents with lower abdominal pain, which may be quite sharp in nature. Therefore, if you get lower abdominal pain after using the morning after pill, you should see a doctor immediately.

Where can I get emergency contraception?

Most women will get it from their local chemist, family planning clinic or GP

Is there any alternative to the morning after pill?

• Whilst it is a less straight-forward option, the copper coil (a small copper device that’s inserted into the uterus), is a highly effective form of emergency contraception.
• It must be inserted by a doctor or nurse.
• It can be used up to 5 days after unprotected sex, will prevent around 99% of pregnancies, and can be left in as long-term contraception for 5-10 years (depending on the type you get).

If you wish to know more about emergency contraception, speak to your doctor, pharmacist

Further Patient Resources

Royal Women’s Hospital website 

Mayo Clinic

Family Planning Victoria 

There are also two antibiotics which are exceptions to the above rule- these antibiotics are very seldom prescribed by a GP- they’re used to treat uncommon infections such as TB and meningitis, and sometimes as a preventive measure in people who have been exposed to a case of meningitis. These antibiotics do have the potential to interfere with the contraceptive pill, and the prescribing doctor should give very clear advice with this in mind.

Whether you choose to get your pill from a regular clinic or from an online doctor, it’s important you understand how to take your pill correctly, so that it works as effectively as possible. Check the patient information leaflet in the pack, or ask your doctor or pharmacist if you are not sure!