It’s your choice

There is no ‘best choice’ of birth control that works for everyone. You have the right to decide what method is best for you. How do you know what method of birth control is right for you?

There are many things to consider when choosing a form of birth control. It is important for you to know the facts about each method to be able to make an informed choice that suits your needs, health, values and lifestyle.

Some questions you may want to consider when choosing a method are:

  •     How effective is this method?
  •     Can I use this method, or do I have to rely on a partner to use it effectively?
  •     Does this method protect against Sexually Transmitted Infections?
  •     How is this method used? Does it fit my needs and lifestyle?
  •     Does this method have any side effects? If yes, what are they?
  •     What is the cost of this method?
  •     How available is this method and where can I find it?
  •     How will this method affect my ability to have or cause a pregnancy in the future?
  •     Do I have an allergy or medical condition that will affect my ability to use this method?
  •     How do I feel about applying this method to my body?
  •     How do I feel about taking hormones or my partner having to take hormones?

For more information about the forms of birth control available, or to discuss which method(s) would work for you, please contact the Calgary Sexual Health Centre at 403-283-5580 to speak with one of our counsellors, or talk to a health care provider. Knowing your options will help you decide on the best method for you.

The information presented here is intended as general information only. It is not intended to be used for medical advice, diagnosis or treatment. It is not intended to replace an in-person consultation with a healthcare professional.

What methods of birth control protect against sexually transmitted infections (STIs)?

There are only three methods of birth control that protect individuals from STIs. These are the male condom, female condom and abstinence (which includes abstaining from oral and anal sex). If you are worried about getting an STI from your partner you should either abstain or use a condom (during oral, vaginal or anal sex). Another option might be talking to your partner about their previous sexual history and whether they have had recent STI testing done. If you or your partner has not had recent STI testing it may be a good idea to consult your doctor or local STI clinic about getting tested






How do I know what method of birth control is right for me?

There is no ‘best choice’ of birth control that works for everyone. You have to decide what will work best for you. Look at the options and decide on a method that feels right for you. There are many things to consider when choosing a form of birth control. Some people need to consider such things as effectiveness, side effects, ease of use, accessibility, cost, possible allergies or other medical conditions, and comfort levels around inserting certain methods vaginally or taking hormones. Choosing a birth control method that works for you may require some planning. It should be something that you feel comfortable with. As you move into different stages in your life your birth control needs may change. Remember, you can always switch methods if your circumstances change or if you are having concerns. You may want to speak to a health professional about your options or to discuss your concerns or questions. If you would like more information about the different forms of birth control that are available please check out the birth control section of our website or call and speak to one of our counsellors.






How can I get the emergency contraception pill (ECP)?

You can buy ECP directly from a pharmacist. The pharmacist will ask some basic questions, fill the prescription and give usage instructions.  Some pharmacists may not prescribe ECP so it is best to call ahead to make sure.  ECP is also available by prescription from a doctor or a walk-in clinic. This prescription would need to be taken to a pharmacy to be filled. ECP can be taken within 120 hours (or 5 days) of unprotected intercourse. Try to take the pills as soon as possible, as the effectiveness decreases every day. Within the first 24 hours the it is 95% effective, the first 48 hours (2 days) 85% effective and after 72 hours (three days ) it is 61 % effective. If you are able to access ECP within 72 hours of unprotected intercourse the risk of pregnancy is reduced from 75%-85%.






Can using hormonal birth control affect my future fertility?

Using hormonal forms of birth control will not cause infertility. However, once hormonal forms of birth control are stopped it may take some time for to resume normal menstrual cycles and to release an egg. Many of the reasons that people have trouble conceiving are not related to hormonal birth control use. For example, on average, it takes about eight months to become pregnant once a couple starts trying. Fertility and conception are based on many factors, such as age of partners, sperm count, frequency of intercourse, timing of intercourse, etc.






malecondom  External Condom

How do I use it

  • Pinch the tip of the condom to prevent an air pocket, roll the condom down the erect penis to the base.
  • Do not use with a female condom or a second male condom.
  • Latex, polyurethane, silicone and lambskin varieties are available.
  • It works 85-98% of the time

How does it work

  • It stops the exchange of genital fluids, prevents some genital contact
  • A new condom should be used for each act of intercourse.
  • Use water based lubrication only with latex condoms.

*Can use silicone based lubrication as well*

What are the positives

  • No prescription required.
  • Easy to find
  • May help to prevent premature ejaculation.
  • Protects against pregnancy and STIs
  • Can be used with a hormonal birth control

What are the negatives

  • Must be stored at room temperature
  • May slip off or break if used incorrectly
  • It may lower sensation for either partner
  • Oil based lubrication will break the latex condom
  • Lambskin condoms don’t protect against STIs

femalecondom  Internal Condom

How do I use it

  • A lubricated sheath made of polyurethane that has thin, flexible rings at each end. The closed end of the condom is inserted into the vagina and held in place by the inside ring. The larger, outer ring rests on the outside of the vagina. It can be placed into the vagina 6 hours before sexual activity.
  • Do not use with an external condom or a second internal condom.
  • It works 79-95% of the time

How does it work

  • Placed in the vagina before intercourse.
  • Lines the vagina and prevents some direct genital contact and exchange of body fluids.
  • A new condom should be used for each act of intercourse.

What are the positives

  • People who are allergic to latex can use the internal condom.
  • It is safe to use with a water based, silicone or oil based lubricant
  • Provides protection against STIs and pregnancy
  • Can be used with a hormonal birth control method
  • Don’t need a prescription for it

What are the negatives

  • Needs to be inserted properly.
  • More expensive than male condoms.
  • May slip or break.
  • More expensive than external condom
  • May make noise during intercourse.

contra_foam  Spermicide

How do I use it

  •  Inserted into the vagina before sexual intercourse.
  • It works 71-82% of the time

How does it work

  • Contains ingredients, mainly non-oxyol-9, that disables sperm
  • Effectiveness increases significantly when used with a barrier method i.e. condoms.

What are the positives

  • Can be used by people who smoke or who are breastfeeding.
  • Does not contain hormones
  •  May provide lubrication.
  • Do not need a prescription

What are the negatives

  • Does not protect against STIs.
  • Some people get an allergic reaction, it may irritate the penis or vagina
  • If a rash develops, it could increase the risk of getting an STI

sponge  Contraceptive Sponge

How do I use it

  • A soft foam sponge filled with spermicide that is inserted into the vagina and placed against the cervix before sexual intercourse
  • Must remain in the vagina a minimum of 6 hours but no longer than 12 hours
  • It works 68-91% of the time

How does it work

  • The sponge acts as a barrier, absorbing sperm while the spermicide disables it.
  •  If you haven’t given birth: 91% effective when used perfectly, 84% effective with typical use. If you have given birth: 81% effective when used perfectly, 68% effective with typical use

What are the positives

  • Does not contain hormones
  • Can be used by people who smoke or who are breastfeeding
  • It could increase lubrication

What are the negatives

  • Does not protect against STIs
  • You may experience an allergic reaction to spermicide. If an allergic reaction occurs this can increase the risk of STI transmission
  • May experience vaginal infection or irritation
  • Symptoms of Toxic Shock Syndrome can occur if left in the vagina longer then 12 hours

pill_combo  Oral Contraception

How do I use it

  • A daily pill to prevent pregnancy.
  • Must remember to take the pill every day at the same time
  • It works 92-99% of the time

How does it work

  • It contains the hormones estrogen and progestin
  •  Prevents the ovaries from releasing an egg.
  • Thickens cervical mucus so sperm cannot pass through it
  • Causes changes in the lining of the uterus.

What are the positives

  • Can help make periods regular and reduce heavy flow and cramps.
  •  Lowers risk for ovarian and endometrial cancer
  • Can be taken safely for many years

What are the negatives

  • Some drugs make the pill less effective; talk to a doctor or pharmacist
  • May experience irregular bleeding or spotting, nausea, bloating, breast tenderness and headaches
  • Increased risk of blood clots.
  •  Women over 35 who smoke should not use it.
  • Does not protect against STIs
  • You need a prescription from a doctor to get it

mini_pill  Oral Contraception Mini Pill

How do I use it

  • A daily pill to prevent pregnancy
  • Must remember to take the pill every day at the same time. If taken after a 3 hour time difference a backup method of birth control is recommended
  • It works 93-99% of the time

How does it work

  • It contains progestin only
  • Thickens cervical mucus so sperm cannot pass through it

What are the positives

  • Can help make periods regular and reduce heavy flow and cramps
  • Does not contain estrogen
  • Lowers risk for ovarian and endometrial cancer
  • Can be taken safely for many years and can be used by women over 35 who smoke

What are the negatives

  • Some drugs make the pill less effective; talk to a doctor or pharmacist
  • May experience irregular bleeding or missed periods
  • Prevents the ovaries from releasing an egg only 40-60% of the time. If irregular periods occur then back up method of birth control should be used
  • Does not protect against STIs.
  • You need a prescription from a doctor

patch  Birth Control Patch

How do I use it

  • Small patch placed on the skin. Apply a patch once a week for three weeks, then let one week pass without a patch.
  • It works 92-99% of the time

How does it work

  • It contains the hormones estrogen and progestin that are released slowly and absorbed through the skin
  • Prevents the ovaries from releasing an egg
  • Thickens cervical mucus so sperm cannot pass through it
  • Causes changes in the lining of the uterus

What are the positives

  • Once a week contraception
  • Can help make periods regular and reduce heavy flow and cramps

What are the negatives

  • May experience irregular bleeding or spotting, nausea, bloating, breast tenderness and headaches.
  • May cause skin irritation where the patch is applied. Patch may detach from skin.
  • There is an increased risk of blood clots.
  • Does not protect against STIs.
  • Women over 198 lbs may experience decreased effectiveness
  • Some drugs make the patch less effective; talk to a doctor or pharmacist
  • You need a prescription from a doctor to get it

vaginal_ring  Vaginal Contraceptive Ring

How do I use it

  • A flexible ring placed in the vagina that contains the hormones estrogen and progestin that are slowly absorbed into the body.
  • The ring stays in the vagina for 3 weeks and is removed for one week
  • It works 92-99% of the time

How does it work

  • Contains estrogen and progestin to stop the ovaries from releasing an egg
  • Thickens cervical mucus so sperm cannot pass through it
  • Causes changes in the lining of the uterus

What are the positives

  • Once a per month contraception
  • Can help make periods regular

What are the negatives

  • May experience irregular bleeding or spotting, nausea, bloating, breast tenderness and headaches
  • May cause vaginal discomfort or irritation
  • Ring may fall out
  • Does not protect against STIs
  • Some drugs make the ring less effective; talk to a doctor or pharmacist
  • Need a prescription from a doctor to get it

depo_provera  Injection Contraception

Also known as: Depo Provera

How do I use it

  • A nurse or doctor gives you an injection into the arm or buttocks every three months
  • It works 97-99% of the time

How does it work

  • Contains only progestin.
  • Prevents the ovaries from releasing an egg
  • Thickens cervical mucus so sperm cannot pass through it
  • Causes changes in the lining of the uterus

What are the positives

  • Only 4 times per year
  • Does not contain estrogen. Maybe suitable for those who are breastfeeding
  • May stop having periods
  • Improves symptoms of endometriosis. Decreases risk of endometrial cancer
  • Can be used by women over 35 who smoke

What are the negatives

  • Irregular bleeding is a common side effect. May stop periods altogether
  • Changes in appetite, weight gain, depression, hair loss, change in sex drive
  • May cause delay in getting pregnant after shots are stopped
  • Makes bones weaker, must take calcium supplements.
  • Cannot be used for more than two years at a time
  •  Does not protect against STIs
  • Need a prescription from a doctor

ecp  Emergency Contraceptive Pill

Also known as: Plan B ®

How do I use it

  • Can be used up to five days after unprotected intercourse but is most effective if taken within the first 24 hours
  • Plan B®: take one pill right away and the second 12 hours later or both at the same time
  • It is 95% effective in the first 24 hours 85% effective in the next 25-48 hours and 61% effective or less after 72 hours.

How does it work

  • Contains high doses of estrogen or progestin
  • It is for emergencies only and does not provide ongoing protection against pregnancy
  • It changes the lining of the uterus so an egg can’t attach
  • It makes vaginal mucus thicker so sperm can’t get to the uterus

What are the positives

  • You can use it after sex if the condom breaks, you forget a pill or if you didn’t use birth control
  • You can buy it to keep it on hand in case you need it
  • You don’t need a prescription and you can get it at most pharmacies

What are the negatives

  • Does not protect against STIs
  • May cause light bleeding/spotting headaches, cramps, breast tenderness
  • May cause nausea and vomiting especially when taking 2 pills at a time; can be taken with anti-nausea medication i.e. Gravol®

copper_iud_2  Intrauterine Device

Also known as: IUD Mirena

How do I use it

  • A small, soft “T” shaped device that contains the hormone progestin it is inserted into the uterus though the cervix
  • Can be left in place for up to 5 years
  • It works 99.9% of the time

How does it work

  • It contains only progestin
  • Preventing the sperm from fertilizing the egg.
  • Causes changes in the lining of the uterus.
  • Thickens the cervical mucus making it difficult for the sperm to get through
  • It may prevent the ovaries form releasing an egg

What are the positives

  • It may help make periods lighter and less painful
  • It can help endometriosis pain
  • It may lower the chance of precancerous cells developing in the uterus
  • 20-30% of women will stop having periods
  • Once every 5 years birth control

What are the negatives

  • Irregular bleeding or spotting. May increase menstrual bleeding or menstrual cramping
  • Does not protect against STIs
  • May be expelled or fall out in 6% of users
  • 20-30% of women will stop having periods
  • A doctor must prescribe, insert and remove it

copper_iud  Intrauterine Device

Also known as: Copper IUD

How do I use it

  • A small, soft “T” shaped piece of plastic wrapped in copper wire inserted into the uterus
  • Can be left in place for up to 5 years
  • It works 99.2-99.4% of the time

How does it work

  • It changes the lining of the uterus so an egg can’t attach
  • It makes vaginal mucus thicker, so sperm can’t get to the uterus

What are the positives

  • It has no hormones
  • It may lower the chance of getting endometrial cancer
  • Once every 5 years birth control

What are the negatives

  • Irregular bleeding or spotting. May increase menstrual bleeding or menstrual cramping
  • Does not protect against STIs.
  • May be expelled or fall out in 2 – 10% of people
  • A doctor must prescribe, insert and remove it.

natural_chart3  Fertility Awareness Methods

Also known as: Sympto-Thermal

How do I use it

  • The sympto-thermal method teaches people how to observe, chart and interpret her cervical mucus secretions and daily waking temperature (basal body temperature or BBT) to understand which are the fertile and not fertile days
  • To prevent pregnancy, avoid  intercourse during fertile days
  • There are many types of Fertility Awareness Methods
  • Fertility Awareness Method (FAM) refers to a natural birth control method outside of a religious framework that supports the use of barrier methods (condom, diaphragm, and spermicide), emergency contraception, and abortion. Justisse is a Canadian developed variant of FAM that teaches both the mucus only and the sympto-thermal approaches.
  • Natural Family Planning (NFP) typically refers to natural birth control that is taught and practised within a religious framework, most commonly Catholic centred organizations. It does not support the use of barrier methods, emergency contraception, or abortion. Billings Ovulation Method teaches only mucus observations. Serena and Couple to Couple League methods are sympto-thermal NFP variants. The Creighton Model will teach both mucus only and sympto-thermal approaches
  • Another form of natural birth control is Lactational Amenorrhea Method (LAM)
    • Lactational Amenorrhea Method (LAM) is used by a woman who has just given birth and is exclusively breastfeeding. This method is highly effective for the first six months after childbirth, provided the woman breastfeeds the baby at least every four hours during the day and every six hours through the night, and that her menstrual period has not yet returned. After six months fertility may return at any time.
  • The sympto-thermal Fertility Awareness Method is 99.6% effective when used consistently and perfectly with avoidance of intercourse during the fertile phase. It is 75- 80 % effective with typical use.

How does it work

  • Keep a record (chart) of daily observations of cervical mucus secretions and BBT which change throughout the menstrual cycle.
  • This information is used to determine when the fertile phase begins and ends
  • The fertile phase typically last between 7 and 10 days and is the time during which ovulation (release of egg) occurs
  • To prevent pregnancy, intercourse is avoided during the entire fertile phase.
  • People can choose to use barrier methods such as condoms for protected intercourse during fertile days

What are the positives

  • Effective method of birth control with no negative health side effects
  • Promotes positive body and menstrual cycle awareness.
  • Fosters communication between partners; all partners can take an active role to achieve effectiveness
  • Knowledge of fertility can be used later to plan a pregnancy
  • Inexpensive after initial investment for training and materials
  • Consistent with many personal, religious and cultural beliefs
  • Can be used to plan or avoid pregnancy

What are the negatives

  • Does not protect from STIs
  • Often difficult to find trained instructors to learn the method.
  • Requires time to learn (usually 3 to 6 cycles) during which abstinence or barrier methods must be used
  • Requires discipline and commitment to chart fertility signs and follow the rules to avoid pregnancy
  • Times of abstinence from intercourse may be a challenge for some couples

For more information about charting your fertility please see:

http://www.tcoyf.com/charting.aspx

http://www.justisse.ca/

Withdrawal

How do I use it

  • A penis is taken out, or withdrawn from a vagina before ejaculation
  • People use this on its own or with another form of birth control
  • It works about 73-96% of the time

How does it work

  • If semen doesn’t get inside the vagina there is lower chance of the sperm meeting the egg
  • It works best for both partners who can talk to each other easily so you can both make sure you pull out at the right time

What are the positives

  • Its free
  • You can use it with other types of birth control
  • There are no side effects

What are the negatives

  • People have trouble with the timing
  • Semen can come out of the penis when you aren’t expecting it
  • There can be sperm in the pre-ejaculate
  • It does not protect against STIs
  • If you pull out too late, access emergency contraception to reduce the chance of pregnancy

tu_ligatFemale Sterilization

Also known as: Tubal Ligation

How do I use it

  • A permanent form of birth control
  • A surgical procedure performed by doctors
  • The fallopian tubes are blocked so that sperm and egg cannot meet
  • It works 99.5% of the time

How does it work

  • Laparoscopy: blocks the fallopian tubes by applying a clip or a ring or burning them. Mini-laparotomy: clip or a ring or to burn or cut a small piece of the fallopian tubes.
  • Hysteroscopy: tiny plugs are inserted into the fallopian tubes.
  • Check with a doctor for more information

What are the positives

  • Permanent and highly effective
  • It works without hormones
  • It doesn’t change periods or the menstrual cycle
  • It is covered under provincial health care

What are the negatives

  • Difficult and expensive to reverse
  • May experience slight pain or discomfort for a short period of time
  • All surgery has risks
  • Does not protect against STIs
  • Requires a doctors referral and may be long wait time
  • You may need to be over 30 to access this surgery

vasectomy  Male Sterilization

Also known as: Vasectomy

How do I use it

  • A permanent form of birth control
  • A surgical procedure done by a doctor
  • Vas deferns are permanently closed or blocked
  • It works 99.9% of the time

How does it work

  • Surgery stops the sperm from leaving the body so the sperm can’t meet the egg and cause pregnancy
  • Ejaculation without sperm
  • Does not interfere with the ability to get or maintain an erection or ejaculation

What are the positives

  • Permanent.
  • Fewer risks and quicker recovery time then female sterilization
  • Procedure is covered by provincial health care

What are the negatives

  • Difficult and expensive to reverse.
  • All surgery has risk
  • Does not protect against STIs
  • Not effective immediately, follow-up sperm analysis needed to ensure no sperm in ejaculate
  • You may have to be over 25 to access this