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Birth Control: Your Contraception Options

Birth control (also known as contraceptives) is the practice of preventing an unintended pregnancy.

As a student, there are many factors to be considered when choosing a method that is right for you. The Choosely Wisely questionnaire will assist you in determining the best contraception for you based on your current needs and lifestyle.

Things to consider

  • Male and female condoms are the only forms of birth control that decrease the risk of contracting an STI in addition to preventing pregnancy. For dual protection, use them with other forms of birth control.
  • Abstinence (though not technically a form of birth control) can be up to 100% effective in preventing pregnancy and STIs. The meaning of abstinence may vary from person to person so it is important to define what it means to you.
  • It is important to consider all the facts before deciding on a form of birth control. The information provided here contains some of the more common forms of contraception that are available. You may want to review these and other possible options with a healthcare provider when deciding which method is right for you. 

The Birth Control Pill (oral contraceptives)

What it is

  • The most popular method of birth control
  • Contain estrogen and progestin
  • Progestin-only pills (“mini-pill”) are also an option. They contain only progestin and can be prescribed to women who can’t take estrogen
  • Requires a prescription

How it works

  • One pill is taken every day by females
  • Prevents the ovaries from releasing an egg
  • Thickens cervical mucus to prevent the passage of sperm
  • Alters the lining of the uterus making implantation of an egg more difficult

Effectiveness

  • The pill is up to 99.7% effective against pregnancy

Advantages

  • Reversible (not permanent) 
  • Can improve periods making them more regular and decreasing cramping 
  • May help improve acne
  • Extended or Continuous Use.  This means taking the hormone pills continuously without stopping and without pill-free days. You will not have a period until you stop taking the hormone pills.  If you plan to try this, talk to your pharmacist or health care provider.  Your pill might not be suited for extended or continuous use.

Disadvantages

  • Must remember to take everyday (around the same time too)
  • Possible side effects for some women can be irregular bleeding/spotting, as well as nausea, bloating, breast tenderness, and headaches
  • Women over the age of 35 who smoke can’t use it
  • May increase the risk of blood clots
  • Does not protect against sexually transmitted infections (STIs) 

Transdermal Patch (Evra)

What it is

  • A small patch placed on the skin of females
  • Contains two hormones (estrogen and progestin) that are released slowly and absorbed through the skin
  • Requires a prescription

How it works

  • Apply patch once a week for three weeks and then one week without the patch
  • Like oral contraceptives, the patch prevents the ovary from releasing an egg, thickens the cervical mucus, and causes changes in the lining of the uterus

Effectiveness

  • The patch is up to 99.7% effective against pregnancy.

Advantages

  • Reversible (not permanent) 
  • Changed once a week
  • Makes periods more regular and decreases menstrual cramping

Disadvantages

  • Possible side effects can include irregular bleeding or spotting, breast tenderness, and headaches
  • Possible skin irritation where the patch is applied
  • Patch may detach from skin (less than 2%)
  • May increase the risk of blood clots
  • Does not protect against sexually transmitted infections (STIs)

Vaginal Contraceptive Ring (NuvaRing)

What it is

  • A flexible ring, containing the hormones estorgen and progestin that is inserted into the vagina
  • The two hormones are absorbed through the vagina into the blood stream
  • Requires a prescription

How it works

  • The ring stays in the vagina for three weeks and removed for one “ring-free” week
  • Like oral contraceptives, the ring prevents the ovary from releasing an egg, thickens the cervical mucus, and causes changes in the lining of the uterus

Effectiveness

  • The ring is up to 99.7% effective against pregnancy

Advantages

  • Reversible (not permanent)
  • Once a month contraception
  • Makes periods more regular
  • Does not interfere with intercourse
  • Extended and Continuous Use:  Women can forgo the "ring-free" week (and menstration period) by inserting a new ring every three weeks.

Disadvantages

  • Possible side effects can include irregular bleeding/spotting, nausea, breast tenderness, and headache
  • May cause vaginal discomfort or irritation (but uncommon)

Intrauterine System (IUS – Mirena)

What it is

  • A T-shaped device that contains the hormone levonorgestrel (also called the “hormonal IUD”) and sits inside the uterus
  • The hormone is released slowly over time and acts on the lining of the uterus
  • Can be left in place for up to 5 years
  • Requires a prescription and needs to be inserted and removed by a health care provider

How it works

  • Mainly by preventing the sperm from fertilizing the egg
  • Thickens the cervical mucus makes it difficult for sperm to pass
  • Causes changes in the lining of the uterus
  • In some women, it prevents the ovaries from releasing an egg

Effectiveness

  • The IUS is 99.9% effective

 Advantages

  • Long-acting (up to five years)
  • Does not contain estrogen
  • Does not interfere with intercourse
  • Decreases menstrual bleeding and cramping; some women will stop having periods
  • May decrease pain associated with endometriosis

Disadvantages

  • Possible side effects after insertion include irregular bleeding/spotting
  • Perforation of the uterus may occur at the time of insertion (but rare)
  • May fall out (expelled) in about 6% of women
  • Does not protect against sexually transmitted infections (STIs)

Intrauterine Device (IUD)

What it is

  • A T-shaped device that contains copper and sits inside the uterus.
  • Can be left in place for up to 5 years
  • Requires a prescription and needs to be inserted and removed by a health care provider

How it works

  • Acts as an irritant in the uterus
  • Prevents the sperm from fertilizing the egg. 
  • Causes changes in the lining of the uterus and in the cervical mucus, preventing implantation.

Effectiveness 

  • The IUD is 99.4% effective

 Advantages

  • Long-acting (up to five years)
  • Does not any hormones.
  • It is reverseable 
  • Can be used as an emergency contraceptive if inserted within 5 days following unprotected sex.

Disadvantages

  • May increase menstrual bleeding or cramping
  • Perforation of the uterus may occur at the time of insertion (rare)
  • May fall out (rare)
  • Side effects may include irregular bleeding or spotting
  • Does not protect against STIs

Condom

What it is

  • A soft disposable sheath that fits over the erect penis                               
  • Available in different sizes, shapes, thicknesses, colours, and flavours
  • Most are latex but non-latex condoms are also available (polyurethane, silicone, lambskin)
  • Available in stores, pharmacies and online
  • There are also condoms designed for females (inserted into the vagina) - for more information click on the link above

How it works

  • Physical barrier over the penis acts to prevent direct genital contact and the exchange of genital fluids
  • A new condom is used for each act of intercourse

Effectiveness

  • The condom is 85 - 98% effective against pregnancy

Advantages

  • Available without a prescription
  • Latex condoms protect against sexually transmitted infections (STIs)                    
  • May help to avoid premature ejaculation

Disadvantages

  • Must be stored and handled properly
  • Must be available at time of intercourse and may reduce spontaneity
  • May slip or break (consider emergency contraception)
  • May reduce sensitivity for either partner

Injectable Contraceptive (Depo-Provera)

What it is

  • An injection that is given in the arm or buttocks 4 times per year (every 12-13 weeks)
  • It contains only one hormone (a progestin) and does not contain estrogen. It can be used by women who cannot take contraceptive methods with estrogen, for example women over 35 who smoke.
  • Requires a prescription and the injection has to be given by a healthcare professional

How it works

  • Prevents ovaries from releasing an egg
  • Thickens the cervical mucus making it difficult for sperm to pass
  • Causes changes in the lining of the uterus
  • May stop having periods. After 1 year, over 50% of users will stop having periods, and after 2 years, over 66% of women will stop having periods

Effectiveness

  • The “shot” is 97 - 99.7% effective against pregnancy

Advantages

  • Reversible (not permanent)
  • Does not contain estrogen
  • Injection occurs only 4 times per year
  • Improves symptoms of endometriosis

Disadvantages

  • Irregular bleeding is a common side effect
  • Causes a decrease in bone mineral density, possibly weakening bones. This may be reversible when the injection is stopped
  • May cause weight gain
  • Delay in getting pregnant when it is stopped. May take up to 9 months after the last injection for the ovaries to start releasing an egg again.
  • Does not protect against sexually transmitted infections (STIs)

Spermicide

What it is

  • Spermicides come in several other forms, including creams, jellies, tablets, suppositories, foams and film
  • Available in stores, pharmacies and online

How it works

  • Spermicides are inserted into the vagina, and contain ingredients that disable sperm. They can be used together with other forms of contraception.

Effectiveness

  • Not very.  Spermicide is 71 -82% effective when used perfectly
  • Spermicides are most effective when used with a barrier method (e.g. condoms) 

Advantages

  • Does not contain hormones
  • Spermicide may also provide lubrication

Disadvantages

  • Does not protect against sexually transmitted infections
  • Some people may be allergic to spermicides

Emergency Contraception (Plan B)

Emergency contraception is used to prevent pregnancy after unprotected sex or when contraception has failed. It does not protect against sexually transmitted infections (STIs). Click on the link above for more information or speak to a healthcare provider as soon as possible. Use emergency contraception within 72 hours.  The sooner emergency contraception is taken, the better the chances are in preventing an unintended pregnancy.

For more information visit:

References

  • SexualityandU, administered by the SOCG
  • PlannedParenhood.org
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