Health Information FAQs: Contraception

Text Size: Normal / Medium / Large
Printer-friendly versionPrinter-friendly version

What kind of choices do I have for birth control?

How do I take the Pill?

What do I do if I have spotting between periods while I am on the birth control pill?

What should I do if I miss one, two or three birth control pills?

I am going on vacation and I will be getting my period that week. Is it safe to skip the week of inactive pills and continue to take the active pills so I don't get it?

 

What kind of choices do I have for birth control?

Making a choice on the right method of birth control can be difficult. You have to learn about all the different methods available to you, and look at all of their pros and cons, not to mention which ones will fit with your lifestyle and budget. All birth control methods are effective but only if used consistently and properly. We have listed below methods which are available and accessible in Canada :

BARRIER METHODS

Male condom: a latex sheath that fits over an erect penis to prevent sperm from entering into a woman's body. Condoms offer the best protection against sexually transmitted infections (STIs) as well as HIV. They are 98% effective in preventing pregnancy and 98% effective against STIs (when used correctly and consistently).

Female condom: a thin polyurethane sheath with a soft ring at each end. One ring fits over the cervix while the other stays outside of the vagina covering part of the perineum and labia during intercourse. It can be inserted up to eight hours before intercourse but must be removed immediately after. It is 95% effective when used consistently and correctly.

For more information on female and male condoms, search our databases.

Diaphragm: a shallow, dome-shaped, soft rubber cup that fits in the vagina to cover the cervix. A spermicide is placed in the cup that faces the cervix to kill the sperm and keep them from entering the uterus. It must be fitted at a clinic so that it is the correct size for you. When they are used correctly diaphragms prevent pregnancy as well as offer limited protection against some STIs including gonorrhea and chlamydia. The effectiveness rating is between 80% and 98% depending on whether it is used properly every time.

Cervical cap: a rubber or silicone cap shaped like a thimble that fits over the cervix and held in place by suction. It is used with spermicide. Most varieties need to be fitted by a medical practitioner who should direct you on how to use it. They can be inserted up to 6 hours before sex. Cervical caps do not protect against STIs. The cervical cap is less effective for women who have not given birth. It is 91% effective with perfect use for women who haven't given birth and 74% with perfect use for women who have given birth.

Sponge: The contraceptive sponge is a small, disposable plastic (polyurethane) foam device that measures approximately five centimeters in diameter. Spermicide, which kills the sperm or leaves them inactive, is released from the sponge for up to 12 hours while the sponge is in place. Before intercourse, insert the sponge into the vagina far enough to cover the cervix (the opening to the uterus at the top of the vagina). Insert the sponge any time prior to sexual intercourse. It remains effective even if intercourse takes place more than once and needs to be left in at least six hours after intercourse (for a maximum of up to twelve hours after being inserted). The sponge is 72% to 82% effective. The sponge does not protect against sexually transmitted infections (STIs)

For more information on diaphragms, cervical caps and sponges, search our databases.

Spermicides: A spermicide destroys or disables sperm so that it cannot fertilize an egg to cause pregnancy. The chemical nonoxynol-9 is the active ingredient in most spermicides, which are available in different forms: foam, jelly, cream, film, and suppositories. Spermicides provide lubrication and are most effective when used consistently and correctly with a barrier method of birth control such as a condom. They are 94% effective when used perfectly.

For more information on spermicides, search our databases.

 

HORMONAL METHODS

The Pill: The most popular form of birth control in North America . There are many different brands available. They come in a pack of 21 or 28 pills; one pill is taken every day. The first 21 pills contain a combination of synthetic estrogen and progestin hormones; the last seven pills have no hormones and are called sugar pills or inactive pills. Monthly bleeding occurs during this week.

The Pill works by stopping the ovaries from releasing eggs, preventing ovulation. It is considered to be 99% effective as birth control when used perfectly and may have other advantages such as reducing painful periods and acne but it does not protect against sexually transmitted infections.

For more information on the Pill, search our databases.

Depo-Provera shot: an injection of the progestin hormone that prevents pregnancy for three months. It is usually given in the arm or buttock. You have to get a new shot once every three months. It does not protect against sexually transmitted infections. Depo is 99.7% effective as birth control.

For more information on Depo-Provera, search our databases.

Contraceptive patch: a prescription method which looks like a square band-aid and applied to the abdomen, buttocks, upper arm, or upper torso. The Patch is changed every week for three weeks, left off for one week, then resumed. It has the same hormones as the Pill and therefore works the same way and has the same side effects. With perfect use it is about 99 % effective (less reliable in women over 198 pounds). Many women find it more convenient than the pill.

For more information on the contraceptive patch, search our databases.

Vaginal ring: a thin, transparent, flexible ring that you insert into the vagina. It is left in place for three weeks and then removed for one week. It provides one month of birth control. The ring works by slowly releasing estrogen and progestin hormones into the body stopping ovulation. urrently the only type available is NuvaRing and is available by prescription from your health provider or family doctor. It is considered 99% effective and is easy to use as it is inserted only once per month. It does not protect against sexually transmitted infections.

Emergency contraception pill (morning after pill): Pregnancy can be prevented after intercourse by taking emergency contraceptive pills available in Canada over the counter at most pharmacies without a prescription. They give the body a short high burst of synthetic hormones that disrupt hormone patterns needed for pregnancy. It is time sensitive so you must take EC within 120 hours after having unprotected sex. It is up to 95% effective when taken within 24 hours.

For more information on emergency contraception, search our databases.

 

OTHER METHODS

Intra-uterine devices (IUDs): small plastic devices that contain copper or progestin and fit inside the uterus. One or more strings are attached to the IUD and extend downward through the cervix inter the upper vagina allowing you to check that the IUD is in place. It is not noticeable during intercourse and is effective for up to ten years. It must be inserted by a trained medical provider. It does not protect against sexually transmitted infections. It is 99% effective and it is reversible when the IUD is removed. IUDs can also be used as emergency contraception if inserted within five days of unprotected intercourse.

For more information on IUDs, search our databases.

Fertility awareness method: This method is scientifically validated as a natural birth control that revolves around charting fertility signs to determine whether or not you are fertile on any given day. This method can also be used to achieve pregnancy as well as greater body awareness. By identifying your fertile phase you can know whether or not you are safe for unprotected intercourse on any given day. Some people choose to use a condom or barrier method during the fertile phase, while others may abstain from intercourse during this period. This method requires some research and even a class to learn it correctly. There are various rates of effectiveness from 88% to 98%.

For more information on fertility awareness, search our databases.

Breastfeeding: Breastfeeding can inhibit ovulation and can work as a natural form of birth control or child-spacing. This depends on the way a woman breastfeeds. It should never be assumed that you are infertile just because you are breastfeeding.

Abstinence: Abstinence can be defined in different ways. Some people may define it as not having any sexual contact with another person while others consider abstinence to be not having intercourse while still engaging in other sexual practices. Either way abstinence is 100% effective as birth control if no semen enters the vagina. There are no physical side affects, it is free and can be very empowering. STIs are still a risk if you are engaging in lovemaking without intercourse.

Vasectomy (male sterilization): A sterilization technique for men involving minor surgery to cut the tubes that carry sperm from the testes to the penis. It is a much more simple, less invasive surgery than tubal ligation. It is usually done in a clinic or doctor's office and takes under fifteen minutes. This should be considered permanent and is over 99% effective.

Tubal ligation (female sterilization): Commonly know as getting your tubes tied, tubal ligation is a surgical sterilization which closes the fallopian tubes. There are different ways of performing this surgical procedure and it is done by a doctor in a clinic, doctor's office or hospital under local or general anesthesia. They should be considered permanent and are over 99% effective as birth control.

Search our databases for more information on vasectomy and tubal ligation.

 

How do I take the Pill?

A common way to start the Pill is beginning on the first day of your period or the day of an abortion. Some women prefer to take it on the Sunday after your period so that their next period will come on a Monday or Tuesday and not having their period on the weekends. If you start taking the Pill within five days after your period starts or five days after an abortion it will be effective immediately – otherwise it becomes effective after one week.

It is suggested that you use a back up method such as condoms for up to first month of taking the Pill.

Take one pill everyday. If you take it at the same time or during a daily activity (lunch time, brushing your teeth etc) it may be easier to remember to take it. If you have a 28-day pack start a new pack immediately after finishing the old one. If you have a 21-day pack take no pills for seven days and then start a new pack regardless of whether you still have your period.

 

What do I do if I have spotting between periods while I am on the birth control pill?

One of the side effects from taking any type of birth control is spotting, or bleeding between periods. This can be a nuisance, but it is not a sign of disease. It usually stops after a few cycles. Breakthrough bleeding is more common among women who use low-dose combination pills. Breakthrough bleeding does not mean that the Pill isn't working as a contraceptive.

ake sure you are taking the Pill at the same time each day. Missing pills can cause bleeding between periods. If spotting continues or begins again after many cycles, see your doctor to make sure there is no other problem. S/he will suggest changing brands or give you additional estrogen until the spotting stops. Smokers may be more likely to have spotting. Some medications can make the Pill less effective and cause spotting. Talk to your doctor if you are taking rifampin or medications for seizures. You can also consult the information pamphlet that comes with your birth control pills and see what directions it gives regarding spotting between periods.

 

What should I do if I miss one, two or three birth control pills?

Your chances of becoming pregnant with a missed pill varies, depending on the kind of pill you are taking. If you are taking a low dosage pill, then missing your pill by 10 hours could increase your risks of getting pregnant.

If one pill is missed take the missed pill as soon as you remember and take your next pill at your usual time, this may involve taking two pills in the same day.

If two pills in a row are missed in the first two weeks take two pills on the day you remember and finish the rest of the pack as usual. Use a backup form of birth control for one week.

If two pills in a row are missed in the third week, continue taking one pill every day until the hormonal pills are finished. Then set aside the rest of the pack and start taking a new pack of pills. Use a backup form of birth control for one week.

If three or more pills in a row are missed in the first two weeks take one pill as soon as you remember and then keep taking one pill every day. Use a back form of birth control until you have taken seven hormonal pills in a row.

If three or more pills in a row are missed in the third week take one pill as soon as you remember then continue taking one pill every day until the hormonal pills are finished. Then set aside the rest of the pack and start taking a new pack of pills. Use a backup form of birth control for one week.

 

I am going on vacation and I will be getting my period that week. Is it safe to skip the week of inactive pills and continue to take the active pills so I don't get it?

Women taking birth control pills can skip their period from time to time by doing as you mention – starting a new package immediately following the last active pill of the previous package. This will in effect stop your period from happening. Once you return to your normal schedule (i.e. 7 days between pill packages), you will get your period back. Some women have reported a bit of spotting when they "skip" a period in this way. If this happens, it will disappear once you return to the regular schedule. If you are still concerned about this, we suggest you discuss it with your family doctor/gynecologist. S/he would be able to tell you what effects this practice could have.

 

<< Looking for Health Information?