Birth Control Methods
If a woman is sexually active and she is fertile and
physically able to become pregnant, she needs to
ask herself, "Do I want to become pregnant now?"
If her answer is "No," she must use some method
of birth control (contraception).
Choosing the Right Method
It can be difficult to decide which birth control method is
best because of the variety of options available. The best
method is one that you will use consistently and that does not
cause bothersome side effects. Other factors to consider include:
- How well does it work?
- Do I need to remember anything to use it?
- How long does it work?
- Can I get pregnant when I stop using it?
- Will I bleed more or less?
- Will I have side effects?
- How much does it cost?
- Does it protect me against sexually transmitted infections?
No method of birth control is perfect. You must balance the advantages of each method
against the disadvantages and decide which method you prefer.
Birth Control Pills
Most birth control pills, also referred to as "the pill," contain a combination of two female hormones.
How well do they work? — When taken properly, birth control pills are very effective. In general,
if you miss one pill, you should take it as soon as possible.
If you miss two or more pills, continue to take one pill per day and use a back-up method of birth
control (eg, a condom) for seven days.
If you miss two or more pills, you should also consider taking the morning after
(emergency contraception) pill.
Side effects of the pill include:
- Nausea, breast tenderness, bloating, and mood changes, which typically
improve after two to three months.
- Irregular vaginal spotting or bleeding. This is particularly common during
the first few months. Forgetting a pill can also cause irregular bleeding.
Unlike traditional birth control pills, the progestin-only pill, also called the mini pill, does not contain estrogen. It does contain progestin, a hormone that is similar to the female hormone. This type of pill is useful for women who cannot or should not take estrogen. This includes women who are breastfeeding or who have worsened migraines or high blood pressure with estrogen-containing birth control pills.
Progestin-only pills are as effective as combination pills if they are taken at the same time every day. However, progestin only pills have a slightly higher failure rate if you are more than three hours late in taking it.
Injectable Birth Control
The only injectable method of birth control currently available in Canada is medroxyprogesterone acetate or Depo-Provera®. This is a progestin hormone, which is long-lasting. DMPA is injected deep into a muscle, such as the buttock or upper arm, once every three months.
The most common side effects of DMPA are irregular or prolonged vaginal bleeding and spotting, particularly during the first three to six months. Up to 50 percent of women completely stop having menstrual periods after using DMPA for one year. Menstrual periods generally return within six months of the last DMPA injection.
Birth control skin patches contain two hormones, estrogen and progestin, similar to birth control pills. The patch is as effective as birth control pills, and may be preferred by some women because you do not have to take it every day. Ortho Evra is the only skin patch birth control available in Canada.
You wear the patch for one week on the upper arm, shoulder, upper back, or hip. After one week, you remove the old patch and apply a new patch; you repeat this for three weeks. During the fourth week, you do not wear a patch and your menstrual period occurs during this week.
The risks and side effects of the patch are similar to those of a birth control pill, although there may be a slightly higher risk of developing a blood clot.
A flexible plastic vaginal ring (Nuvaring®) contains estrogen and a progestin. You wear the ring in the vagina, where there hormones are slowly absorbed into the body. This prevents pregnancy, similar to a birth control pill.
You wear the ring inside the vagina for three weeks, followed by one week when you do not wear the ring. Your menstrual period occurs during the fourth week.
The ring is not noticeable, and it is easy for most women to insert and remove. You may take the ring out of the vagina for up to three hours if desired, such as during intercourse. Risks and side effects of the vaginal ring are similar to those of birth control pills.