Birth Control

Not ready for motherhood just yet? Or perhaps you've had kids and are ready to say goodbye to diapers--forever. Good news! There is a wide range of birth control methods available to women who want to avoid pregnancy. Birth control methods may be permanent, such as tubal ligation, or reversible, such as the birth control pill, so a woman can become pregnant later in life. Hormonal methods prevent pregnancy by changing a woman’s hormone levels to stop the ovary from releasing eggs.

• The birth control pill, or oral contraceptive, is the most popular method of birth control, according to The Society of Obstetricians and Gynaecologist of Canada. The Pill contains low doses of estrogen and progestin, or progestin alone. When taken properly, birth control pills are 99 percent effective for preventing pregnancy.

Need to know: The Pill does not protect against sexually transmitted infections (STIs) and may not be as effective if taken late or missed, or when a woman is taking certain medications, such as antibiotics. Vomiting or diarrhea may also reduce the efficacy of birth control pills. Women with certain medical conditions, such as blood clots and severe migraines, should not take birth control pills.

Benefits In addition to preventing pregnancy, the Pill may decrease acne and menstrual cramps and help control the pain of endometriosis.

• The birth control patch contains the same hormones as the birth control pill, but those hormones are absorbed through the skin. The patch can be worn on the stomach, buttocks, back or upper arm. It’s about as effective as the Pill but does not protect against STIs.

Need to know: The patch may be less effective for women weighing more than 198 pounds. Some patch users experience skin irritation, headache, nausea and breast tenderness.

Benefits Since a new patch is applied weekly, you’re less likely to forget to use the patch compared to a daily pill.

• The vaginal contraceptive ring is a flexible ring inserted into the vagina for three weeks. The ring releases estrogen and progestin, which are absorbed through the vagina. This form of birth control is 92 to 99.7 percent effective.

Need to know: Possible side effects of the ring include irregular bleeding, nausea and headache.

• Depo-Provera is an injection of progestin given in the arm or buttocks every 12 weeks to prevent pregnancy. This method is more than 99 percent effective. Most women get their periods within six months of the last injection; however, some women take up to two years to get their periods back.

Need to know: This form of birth control may cause irregular menstrual bleeding or more frequent bleeding or side effects, including headaches, depression and unwanted hair. Women with certain medical conditions, including liver disease, cannot use Depo-Provera, and this method doesn’t protect against STIs.

Benefits There’s no need to remember to take a daily pill, which is an advantage.

• Condoms are an effective way to prevent STIs and are 88 to 90 percent effective alone and 98 percent effective when a woman also uses a spermicide cream or jelly for preventing pregnancy. The male condom is put over the penis to prevent sperm from entering the vagina. Female condoms are used to line the vagina to prevent genital contact and the exchange of bodily fluids; they are 79 to 95 percent effective.

Need to know: Spermicides on condoms may irritate the vagina; people with latex allergies may be allergic to condoms.

• Inter-uterine devices (IUD), which are made of copper and plastic, may be inserted into the uterus to prevent pregnancy by preventing the sperm from fertilizing the egg. A new form of IUD, called Mirena, also contains a hormone to increase its effectiveness. IUDs are 96 to 98 percent effective against pregnancy but offer no protection against STIs.

Need to know: Women who are pregnant, allergic to copper or who have large fibroids, among other conditions, cannot use IUDs. This form of birth control may cause longer or heavier periods, or in rare cases puncture the uterus wall.

Benefits IUDs can be left in place for up to five years but can easily be removed if a woman wants to get pregnant.

• Cervical barriers, such as the diaphragm, block the narrow entrance of the cervix to prevent sperm from entering the uterus. They must be combined with spermicide to prevent pregnancy. This form of birth control is 80 to 90 percent effective against pregnancy but it does not protect against STIs.

Need to know: Diaphragms may increase the risk of recurrent urinary tract infections.

• The sponge is a soft round piece of foam containing spermicide cream or jelly that absorbs and kills sperm, preventing it from entering the cervix. The sponge is 75 to 90 percent effective and is considered to be more effective when combined with condoms.

Need to know: The sponge is less effective in women who have given birth. Spermicide may irritate the vagina.

Benefits The sponge provides some protection against STIs, can be inserted hours before intercourse and does not contain hormones.

• Tubal ligation is a surgical procedure that makes a woman infertile; it is a permanent form of birth control. The surgery is performed in a hospital, and recovery is no more than a few days in most cases. About ten percent of Canadian women rely on this method of birth control, which has a failure rate of lower than 0.1%.

Need to know: Reversal of this form of birth control is difficult and sometimes impossible. Tubal ligation does not protect against STIs.

• Vasectomy is a surgical procedure that makes a man infertile by making two incisions in the tubes that carry sperm from the testicles to the penis in order to seal the tubes. This method is 100 percent effective in preventing pregnancy but does not prevent STIs.

Need to know: Vasectomy takes about three months to be fully effective and is permanent; reversal is difficult if not impossible.

Benefits Vasectomy is done in a doctor’s office on an outpatient basis.

More info from Chatelaine
Happy Birthday, Pill
Modern times: Men and birth control Morning-after-pill update
Multiple ovulation

Outside resources
Women’s Health Matters
Sexualityandu.ca