The birth control pill (The Pill)
The Pill comes in packs that contain one pill to take for each day of a menstrual cycle. These pills should be taken at approximately the same time each day (within a 3-hour window). Depending on the brand of pill you take, your pack may also include a week of placebo or sugar pills to take during your period. The pills contain a low dose of female hormones that prevent the ovaries from releasing an egg each menstrual cycle (ovulation), change the texture of the cervical mucous to create a barrier for sperm and make the lining of the uterus thinner, making it harder for a fertilized egg to implant and result in a pregnancy. The sugar pills don’t contain any hormones and are used to help to keep track of where you are in your pack of pills and stay in the habit of taking a pill every day. Some people choose not to take these pills, and to immediately start the next pack of pills, in order to supress their menstrual period. If this is something you’re interested in, it can be helpful to chat with your local sexual health clinic or health care provider.
Pros: The Pill is highly effective in preventing pregnancy if taken properly. It can regulate or reduce menstrual flow, alleviate pre-menstrual symptoms, and may help clear acne. The person taking the pill is the one in charge of their fertility. The pill doesn’t rely on a sexual partner’s compliance.
Cons: To use the birth control pill requires a visit to a doctor for a prescription. Some people may experience side effects or may not be able to use them at all.* If it is not used with great regularity, which can be hard for some, it becomes less effective. The Pill does not protect from STIs.
Effectiveness: The pill is 92% effective with typical use and 99.7% effective with perfect use. Typical use refers to the way most individuals will use this method of contraception, factoring in human error and the possibility to miss a pill.
Did you miss a pill? Visit the “Stay on Schedule” tool to find out what to do next.
*Birth control pills and patches, when used correctly, are very effective in preventing pregnancy. They’re safe for most people and can even be used to treat a few health problems, like endometriosis. Some of us may experience side-effects, like migraine headaches or changes in appetite. Click here for a visual of potential effects
The Birth Control patch (The Patch)
The contraceptive patch is a thin, square patch (similar to a patch used to quit smoking) that can be worn on the buttcheek, abdomen, or outer upper arm. You wear the patch for one week at a time for three consecutive weeks. The fourth week is patch-free and this is when you’ll get your period. It prevents pregnancy the same way the Pill does, by changing the texture of your cervical mucus to make it difficult for a fertilized egg to implant, causing a pregnancy.
Pros: It’s highly effective in preventing pregnancy when used properly. You only have to remember to change the patch once a week as opposed to taking a pill every day. It can regulate or reduce menstrual flow, alleviate pre-menstrual symptoms, and may help clear acne. The person wearing the patch is the one in charge of their fertility as it doesn’t rely on a sexual partner’s compliance. It can be a great choice for those who have a less predictable schedule and might have difficulty taking the pill at around the same time each day.
Cons: To use the birth control patch requires a visit to a doctor to get a prescription. Some people may experience side effects, like recurring migraines, and not be able to use them. Unlike the birth control pill, there is currently only one type of patch and it contains the same amount of hormones in each one. If the dosage of hormones does not work well for you, there is no alternative patch with higher or lower doses of hormones in it. The patch only comes in one colour and doesn’t match everyone’s skin. The patch may be less effective for those weighing over 190 pounds. If you use the patch, it’s possible to forget to change the patch on time, or it may become loose or fall off. It doesn’t protect from STIs. It also shouldn’t be taken by people who are breastfeeding, over age 35, or those who smoke.
Effectiveness: The patch is 92% effective with typical use and 99.7% effective with perfect use.
Did your patch fall off too early, or did you wear it longer than scheduled? Visit the “Stay on Schedule” tool to find out what to do next.
The Shot (Depo Provera)
An injectable contraceptive contains the hormone progestin and is injected into your arm or buttcheek once every 12 weeks. The hormone prevents the ovaries from releasing eggs. If an egg is released, the hormone prevents sperm from fertilizing an egg.
Pros: It’s highly effective for preventing pregnancy. You only need to think about birth control once every 12 weeks. If you are sensitive to estrogen, you can still use injectable contraceptive as it’s made up of progestin. You may stop having your period while you are on it, and as a result not have to deal with any cramping or bleeding.
Cons: To get an injectable contraceptive, you must see a doctor. You will not start releasing eggs again (and therefore may not be able to get pregnant) for up to 9 months or longer after stopping injections. This means that if you are planning to conceive in the next year, a different contraceptive might be the best choice for you. Side effects can include shorter periods, or no periods at all (which can be an advantage for some people and a disadvantage for others). If you have a history of depression this may not be the best method for you, as it can be exacerbated by the dosage of hormones. The hormone is in your system for 12 weeks at a time. Scientists have established that there is a link between the use of injectable contraceptives and osteoporosis (a decrease in bone mineral density) so a bone density test will likely be scheduled every so often by your doctor or health care provider to ensure that your bones are still strong. The injections do not prevent STIs.
Intrauterine system (IUS) or Intrauterine Device (IUD)
There are two types of intrauterine contraceptive options – the copper IUD and the hormonal IUS. Intrauterine refers to contraception within the uterus – in this case, a small device placed within the uterus during a simple, non-invasive procedure. The hormonal IUS contains hormones that slow release over time, thickening your cervical mucous and creating a barrier for sperm to get through, while also thinning the lining of your uterus to make it difficult for a fertilized egg to implant. The IUS is a long-acting, reversible (non-permanent) device that is inserted by a health care provider. It can be removed anytime by a health care provider, or it is good for up to 5 years, with new studies showing that it can be effective up to even 7 years.
The copper IUD does not contain hormones, and the copper in the device changes the chemistry of your endometrium in a way that makes it less likely for a sperm to reach and egg and fertilize it. It also thickens the cervical mucus, making it harder for sperm to get through and reach an egg. This is a long-acting, reversible (non-permanent) device that is inserted by a health care provider. It can be removed anytime by a health care provider, or it is effective for between 5 and 10 years.
Pros: It’s a highly effective way to prevent pregnancy. Once the IUS or IUD is in place, you don’t have to worry about birth control for several years. This is why the effectiveness rates are incredibly high with an IUS or IUD, as it removes the potential for human error. The IUS or IUD works for between 5 and 10 years, depending on the one you select. It’s also a discrete method, meaning no one has to know you have an IUD in place. Over time, it becomes one of the most cost effective methods of contraception because you only have to purchase it once every 5 years. However, it initially can be quite costly, depending on the option you choose. A pro of the copper IUD is that it doesn’t contain estrogen, which can cause adverse effects in some people, like headaches. However, some people opt for the hormonal IUS as it can reduce cramping and bleeding during your period and may over time eliminate your period entirely. If this happens, your period will eventually return once the IUS is removed.
Cons: You need a prescription for the IUS or IUD, and you need to see a doctor to get the IUS or IUD installed. For the first 6 months or so you may experience bleeding or spotting between periods or some side-effects from the hormones (for the IUS). You may lose your period entirely while the hormonal IUS is in your body (this is an advantage for some people and a disadvantage for others). Some people find that the copper IUD makes their periods heavier and the cramping more intense. An IUD or IUS does not protect against STIs, and there there’s an increased risk of getting Pelvic Inflammatory Disease only if you contract certain STIs such as chlamydia or gonorrhea. Finally, the cost is more expensive than other methods, although it does provide you with 5 or more years of contraception. Check in with your health care provider to find out about exact costs, and whether programs exist to help with these costs.
Effectiveness: The hormonal IUS is 99.8% effective. The copper IUD is 99.1% effective.
The Ring (e.g. Nuva ring)
The vaginal contraceptive ring is a small, flexible, transparent ring containing hormones. The ring is inserted into the vagina and worn for three consecutive weeks, followed by a ring-free week. During the ring-free week you will get your period. A new ring is then inserted for the next three-week cycle. If necessary, you can remove the ring for up to three hours. If your vaginal ring slips out at any time, simply rinse it with lukewarm water and re-insert it.
Pros: It’s a highly effective in preventing pregnancy when used properly. You may experience fewer side effects from it because it contains a lower dosage of hormones than some other hormonal methods. You only have to remember to change the ring once a month. A vaginal ring can help regulate your period and help reduce cramping and bleeding during your period.
Cons: You need to visit a doctor to get a prescription for a vaginal ring. Side effects can occur and may include: headache, vaginitis (inflammation in the vagina that causes itching, pain or discharge), weight increase, nausea, mood changes, breast tenderness, and bleeding between periods. A small number of people experience a heightened risk of blood clots. Vaginal rings do not protect against STIs.
Effectiveness: The ring is 92% effective with typical use and 99.7% effective with perfect use.
The Implant (e.g. Nexplanon)
The implant is a 3-year contraceptive that takes the form of a small, removable device that is implanted through a minor procedure into your upper arm. The implant is a long-acting, reversible form of contraception that lasts for 3 years, though it can be removed any time before. Insertion and removal take the form of a minimally invasive small procedure done by health care provider.
Pros: The implant is effective for those who cannot take estrogen, as it is a progestin-only contraceptive. It is extremely effective, and removes the possibility for human error, as it is placed just under the skin on your arm and left for 3 years.
Cons: You need to visit a doctor to get a prescription for the implant, and a health care provider needs to insert it. Some people experience changes to their normal menstrual patterns, like a reduced or non-existent period. Some people may also experience mood swings, weight gain, headaches, or acne on the implant.
Effectiveness: The implant is 99.95% effective.