This information will help you understand the many birth control options available today and how to choose what’s right for you. You will also learn how to prevent sexually transmitted diseases (STDs). If you are already sexually active, or if you are thinking about becoming sexually active, it is important that you have all the facts.

• Introduction

• Birth Control Options

  • Abstinence

  • Hormonal Methods

  • Barrier Methods

  • Spermicidal Methods

  • Intrauterine Devices

  • Other Methods

  • Birth Control Options Summary Table

• Glossary of Terms

• References

Sexual intercourse is a natural human act.  It can be a joyful part of an intimate and caring relationship. Sexual intercourse is also the way that new human life is created — through pregnancy and birth.

If you decide to be sexually active, it’s important to have all the facts. This booklet outlines birth control methods, including abstinence. It also talks about methods of preventing sexually transmitted diseases (STDs), including Human Immunodeficiency Virus (HIV).

If you have any questions after reading the booklet, contact your local birth control centre, local health region office, or your doctor. You have the right to decide when to have sex, when to become pregnant and what method of birth control is best for you. It’s your choice.

CHOOSING A BIRTH CONTROL METHOD
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If you want to be sexually active but do not want to get pregnant, you need to use birth control. Birth control, which includes abstinence, is the best way to prevent pregnancy. Birth control methods work best when used consistently and correctly.

These questions may help you choose a birth control method that is right for you:

• Can I share the responsibility for birth control with my partner?

• Do I want to use a method of birth control that only I need to know about?

• How do I feel about taking hormones?

• How do I feel about touching my genitals?

• Will I consistently use a method of birth control that needs to be used just before sexual intercourse?

• Do I need a method of birth control that I can use while I’m breast-feeding?

• How effective is each method of birth control? (For effectiveness rates, see the chart on page 43)

“I’ve chosen to remain abstinent because I don’t need to worry about a kid or STDs at my age. There are more important things for me to focus on at 17.” – Mike, age 17

If you are in a relationship, it is helpful if your partner is involved in this decision. Sometimes it seems easier to have sex than to talk about it. One approach does not work in all situations, but here are some tips that may be helpful:

• Do not wait until you are in the heat of passion or until you are under the influence of drugs or alcohol to talk about birth control with your partner.

• Be calm, clear and to the point. If you and your partner have open communication you won’t have to constantly talk about the “sex issue.”

• Try to express your thoughts and feelings in a way that your partner will listen to. Avoid blaming and accusing your partner.

• Show consideration and respect when talking to your partner.

Choosing a method of birth control that is right for you may require some time and planning. It should be something you feel comfortable with and that you know you will use every time you have sexual intercourse.

Your birth control needs may change as you move into different stages of your life. You may want to speak to a health professional about your options, or questions you have about any birth control methods.

HOW BIRTH CONTROL PREVENTS PREGNANCY
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A woman’s body releases an egg every month. The egg moves down one of the fallopian tubes toward the uterus. If the egg does not join with a sperm, the egg leaves the body.

A man’s body produces billions of sperm. Every time a man ejaculates (“cums”), he releases about 500 million sperm in the milky fluid called semen. During unprotected sex, the sperm move up inside a woman’s vagina, through the uterus and into the fallopian tubes.

If there is an egg in one of the fallopian tubes, one sperm may join with the egg. This is called fertilization. The fertilized egg then attaches to the wall of the woman’s uterus and she becomes pregnant (See Figures 1 and 2).

Birth control methods prevent pregnancy by:

1. stopping the woman’s body from releasing an egg, or

2. stopping the egg and sperm from joining, or

3. stopping a fertilized egg from attaching to the wall of the uterus.

Birth Control and Sexually Transmitted Diseases
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Sexually transmitted diseases (STD) are infections acquired by having vaginal, anal or oral sexual contact with someone who is infected with an STD. Some examples of STDs are chlamydia, gonorrhea, syphilis, hepatitis B, herpes, genital warts, crabs and human immunodeficiency virus (HIV). 

Men and women can be infected with an STD and not have any signs or symptoms.

If STDs are left untreated, men and women can experience scarring or pain in their reproductive systems, or even become infertile. Females can also develop pelvic inflammatory disease (PID) from STDs.

The best protection against STD/HIV is abstinence. Condoms, used properly every time you have sex, are also a very effective way of protecting yourself from STD/HIV. Birth control methods such as the combination birth control pill, injectible contraceptives and intrauterine devices (IUDs) do not provide protection against STD/HIV. If you choose to be sexually active, protect yourself against STD/HIV by using condoms with another method of birth control each time you have sex and have regular STD/HIV testing.

For confidential STD/HIV testing, you can go to a STD clinic, birth control centre or your doctor. For confidential information about STD/HIV, call the STD/HIV Information Line at 1-800-772-2437. For detailed information on STDs, please refer to the booklet, STD: Taking Care of Yourself and Others, produced by Alberta Health and Wellness, available at your local health region office or on this site.

“Birth control pills are an effective method of birth control – but it’s important to be responsible and use condoms to prevent STDs.” – Elizabeth, age 27

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ABSTINENCE
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Not having sexual intercourse

If you want to prevent pregnancy only, abstinence means not having vaginal intercourse. The penis and semen (fluid from the penis) should not enter or get close to the vagina. If you want to prevent pregnancy and STD/HIV, abstinence means not having vaginal, anal or oral intercourse because some STD/HIV can also be passed through oral and anal sex.

Being abstinent does not mean that you must stop being a sexual person — it simply means that you need to decide how to be affectionate without having intercourse. Abstinence requires setting some limits for you and your partner, and those limits are different for everyone.

When practised consistently and correctly, abstinence is 100 per cent effective in preventing pregnancy, and it provides the best protection against STD/HIV.

“We have chosen to remain abstinent. In order to do this, we try and hang out in groups a lot. Also, we always try and stay active doing different things. If we stay active, we don’t just lay around with nothing to do.” – Lance and Jill, age 20 and 18

To help you stick with your decision to abstain:

• Try and stay out of situations that will test your limits. For example, using alcohol and drugs can put you in a risky situation where you have no control or you may make choices that you will later regret.

• Talk to your partner about how far you want to go in your relationship. Make sure your partner knows and respects how you feel before you get sexually involved. Be sure your partner is willing to respect the limits you decide are best for you. 

Entering into a sexual relationship can have a big impact on you and your partner. It is important to take this step only when you are ready. You have the right to say “no” to sex. You should not feel guilty about deciding to abstain, and you do not have to explain your reasons for doing so.

If your partner pressures you to have sex, here are some ideas for responding to common “lines:”

• You would if you loved me.
  If you really loved me, you wouldn’t push me.

• Everybody’s doing it.
  But I’m not everyone.

• I need you. I have to have it.
  No you don’t. If I can wait, so can you.

• If you don’t, I’ll find someone who will.
  Okay. Go ahead.

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HORMONAL METHODS
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Methods of birth control that change hormone (estrogen and progestin) levels in the female to prevent pregnancy 

Combination Birth Control Pill

WHAT IT IS 

The combination birth control pill is a pill you take daily to prevent pregnancy. It contains two hormones, estrogen and progestin.

HOW IT WORKS

The combination birth control pill stops a woman’s body from releasing an egg each month. It needs to be taken at the same time every day to be effective.

WHERE TO GET IT

The combination birth control pill is available by prescription from a doctor.

FACTS TO CONSIDER

• The combination birth control pill can help make your periods regular and reduce a heavy flow and cramps.

• The combination birth control pill may decrease breast milk supply. If you are planning to breast-feed consult your physician or lactation consultant before using the combination birth control pill.

• The pill lowers your risk for ovarian and endometrial cancer.

• Some side effects of the combination birth control pill may include:

  • Spotting or bleeding between periods during the first three months that you are taking your pill or when you are late in taking your pill.

  • Upset stomach (nausea). To help prevent nausea, take your pills with food.

  • Tender breasts, moodiness, bloating, acne, mild headaches and slight weight gain.

• If you are having side effects, do not stop taking the combination birth control pill. Talk to your doctor about trying a different pill.

• The combination birth control pill can be taken safely for many years. Once you stop taking the pill, you will return to your normal cycle and will be able to become pregnant. The pill will not make you sterile.

• The combination pill is not recommended for women 35 years of age and older who smoke because of the increased risk of a stroke or heart attack.

• Some drugs make the pill less effective. Ask your doctor or a pharmacist if a new prescription or over-the-counter medication will affect the pill.

• The combination birth control pill does not protect against sexually transmitted diseases (STD) or HIV. Use another birth control method, like a latex condom to protect against STD/HIV.

Progestin-only birth control pill
Mini-Pill or Micronor

WHAT IT IS

The progestin-only pill is a pill you take daily to prevent pregnancy. This pill contains one hormone, progestin.

HOW IT WORKS

The progestin-only pill works by thickening the mucus of your cervix (the opening of your uterus), making it difficult for sperm to enter the uterus. The progestin-only pill also stops your ovaries from releasing an egg 40 to 60 per cent of the time. To be effective, the progestin-only pill must be taken at the same time every day.

WHERE TO GET IT

The progestin-only pill is available by prescription from a doctor.

FACTS TO CONSIDER

• The progestin-only pill is most often recommended for women who are breast-feeding or for those who cannot take estrogen. It is recommended to wait until six weeks after delivery to start the progestin-only pill. Consult your physician or lactation consultant if you are breast-feeding.

• The progestin-only pill is safe to take if you are over 35 and a smoker.

• Irregular bleeding or missed periods are common when taking the mini-pill. If you have regular monthly periods while you are on the progestin-only pill, you should use a back up method of birth control, such as condoms or a diaphragm, because you are probably ovulating most months and are at a higher risk of getting pregnant.

• Some drugs make the progestin-only pill less effective. Ask your doctor or a pharmacist if a new prescription or over-the-counter medication will affect the pill.

• The progestin-only birth control pill does not protect against sexually transmitted diseases (STD) or HIV. Use another birth control method, like a latex condom to protect against STD/HIV.

Injectible Contraceptive
Depo-Provera

WHAT IT IS

An injectible contraceptive is an injection or shot containing the hormone progestin that provides continuous birth control protection for 12 weeks.

HOW IT WORKS

The shot prevents pregnancy by stopping a woman’s body from releasing an egg every month. The first injection is given during the first five days of a woman’s menstrual period and must be repeated every 12 weeks to be effective.

WHERE TO GET IT

Available by a prescription, the injectible contraceptive can be given by a doctor or registered nurse at most birth control centres.

FACTS TO CONSIDER

• The injectible contraceptive may be prescribed while you are breast-feeding. It is recommended to wait until six weeks after delivery to begin this method. Consult your physician or lactation consultant before having the injectible contraceptive.

• Injectible contraceptives can cause irregular periods, extra bleeding, and spotting or missed periods. It is also normal for some women to have no bleeding after six to 12 months while on this contraceptive.

• Some rare side effects of the injectible contraceptive are:

  • Weight gain

  • Breast tenderness

  • Acne (pimples)

  • Depression

• Headaches and/or heavy bleeding (See your doctor if you have heavy bleeding) 

• It can take one to two years after your last shot to become pregnant, although some women can become pregnant sooner.

• Injectible contraceptives may cause a loss of calcium from your bones. It is very important to ensure you are getting extra calcium in your diet if you are using this contraceptive. If you have osteoporosis or are at risk for getting it, talk to your doctor about the best birth control method for you.

• Injectible contraceptives do not protect against sexually transmitted diseases (STD) or HIV. Use another birth control method, like a latex condom to protect against STD/HIV.

“Injectible contraceptives have made my life easier. I no longer have to rely on remembering to take a pill. I get a shot every 12 weeks and I am fine.” – Erin, age 22

Emergency contraceptive pill
“morning after” pill

WHAT IT IS
The emergency contraceptive pill contains high doses of the female hormones, estrogen or progestin. Women can use the emergency contraceptive pill to prevent pregnancy after having unprotected sex, or if their birth control method has not worked (for example, when a condom breaks).

HOW IT WORKS
The hormones in an emergency contraceptive pill stops your body from releasing an egg and joining with the sperm, or stops a fertilized egg (an egg that has joined with a sperm) from attaching to the wall of the uterus. This method must be used within 72 hours (three days) of having unprotected sex. The sooner you take your first dose of the emergency contraceptive pill, the more effective it is. It does not have to be taken “the morning after,” but it is most effective when taken within the first 24 hours after sexual intercourse.

WHERE TO GET IT
You can get the emergency contraceptive pill from some birth control and STD centres, most walk-in clinics, doctor’s offices and hospital emergency departments.

FACTS TO CONSIDER

• The emergency contraceptive pill will not protect you for the rest of your menstrual cycle and should not be used as a regular method of birth control.

• If you do become pregnant, the emergency contraceptive pill will not harm the growing fetus.

• The emergency contraceptive pill will not disrupt an established pregnancy.

• Some side effects of the emergency contraceptive include:

  • Breast tenderness

  • Diarrhea

• The amount, length or timing of your menstrual period after taking the emergency contraceptive pill may change. If you do not get a period after seven days or more contact your doctor, as you may be pregnant.

• You may experience upset stomach (nausea). You may need to take an anti-nausea medication, such as Gravol and food.

• Emergency contraceptive pills do not protect against sexually transmitted diseases (STD) or HIV. Use another birth control method, like a latex condom to protect against STD/HIV.

Birth Control Patch
EVRA

WHAT IT IS
The birth control patch is square in shape and is the size of a matchbook. The patch is used to prevent pregnancy and contains two hormones, estrogen and progestin.

HOW IT WORKS
The birth control patch prevents pregnancy by releasing a steady stream of hormones, estrogen and progestin into a woman’s bloodstream through the skin. These hormones thicken the mucus in the cervix, making it difficult for sperm to enter the uterus. The patch can be applied onto a women’s arm, abdomen, buttock (bum) or upper torso (chest or back). The patch should not be applied to a women’s breast.

WHERE TO GET IT
The birth control patch is available by prescription from a physician.

FACTS TO CONSIDER

• The patch is good for women who forget to take the birth control pill every day.

• You wear one patch a week consistently for three weeks and do not wear one the week you are having your period.

• When applying a new patch, it should be applied on the same day of the week.

• The side effects of the patch may be:

  • Nausea

  • Breast tenderness

  • Rare long-term risks of blood clots, heart attack, and stroke

• The patch is not recommended for women over 35 years of age who smoke because of the increased risk of a stroke or heart attack.

• The patch does not protect against sexually transmitted diseases (STD) or HIV. Use another birth control method, like a latex condom to protect against STD/HIV.

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BARRIER METHODS
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Methods of birth control that stop sperm from joining with the egg 

Male Condom

WHAT IT IS
A condom is a sheath that is put on an erect penis before the penis touches the genital area or enters the vagina.

HOW IT WORKS
The condom acts as a barrier and prevents pregnancy by stopping a man’s sperm from entering a woman’s vagina. The condom may also offer protection against infection by a sexually transmitted disease (STD).

WHERE TO GET IT
You can buy condoms in drugstores and grocery stores. You can also pick them up at birth control and STD centres and some local health centres.

FACTS TO CONSIDER

• A new condom should be used every time you have sex.

• Condoms let men and women share the responsibility for birth control. Both partners can buy and carry condoms.

• Choose a condom that will be most comfortable for you and your partner.

• Novelty condoms designed for fun and pleasure do not provide protection from STD/HIV or pregnancy.

• Latex or polyurethane condoms will protect against STD/HIV if a new condom is used each time during sex.

• Anyone with latex allergies will need to use condoms made from polyurethane (a thin plastic), synthetic rubber or animal material (“lambskin”). Natural (lambskin) condoms have tiny pores in them and do not provide protection against STD/HIV. If you or your partner is sensitive to latex, talk to a health professional about non-latex condom options.

• Some condoms are lubricated with a spermicide called Nonoxynol-9. Condoms with spermicide may cause irritation of the vaginal and rectal lining, making it easier for STD/HIV to enter your body.

• If you or your partner is at risk of having/getting an STD/HIV, you should not use condoms with Nonoxynol-9. Talk with a health professional about the best method of birth control for you.

• The male condom, when used properly and every time you have sex, helps provide some protection against STD/HIV.

Tips on using male condoms

• Friction can cause condoms to break. Use lubricated condoms or apply extra water-based lubricant to prevent condoms from breaking. Do not use Vaseline or other oil-based lubricants with condoms because they will weaken the condom.

• Using a small dab of water-based lubricant (for example, Astroglide or KY jelly) inside the condom can help increase feeling.

• Make sure there is no air in the tip of the condom when you put it on. Pinch the reservoir tip about 1/2 inch from the end to keep air out.

• After sex, a man should hold onto the condom when “pulling out” so that it does not slip off. The condom should be taken off away from the vagina to avoid spilling the semen on or near the vagina.

• Keep condoms in a cool, dry place.

• Check expiry dates on the condoms and do not use condoms that are past their expiry date.

• The male and female condom should not be used at the same time because the condoms may slip off more easily or break.

“My method is male condoms and birth control pills. I’m always worrying about pregnancy and STDs. I feel safe with condoms.” – Mary, age 19

Female condom

WHAT IT IS
The female condom is a lubricated pouch-like device made of polyurethane (a thin plastic) that has thin, flexible rings at each end. The closed end of the condom is inserted into the vagina and held in place by the inside ring. The larger, outer ring rests on the outside of the vagina.

HOW IT WORKS
Like a male condom, the female condom acts as a barrier and prevents pregnancy by stopping sperm from entering the vagina when used properly and every time you have sex.

WHERE TO GET IT
You can buy female condoms in drugstores and grocery stores. You can also pick them up at birth control and STD centres and some local health region offices.

“I use condoms every time along with the pill. I feel particularly safer using these two methods.” – Helen, age 22

FACTS TO CONSIDER

• A new female condom must be used each and every time you have sex. 

• People who are allergic to latex can use the female condom because it’s made of polyurethane.

• It’s safe to use a water-based or oil-based lubricant, such as Vaseline, with a female condom.

• The female condom, when used properly and every time you have sex, helps provide protection against STD/HIV.

Tips on using female condoms

• Take time and care putting a condom in. The female condom can be slippery. If you lose your grip, or it gets twisted, start over.

• You may have better results keeping the condom in place if you guide your partner’s erect penis into the condom.

• After intercourse, twist the condom before removing it from the vagina to avoid spilling the semen.

• Keep condoms in a cool, dry place.

• Check the expiry date on the condoms and do not use condoms that are past their expiry date.

• The female and male condom should not be used at the same time because the condoms may slip off more easily or break.

Diaphragm, Cervical Cap, and Lea’s Shield

WHAT THEY ARE
A diaphragm is a round piece of thin latex that is attached to a round rim. It is held in place by the muscles of your vagina.

A cervical cap is a small piece of rubber with a hard rim and soft, domed top. The Lea’s Shield is oval and larger than a cervical cap. The cervical cap and Lea’s Shield stay in place over your cervix by suction.

HOW THEY WORK
To prevent pregnancy, place any of these barrier methods into your vagina before you have intercourse. These barriers are used with spermicidal gel and fit over the cervix (the opening to the uterus).

For more information on spermicidal gel and other spermicides, please see page 26.

Together with spermicide, barrier methods stop the sperm from meeting the egg by killing sperm and blocking the entrance to the uterus. Do not take these barriers out of your vagina for at least six hours after having sex.

When using a diaphragm, cervical cap or Lea’s Shield, always use spermicide. When first starting to use the diaphragm, cap or Lea’s Shield, it is a good idea to use a condom or another birth control method for extra protection.

WHERE TO GET THEM
You must see a health professional to be fitted for a diaphragm or cervical cap and obtain a prescription. With this prescription, you can buy the diaphragm/cervical cap along with spermicide at some birth control centres and most drugstores. Lea’s Shield comes in one size and can be purchased without a prescription at some drugstores.

FACTS TO CONSIDER

• A diaphragm/cervical cap or Lea’s Shield cannot be used while you have your period or if you have unusual vaginal discharge.

• The cervical cap is less effective when used by a woman who has given birth.

• A diaphragm may need to be re-fitted by a doctor after a woman has given birth, or lost or gained 10 or more pounds or after an abortion.

• Do not leave these barriers in the vagina for more than 24 hours at a time. This may increase your risk of Toxic Shock Syndrome (TSS).

• Some people are sensitive or allergic to the spermicide or the latex. If you notice any side effects like itching, redness, or burning, talk to a health professional.

• Some women are more likely to have bladder infections when they use a diaphragm/cervical cap or Lea’s Shield.

• A cervical cap can sometimes lead to changes in the cells of your cervix. If you use a cap, remember to have a pap smear every year.

• A diaphragm, cervical cap and Lea’s Shield does not protect against sexually transmitted diseases (STD) or HIV. Use another birth control method, like a latex condom to protect against STD/HIV.

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SPERMICIDAL METHODS
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Methods of birth control that kill sperm

Spermicide

WHAT IT IS
Spermicide contains Nonoxynol-9, a chemical that kills sperm. Spermicide comes in many different forms, including contraceptive foam, gel, film and a contraceptive sponge.

HOW IT WORKS
To prevent pregnancy, you insert spermicide into your vagina before you have sexual intercourse. Spermicide is not intended to be used alone and should be used with another birth control method.

WHERE TO GET IT
Spermicide can be bought without a prescription at most drugstores.

Tips on using spermicide:

• Use a new application of spermicide each time you have sexual intercourse.

• Do not take a bath for six hours after having intercourse so that the spermicide remains in the vagina.

• You do not need to wash spermicide out of the vagina because it washes out with your own body fluids.

• Read the package instructions for directions of when and how to apply the spermicide.

• Spermicides might cause itching, swelling or burning in some people. If spermicide causes irritation, stop using it.

• Spermicides do not protect against sexually transmitted diseases (STD) or HIV. Use another birth control method, like a latex condom to protect against STD/HIV.

Nonoxynol-9:
CAUTION: Nonoxynol-9 does not provide protection against STD and HIV infection. Nonoxynol-9 may cause irritation to the lining of the vagina and the rectum. This makes it easier for STD/HIV to enter your body. The more you use spermicide, the greater your chance of vaginal and anal irritation, putting you at a greater risk for STD/HIV.

Types of Spermicide

Foam (Delfen)

WHAT IT IS
Foam is a spermicide that prevents pregnancy. It is a foamy base contained in a metal can with an applicator that looks like hair mousse or shaving cream.

HOW IT WORKS
The foam traps the sperm, while the spermicide kills it. Foam must be put high into the vagina against the cervix (opening of the uterus) no longer than one hour before sex. Once foam is inserted, it is effective for one hour. If longer time has passed, or you have intercourse again, a new application of foam must be inserted.

WHERE TO GET IT
Foam is available without a prescription and can be purchased at drug stores and grocery stores.

FACTS TO CONSIDER

• Spermicides like foam do not protect against sexually transmitted diseases (STD) or HIV. Use another birth control method, like a latex condom to protect against STD/HIV.

Gel

WHAT IT IS
Gel is spermicide that prevents pregnancy. It is in a gel base that comes in a pre-filled applicator.

HOW IT WORKS
The gel forms a barrier to stop sperm from entering the uterus and the spermicide kills the sperm.

When using gel, it must be put high into the vagina against the cervix.

Most gels are effective for one hour after being inserted. If longer time has passed, or you have intercourse again, a new application of gel must be inserted.

Advantage 24 is a gel that is effective for up to 24 hours, but is most effective 15 to 30 minutes after being inserted. The protection begins to decrease after 30 minutes. A new application of gel must be inserted into the vagina each time you have intercourse.

There are a variety of brands of gel available to buy. Before using gel, talk to your doctor, pharmacist, local birth control centre or local health region office for more information.

Tips on using spermicide

• Use a new application of spermicide each time you have sexual intercourse.

• Do not take a bath for six hours after having intercourse so that the spermicide remains in the vagina.

• You do not need to wash spermicide out of the vagina because it washes out with your own body fluids.

• Read the package instructions for directions of when and how to apply the spermicide.

• Spermicides might cause itching, swelling or burning in some people. If spermicide causes irritation, stop using it.

• Spermicides do not protect against sexually transmitted diseases (STD) or HIV. Use another birth control method, like a latex condom to protect against STD/HIV.

WHERE TO GET IT
Gel is available without a prescription and can be purchased at drug stores and grocery stores.

FACTS TO CONSIDER

• Gel is not recommended for use during your period and for a few days after because the spermicide may be less effective during this time.

• Spermicides like gel do not protect against sexually transmitted diseases (STD) or HIV. Use another birth control method, like a latex condom to protect against STD/HIV.

Vaginal Contraceptive Film

WHAT IT IS
Vaginal Contraceptive Film (VCF) is spermicide that prevents pregnancy. It is in the form of a small thin plastic-like film. 

HOW IT WORKS
The gel traps the sperm, while the spermicide kills it.

VCF must be put high into the vagina against the cervix 10 to 15 minutes before sex to allow it time to dissolve. VCF works for only one hour. Insert a new VCF each time you have intercourse.

WHERE TO GET IT
VCF is available without a prescription and can be purchased at drug stores.

FACTS TO CONSIDER

VCF does not protect against sexually transmitted diseases (STD) or HIV. Use another birth control method, like a latex condom to protect against STD/HIV.

Tip
Make sure your fingers are dry when inserting the VCF, otherwise the film sticks to your fingers.

Contraceptive sponge

WHAT IT IS
The contraceptive sponge is a soft foam sponge filled with a spermicide, which prevents pregnancy.

HOW IT WORKS
The sponge traps the sperm while the spermicide kills the sperm. The sponge must be put into the vagina against the cervix (opening of the uterus) before sexual intercourse.

The sponge can be left in for up to 24 hours. You can have sex several times during those 24 hours. The sponge must be left in place for six hours after intercourse to be effective.

The sponge should not be used while you have your period and should not be used by anyone who has had symptoms of Toxic Shock Syndrome (TSS).

WHERE TO GET IT
The contraceptive sponge is available without a prescription and can be purchased at drug stores or grocery stores.

FACTS TO CONSIDER

• The sponge is less effective when used by women who have given birth.

• The sponge does not protect against sexually transmitted diseases (STD) or HIV. Use another birth control method, like a latex condom to protect against STD/HIV.

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INTRAUTERINE DEVICES
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Methods of birth control that prevent sperm from joining with the egg.

Intrauterine Contraceptive Device IUD

WHAT IT IS
An intrauterine contraceptive device (IUD) is a small, soft, ‘T’ shaped piece of plastic wrapped in copper wire that prevents pregnancy.

HOW IT WORKS
An IUD keeps the egg and sperm from meeting so that the egg is not fertilized in one or both of these ways:

• Slowing down or stopping the sperm from moving

• Making the egg travel faster down the fallopian tube.

WHERE TO GET IT
A doctor or nurse inserts the IUD through the vagina into the uterus.

FACTS TO CONSIDER

• An IUD can be left in the uterus for several years, depending on the type of IUD. Your doctor can remove an IUD at anytime.

• You might have heavier bleeding and more cramps with your periods.

• You are at higher risk for developing pelvic inflammatory disease (PID) if you are exposed to a STD/HIV when you have an IUD in place.

• Some side effects of the IUD are:

  • Slightly higher risk of tubal (ectopic) pregnancy. If you miss a period get a pregnancy test right away.

  • 50 – 60 per cent of pregnancies that occur while using the IUD are miscarried (spontaneous abortions) if the IUD is not removed

• If you think you have an infection, see your birth control centre or doctor right away. Untreated vaginal infections can develop into pelvic inflammatory disease (PID). An IUD can cause PID to develop more quickly.

• In very rare cases, the IUD attaches to, or perforates the wall of the uterus and might need to be taken out through minor surgery.

• An IUD does not protect against sexually transmitted diseases (STD) or HIV. Use another birth control method, like a latex condom to protect against STD/HIV.

Progestin Only IUD
Mirena

WHAT IT IS
The progestin IUD is a T-shaped piece of plastic that contains the hormone progestin. The progestin IUD prevents pregnancy.

HOW IT WORKS
The progestin IUD keeps the egg and sperm from meeting by:

• Stopping the ovaries from releasing an egg

• Blocking the sperm from reaching or fertilizing the egg

• Thinning the lining of the uterus and increasing mucus in the cervix.

WHERE TO GET IT
The progestin IUD is available by prescription from a doctor.

FACTS TO CONSIDER

• The progestin IUD can be left in for up to five years and your doctor can remove it at anytime.

• For the first three to six months using the progestin IUD your period may be heavy, irregular or you may experience frequent spotting or light bleeding. Once your body adjusts, the number of bleeding days may decrease or you may not get your period at all after one year of using the progestin IUD.

• When the progestin IUD is removed your period will return to normal

• You are at higher risk of developing pelvic inflammatory disease (PID) if you are exposed to a sexually transmitted disease (STD) or HIV when you have any IUD in.

• When the progestin IUD is being inserted you may experience cramps, dizziness or faintness.

• If you think you may be pregnant while using the progestin IUD, contact your doctor.

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OTHER METHODS
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Natural Family Planning (fertility awareness)
A method of birth control used to tell which days of the month a woman is able to become pregnant.

WHAT IT IS
Natural family planning is a method of birth control used to tell which days of the month a woman is fertile. (when her egg is released from the ovary).

HOW IT WORKS
A woman can get pregnant only when she is fertile. You can be fertile at different times during your cycle, so it is best to monitor for six months before you use this method of birth control. If your cycle is irregular, it is harder to predict when you ovulate.

WHERE TO GET IT
A doctor, nurse or trained professional should teach you about natural family planning before you use this method.

FACTS TO CONSIDER

• Natural family planning works best for women who have regular menstrual cycles. To practice natural family planning, you keep a daily record of your body temperature, look for changes in the mucus (discharge) that comes from your vagina and keep track of your menstrual cycle. This will help you to know when you will be ovulating.

• You are ovulating and fertile when your temperature is higher and your mucus is clear, slippery and stretchy like a raw egg white. With natural family planning, you should not have sexual intercourse close to the time when you are fertile (because sperm can live up to five days in the uterus).

• This method works best when both partners are involved in the planning.

Sterilization
A permanent method of birth control for men and women

Tubal Ligation (female sterilization)

WHAT IT IS
A tubal ligation (getting your “tubes tied”) is a permanent method of birth control intended to make a woman sterile, never able to get pregnant again. A woman who has a tubal ligation must be sure that she does not want to have any children.

HOW IT WORKS
A tubal ligation blocks the fallopian tubes so the sperm and egg can no longer meet and pregnancy does not occur. The operation makes a woman sterile immediately after it is done.

WHERE TO GET IT
The surgery is done by a family doctor or gynecologist and is paid for by the Alberta Health Care Insurance Plan.

FACTS TO CONSIDER

• Your body will continue to make female hormones and you will still get your period every month. 

• After the surgery you may experience slight pain or discomfort.

• If the pain/discomfort increases or becomes worse call your doctor.

• More serious side effects following a tubal ligation include:

  • Fever greater that 39^C

  • Dizziness followed by fainting

  • Abdominal pain that does not go away or becomes worse

  • Bleeding or fluid from the cut.

• If any of the more serious side effects occur contact your doctor immediately.

• A tubal ligation will not affect your sex drive or your ability to have sex.

• The decision to have a tubal ligation is your choice. Do not let anyone talk you into a tubal ligation if you do not want it.

• There is no medical reason for a tubal ligation except to make it impossible to get pregnant.

• Tubal ligation does not provide protection from sexually transmitted diseases (STD/HIV). Use another birth control method, like a latex condom to protect against STD/HIV.

Vasectomy (male sterilization)

WHAT IT IS
A vasectomy is a permanent method of birth control intended to make a man sterile. Surgery to undo a vasectomy is difficult and does not always work. A man who has a vasectomy must be sure that he does not want to have any children.

HOW IT WORKS
A vasectomy cuts the tubes that carry sperm so that the sperm cannot reach the penis. When a man ejaculates (“cums”) during sex, the fluid does not contain sperm.

WHERE TO GET IT
The surgery is done by a family doctor or urologist and takes 15 to 20 minutes. It is done in a doctor’s office. The Alberta Health Care Insurance Plan pays for this surgery.

FACTS TO CONSIDER

• A man will not be sterile right after a vasectomy because some sperm might still be in his tubes for a few weeks or months.

• A man must return to his doctor to have tests to make sure all sperm are blocked and he is sterile. In the meantime, other birth control methods should be used.

• A vasectomy will not affect a man’s sex drive or his ability to have sex.

• The penis, testicles and sex hormones will not change. A man who has had a vasectomy will feel the same sensations during sex and will still have an erection and ejaculation. ? If you have any questions after reading this booklet, contact your local birth control centre, health region office, or your doctor.

• The fluid ejaculated does not contain sperm, but will look the same as before.

• The body naturally absorbs the sperm that is produced.

• There is no medical reason for a vasectomy, except to make it impossible for a man to get a woman pregnant.

• A vasectomy does not provide protection from sexually transmitted diseases (STD/HIV). Use another birth control method, like a latex condom to protect against STD/HIV.

Withdrawal

WHAT IT IS
Withdrawal is where a man pulls his penis out of a woman’s vagina before he ejaculates (“cums”). Withdrawal can stop most sperm from entering a woman’s vagina. However, some sperm might leak out before ejaculation or the man might not pull out in time. STDs can be passed on during any unprotected sexual activity with an infected partner. For these reasons, withdrawal is not reliable for preventing STDs or as a method of birth control. Do not take chances. Choose a method of birth control that gives you the protection you need.

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BIRTH CONTROL OPTIONS SUMMARY TABLE
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The following chart summarizes the birth control options discussed in this booklet. The range of effectiveness indicates the percentage of women who use this method of birth control and who do not become pregnant. For example, between 97 and 99 out of 100 women who choose to use the birth control pill will not get pregnant. If you have additional questions and/or concerns be sure to contact a birth control centre, your local health region office or your doctor.

Note: If you are breast-feeding, talk to your doctor or lactation consultant about the best method of birth control for you.

This chart has been adapted from: Hatcher, R.A., Stewart, F.,Trussel, J., Kawal, D., Stewart, G., Cales,W. (1998) Contraceptive Technology, (17th Rev. Ed.) New York: Irving Publishers.

* http://www.orthoevra.com/

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Abstinence: not having sexual intercourse.
Anal Intercourse: Sexual intercourse when the penis is inserted into the anus (rectum; bum).
Anti-nausea medication: a medication that prevents nausea (throwing up).
Barrier method: a device that separates sperm from the egg.
Cervix: the opening of the uterus.
Ejaculation: the release of semen. Referred to as when a man “cums.”
Egg: a female reproductive cell. 
Erect: when the penis becomes hard.
Estrogen: female sex hormone produced by the ovaries and regulates sexual function.
Fallopian tubes: the tubes in the female, where the egg is fertilized by the sperm.
Fertilization: when the sperm from a man joins the ovum (egg), from a woman.
Genital: related to the male and female sexual organs.
Hormonal method: a method of birth control that changes hormone (estrogen and progestin) levels in the female to prevent pregnancy.
Mucus: thick, slick substance produced from the mucus membrane glands in the body.
Natural family planning: a method of birth control used to tell which days of the month a woman is able to become pregnant.
Oral Intercourse: mouth-togenital (penis, vagina or anus) contact between two people.
Ovulation: release of the ovum from the ovary.
Ovaries: female sex gland that produces sex hormones estrogen and progestin.
Ovum: female reproductive cell. Also known as “egg.”
Pap Smear: a test done on women to screen for cancer of the uterus and cervix.
Penis: external male organ. 
Pelvic Inflammatory Disease (PID): PID is a progressive infection that causes harm to the women’s reproductive system and affects the fallopian tubes, uterus, and the ovaries. PID can lead to sterility, ectopic pregnancy (pregnancy that occurs in the fallopian tubes) and chronic pain. This is often a complication of gonorrhea or chlamydia.
Progestin: female sex hormones produced by the ovaries and regulate sexual function.
Semen: a milky fluid that is released during ejaculation and contains sperm.
Sex hormones: secretions that regulate reproductive functions. In the male, the sex hormone is testosterone and is produced in the testes. In the female the sex hormones are estrogen and progestin and are produced by the ovaries.
Sexual Intercourse: this usually means the penis is inserted into the vagina, but this could also be used to refer to other forms of intimate physical contact, such as oral-genital sex and penile-anal sex.
Sexually Transmitted Diseases (STDs): a group of diseases that can be transmitted (passed on) from person-to person primarily through anal, oral, or genital sexual intercourse.
Sperm: male reproductive cell.
Spermicide: chemicals that kill sperm.
Sterilization: a person (male or female) is not able to produce a child. Sterilization is a permanent method of birth control.
Testicles: male sex glands, which produce the sex hormone testosterone.
Testosterone: male sex hormones produced by the testis and regulates sexual functions.
Toxic Shock Syndrome (TSS): An infection caused by a bacteria called Staphylococcous Arueus and is characterized by a high fever, vomiting, diarrhea, low blood pressure and in severe cases shock and death. TSS mostly affects menstruating women who use tampons. Treatment is available.
Uterus: the muscular organ in the female, also known as the womb.
Vagina: The canal in the female from the external genitals to the cervix. It is approximately three inches in length.
Vaginal Intercourse: penis is inserted into the vagina during sexual intercourse. Vaginal intercourse occurs between a woman and a man.

REFERENCES

Alberta Health and Wellness (August 2000). STD: Teaching Outline and Resource Guide

Miller, F., B., & Keane, B., C. (1987). Encyclopedia and Dictionary of Medicine, Nursing and Allied Health (4th Ed.). Philadelphia, W. B. Saunders Company.

Hatcher, A., R.,Trussell, J. , Stewart, F., Cates,W., Jr, Stewart, K., G., Guest, F., and Koval, D., (1998) Contraceptive Technology, (17 ed.). Ardent Media, Inc. New York.

You have the right to decide when to have sex, when to become pregnant and
what method of birth control is best for you.

It’s your choice.

Who to contact for more information
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If you have any questions after reading this, contact your local birth control centre, health region office, or your doctor.

For STD/HIV testing, you can go to a STD clinic, birth control centre or your doctor. For confidential information about STD/HIV, call the STD/HIV Information Line at 1-800-772-2437.

Also available in PDF format

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