Millions of Canadians use birth control, and yet more than 40% of pregnancies in Canada today are unplanned. Contraceptives will only prevent pregnancy if they're used properly and consistently, so it's important to know what your options are and to find the kind of birth control that works best for you.
Which contraceptive should you use?
You may be using birth control, but is it sometimes too much bother or too easy to forget? Contraceptives will only prevent unwanted pregnancies if they're used properly and consistently. If you're using a method that you forget to use, that has unwanted side effects, or that is difficult to use, you're likely to stop using it or not to use it all the time. That's why it's important to use a method of birth control that suits you and your lifestyle.
When you're thinking about what kind of contraceptive to use, make sure to consider all the details. Ask yourself questions such as:
- Which will work best with my schedule and habits? (Which will I be least likely to forget?)
- Are there extra health benefits?
- Which have possible unwanted effects or features?
- Am I protected against sexually transmitted diseases?
- Which kind is the most appropriate for my current state of health?
- How effective is it?
Surgery
For people who have no intention of having children in the future, surgery can be a viable option. For men, the usual operation is a vasectomy. This operation involves cutting or blocking the tube that carries sperm from the testes to the penis. It can now be done in a very short time using local anaesthetic and requiring only a small puncture in the skin, with no stitches needed. For women, the usual surgery is a tubal ligation: the fallopian tubes are cut, sealed, or blocked, making a permanent barrier between sperm and egg. This is usually done with laparoscopy, using a small incision; the woman can normally go home the same day, but it is a more complicated operation than a vasectomy. Both of these methods are designed to be permanent, but an operation called reanastomosis that unblocks or reconnects the tube(s) can restore fertility in roughly half of all cases.
Long-term options
Some forms of birth control last a long time and only have to be changed or used very infrequently. If you're constantly on the go, if you don't want the hassle of having to remember to take a birth control pill every day, and if you're not planning on starting a family in the near future, these birth control options may suit you:
- contraceptive patch (change weekly)
- hormonal injection (receive once every 3 months)
- vaginal ring (change once a month)
- progestin-releasing intrauterine devices (change once every 5 years)
- copper intrauterine devices (change once every 10 years)
Pills
Perhaps the best-known kind of birth control is "the pill." It's no longer just "the" pill - in fact, there are now many different kinds of birth control pills available. Some use a single hormone and some use a combination; some have low doses and some have high doses; some have a 28-day cycle of pills and some have 21 pills and a 7-day period without pills. Talk to your doctor about which would be best for you. You may need to try a few before you find one you feel perfectly comfortable with.
And what about a pill for men? Research into a male birth control pill continues. Scientists in Great Britain have found a way to block the daily production of sperm and keep testosterone levels normal. Other major studies sponsored by the World Health Organization showed that high doses of testosterone were able to produce effects similar to the female birth control pill; however, there are unwanted side effects, so further study is required. In general, men will have to keep waiting for an option that will provide proven protection without undesirable side effects.
Barrier options
There are several kinds of birth control that work by keeping the sperm from reaching the egg. These normally have to be applied or inserted just before intercourse and removed shortly after it. They include:
- diaphragm
- cervical cap
- vaginal sponge
- male condom
- female condom
Most of these come in several varieties, and it may be necessary to try a few of any given kind before you find one that has the right fit and sensation. Each has advantages and disadvantages. Sponges may be inserted hours before sex and removed hours after, for example, while condoms are the only kind of birth control that also offer reliable protection against sexually transmitted infections (STIs).
Emergency contraception
If you forget to use birth control or your usual method has failed, emergency contraception can prevent pregnancy after you've already had sex.
Emergency contraception works because the fertilization of an egg by the sperm doesn't happen right at the time of the intercourse. In fact, it can happen up to two or three days later. Emergency contraceptives work by preventing fertilization and implantation, just like other contraceptives. But they don't stop a pregnancy that is already in progress. That is why it is important to use emergency contraception as soon as possible after intercourse.
Emergency contraception is designed as a "last-chance" measure, and it's only about 90% effective. It also can't protect you from sexually transmitted diseases. But, while it isn't meant to be relied upon as your primary method of birth control, it is an effective backup in circumstances such as the following:
- You had sex and used no other form of birth control.
- Your usual form of birth control failed - the condom broke or slipped, your diaphragm slipped out of place or was removed too soon after sex, or you missed two or more birth control pills.
- You were on medication that may interfere with your oral contraceptives.
- You were sexually assaulted.
Depending on how long it has been since you had unprotected sex, there is more than one option for emergency contraception. The better-known method is hormonal, which is most effective within 72 hours of unprotected sex and consists of two doses of pills containing the same ingredients as regular birth control pills, but in higher strength.
Emergency contraception medication is available in three forms:
- It is available as a prescription from your doctor which consists of four tablets of a birth control pill called Ovral®. If you have a drug plan that pays for your prescriptions and you want the medication to be eligible for reimbursement, a prescription will be required.
- There is also a product called Plan B® available without prescription at the dispensary counter in your local pharmacy.
- If you've left it beyond the 72-hour window, there is still the option of inserting an IUD (intrauterine device), which prevents a fertilized egg from implanting itself in the uterus, and is effective up to a week after intercourse.
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Resources
Canadian Federation for Sexual Health
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