Different types of Birth Control
Birth control (also known as contraception and fertility control) are methods or devices used to prevent pregnancy when having vaginal sex.
There are many options, all with differing rates of effectiveness and cost. There isn’t one single best method of contraception. The best method for you will be different than the best method for someone else.
While people choose the birth control method that suits them best to prevent pregnancy, using condoms (either in by itself or in tandem with another contraceptive method) is the only way to prevent both pregnancy and STIs.
To learn more about your contraceptive options, take a look at the list below. For more detailed instructions on how to use each of these methods in their optimal way, consult your health care provider or visit your local sexual health clinic.
The Birth Control Pill (The Pill)
The Pill comes in packs that contain one pill to take for each day of a menstrual cycle. It sometimes also includes 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.
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.
(*) Birth control pills and patches, when used correctly, are very effective in preventing pregnancy. They’re safe for most healthy women and can even be used to treat a few health problems. Some of us may experience side-effects. 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 buttocks, 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.
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.
Cons: To use the birth control patch requires a visit to a doctor to get a prescription. Some people may experience side effects or may not be able to use them at all. 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 women with a body mass greater than 190 lbs. (90 Kg). 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.
Injectable contraceptive (e.g. Depo)
An injectable contraceptive contains the female hormone progestin and is injected into your arm or buttocks 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 may not be able to get pregnant for up to 2 years after you’ve stopped using it. Side effects can include irregular bleeding, lighter or heavier periods, shorter or longer 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. The possible side effects will not necessarily go away very quickly. 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 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. Injectable contraception doesn’t protect against STIs.
Intrauterine System/IUS (e.g. the Mirena)
An intrauterine system is a contraceptive device that contains female hormones. It’s placed inside your uterus (womb) by a doctor to prevent pregnancy. The IUS is a small T-shaped frame with a cylinder containing hormones that it slowly releases over time. The hormone in the IUS thickens the mucous in your cervix to create a barrier for sperm to get through and thins the lining of your uterus to make it difficult for a fertilized egg to implant. It’s important to regularly check that your IUS is in place by feeling in your vagina for the thread hanging outside your cervix. You can have an IUS removed by a doctor at any time.
Pros: It’s a highly effective way to prevent pregnancy. Once the IUS is in place, you don’t have to worry about birth control for several years. The IUS needs to be replaced every 5 years. It’s safe and discreet. 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 costs more than the copper IUD. It doesn’t contain estrogen. The hormone in the IUS 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 to see a doctor to get the IUS installed. For the first 6 months or so you may experience bleeding or spotting between periods or some side-effects from the hormones. You may lose your period entirely while the IUS is in your body (this is an advantage for some people and a disadvantage for others). There’s an increased risk of getting Pelvic Inflammatory Disease only if you contract certain STIs such as chlamydia or gonorrhea. An IUS does not protect against STIs.
The Vaginal Contraceptive Ring (e.g. Nuva Ring)
The vaginal contraceptive ring is a small, flexible, transparent ring containing female 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, weight increase, nausea, mood changes, breast tenderness, and bleeding between periods. A small number of women experience serious complications such as blood clots or respiratory problems. Vaginal rings do not protect against STIs.
Most condoms are made of latex which is a type of rubber. It’s placed on an erect (hard) penis and works by preventing sperm from entering into the other person’s body. Condoms can be used for anal sex, vaginal sex or oral sex on a penis (many prefer the non-lubricated condoms for oral sex). It’s the only form of birth control that also protects against STIs, including HIV. Because some people have latex allergies, there are also non-latex options made of polyurethane. Condoms can be bought from most pharmacies and convenience stores.
Pro-tips: It’s important to store condoms in cool and dry places like backpacks, purses, or bedside drawers (as opposed to your wallet, glove box, or the pockets of your skinny jeans) to make sure the heat doesn’t break them down. Using water or silicone-based lubricants on the inside (just a few drops) and outside of the condom can enhance sexual enjoyment for both partners and reduces friction that can cause tears. Do not use oil based lubricants such as petroleum jelly, massage oil or hand lotion because they will destroy the latex. Never double up two condoms together as the friction will tear the condoms.
Pros: Condoms are easily accessible. Most latex condoms are fairly inexpensive and can be purchased at pharmacies, corner stores and vending machines. Many sexual health clinics, medical clinics and youth drop-in centres have free condoms available. They protect against STIs and pregnancy.
Cons: Condoms can tear, slip off, and may reduce sensation for some people. If you have vaginal sex and the condom breaks, you can get emergency contraception. Latex condoms can cause an allergic reaction if you are allergic to rubber. Polyurethane condoms are available but are more expensive. They can be time sensitive. A person’s penis has to be erect in order to put a condom on. One condom is only good for one ejaculation.
Internal Condoms (also known as the Reality Condom or the Female Condom)
The internal condom is a lubricated pouch made of polyurethane that’s inserted into the vagina or the anus before sex. The internal condom can help prevent pregnancy, STIs or both. It’s 79-85% effective for preventing pregnancy. When used vaginally, one end of the condom covers the cervix and the other end covers the external genitals. The internal condom stops sperm from entering the person’s body. When used for anal sex, the inner ring of the condom is inserted into the rectum and the outside ring rests on the anus. The internal condom can also be used like an external condom if you take the inner ring out and put the condom directly onto the penis.
Pro tips: The internal condom is available in drugstores. Some sexual health centers may carry them and offer them for free. One condom can only be used for one act of sex. Never use two condoms together i.e. an internal condom paired with a regular condom, because the friction can tear both condoms.
Pros: It protects against both STIs & pregnancy. It can increase pleasure for some people because the outer ring may rub against the clitoris. Many people like the internal condom because it fits loosely around their penis. Polyurethane transmits heat better than latex, which may also enhance pleasure. It can be used if you have an allergy to latex. The penis doesn’t need to be erect in order to use it.
Cons: It can be messy, tear or slip out of place, and some people may have a hard time putting it in. You have to make sure the condom stays in place or the penis could slip out and enter the vagina or rectum outside the condom. (If your partner’s penis slips out of the condom and enters your vagina, you can take emergency contraception up to 5 days after having sex). The condom can also make funny noises during intercourse because it’s made of plastic (adding extra water-based lubricant can help reduce the noise). They are more expensive than most condoms.
The Cervical Cap
The cervical cap is a small flexible cup that is inserted into the vagina before vaginal sex. It covers the cervix and prevents sperm from getting inside. The cervical cap is used with a spermicidal jelly to help prevent pregnancy. It is 80-91% effective (less for people who have previously had children). It’s important not to use any kind of oil based lubricants such as petroleum jelly, massage oil or hand cream during sex. If it gets into contact with the cervical cap, it will destroy the latex.
You should know: In Canada, the only cervical cap available is called FemCap. The FemCap distributer also stocks a contraceptive gel called Contragel that they recommend as the accompanying spermicidal jelly. As of August 2009, apart from Contragel, it’s difficult to purchase the necessary spermicidal jelly. Ask your health care provider for more information.
Pros: Can be inserted ahead of time so sex play is not interrupted. May be a good choice for people who do not want to use hormonal birth control. Can be used multiple times and does not have to be discarded after one use. But, spermicide does need to be reapplied each time. The cervical cap is small & discreet and can be easily carried around in a purse or bag.
Cons: Some find the cervical cap hard to insert. Some people may be allergic to the latex or develop an irritation from the spermicide. The cervical cap does not protect against STIs. It has to be fitted by a doctor since they come in different sizes. It may be very hard to find a doctor who knows how to fit a cervical cap. Some people are also simply hard to fit.
The Contraceptive Sponge
It’s a soft round sponge filled with spermicide. You use it by inserting it into your vagina before intercourse. The sponge covers the cervix and blocks sperm from getting into the uterus and the spermicide kills the sperm. The sponge has to be in the vagina for 6-8 hours after ejaculation to ensure that all sperm are killed. Depending on the brand, the sponge is effective for 12-24 hours after it’s in place. The contraceptive sponge is 80-91% effective in preventing pregnancy (less for women who have previously had children).
Pros: The sponge can be inserted several hours before having sex. You do not require a prescription to get the sponge. It can be purchased at pharmacies. It’s good for multiple ejaculations (as long as it’s left in 6-8 hours after the last ejaculation). The package is discreet, making it easy to carry in a purse or bag
Cons: It’s possible to develop an irritation from the spermicides. If the sponge is left in too long there is a risk of developing Toxic Shock Syndrome (TSS), which can be very harmful if not treated. The sponge will not protect against STIs. The active ingredient in the spermicide can also be irritating to the vaginal wall, making you more susceptible an STI.
A diaphragm is a soft, dome-shaped cup made of latex. You insert it into your vagina before vaginal sex to prevent pregnancy. The diaphragm needs to be filled with spermicide and covers your cervix to block sperm. It’s 80-94% effective. The only diaphragm currently available in Canada is a non-latex silicone diaphragm. As of August 2009, it’s been a bit of a challenge to purchase the necessary spermicidal jelly to use with the diaphragm.
Pros: You can insert the diaphragm ahead of time so sex is not interrupted. It’s reusable. You don’t have to use a new one every time you have sex. But, you do need to apply more spermicide each time to ensure optimal effectiveness. The case that holds the diaphragm is fairly discrete and can easily be carried in a purse or bag. The diaphragm is an alternative to using hormones.
Cons: Some people find the diaphragm to be messy or hard to insert and remove. Some people develop an irritation from the spermicide. Some people develop bladder infections from using a diaphragm. The diaphragm doesn’t protect against STIs. Diaphragms have to be fitted by a doctor or a health worker because they come in different sizes. It may be hard to find a doctor who knows how to fit a diaphragm.
Spermicides are contraceptive foams, gels or films that you insert into your vagina before having vaginal sex to help prevent pregnancy. Spermicides work by killing sperm. If you or your partner has an allergy to nonoxynol–9 (the main ingredient in the spermicide) it may cause irritation inside the vagina or the penis.
Pros: Contraceptive film is very small and discrete and can be easily carried in a purse or bag. Spermicides may be a good choice for people who do not want to use hormonal contraception. When used with a condom, spermicides are approximately 99% effective in preventing pregnancy. Spermicides do not require a doctor’s prescription. They can be purchased at pharmacies.
Cons: If you or your partner(s) has an allergy to nonoxynol–9 (the main ingredient in the spermicide) it may cause irritation inside the vagina or on the penis. Some people find spermicides messy. Spermicides do not taste good, so if you are planning to have oral sex, you may want to consider another option. Spermicides do not protect against sexually transmitted infections.
Tubal ligation and tubal implants
Often referred to as “having your tubes tied,” tubal ligation is a surgical procedure in which someone’s fallopian tubes are blocked, tied or cut. Depending on the preferred method, it might involve general anesthetic or a regional anesthetic (epidural). Tubal implants are small metal springs that are placed in each fallopian tube in a nonsurgical procedure (no cutting is involved). Over time, scar tissue grows around each implant and permanently blocks the tubes. Both procedures stop eggs from traveling from the ovaries into the fallopian tubes, where the egg is normally fertilized by a sperm. Tubal ligation and tubal implants are both considered permanent methods of birth control. These procedures are done by trained medical professionals.
Pros: Both of these methods are highly effective and considered to be permanent procedures.
Cons: The procedures cannot be reversed if you change your mind afterwards. Tubal ligation or implants do not protect against STIs. While major complications of tubal ligation aren’t common, minor complications include infection and wound separation. For tubal implants, there are rare reports of implants causing pelvic pain that doesn’t go away. In these cases, the implants are removed. There is a higher risk of pelvic infection. In both cases, if the procedures fail and you do get pregnant, there is a higher risk of ectopic pregnancy.
You should know: An ectopic pregnancy is a complication of pregnancy in which the embryo implants outside the uterus. Ectopic pregnancies are not viable, but there are rare exceptions. These pregnancies are dangerous for the person who is pregnant because internal bleeding is a life-threatening complication. Most ectopic pregnancies happen in the Fallopian tube (so-called tubal pregnancies), but implantation can also occur in the cervix, ovaries and abdomen. An ectopic pregnancy is a potential medical emergency, and, if not treated properly, can be fatal.
A vasectomy is a minor medical procedure where the vas deferens (the tubes that carry the sperm away from the testicles) are blocked. If you are certain you do not want biological children, vasectomy is a good option for birth control. It’s done in a doctor’s office under a local anesthetics (the area being worked on is frozen but you are awake for the procedure). The procedure takes approximately 20 minutes to complete. The rates of successes for reversing a vasectomy are low.
Pros: A vasectomy is 99.9% effective. This is a permanent procedure with no lasting side effects and few complications.
Cons: There is no guarantee that the procedure can be reversed. There are possible short-term side effects that can include: temporary bruising, swelling and tenderness of the scrotum or possible infection. A vasectomy does not protect against STIs. This procedure needs to be performed by a medical professional.
Abstinence means different things to different people. For some, abstinence means no genital or sexual contact at all. For others, abstinence may mean not having vaginal or anal sex but oral sex and/or mutual masturbation is okay. Everyone has a different definition of what sex is and this can be reflected in a person’s definition of abstinence. If you opt to abstain, informing your partner of how you define that can help them understand your personal limits.
How effective is abstinence? It depends on how you define it. Avoiding any type of sexual activity is the only method of birth control that is 100% effective. Depending on how you practice abstinence, you may be at risk for some STIs. For example, some STIs, such as herpes, can be transferred by having direct skin to skin contact with the infected area of a person who has the STI.
Establishing clear limits and communicating them to your partner can help to avoid sexual activity that you’re not comfortable with.
How do I make and maintain my decision? Only you can decide for yourself what level of sexual activity you’re comfortable with. You have the right to set your own limits and not be pressured into doing anything you aren’t comfortable with.
Some helpful tips
1. Think about the responsibilities, consequences and pleasures that come with different sexual activities. Do you feel ready to accept each of those outcomes?
2. Read about the risks associated with different kinds of sexual activity and decide which risks you’re comfortable taking.
3. Reflect on your own personal attitudes and values and how you may or may not apply them to your choices about sexual activity.
4. How will your family react if they know or find out that you’re sexually active? Would you be comfortable with their reaction?
5. Are there any situations that may put you at risk of acting against your decision? (drugs, alcohol, being alone with your partner etc.). Being aware can help you manage different situations and contexts.
6. Talk to your partner about your values, decisions and the kind of relationship you want.
7. Work towards a strong sense of self-respect. If you’re in a relationship with someone that is pressuring you to do things you don’t want to do or makes you feel childish, dumb or wrong, you may want to re-evaluate the relationship. Everyone has the right to choose what happens with their body and who has access to it. If your partner doesn’t respect your choice to abstain, then they don’t respect you.
8. Think about who you’re making this decision for. Do others expect you to abstain or to be sexually active? Are you making a choice about sexual behaviour or abstinence to please a partner?
9. Know that you have the right to change your mind. You may choose to abstain even if you have had sex before. You may also decide to have sex if you have abstained for years. Only you can make that choice.
10. Know that you’re not alone. Many people practice abstinence at different times of their life.
Pros: Abstinence helps to prevent pregnancy and STIs. It doesn’t cost anything. It may be in line with your own personal values or beliefs.
Cons: It can be difficult to manage sexual tension. Abstinence may be difficult to maintain especially if you are feeling pressured to have sex. It may still carry risks for pregnancy or STIs depending on how you and/or your partner define abstinence.
Breastfeeding (also called Lactational Amenorrhea Method or LAM)
Breastfeeding can be used as a method of contraception during the first 6 months after giving birth, under the following circumstances: if you have not yet started getting your period again and you are breastfeeding or pumping regularly (no more than 4 hours apart). As long as these conditions are strictly in place, this method can be 98% effective during the first 6 months after birth.
Pros: Breastfeeding is beneficial for a baby’s health and for developing a mother-child bond. This method is free and doesn’t cause any side effects.
Cons: It can only be used for 6 months after delivery, with certain conditions. Once conditions change, another birth control method is needed. It does not protect against STIs.
Fertility Awareness Method (FAM)
This is a natural method of birth control that involves charting signs of fertility on a daily basis so that you can understand your fertility patterns and know when you are fertile and able to conceive. There are two ways to go about it. The first one involves examining your cervical mucous (normal vaginal discharge) daily for its color and texture. The second one combines examining your cervical mucous and taking your temperature each morning with a basal thermometer. The second way is more effective. FAM can be used to plan a pregnancy or to avoid one. It requires commitment and daily monitoring of fertility patterns. If you are using this method to avoid pregnancy, you will have to avoid having vaginal sex or use condoms on fertile days.
You should know: FAM is sometimes confused with other natural methods of birth control such as the rhythm method and natural family planning. Natural family planning can involve either of the above mentioned approaches but it does not support the use of barrier methods for your fertile days and is typically done within a religious framework. The rhythm method (calendar method) involves a series of calculations to determine your most fertile days. The rhythm method is not a reliable form of birth control.
Pros: If used perfectly, FAM is an effective form of birth control. FAM increases awareness of your body and can increase communication between partners. It’s also free and has no side-effects.
Cons: Using FAM properly requires education and practice as well as constant monitoring. If you have an irregular cycle, it’s still possible to use this method effectively, but it may be more difficult. The fertility awareness method requires both partners to be motivated and knowledgeable about fertility. Body disturbances (e.g. fevers, stress, and medication) may change body symptoms, throwing off the patterns you are familiar with. FAM does not protect against STIs.
The Pull out Method
This method relies on a person withdrawing, or pulling out their penis out of the vagina before ejaculation (the moment when semen spurts out of the penis). Its effectiveness relies on doing it correctly, every single time. You must be able to know when you are reaching the point when ejaculation can no longer be stopped or postponed. If you cannot predict this moment accurately, withdrawal will not be as effective. That said, even when done perfectly and the penis is pulled out in time, pregnancy can still happen as pre-cum may contain enough sperm to cause pregnancy.
Pros: It can be used to reduce the risk of unintended pregnancy when no other method is available. There are no medical or hormonal side effects. No prescription is necessary. It’s free.
Cons: The biggest disadvantage is the risk of using withdrawal incorrectly. It makes it an unreliable method of birth control. The pull out method requires great self-control, experience and trust. It’s not recommended as a birth control method for people who don’t know when to pull out. It’s not recommended for teens and sexually inexperienced people because it takes lots of experience before someone can be sure to know when they’re going to cum. It does not protect against STIs.
The Intrauterine Device (IUD)
An intrauterine device is a small piece of plastic with copper wrapped around it that is placed inside the uterus (womb) by a doctor. The IUD prevents sperm from fertilizing an egg. If the sperm does fertilize the egg, the IUD prevents it from implanting in the uterus. It’s approximately 99% effective. An IUD can be removed at any time by a doctor. Once it’s been removed, it’s possible to become pregnant immediately.
Pro-tips: It’s important to regularly check that your IUD is in place by feeling in the vagina for the thread hanging outside your cervix.
Pros: It’s a highly effective form of birth control. Once the IUD is in place, you don’t have to worry about birth control for several years. They only need to be replaced every 5 years. It’s safe and discreet. Over time, it becomes one of the most cost effective method of contraception. It’s a good option for those who want to avoid hormonal forms of birth control. It can be used as emergency contraception up to 7 days after unprotected sex.
Cons: Side effects can include cramping in the first 24 hours after insertion, and heavier blood flow and stronger cramping during your periods. It’s possible to expel the IUD, especially within the first year of insertion. There’s an increased risk of getting Pelvic Inflammatory Disease if you contract an STI like chlamydia or gonorrhea so it’s important to get tested regularly. It does not protect against STIs.
Accidents Happen. The condom broke or you forgot to take your birth control pill. Or maybe you didn’t plan or want to have sex. Emergency contraception offers a back-up plan to prevent pregnancy after unprotected sex or failed contraception.
There are two types of emergency contraception:
Emergency contraceptive pills (ECP)
Emergency contraceptive pills (ECP) also known as the morning after pill is approved for purchase over the counter at pharmacies (you don’t need a prescription). You can also purchase ECP from your local sexual health clinic or health care provider.
When taken within five days of unprotected sex, the morning after pill reduces the risk of pregnancy. The sooner you take it, the more effective it is. It’s important to not delay. If it’s been more than seven days since you’ve had unprotected sex and you do not get your menstrual period on time, take a pregnancy test. If you are pregnant, there are options available to you. ECP is not an abortion pill. Once a pregnancy has occurred, ECP will not work.
Have Questions? This might help: FAQs on ECP
What are emergency contraceptive pills (ECP)?
Emergency Contraceptive Pills are also popularly called the “morning-after-pill”. They may be taken up to 5 days (120 hours) after unprotected sex to prevent pregnancy – not just the next morning. The sooner you take ECP – the more effective they will be for preventing pregnancy. The most common type of ECP contain progestin, which is one of the hormones found in combined oral contraceptive pills. It is more effective than other forms of ECP and has fewer side effects. ECP does not protect you from sexually transmitted infections, including HIV/AIDS.
There are two forms of ECP, the ECP pill (levonorgestrel) and the Yuzpe method. Plan B™ was the first levonorgestrel product available in Canada. There is now a generic product also available in Canada. You no longer need a doctor’s prescription to obtain the ECP pill. It is available Over-the-Counter (OTC) and you can choose whether or not you would like to have a consultation with a pharmacist.
The other method of ECP, the Yuzpe method, involves high doses of combination birth control pills which contain the hormones estrogen and progestin. Some clinics in Canada will offer this method by giving you Ovral™ pills. Your local health centre or health care provider can give you more information about this method.
What’s the difference between ECP and the abortion pill?
ECP is not the abortion pill, also called RU-486. It can only prevent a pregnancy from happening after unprotected sex if you take it within 5 days. If you are already pregnant, ECP does not harm your fetus and it will not cause an abortion or miscarriage. It is not 100% effective. RU-486 is not available in Canada, although another form of medical abortion is.
If I have a consultation, what might the pharmacist ask me?
If you wish, the pharmacist will do a consultation with you before they will dispense ECP. The pharmacist usually has a screening form they use as a guideline. They might ask you your name (they need a name to input into the computer, you don’t have to give your real name if you don’t want to). The pharmacist might ask the date of your last period, when you last had unprotected sex and if you have used ECP before. This information is kept confidential.
You may feel uncomfortable answering these questions at a pharmacy counter – and in some cases the pharmacist may make you feel uncomfortable. Remember that you have a right to take control of your body and choices – you have the right to ECP, and you can choose to end the consultation at any time.
What if the pharmacist refuses to give me ECP?
There have been some rare cases of pharmacists refusing to dispense ECP due to their personal values. Pharmacists have this right as a health professional, but they are also obliged to refer you to a pharmacist who is willing to provide the service and dispense ECP. If you have ever been in the position where a pharmacist has refused to give you ECP and did not refer you to another pharmacist and/or alternative location to obtain ECP please contact the Canadian Pharmacists Association.
Although it may be difficult, try not to be discouraged if this happens to you. Find another pharmacy and/or clinic nearby that will dispense ECP to you – remember it is your right to access ECP.
Can ECP be obtained directly from a pharmacist on someone else’s behalf?
Some pharmacists may distribute ECP without a doctor’s prescription to someone other than the person requiring ECP, provided that they know the date of their last period and when they last had unprotected sex; however, some pharmacists will only provide ECP to the person requiring it.
I had unprotected sex, but my partner did not ejaculate in me. Is sperm present in pre-ejaculatory fluid (“pre-cum”)?
There is a very low chance of pregnancy and a few studies indicate that there is no evidence of motile sperm in pre-ejaculatory fluid (pre-cum); however, if you are worried about pregnancy and/or you are not sure if ejaculation occurred, ECP is an option.
When will my next period come after taking ECP?
Your next period may come a little early or a little late and may be heavier or lighter than usual. If you have not started your period after three weeks of taking ECP, you should get a pregnancy test and talk to your health care provider. If you are pregnant and are unsure about it, there are options available to you.
What if I bleed (spotting) after taking ECP?
You may experience vaginal bleeding after taking ECP because of the hormones in the pills. Some bleeding is normal and it will likely go away by itself or after you get your period. Not everyone experiences bleeding after taking ECP.
In some cases, the bleeding is due to another cause. If you experience unusual vaginal bleeding coupled with other symptoms such as abdominal pain and dizziness that last longer than a few days, or the symptoms start getting worse, speak with a health care provider.
What if I take ECP and my period does not come after three weeks?
Using ECP is not 100% effective in preventing a pregnancy. If your period has not started within three weeks after taking ECP, you should take a pregnancy test and consult a health care provider.
Is it okay to use ECP frequently?
ECP is not as effective as other contraceptive methods and should therefore be used as a back up method of birth control. While frequent use of ECP is not recommended, repeated use over time poses no known health risks. Taking ECP won’t have any effect on your future ability to get pregnant. If you’d like to find out more about consistent methods of birth control visit our contraception pages.
I want to find out more about birth control options – what’s the best for me?
Copper Intrauterine Device (IUD)
Copper Intrauterine Device (IUD) is a small T-shaped device that’s placed inside your uterus (womb) by a doctor up to seven days after unprotected sex or failed contraception. It can also be used as a consistent form of birth control for up to seven years, reducing the risk of pregnancy by 98-99%. IUDs work much the same way as other birth control, by preventing fertilization or implantation.
While it has a high rate of success, An IUD is not as easily accessible as ECP because it requires a doctor’s prescription and must be inserted by a doctor. It might also be difficult to find a doctor who is able to insert the IUD on time.
It’s important to remember that both ECP and the IUD only prevent pregnancy. Neither protects against STIs. Only condoms and dams can do both.
CONTRACEPTION AFTER BIRTH
After giving birth, there are lots of things to consider about your sexual health. You might be contemplating whether or not you want more children, whether or not you want to breastfeed, when you want to start having sex again or other important decisions.
If you don’t want to get pregnant shortly after giving birth, you might want to consider your contraceptive options. The chart below outlines the effectiveness of different contraceptives for post-partum use, when they can be taken and their effect, if any, on breastfeeding.
|Method of Contraception||Effectiveness||When you can begin using it if you are NOT breastfeeding||When you can begin using it if you are breastfeeding||Effect on Breastfeeding|
|Breastfeeding (Lactation Amenorrhea Method)||Depends on how consistently it is used.||Not Applicable||Immediately, because you can only use L.A.M. if your period has not returned yet.||No Effect|
85-98% for male condoms
79-95% for female condoms
|Spermicides-contraceptive foam, jelly, film||71-82% effective if used alone. If used with a condom the effectiveness rises to 99%||6 weeks after childbirth||6 weeks after childbirth||No Effect|
|Diaphragm with spermicide||84-94% effective. Your diaphragm needs re-fitting after giving birth.||6 weeks after childbirth||6 weeks after childbirth||No Effect|
|Cervical cap with spermicide||84-94% effective. Your cervical cap needs to be re-fitted after giving birth||6 weeks after childbirth||6 weeks after childbirth||No Effect|
|Contraceptive Sponge||68-80% effective||6 weeks after childbirth||6 weeks after childbirth||No Effect|
|Intra-Uterine Device (IUD)||Approximately 99% effective||6 weeks after childbirth||6 weeks after childbirth||No Effect|
|Intra-Uterine System (IUS)||Approximately 99% effective||6 weeks after childbirth||6 weeks after childbirth||No Effect|
|Contraceptive patch||Approximately 99% effective||4+ weeks after childbirth. Talk to your doctor because every woman is different.||Not generally recommended if you are breastfeeding||May affect milk production & chance of hormones being passed through breast milk.|
|Vaginal Contraceptive Ring||Approximately 99% effective||4 weeks after childbirth||Not recommended if you are breastfeeding.||May affect milk production & chance of hormones being passed through breast milk.|
|Progestin-only contraceptive pills & injectable contraceptives||Approximately 99% effective||Immediately||Immediately||No Effect|
|Combined oral contraceptive pills||Approximately 99% effective||4+ weeks after childbirth||Not recommended if you are breastfeeding||May affect milk production & chance of hormones being passed through breast milk.|
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