Birth control: Making sense of the options

Using contraception regularly and as indicated is the best way to optimize the effectiveness of your birth control method and prevent unwanted pregnancies. Given the wide array of contraceptive methods available, figuring out which product is best for you can be a challenge. Some products may not be suitable for your lifestyle, which can prevent you from using them properly. For this reason, it’s important to choose your contraceptive method carefully. You’re far more likely to use a product incorrectly if it isn’t adapted to your needs. The goal is to find a method that will allow you to fully enjoy your sexuality!

Here’s an overview of the different methods available.

A couple that practises good sexual health.

Hormonal birth control

Products in this category contain hormones that control a woman’s menstrual cycle to prevent pregnancy. Therefore, they can only be used by women. Some products combine two hormones (estrogen and progestin), while others contain just one (progestin only).

The birth control pill is the most widely known method in this category. Generally speaking, to ensure the pill’s effectiveness, one tablet is taken at approximately the same time every day. That being said, the effectiveness of combined oral contraceptives (containing estrogen and progestin) can be maintained with proper management of administration times if you ever forget to take your pill or take it later than usual (consult your pharmacist for more information). The progestin-only pill does not offer this flexibility; it must be taken regularly at the same time (or close to it) every day, otherwise it may not be effective. A certain level of rigour is therefore required to take the progestin-only pill, unlike combined hormonal contraceptives, which offer a little more leeway as far as when they can be taken.

There are also several other forms of hormonal contraception that are not taken orally. First, there is the vaginal ring, which is inserted into the vagina and replaced every month. There is also the contraceptive patch, which is applied to the skin and replaced every week. Alternatively, intramuscular injections can be appealing to some women, since they are administered by a health care professional once every three months. Another option is the hormonal IUD, which provides five years of protection against pregnancy once inserted into the uterus. Contrary to popular belief, IUDs are safe for women who have never had a child. More recently, the subcutaneous contraceptive implant was approved for use in Canada. This small device is inserted under the skin of the upper arm by a health care professional and is effective for three years.

Barrier methods

Barrier methods physically prevent sperm from reaching the cervix, thus preventing fertilization.

The male condom is the best known and most frequently used barrier method. Condoms are inexpensive and easy to obtain and use as needed. The female condom is a little less well known, and is inserted inside the vagina before sexual intercourse. Barrier methods (i.e., male and female condoms) have an additional advantage in that they protect against sexually transmitted infections (STIs); other contraceptive methods don’t offer this protection.

Diaphragms, cervical caps, and sponges are all designed to be inserted into the vagina and cover the cervix. These devices are often used in combination with a spermicide—a substance that kills sperm. Because the effectiveness of spermicide is limited, it should not be used on its own.

The sponge already contains spermicide, but the cervical cap and diaphragm do not. In other words, spermicide must be added when choosing either of these methods. Since they can be used multiple times, these devices have an advantage over condoms, which are single-use prophylactics.

Other methods

The copper IUD, which doesn’t contain hormones, needs to be inserted into the uterus by a health care professional. Depending on the model, it provides three to ten years of protection.

Natural birth control methods consist in avoiding sexual intercourse during the fertile period of a woman’s menstrual cycle, i.e., around ovulation. In addition to practising abstinence during this time, natural methods require women to be diligent about observing the physical indicators of their fertility window. The withdrawal method consists in pulling the penis out of the vagina before ejaculation. It’s considered a natural birth control method, but is not very reliable. This is because the seminal fluid that’s released before ejaculation can sometimes be contaminated with sperm. It’s important to keep in mind that natural methods should not be the first choice of contraception for teenagers or women who do not want to become pregnant. These methods are not reliable enough to prevent fertilization.

Sterilization, which involves tubal ligation for women and vasectomy for men, are other possible birth control methods. That being said, since these methods are more or less permanent, they should only be considered by people who are absolutely certain they do not want children in the future.

Effectiveness of the different methods

Strict abstinence is the only birth control method that’s 100% effective. Even if a contraceptive is used perfectly, pregnancy can still occur. Typical use, which accounts for forgetting to take a pill or taking it late from time to time, results in decreased effectiveness compared to perfect use. The following is a list of recognized efficacy rates by birth control method:

Method

Perfect use

(% efficacy)

Typical use

(% efficacy)

Oral contraceptive, vaginal ring, or patch

99.7%

91%

Subcutaneous implant

99.9%

99.9%

Hormonal IUD

99.8%

99.8%

Copper IUD

99.2%

99.4%

Intramuscular injection

99.7%

94%

Male condom

98%

85%

Female condom

95%

79%

Diaphragm with spermicide

94%

88%

Sponge

91% (women without children)

80% (women who have been pregnant before)

88% (women without children)

76% (women who have been pregnant before)

Cervical cap

91% (women without children)

74% (women who have been pregnant before)

80% (woman without children)

60% (women who have been pregnant before)

Choosing a method

Each birth control method has pros and cons. Only condoms protect against sexually transmitted infections. That’s why it’s important to get screened for STIs before switching from condoms to another birth control method. Moreover, some methods may be contraindicated depending on the health of the person using them. You can always talk to your pharmacist for more information about this topic.

Contraception is an important teen health issue. For this reason, educational institutions and youth workers are doing everything they can to raise awareness and share information about birth control and safe sex practices. Parents also have a major role to play. If you’re a parent, don’t hesitate to discuss these matters with your teen!

Get information about different birth control methods to find out which one is right for you. Learn more about how to use your chosen method of birth control to maximize its effectiveness, and keep in mind that the best contraception method is the one you’re most likely to use properly and consistently! All this to help protect your sexual health and avoid unplanned pregnancies.

Last updated on February 8, 2023

Have questions about birth control?

Your pharmacist can answer your questions about sex and contraception with complete discretion and confidentiality. Don’t hesitate to consult them!

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Birth control: Making sense of the options

For maximum effectiveness of any method of birth control, regular and correct use is essential. Yet some products may not suit your lifestyle, making it difficult to use them properly. Find a method you are comfortable with so that you can enjoy a healthy sexuality!
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