W w w. s e x u a l i t y a n d u. c a Choosing a contraception that’s right for u.

w w w . s e x u a l i t y a n d u . c a

Choosing a contraception that’s right for u

Abstinence

Hormonal

Barrier

IUD

Methods Based on Information

Permanent Sterilization

Types of Birth Control

• Only 100% method of birth control • Abstinence is when partners do not

engage in sexual intercourse• Communication between partners is

important for those practicing abstinence to be successful

Abstinence

• Moral or religious values• Personal beliefs• Medical reasons• Not feeling ready for an emotional,

intimate relationship• Future plans

Reasons for abstaining

What are they? (The Pill)• Prescription tablets taken once a day• There are two main types:

1. Combination pill which contains two female hormones similar tothe body’s own estrogen and progesterone2. Progestin-only pill (or mini-pill) which does not contain estrogen

• Available under a variety of brand names with various strengths and formulations

How do they work?• Stop the release of a mature egg• Thicken the cervical mucus making it difficult for sperm to get to the egg• Change the lining of the uterus making implantation difficult

Effectiveness: 99%

O r a l c o n t r a c e p t i v e s Hormonal

O r a l c o n t r a c e p t i v e s

What are the advantages?

1. One of the most effective reversible birth control methods when taken consistently and reliably

2. Simple and easy to use3. Regulates menstrual cycle and reduces cramps 4. Does not interfere with intercourse 5. Decreases acne6. Reduces the risks of endometrial and ovarian cancer7. May reduce perimenopausal symptoms

Hormonal

O r a l c o n t r a c e p t i v e s

What are the disadvantages?

1. Must be taken every day. The progestin-only pill must be taken at the same

time every day2. May cause irregular bleeding or spotting 3. Effectiveness may be reduced by other medications 4. Should not be used by women over the age of 35 who smoke 5. May increase the risk of blood clots, particularly in women who

have certain blood disorders or a family history of blood clots 6. Does not protect against STIs 7. May increase the number of headaches 8. May not be suitable for breastfeeding women9. Brest Tenderness10. Change in Weight

Hormonal

What is it?• A patch that releases hormones through the skin• Can be placed on the buttocks, upper outer arms, lower abdomen, or

upper torso excluding the breast

• A new patch is applied once a week for three weeks followed by one week without a patch

How does it work?• Prevents the ovary from releasing an egg• Thickens the cervical mucus making it difficult for sperm to get to the

egg• Changes the lining of the uterus making implantation difficult

Effectiveness: 92%

T r a n s d e r m a l p a t c h Hormonal


1. A reversible and highly effective birth control method2. Once-a-week regimen; no daily contraceptive routine

required3. Simple and easy to use4. Regulates menstrual cycle and reduces cramps 5. Does not interfere with intercourse 6. Expected to provide other benefits similar to oral

contraceptives; research is needed



1. May cause irregular bleeding or spotting2. May cause breast sensitivity or headache 3. Does not protect against STIs 4. Patch may detach from skin (less than 2%) 5. Possible skin irritation at the application site


What is it?

• A flexible, nearly transparent ring that measures 54 mm (about 2 inches) across

• The ring releases a continuous dose of hormones for three weeks while it is in the vagina

How does it work?

• Prevents the ovary from releasing an egg • Thickens the cervical mucus making it difficult for sperm to

reach the egg • Changes the lining of the uterus making implantation difficult

Effectiveness: 92%

V a g i n a l r i n g / NUVARING Hormonal


1. A reversible and highly effective birth control method2. Once-a-month regimen; no daily contraceptive routine

required3. Regulates menstrual cycles4. Does not interfere with intercourse5. Does not require daily attention6. Expected to provide other benefits similar to oral

contraceptives; research is needed

V a g i n a l r i n g Hormonal


1. Does not protect against STIs 2. May cause irregular bleeding or spotting3. May cause side effects such as headache, nausea, or

breast tenderness

4. May cause vaginal discomfort 5. The ring may be expelled from the vagina but this is

uncommon

V a g i n a l r i n g Hormonal

What is it? Depo-Provera

• It contains a hormone called progesterone; it does not contain estrogen

• The injection is given in the upper arm or buttocks every 12 to 13 weeks

(four times a year)

How does it work?

• Prevents the ovary from releasing an egg • Thickens the cervical mucus making it difficult for sperm to

get to the egg• Changes the lining of the uterus making implantation difficult

Failure rate: 99.7%

I n j e c t a b l e c o n t r a c e p t i v e Hormonal


1. One of the most effective reversible birth control methods available 2. Does not contain estrogen 3. No daily contraceptive routine required; 1 injection lasts for 3 months 4. Effectiveness is not reduced by other common medications5. May be suitable for breastfeeding women or women who smoke6. With continued use, menstrual cycles cease in over half of users after

the first year, and two-thirds of users after two years of use 7. Improves symptoms of endometriosis 8. Reduces the risk of endometrial cancer 9. Effective immediately when given during the first 5 days of a normal

menstrual period



1. Initially, irregular bleeding is the most common side effect2. Decrease in bone mineral density which may be reversible

when a woman stops taking the injection. Calcium supplementation is advised.

3. May be associated with weight gain in some women 4. Takes an average of nine months after the last injection for

the ovaries to start releasing eggs again

5. Does not protect against STIs6. The lack of a monthly period may be bothersome for some

women


Norplant Implant

• Should be considered long term birth control

• Requires no upkeep • Extremely effective in pregnancy

prevention > 99%

Norplant Implant

Side-Effects of Hormonal Contraception

Side effects that may occur during the first few months on hormonal contraception include :

irregular bleeding, spotting nausea mood swings bloating breast tenderness headaches

Side-Effects of Hormonal Contraception

Reason: Your body is getting used to birth control Fluctuating hormone levels when you start

When will it stop? Most symptoms are normal and will decrease or stop in the first 2-

3 months.

If they bother you or don’t get better: Talk to your healthcare provider There might be a method that’s better suited for you.

How does it work?

• Causes changes in the lining of the uterus • Prevents the sperm from fertilizing the egg• Decreases the ability of the sperm to penetrate the cervical

mucus

Failure rate: 8 per 1000 women per year

I n t r a u t e r i n e d e v i c e ( I U D )

What is it?

• A T-shaped device with a copper wire around it • It is inserted into the uterus by a physician in the doctor’s office • Two threads may be felt in the vagina, so a woman can check for herself to ensure that the IUD is still in place


1. Long-acting contraceptive; can be left in place for up to five years

2. No daily contraceptive routine required; device provides five years of

contraception 3. Does not contain estrogen4. Does not interfere with intercourse5. May reduce the risk of endometrial cancer 6. May be suitable for women who are breastfeeding



1. Possible side effects include irregular bleeding or spotting in the first months after insertion

2. Perforation of the uterus may occur at the time of insertion but this is rare

3. May increase menstrual bleeding or menstrual cramping4. May be expelled from the uterus. This happens in 2–10% of

IUD users5. Does not protect against STIs


F e m a l e c o n d o m

How does it work?• Placed in the vagina before intercourse • Lines the vagina completely, preventing direct contact between the penis

and the vagina and preventing the exchange of body fluids

• Sperm is trapped in the condom, which is thrown away after intercourse• A new condom should be used for each repeated act of intercourse

Effectiveness: 79%

What is it? • Soft, disposable, polyurethane sheath • Available in drugstores without a prescription

s e x u a l i t y a n d u . c a


1. Available widely without a prescription2. No daily contraceptive routine or continued use required3. Woman remains in charge of placement and use 4. Protects against some STIs




1. Must be available at time of intercourse2. Requires proper insertion technique 3. Flexible inner ring may cause discomfort for some 4. More expensive than the male condom and not available in

all stores 5. Makes a noise during intercourse 6. May slip or break during intercourse 7. May be considered messy by some


s e x u a l i t y a n d u . c aF e m a l e b a r r i e r m e t h o d s

How do they work?• A pelvic examination by a qualified health care professional is required for fitting diaphragms and cervical caps• Inserted into the vagina and fit over the cervix • When positioned properly, they block the entry to the uterus so sperm cannot enter and fertilize the egg• Spermicide should be reapplied for each repeated act of intercourse

Failure rate: 160-320 per 1000 women per year

What are they? • Intravaginal barrier methods that are used together with a spermicide • The diaphragm is a latex dome with a flexible steel ring around its edge (a non-latex diaphragm is also available) • The cervical cap is thimble-shaped silicone cap • Positioned into the vagina (diaphragm) or over the cervix (cervical cap) before intercourse • Must be left in the vagina for 6–8 hours after intercourse

Cervical Cap

Diaphragm

Diaphragm and Cervical Cap



1. Does not contain hormones2. Can be used by women who are breastfeeding 3. Some protection against certain STIs

F e m a l e b a r r i e r m e t h o d s



1. Must be available at time of intercourse2. Requires proper insertion technique 3. Does not protect against certain STIs 4. Cannot be used by people who are allergic to spermicides 5. Diaphragm may increase the risk of persistent urinary tract

infection 6. Cervical cap should not be used during menstruation7. May become dislodged during intercourse8. Cervical cap may cause vaginal odour and discharge


s e x u a l i t y a n d u . c aF e m a l e b a r r i e r m e t h o d s

Sponge and Spermicides

What are they?• The sponge is a soft, disposable, polyurethane foam device impregnated with a spermicide• Spermicides disable sperm and come in several forms, including creams, jellies, tablets, suppositories, foams, and film

How do they work? Sponge

• Fits over the cervix• Traps and absorbs sperm to augment effect of spermicide• Spermicide in the sponge disables the sperm • Effective for up to 12 hours

Spermicides• Contain an ingredient that disables sperm • Should be used together with another form of contraception

Effectiveness: 71%



1. Does not contain hormones 2. Can be used by women who are breastfeeding3. Can be used by women who smoke4. Spermicide may provide added lubrication




1. Must be available at time of intercourse2. Does not protect against certain STIs 3. Cannot be used by people who are allergic to spermicides4. Requires proper insertion technique 5. Sponge users may experience vaginal irritation or infection 6. Spermicide must be inserted into the vagina in advance (time depends on product)7. If left in the vagina in excess of the recommended time,

symptoms of toxic shock syndrome may appear



How does it work? • Fits over the erect penis • Acts as a physical barrier preventing direct genital contact and the exchange of genital fluids, so the sperm does not enter the uterus and fertilize the egg • A new condom is used for each repeated act of intercourse

Effectiveness: 85%

What is it?

• A soft disposable sheath • Available in various shapes, sizes, thicknesses,

colours and flavours • Most are latex, but non-latex condoms are also available in polyurethane, silicone, and lambskin

M a l e b a r r i e r m e t h o d s

Male Condom



1. Available widely without a prescription2. Inexpensive3. Latex condoms protect against STIs4. Allows the male partner to assume some responsibility for

birth control5. Both partners can participate in their use6. May help the wearer avoid premature ejaculation




1. Must be available at time of intercourse2. May slip or break during intercourse3. Must be stored and handled properly4. People with latex allergies cannot use latex condoms, but

may be able to use non-latex condoms

5. May reduce sensitivity for either partner6. May interfere with the maintenance of an erection7. May reduce spontaneity 8. Lambskin condoms do not protect against STIs


F e m a l e s t e r i l i z a t i o n

Tubal occlusion “Having your tubes tied”

What is it?• A surgical procedure to close or block the fallopian tubes• Techniques include: • Laparoscopy – special instruments are inserted through two tiny incisions (less than 1 cm long) in the abdomen • Mini-laparotomy – also requires a small cut in the abdomen • Hysteroscopy – use of a thin telescope inserted into the uterus• Fallopian tubes may be blocked by using one of the following: • A clip or a ring • Cautery (an electric current) • Removing a small piece of each tube • Hysteroscopy for the insertion of tubal plugs (Essure)

How does it work?• The fallopian tube is blocked and therefore the sperm and egg cannot meet

Failure rate: 5 per 1000 women per year

Essure Cauterization

Clips

Ligation

Sites ofSterilization


1. No daily contraceptive routine required; nothing to remember

2. Private3. Does not interfere with intercourse 4. No significant long term side effects



1. Usually permanent and difficult to have reversed2. Possible post-sterilization regret 3. Possible short-term surgery-related complications:

abdominal discomfort; bruising, bleeding, or infection at the incision site; reaction to anesthesia

4. If pregnancy occurs, there is a higher chance that it will be an ectopic

pregnancy 5. Does not protect against STIs


s e x u a l i t y a n d u . c aM a l e s t e r i l i z a t i o n

Vasectomy

What is it?• A surgical procedure to close or block the vas deferens (the tubes that carry sperm to the penis)

How does it work?• The vas deferens are closed so that no sperm is released to fertilize the egg• Common techniques include: • Conventional vasectomy – one or two incision are made in the scrotum to reach the vas deferens • No-scalpel vasectomy – a puncture opening is made in the scrotum• Vas deferens are closed by: • Electric current (cauterization) • A mechanical method, such as a clip • Removal of a small segment of each tube• Another form of contraception is required until a semen analysis shows no sperm

Failure rate: 1.5 per 1000 women per year

Urethra

Site ofVasectomy

Vasdeferens



1. No contraceptive routine required; nothing to remember2. Private3. Does not interfere with intercourse4. No significant long-term side effects5. Simple procedure6. Less invasive and more cost-effective than tubal ligation for

women7. Allows the male partner to assume some responsibility for

birth control

M a l e s t e r i l i z a t i o n



1. Difficult to have reversed2. Possible post-sterilization regret 3. Possible short-term surgery-related complications: pain and

swelling; vasovagal reaction; infection at the incision site4. Does not protect against STIs5. Not effective immediately. Must do a follow-up sperm

analysis that shows no sperm are present in the semen

M a l e s t e r i l i z a t i o n

• Women take a class on the menstrual cycle to calculate more fertile times– Requires special equipment and cannot be

self-taught– NFP abstains from sex during the calculated

fertile time– FAM uses barrier methods during fertile time– Perfect effectiveness rate = 91%– Typical effectiveness rate = 75%– No 100% safe day-irregular periods

Natural Family Planning & Fertility Awareness Method


Emergency contraception pills can reduce the chance of a pregnancy by 75% if taken within 72 hours of unprotected sex!

– Must be taken within 72 hours of the act of unprotected intercourse or failure of contraception method

– Must receive ECP from a physician– 75 – 84% effective in reducing pregnancy– Floods the ovaries with high amount of hormone and

prevents ovulation– Alters the environment of the uterus, making it disruptive to the

egg and sperm

Emergency ContraceptionEmergency Contraception

W w w. s e x u a l i t y a n d u. c a Choosing a contraception that’s right for u.

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