What is birth control?

Birth control refers to all the different methods that prevent pregnancy.

What are different types of birth control?

There are many kinds of birth control methods. Some are more effective than others at preventing pregnancy. Some methods can also be used for other purposes, like preventing sexually transmitted infections (STIs) or treating other medical conditions. 

You should be aware of all birth control methods so you can choose the one that best serves your needs and lifestyle. 

Hormonal contraceptives 

Hormonal contraceptives come in many forms. All types release hormones (usually estrogen, progestin, or both) into your body that prevent you from getting pregnant.

  • Hormonal IUDs (intra-uterine devices) are T-shaped, made of plastic and inserted into the uterus. Once placed in your body by a healthcare professional, they don’t need to be replaced for three or more years. The hormonal IDU is 99.8% effective at preventing pregnancy. 
  • Implants are about the size of a matchstick and are placed under the skin of your upper arm by a clinician. The implant contains the hormone progestin and is over 99% effective at preventing pregnancy. 
  • Injections are shots that contain the hormone progestin. A healthcare professional gives you a shot on your buttocks or arm every three months. To be effective, you must get the injections on time. Shots can be up to 99.7% effective at preventing pregnancy, but if you do not receive your next dose on time, your risk of pregnancy increases.
  • Birth control pills contain different doses of hormones depending on the brand and are taken orally every day. They can also be used to address irregular or painful menstrual cycles, acne, polycystic ovarian syndrome, and even iron deficiency. Birth control pills are up to 99% effective at preventing pregnancy if taken correctly. Missing a dose by 24 hours or more will increase your risk of pregnancy. 
  • Birth control rings are thin plastic rings that you place into your vagina once a month and stay in place for three weeks. You must remove the ring for one week; then you will get your period. The rings are between 92-99% effective at preventing because it can be difficult to use them correctly. 
  • Contraceptive patches release hormones that are absorbed through your skin. You replace the patch every week for three weeks. Then, for one week, you don’t wear a patch at all and get your period. Patches are between 92-99% effective at preventing pregnancy because not everyone uses them correctly. 

All types of hormonal contraceptives come with risks and side effects like irregular bleeding or spotting, headaches, breast tenderness, and more. Before taking any kind of contraceptive, you should talk to your healthcare provider about all the possible benefits and risks. 

Non-hormonal contraceptives

  • The copper IUD is a T-shaped plastic device wrapped in copper wire that is inserted into your uterus by a clinician. It operates by changing the chemicals in your uterus, making it difficult for sperm and eggs to survive and come together. The copper IUD can stay in your uterus for up to 10 years, and it is 99% effective at preventing pregnancy. 
  • External (male) condoms are thin, flexible tubes usually made of latex rubber with a closed end. They are placed over an erect penis before sex. External condoms are up to 97% effective at preventing pregnancy when used correctly. Because they may be used incorrectly, external condoms are 86% effective with typical use. Do not use two external condoms at the same time because it increases the likelihood that they will slip off or break during sex. Using a condom incorrectly greatly increases your risk of pregnancy and/or sexually transmitted diseases. Planned Parenthood Toronto’s teenhealthsource.com has an excellent guide on how to use external condoms. 
  • Internal (female) condoms are tubes of soft plastic with flexible rings at both ends. One end is closed, and the closed end is placed deep into the vagina or anus before sex. Do not use both an internal and external condom at the same time. Internal condoms are about 95% effective at preventing pregnancy when used correctly. Because they may be used incorrectly, internal condoms are 80% effective with typical use. Planned Parenthood Toronto’s teenhealthsource.com has an excellent guide on how to insert an internal condom. 
  • Diaphragms or cervical caps are flexible, dome-shaped cups that can be placed inside the vagina to cover your cervix during sex and prevent pregnancy. They should be sprayed with spermicide to work best. Diaphragms are between 83-94% effective at preventing pregnancy because not everyone uses them correctly.
  • The sponge is made of soft plastic that contains spermicide and is inserted deep into the vagina before sex. After sex, it has to be left inside you for at least 6 hours. The sponge is between 78-91% effective at preventing pregnancy because they can be hard to use correctly. The sponge is more effective if you have never given birth before. 
  • Spermicide is a cream, foam, gel, or film that’s inserted deep into the vagina, close to the cervix. It prevents pregnancy by slowing sperm from reaching the egg. You usually wait at least 10 minutes after applying before having sex, and it is effective for only one hour. Spermicide is one of the least effective forms of birth control and should be used with other methods, like condoms. 
  • Withdrawal, also known as the “pull-out method,” is when a penis is taken out of the vagina before ejaculation. It is not as effective at preventing pregnancy as other forms of birth control because it’s hard to predict accurately when you ejaculate, and fluid can come out before you pull out. If any sperm is released around the vagina, it can still swim up inside. 
  • Fertility awareness is when you carefully keep track of your menstrual cycle to predict when you will ovulate (i.e., release an egg). Pregnancy occurs when at least one sperm fertilizes an egg, and for that to happen, the egg must be released through a process called ovulation every month. To know when this happens, you must keep track of when you have your period, check your basal temperature and monitor the colour and texture of your cervical mucus every day. Even then, sperm can live inside you for up to five days. Since it’s common for young people to have irregular periods, it can be hard to predict when you will ovulate. This is why fertility awareness is not a very effective method of birth control. 
  • Abstinence and outercourse. Abstinence is when you do not have any type of sexual contact. Outercourse refers to other sexual activities apart from vaginal sex (penis-in-vagina). Both are effective at preventing pregnancy as long as semen is kept away from the vagina. Remember that some kinds of outercourse can spread STIs.

Emergency contraception

Emergency contraception is commonly referred to as “the morning-after pill.” It can be used for up to three days (i.e., 72 hours) after having sex and can reduce the risk of pregnancy by about 75%. The sooner you take it, the more effective it is.

As its name suggests, it should be used in case of emergency, NOT as a regular method of birth control. The hormones in emergency contraception are strong, and side effects can include nausea and vomiting, headache, dizziness, vaginal bleeding, and more. It can also disrupt your cycle if you use it often.

Some situations in which you may need emergency contraception include:

  • The condom you or your partner used during sex broke
  • Neither you nor your partner used any other form of birth control 
  • You missed at least two birth control pills in the past month 
  • You were late for your shot 

How do I get access to birth control? 

Many forms of birth control, like condoms and emergency contraception, are available at your local pharmacy. 

However, if you want to get on a birth control pill or get some other form of hormonal contraceptive, you will have to talk to a clinician. They will prescribe you the medication or insert it into your body safely. 

Implants, injections, IUDs, emergency contraceptives, and most oral contraceptives are covered by OHIP+. Check to see what may be covered on Teen Health Source’s website before you try to buy birth control. 

If you do not have health insurance, you can visit a sexual health clinic, community health centre, or public health unit and ask about your options. You do not need a doctor’s referral or health insurance to access these options in Ontario. 

If you’re attending a college or university, it may also be a good idea to check with your students’ union to see if they have any free products available. Usually, student unions or other campus services will provide free tampons, pads, and condoms for their members. 

Will using birth control affect my ability to get pregnant in the future?

No. None of the birth control methods listed will affect your fertility in the future. Sterilization (vasectomy or tubal ligation) is the only permanent method of birth control. To learn more, read this informative article by Planned Parenthood Toronto’s teenhealthsource.com.

What form of birth control is right for me?

There is no one “right” method of birth control. You should choose a method that suits you and be open to changing methods if your needs or lifestyle changes. 

Some things to consider when choosing birth control include:

  • How effective is it at preventing pregnancy?
  • Are there additional benefits, like preventing STDs or regulating your menstrual cycle?
  • Are there any side effects or risks?
  • How frequently do you have to use it, and can you keep up with the schedule?
  • How easy is it to access? Is it available under OHIP+, or do you need to pay for it? 

You can also read this article or take this quiz by Planned Parenthood Toronto’s teenhealthsource.com to help you decide what type of birth control is right for you.

Do I still need to wear a condom?

Yes. All other forms of birth control do not protect you from sexually transmitted infections (STIs) and sexually transmitted diseases (STDs). Only condoms can protect you from STDs and STIs. 

Remember, condoms are not the most effective at preventing pregnancy, so you may want to explore other birth control methods in addition to using condoms during sex.