How to decide which contraception is best for you

Birth Control Methods and Products

• Women should choose birth control specific to their needs and how they respond to the treatment – Not all birth control is for everyone
• Remember that no birth control can protect you against STDs
• Smoking and birth control that contains estrogen is not recommended
• They recommend not to use birth control with hormones if you have:
  •  Blood clots, an inherited blood-clotting disorder or vein inflammation, breast cancer, heart attack, stroke, angina, migraine headaches with aura, uncontrolled high blood pressure, very bad diabetes or liver disease
    • Sides effects of birth control is not always a bad thing
  • Prevent or lessen:
    • Acne
    • Bone thinning
    •  Cysts in your breasts and ovaries
    •  Ectopic pregnancy
    •  Endometrial and ovarian cancers (NuvaRing, Birth Control Patch, etc.)
    •  Serious infections in your ovaries, fallopian tubes, and uterus (NuvaRing, Birth Control Patch, etc.)
    •  Iron deficiency/ Anemia (NuvaRing)
    •  PMS

ASRM – Contraception

• Contraceptive is divided into hormonal or nonhormonal
• Most contraceptives work by changing women’s hormones to mimic pregnancy, therefore, eggs are not being released from the ovary
  • This does not preserve your fertility

• Nonhormonal contraceptive agents or devices work by preventing a man’s sperm from join a woman’s egg

SOGC clinical practice guidelines: Canadian contraception consensus

• Contraception is credited to reduction in pregnancy rate, risk of infection, promotes safety, ease of use and side effects

Birth Control
– 18 Different Types of birth control:

1. Birth Control Implant

• Low Maintenance
• Tiny thin rod approximately the size of a matchstick
• Releases hormones into your body that prevent you from getting pregnant
• 99% effective
• Costs: $0 – $1300
• Lasts up to 5 years

Benefits

• 99% effective
•  Convenient and private
• Make your periods better – 1 in 3 people stop getting their periods after a year
• Only has one hormone
  • Many hormonal birth control methods contain two hormones: estrogen and progestin – some people can’t have estrogen
  • Nexplanon is effective at preventing pregnancy

Disadvantages

• Some people experience negative side effects from Nexplanon – they go away after a few months
  • Bleeding (aka spotting) in the first 6-12 months, the implant causes long-term spotting, or periods get longer and heavier
• Headaches, breast pain, nausea, weight gain, ovarian cysts, pain or bruising where the implant was inserted, an infection where the implant was inserted

2. Intrauterine Device (IUD)

• Low maintenance
• 99% effective
• Costs: $0 – $1300
• Lasts up to 3-12 years
• IUD is a tiny device that’s put into your uterus to prevent pregnancy, long-term and reversible
• Different types; Paragard, Mirena, Kyleena, Liletta, and Skyla

Benefits

• The Paragard (copper) IUD works super well as emergency contraception. If you get it put in within 120 hours (5 days) after unprotected sex, it’s more than 99.9% effective. It’s actually the most effective way to prevent pregnancy after sex.
• 99% effective, convenient, you can get pregnant after taking it out, they can make periods better, the copper IUD doesn’t have hormones

Disadvantages

• Some people have side effects that last 3-6 months
• Pain when the IUD is put in, cramping or backaches for a few days, spotting between periods, irregular periods, heavier periods and worse menstrual cramps

3. Birth Control Shot

• Used on a schedule
•  94% effective
•  Can cost $0 to $100
•  Get every 3 months

Benefits

• If you remember to get your shot on time it is effective
• Convenient and private
•  The shot can make you get your period less often
•  The shot can help protect you from cancer of the uterus and ectopic pregnancy
•  You can get pregnant after using it

Disadvantages

• You have to get an injection every 3 months – you have to remember
• There can be negative side effects while you use the shot
  • Nausea, weight gain, headaches, breast tenderness, depression, slight bruising where the shot was given, very rarely, a small, permanent dent in the skin where the shot given
• It may take up to 10 months after stopping the birth control shot to get pregnant

4. Birth Control Vaginal Ring (aka NuvaRing)

• Used on a schedule – used monthly/ needs to be replaced monthly
•  31%. Effective
•  Costs: $0 to $200
•  Works well when used correctly
•  Flexible ring inserted in vagina and releases hormones

Benefits

• Safe, simple, and convenient
•  Reduces acne, lighter periods, regular and easing menstrual cramps
•  You can get pregnant right away after stop using the ring
•  Safe, simple, and affordable that is worn on the skin of your belly, upper arm, but or back

Disadvantages

• Remembering to put a new ring in on time
• Side effects usually go away after 2 or 3 months – can change sexual desire, spotting or bleeding between periods, sore breasts, nausea, headaches

5. Birth Control Patch

• Used on a schedule – replaced weekly
• 91% effective
•  Costs: $0 to $150

Benefits

• Effective when used correctly – you need to change on time
• Convenient, make your period more regular, ease menstrual cramps, lighten bleeding, help protect you against pelvic inflammatory disease

Disadvantages

• You have to change the patch, usually side effects go away after 2 to 3 months

6. Birth Control Pill

• Used on a schedule – Daily
• 91% effective
• Costs: $0 to $50

Benefits

• Can make your periods regular and predictable, reduces menstrual cramps and make your period lighter, you can safely skip your period, you can get pregnant after you stop taking the pill, it is convenient

Disadvantages

•  You have to take the pill every day, can change your sexual desire, side effects may last up to 2 or 3 months

7. Condom

• Use every time
• Can cost $0 to $2

Benefits

• Help protects against STDs
• if you cut a condom up the side, you can open it out and put it over the vulva for safer oral sex there.
• No prescription required

Disadvantages

• They can take some getting used to (practice makes perfect, different types), you have to use them every time

8. Internal Condom (aka Female Condoms)

• Use every time
• 79% effective
• Costs: $0 to $3
• No prescription required

Benefits

• Help protects against STDs
• Latex-free and comfortable
•  Increase sexual pleasure – may stimulate the tip of the penis, and the external ring can rub against your vulva and clitoris

Disadvantages

• You have to use one every time you have sex
• Internal may require getting use to – practice makes prefect, may require an attitude adjustment, make it part of foreplay, some women may feel an irritation

9. Diaphragm

• Use every time
• 88% effective
• Costs: $0 to $75
•  Prescription required

Benefits

• Convenient, gives you control, doesn’t interrupt sex, doesn’t use hormones, last long

Disadvantages

• If you use spermicide lots of times a day, it can irritate your vagina and increase your risk of getting HIV and other sexually transmitted infections
• People who use diaphragms get urinary tract infections (UTIs) a lot
• Size matters – they come in different sizes and changes in your body may change the required size

10. Birth Control Sponge

• Use every time
•  76-88% effective
•  Can cost $0 to $15
•  Small, round sponge made from soft, squishy plastic. The sponge covers your cervix and contains spermicide to help prevent pregnancy
  Benefits
   Convenient and give you control, doesn’t interrupt sex, hormone-free

Disadvantages

• You have to use one every time you have seex and use it correctly, can be hard to use correctly, some people are sensitive to Nonoxynol-9

11. Cervical Cap

• Use every time
•  71-86% effective
• Costs: $0 to $90
• Soft silicone and shaped like a sailor’s hat. You place it deep inside your vagina to cover your cervix

Benefits

• Convenient and gives you control, they don’t interrupt sex, does not have hormones, they last a long time

Disadvantages

• You have to use it every time you have sex, can be hard to use, spermicide may have side effects, size matters

12. Spermicide

• Use every time
• 71% effective
• Costs: $0 to $8
• No prescription required
• It’s a chemical that you put deep in your vagina right before sex – prevents sperm from entering your cervix
• Spermicide comes in: creams, gels, film, foam, and suppositories

Benefits

• It’s convenient and cheap, doesn’t interrupt sex, doesn’t have hormones

Disadvantages

• You have to use it every time you have sex, Nonoxynol-9 may irritate sensitive genital tissues, can be messy

13. Fertility Awareness (FAMs)

• Lifestyle – monitor daily
• 76-88% effective
•  Costs: $0 to $20
•  Track your ovulation to prevent pregnancy to prevent pregnancy; the temperature method, the cervical mucus method, the calendar method, standard days method
•  Avoiding sex on “unsafe” fertile days
•  You have to be committed and diligent

14. Withdrawal (Pull Out Method)

• Use every time
• 78% effective
• Costs: $0
• is a way to prevent pregnancy by keeping semen away from the vagina

Benefits

• It is free, has no side effects, used with other types of birth control it can be effective
  Disadvantages
• It’s hard to pull out in time, certain people can’t use withdrawal effectively, you need a lot of self-control and trust to use withdrawal

15. Breastfeeding as Birth Control

• Lifestyle – need to breastfeed exclusively when feeding your baby 4-5 hours during the day and ever 6 hours at night
• 98% effective
• Costs: $0
•  Your body naturally stops ovulating

Benefits

• It is free, prevents pregnancy right away, it’s safe, you don’t need a prescription, reduces bleeding after you deliver your baby, breastfeeding may reduce your chance of getting breast cancer, benefits the baby’s development

Disadvantages

• It can be hard to breastfeed exclusively, only prevents pregnancy for 6 months, can lower vaginal lubrication, some people find that nursing makes their breasts feel less sexual

16. Outercourse and Abstinence

• Lifestyle – used every time
• 100% effective
•  Costs: $0
•  Abstinence is not having sex and therefore, outercourse is other sexual activities besides vaginal sex

Benefits

• Wait until you feel ready for sex, wait to find the right partner, enjoy their partner’s company, focus on career or school or hobbies, prevents pregnancy, helps you learn what feels good

Disadvantages

• It can be hard to not have sex

17. Sterilization (Tubal Ligation)

• Permanent
• 99% effective
•  Costs: $0 to $6000
•  Tubal ligation – is a surgical procedure that permanently closes or blocks your fallopian tubes

Benefits

• Very effective, sterilization is convenient, doesn’t change your hormones

Disadvantages

• Permanent, you can have pain or discomfort before and after the procedure

18. Vasectomy

• Permanent
• 99% effective
•  Costs: $0 to $1000
•  A vasectomy is a simple surgery done by a doctor in an office, hospital, or clinic. The small tubes in your scrotum that carry sperm are cut or blocked off, so sperm can’t leave your body and cause pregnancy.

Benefits

• Very effective, convenient,

Disadvantages

• Permanent, you can have pain or discomfort before and after the procedure, common to have an infection

Non-contraceptive Benefits of Birth Control

• Decreased risk of endometrial, ovarian, and colorectal cancers
  • Improved bone mineral density in older women
  • Induction of amenorrhea for lifestyle considerations
  • Menstrual cycle regularity
  • Prevention of menstrual migraines
  • Treatment of acne
  • Treatment of bleeding from leiomyoma
  • Treatment of dysmenorrhea
  • Treatment of hirsutism
  • Treatment of menorrhagia
  • Treatment of pelvic pain from endometriosis
  • Treatment of premenstrual syndrome