Contraception Methods

Women’s Health Centre

CEAC 1198 February 2019 *This document was designed to support the patients of the former RQHR.

Notes: Contraception Booklet ______This booklet covers the most common types of contraception, or birth control, that are available to help prevent pregnancy. Some ______have female hormones and some do not. Condoms are the only type that provide protection against Sexually Transmitted ______Infections (STI’s). Condoms can be used in combination with all of the other types of birth control. ______Common hormonal forms of contraception: ______ Oral contraceptive pill (OCP) (“the pill”) ______ Emergency Contraceptive Pill (ECP) (Plan B®)

 The vaginal ring (NuvaRing®) For more information:  The birth control patch (Evra Patch®)  Intrauterine System (IUS) (Mirena®, Kyleena®, Jaydess®) visit www.sexualityandu.ca  Injectable contraception (Depo-provera®)

Ask your health care professional Common non-hormonal forms of contraception: Talk to a nurse at the RQHR Women’s Health Centre  Condoms

Call (306)766-0586  Intrauterine Device (IUD) (Liberté Copper®, Flexi-T®)

 Male Sterilization (Vasectomy)

For 24 hour professional health advice and information, call

From L to R: Oral contraceptive pills, birth control patch, male condom, vaginal ring, Intrauterine System and Intrauterine Device

Photograph courtesy RGH Women’s Health Centre

12 1 Male Condoms Male Sterilization (Vasectomy) Condoms are a method of birth control that act as a physical barrier to prevent sperm from entering the vagina. It is placed on A permanent surgical procedure that blocks or cuts the tubes the end of an erect penis. While pinching off the space at the tip (called vas deferens) that carries sperm to the penis. There is no of the condom it is rolled down to the base of the penis. After sperm in ejaculate to fertilize a female egg. It is 99.9% effective ejaculation hold the base of the condom to withdraw and remove once semen samples have been given after the procedure to it from the penis while it is still erect. If a condom breaks, use a confirm there is not any sperm in it. form of emergency contraception (page 3). It is 85% effective in preventing pregnancy with typical use and 98% effective with Benefits of male sterilization: perfect use.

 effective and permanent Benefits of male condoms:  does not affect ability to have an erection or enjoy intercourse  purchased without a prescription in stores and pharmacies  done under local anesthetic  provides protection from STI’s such as HIV/AIDS, syphilis,  gives a man a chance to play a role in birth control choices chlamydia, gonorrhea and some protection against herpes, HPV and genital warts  cost effective.

 lubricated condoms may make intercourse more comfortable

 available in various sizes, textures and flavors. Drawbacks of male sterilization:

 does not protect against sexually transmitted infections (STI’s)

Drawbacks of male condoms:  not effective immediately. 15 to 20 ejaculations are needed to  must be available and used at the time of intercourse clear the sperm from the tubes. This must be confirmed by bringing a semen sample in to the hospital for analysis  may tear or slip off  requires minor surgery, which may cause pain, bruising,  must be stored and handled properly. swelling or infection

 a referral from a health care provider to a specialist is needed Spermicidal foams, creams and jellies disable sperm and when  possible regret following procedure. used with condoms, are very effective. They are inserted into the vagina, do not have hormones and do not protect from STI’s.

2 11 Oral Contraceptive Pill (OCP) Female Sterilization (Tubal Ligation) “The Pill”

This method of birth control is considered a permanent surgical OCP comes in 21, 28 or 91 day pack of pills. The hormones procedure in which the fallopian tubes are disconnected. Tubal estrogen and progestin in the pills prevent pregnancy by stopping ligations can be done by a doctor in an operating room, either the ovary from releasing an egg, thickening the cervical mucous through laparoscopy using general anesthesia to make small to stop sperm from passing through and changing the uterine incisions in the abdomen or abdominally during a caesarean lining. One pill is taken everyday at the same time. With perfect section. use, it is 99.7% effective in preventing pregnancy. With typical use, it is 92% effective.

Benefits of female sterilization: Benefits of OCP:

 safe, simple and highly effective  may make periods more regular, with fewer cramps

 permanent birth control  reversible

 non-hormonal  may help with acne

 does not interfere/affect with sex or sexual function  may reduce the risk of ovarian and endometrial cancers

 discreet and cost-effective.  is a progestin-only pill for those who cannot take estrogen.

Drawbacks of female sterilization: Drawbacks of OCP:

 permanent and irreversible  does not protect against STI’s

 possible short-term surgery-related complications (ie.  must remember to take it everyday, at the same time anesthetic risks, bleeding, pain, infection at incision site, damage to other organs)  may cause nausea, breast tenderness, bloating and headaches  rarely, the fallopian tubes can reconnect by themselves  may cause blood clots  does not protect against STIs  may be contraindicated in women with hypertension  chance of regret in the future.  women over the age of 35 who smoke can not take it

 it is only available by prescription.

10 3 Emergency Contraceptive Pill (ECP) Intrauterine System (IUS) Mirena® Plan B®

ECP is used to prevent pregnancy resulting from a single act of IUS is a longer term, reversible birth control option. The IUS is a ‘T’ intercourse when birth control either was not used or failed. The shaped device that is inserted into the uterus by a doctor. It has ECP must be used within 72 hours of unprotected intercourse in the hormone progestin on it and strings that are cut short high up order to be effective, but the sooner it is taken, the better. It will in the vagina. The IUS is 99.9% effective in preventing pregnancy. not interrupt a pregnancy from earlier sexual contact nor does it An Intrauterine Device (IUD) is available that does not contain any protect you from pregnancy for the rest of the month. The ECP is a hormones. combination of female hormones estrogen and progestin. It acts by affecting the lining of the uterus (womb) so that if an egg has Benefits of the IUS: been fertilized by sperm, it will not implant and continue to  effective for up to 5 years develop.  may cause lighter periods with milder cramps or stop periods

 not taken daily or used at the time of intercourse Benefits of ECP:  one time cost  it can be taken if other methods of birth control have failed  reversible and removable  you do not need to get it from a doctor. In Saskatchewan it is available from a pharmacist or Planned Parenthood Regina  can be used while breast feeding.

 it is only 2 pills to take, taken at the same time. Drawbacks of the IUS: Drawbacks of ECP:  does not protect against STI’s

 does not protect against STI’s  it is recommended that you check the location of the strings once a month to confirm your IUS is still in place  can cause irregular bleeding, cramping or diarrhea  breakthrough bleeding and spotting may occur during the first  is not to be used as regular birth control. 2 to 4 months

 there is a very small chance of uterine perforation (poking through the uterine muscle).

4 9 Intrauterine Device (IUD) Vaginal Ring NuvaRing® IUD is a longer term, reversible birth control option. The IUD is a ‘T’ shaped device that is inserted into the uterus by a health care The vaginal ring is a flexible ring that is inserted high up into the professional. It contains copper and does not have any hormones. vagina by the user and left in place for 21 days, then removed by It has a string that is cut short high up in the vagina. The IUD is the user and left out for 7 days. During the 7 days it is not in, the 99.2% effective in preventing pregnancy. An Intrauterine System vagina menstruation will occur. A new ring is used each cycle. (IUS) is available that does contain hormones. When in place, it slowly releases the hormones estrogen and progestin to prevent the ovaries from releasing eggs. It is 99.7% Benefits of the IUD: effective with perfect use and 92% effective with typical use.  effective for up to 5 years, reversible and removable Benefits of Vaginal Ring:  not taken daily or used at the time of intercourse  it is not taken daily or at the time of intercourse (it is monthly)  one time cost.  you should not be able to feel the ring when it is in place and it Drawbacks of the IUD: should not interfere with intercourse  does not protect against STI’s  is effective and reversible  may increase menstrual bleeding and cramping  may make periods more regular, light and with less cramping.

 it is recommended that you check the location of the strings once a month to confirm your IUD is still in place Drawbacks of Vaginal Ring:  breakthrough bleeding and spotting can occur after insertion  does not protect against STI’s

 there is a small chance of it poking through the uterine  may be expelled or fall out of the vagina (uncommon) muscle.  may cause irregular bleeding, breast tenderness, spotting, When to See Your Health Care Provider about IUD or IUS nausea or headaches

 you are unable to feel the strings when checking for them  the user must be comfortable to insert and remove the ring.

 you think the IUD may have fallen out

 you think you might be pregnant

 you are experiencing constant abdominal pain, fever, or unusual vaginal discharge

 you or your partner feel pain or discomfort during intercourse

 you want the IUD removed. 8 5 The Birth Control Patch Injectable Contraception

Evra® Depo-Provera®

The patch is a 4.5 cm peach coloured patch that has the hormones An injection given once every 12 weeks into the arm, hip or estrogen and progestin in it and is worn on the skin. These buttocks. It contains the hormone progestin that prevents hormones are absorbed through the skin to prevent ovulation and ovulation, thickens the cervical mucus to prevent sperm from pregnancy. The user puts 1 patch on and replaces it on the same getting through to the uterus and changes the lining of the uterus, day 1 and 2 weeks later. On the 4th week a patch is not worn and to prevent pregnancy. this is when menstruation occurs. With perfect use it is 99.7% effective and 92% effective with typical use. Benefits of injectable contraception:

 it is not taken daily or at time of intercourse (injection is given Benefits of the Patch: every 12 weeks)

 it is not taken daily or at the time of intercourse (it is weekly)  can be used by women who cannot take estrogen

 it can be discretely worn under clothing  is effective and reversible

 is effective and reversible  after one year of use over 50% of women stop having periods

 may make periods more regular, lighter and with less cramps  may decrease pain from endometriosis

 can bath, swim, and exercise without it falling off.  may be suitable for women who are breastfeeding

 is discrete. Drawbacks of the Patch: Drawbacks of injectable contraception:

 does not protect against STI’s  does not protect against STI’s

 may cause irritation to the skin where it is applied  irregular bleeding is a common side effect

 may cause irregular bleeding, breast tenderness, spotting,  causes a decrease in bone mineral density which appears to be headaches, blood clots reversible when the injection is stopped

 may detach from skin, but this is not common  may cause weight gain

 it only comes in one color.  may be a delay in the return to fertility after stopping the injection

 the injection must be given by a health care professional.

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