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Deciding to have a baby can be an exciting time. However, for people trying to prevent a pregnancy, birth control (also called contraception) can help.

Path to improved health

There are many options for preventing a pregnancy. Whether it’s a method, a medicine, or a device, each has its pros and cons. Some choices are permanent. Others are reversible.

Birth control pill

This is a popular form of birth control. Taken every day by mouth, the pill is 99% effective in preventing pregnancy when used as prescribed. There are two types of birth control pills: the combination pill and the mini-pill. The combination pill works by combining the hormones estrogen and progestin to prevent ovulation (which is necessary for a pregnancy to happen). This means your ovaries don’t release eggs. The hormones also make your cervical mucus thicker, which makes it harder for sperm to move. They also thin the lining of your uterus, which makes it harder for an egg to attach there. Women who are sensitive to estrogen can take the mini pill. The mini pill only contains the progestin hormone. While it thickens cervical mucus and thins the lining of the uterus like the combination pill, it also slows the path of eggs traveling through fallopian tubes during ovulation. This helps prevent pregnancy.

Other hormone based methods

These include a patch, shot, implant (under the skin in the arm), and a vaginal ring that releases the hormones. These methods are 93% to 99.95% effective.

Intrauterine devices (IUD)

This method requires a healthcare provider to insert a small, T-shaped device into the uterus. There are two kinds: copper and hormonal (progestins). You may have pain and cramping when inserting and removing IUDs. Copper IUDs might increase menstrual cramping, as well. IUDs change the mucus inside a woman’s cervix (the lower end of a woman’s uterus). This prevents the sperm from meeting with the egg. They are more than 99% effective when used properly.

Barrier methods of birth control

Several birth control products can create a barrier between sperm and the uterus. This includes condoms, diaphragms, cervical caps, and contraceptive sponges. These methods are between 79% to 86% effective.

Sterilization

Sterilization is when a person has surgery to permanently prevent pregnancy. One option women have is a tubal ligation (some people refer to this as having their tubes tied). This procedure surgically blocks a woman’s fallopian tubes. This prevents sperm from entering the fallopian tube. For men, a vasectomy is a form of birth control. This surgical procedure prevents sperm from mixing with a man’s semen when they ejaculate. This doesn’t interfere with sexual intercourse, and is considered a permanent method of birth control. In some instances, the procedure can be reversed. However, it depends on age, circumstances of the first surgery, and potential health complications. Sterilization is more than 99% effective.

Spermicides

These foam or gel-like substances kill sperm. A woman can apply them directly into the vagina. These are around 78% effective.

Natural family planning

There is no medicine or device with this form of birth control. It relies on avoiding sexual intercourse in the days leading up to when you are more likely to be ovulating. Ovulation is the time when a woman is most likely to become pregnant. Sperm can live for a short period of time in the vaginal area. So you need to avoid sexual intercourse prior to and during ovulation. Ovulation kits and fertility monitors can help you determine if you’re ovulating. Even the visual presence of vaginal discharge (clear or cloudy, stretchy mucus) can mean you’re ovulating. However, natural family planning isn’t an exact science. This method is effective about 76% of the time.

Things to consider

Your choice of birth control should consider several things. This includes your age and overall health. You also should consider the risks and possible non-contraceptive benefits of the method, medicine, or device. Estrogen-containing contraceptives, for example, can increase your risk of blood clots. Some hormonal methods can help with painful periods or heavy menstrual bleeding. Your choice should consider how well it works for your needs. That includes thinking about whether or when you might want to start a family in the future.

Finally, your choice should consider how frequently you have to manage your birth control. For example, birth control pills must be taken daily. If you aren’t able to take a pill at the same time each day, you may want to consider another form. Some options (such as hormonal injections and vaginal rings) will last for up to a few months. Some vaginal rings can be left in for a few months. Barrier methods, such as diaphragms and cervical caps, have to be removed after 6 to 8 hours. Condoms are immediately removed. However, intrauterine devices can stay in place for 3 to 10 years before having to be changed.

For More Information

Sex & U-  is an initiative of the Society of Obstetricians and Gynaecologists of Canada, Canada’s leading authority on sexual and reproductive health
http://www.sexandu.ca/