Female contraception

What methods of contraception are there for women?

There are lots of contraception choices for women. Some types of contraception, for example, female condoms, are freely available from pharmacies.

Other types of contraception are only available if you get a prescription from a doctor and get it filled at a pharmacy. And some types of contraception must be fitted by a healthcare professional.

The main contraception options for women are:

• hormonal contraception
• barrier contraception
• IUDs
• natural methods

There are also methods of contraception that can be used in an emergency, for example, if you have been assaulted or your usual contraception has failed.

Hormonal methods of contraception

Hormonal contraception works by using synthetic versions of estrogen and progesterone to regulate a woman’s menstrual cycle. There are several different types of hormonal contraception available to women and they are all reversible. These include:

• oral contraception such as the combined pill and progestogen-only pill
• contraceptive implant (Nexplanon)
• contraceptive injection (Depo-Provera, Sayana Press or Noristerat)
• contraceptive patch (Evra)
• vaginal ring (NuvaRing)
• emergency birth control

Hormonal birth control is available only on prescription and the contraceptive injection and implant need to be administered by a healthcare professional.

Before you start hormonal contraception you will need to speak with a healthcare professional. They will check your weight and blood pressure, as well as asking a few questions about your lifestyle and health and your birth control needs.

Some types of hormonal contraception will decrease body hair growth, reduce menstrual flow and cramping. It may also improve acne. Hormonal birth control may reduce the risk of certain health problems, too.

A family planning doctor can help you decide which type of hormonal contraception will suit you.

Hormonal contraceptive methods do not protect against sexually transmitted infections (STIs).

What are the different types of oral contraception?

There are two types of birth control pill: the combined pill and the progesterone-only pill.

Birth control pills work by preventing ovulation and by thickening the cervical mucus so the sperm cannot reach the egg, and altering the lining of the uterus so implantation is less likely to occur. You take the pill at the same time each day. Some kinds of pill have either a pill-free week or a week of ‘blank’ or placebo pills. Other types have just two placebo days to minimize hormone fluctuations.

There are many different brands and types of contraceptive pill, and it may take a few months to work out a type of birth control pill that is right for you. You and your doctor can try several different types.

Oral contraception, particularly the progestogen-only pill, needs to be taken at the same time every day or it will be less effective. Oral contraceptives may not work if you have vomiting or diarrhea. If this happens to you, use another method of contraception.

Emergency birth control pills

If your normal method of contraception has failed or you have not used contraception, hormonal pills are available that will prevent pregnancy. Examples of emergency birth control pills include:

• LNG-EC pills (Plan B, Norlevo, Option 2, and Next Choice)
• UPA-EC (Ulipristal acetate 30 mg, branded as Ella)

The morning after pill is not intended as a regular method of contraception. LNG-EC pills are available over the counter. UPA-EC is available only with a prescription.

Where can I get my prescription for birth control pills filled?

Oral contraceptive pills are one of the world’s most prescribed drugs. You get a prescription from a family planning doctor, and get it filled at any pharmacy. Some people prefer to get their contraceptive pills sent straight to their home. With NX Pharmacies, you can get automatic refills of your oral contraceptive prescription so you don’t need to worry about remembering to visit the pharmacy. We use next-day delivery to send your birth control pills to your chosen address in discreet packaging.

How do I start birth control pills?

Your doctor should advise you on the best way to start your birth control pills; or there may be instructions on the patient information leaflet. You may need to use a back-up method of contraception for the first seven days. To ensure effective contraception, always follow the instructions your doctor has given to you.

Will my birth control pills start working immediately?

Depending on the type of pill you are taking and on how you start them, you may need to use a back-up method of contraception for seven days, otherwise you are at risk of pregnancy.

Do birth control pills have side-effects?

Some hormonal contraceptive pills have side-effects. They can cause headaches, mood swings or breast tenderness, for example. If you experience side-effects from your contraceptive pills, it is best not to stop taking them without consulting your doctor. Sometimes side-effects settle after a few months as your body gets used to the hormonal contraception. There are lots of different kinds of contraceptive pills, and your doctor can prescribe another sort of birth control pill at your follow-up appointment.

Will the pill make me put on weight?

Some types of oral contraceptive are linked to weight gain. If you think that your birth control pill is causing you to gain weight, speak with your healthcare provider. They can try a different type of contraceptive pill.

Is oral contraception linked to low mood?

Some women experience low mood when they use birth control pills or other hormonal methods of contraception. If you find this low mood intolerable, or it lasts for longer than three months, your doctor will switch you to a different type of pill or recommend another method of contraception.

Will birth control make my acne worse?

Some types of birth control are actually prescribed to improve acne. But other types of hormonal contraceptives can make acne worse. If acne is a concern for you, mention this at your family planning appointment. Your doctor may be able to prescribe an oral contraceptive that will improve your acne.

Can I use oral contraceptives to stop my periods?

Some women use their birth control pills to suppress their periods and there are two types of contraceptive pill intended for extended use: Seasonale and Seasonique. It is best to ask your doctor about stopping your periods with birth control.

Some types of hormonal birth control will relieve some unpleasant period symptoms, like heavy bleeding, mood swings and menstrual cramps. Tell your doctor if you are troubled by any particular symptoms during your period. They will take this into account when prescribing your birth control.

Do antibiotics make oral contraceptives less effective?

One kind of antibiotic, rifampin, reduces the effectiveness of some hormonal contraceptives. When prescribing this antibiotic, a doctor will ask if you are using oral contraceptives. You will need to use a back-up method of contraception if you are sexually active while you are taking rifampin.

What should I do if I miss a dose of my birth control pill or forget to change my patch or vaginal ring?

If you miss a dose of hormonal contraceptives, use Sex & U’s Stay on Schedule tool to work out what to do. It will tell you if you should continue taking your pills or apply another patch or ring. It may recommend that you get emergency contraception, too. And it will tell you if you need to use another method of contraception for a few days.

If you keep missing doses of your oral contraceptive pill or can’t remember to change your patch or ring, let your doctor or family planning adviser know. They may have some tips to help. Or it may be that another method of birth control would suit you better.

Am I at risk of blood clots if I take the pill?

Some methods of hormonal contraception, such as the combined pill, contraceptive patch and vaginal ring, increase your risk of getting a blood clot. If you use these methods of contraception, make yourself aware of the symptoms of blood clots, which include:

• swelling, redness, warmth and pain in a limb
• sudden breathlessness
• sharp chest pain
• cough
• coughing up blood

Get medical advice quickly if you think you have a blood clot, and mention that you are using hormonal contraception.

Barrier methods

Barrier methods prevent the sperm from making contact with the egg. Some barrier methods also affect the vagina so that it is more hostile to sperm. These are some examples of barrier methods that are available to women:

• cap
• diaphragm
• sponge
• female condoms

Caps, diaphragms and sponges are available at pharmacies without prescription. They sit over the cervix at the top of the vagina and prevent the sperm from going any further. Caps and diaphragms are re-usable and should be used with a spermicidal gel that forms a barrier. Sponges are disposable and have their own spermicide. They do not offer protection against sexually transmitted infections (STIs).

Female condoms are worn inside the vagina, and male condoms are worn over the penis. Both are available from pharmacies without prescription and are single-use. Condoms offer good protection from STIs.

Intrauterine devices (IUDs)

IUDs are a long-acting reversible but highly effective method of contraception.

• IUD (intrauterine device or coil)
• IUS (intrauterine system or hormonal coil)

IUDs do not protect against sexually transmitted infections (STIs). They must be prescribed and fitted by a healthcare professional at a specialist clinic. One type of IUD can be used as emergency birth control if it is administered promptly. To find an IUD clinic near you, use Rapid Access IUC Centres of Excellence.

Natural methods of contraception

Some couples get training in natural family planning or fertility awareness. They learn how to recognize the days in a woman’s menstrual cycle when she is fertile or not fertile. By restricting sexual intercourse to non-fertile days, they can minimize the chances of pregnancy.

Natural family planning provides no protection against sexually transmitted infections (STIs).

Sterilization

Male and female sterilization are permanent methods of contraception involving a surgical procedure. Talk to your doctor about the advantages and disadvantages of sterilization.

What is the best birth control method for me?

Each method of contraception has its own advantages and disadvantages. If you need help deciding what birth control is best for you, the website itsaplan.ca can tell you more about each method, whether it’s a pill, vaginal ring or barrier method.

You can also make an appointment with your gynecologist or at a family planning clinic to discuss contraception. The health professionals at a family planning clinic can fit IUDs, administer contraceptive injections and prescribe hormonal contraception like the pill, vaginal ring or contraceptive patch.

You can then fill your prescription for contraception at any pharmacy, including NX Pharmacies.

How can I get emergency contraception?

There are two types of emergency contraception, an IUD and emergency contraceptive pills.

The levonorgestrel morning after pill can be bought over the counter in most Canadian pharmacies. Emergency contraception should be taken by the woman within 72 hours of unprotected sex, but it is most effective if taken within 12 hours. Examples of levonorgestrel emergency contraception include Plan B, Norlevo, Option 2, and Next Choice.

If there has been a longer delay, your doctor can prescribe a different kind of emergency contraceptive or fit you with an emergency IUD. Make an appointment as soon as possible with your usual doctor or with a family planning clinic to arrange this. To find your nearest IUD clinic, use Rapid Access IUC Centres of Excellence.

Note that emergency contraception gives no protection against sexually transmitted infections (STIs), including HIV. If you have had unprotected sex or your condom broke, consider getting a check-up at an STI clinic. If you have been assaulted, your provincial or territorial health organization will have resources to help you. The Canadian Association of Sexual Assault Centres has a list of anti-violence centres organized by province or territory.