Birth Control - Choosing the method that's right for you

The information contained in this brochure may be out of date and is currently being reviewed. It is not intended to answer specific medical questions, but is provided for general information only. Please talk to your family physician directly about your health concerns.

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Ask Your Family Doctor

Developed by the College of Family Physicians of Canada

The type of birth control you should use depends on your needs. Some people only need to prevent pregnancy. Other people may also want to protect themselves or their partners from diseases that can be passed by having sex. These sexually transmitted infections (STIs) include AIDS, herpes, genital warts and chlamydia. You and your family doctor can talk about what birth control method is right for you.

For any method to work, it must be used every time you have sex, and it must be used the right way. The table to the right shows the failure rates of the different types of birth control during the first year a couple uses them. These numbers are for couples that use the methods the right way every time they have sex. The failure rates are much higher if you don't use the methods the right way every time.

Yes. The risk of pregnancy or catching an STI may outweigh the pleasure you get from having sex. The only way to make sure you don't get pregnant, get someone pregnant or get an STI is to not have sex at all.

Spermicides help prevent pregnancy by killing sperm. They also help protect against some STIs. Spermicides come as foams, jellies or creams that are put into the vagina. They work best when used with another form of birth control, such as condoms, diaphragms or cervical caps. Some women may develop urinary tract infections with the use of spermicides. If you think this is a problem for you, talk to your doctor.

Yes. Condoms for men and women help prevent pregnancy and can also help prevent STIs. Condoms are good to use if you or your partner are having sex with other people or if either of you has had sex with other people in the past. The more partners either one of you has had, the more risk one of you may have an STI. Many STIs don't have any warning signs.

Be sure to use condoms made of latex (rubber). The AIDS virus can get through condoms made of animal membranes. Don't use lotions or petroleum jelly (such as Vaseline) as a lubricant. These can cause the rubber to break. Use only water-based lubricants (such as K-Y Jelly).

Carefully follow directions when you use a condom. Condoms work best if you use spermicides along with them. The spermicides should be placed in the vagina (not just on the male condom). Coloured or flavoured condoms are not as effective in preventing STIs.

*Condoms can be made even more effective if they are used with spermicides in the vagina.

Barrier methods for women cover the cervix (the opening of the uterus) to block sperm from getting into the uterus. They also help protect against some STIs. Barrier methods include the cervical cap and the diaphragm.

The cervical cap and diaphragm require a visit to your doctor to be fitted. They're used along with spermicides. Both must be left in place at least six hours after having sex. The cervical cap can be left in place for up to 72 hours and you don't have to add fresh spermicide each time you have sex. It should not be removed 6 to 8 hours after intercourse. The diaphragm shouldn't be left in place longer than 24 hours and you should add fresh spermicide each time you have sex. The diaphragm may increase your risk of urinary tract infections.

IUDs are made of flexible plastic. They are put into your uterus by your doctor. It isn't known exactly how IUDs prevent pregnancy. They seem to stop sperm from reaching the egg or prevent the egg from attaching to the uterus. Some health risks are connected with the IUD. The IUD may increase your risk for infections and is usually used after a woman has had a child and when they have only one partner. You should discuss these with your doctor. The most common side effects of using the IUD include heavier bleeding and stronger cramps during periods. A benefit of the IUD is that you don't have to worry about birth control every day.

Sterilization is when a man or woman has an operation to prevent pregnancy. If you're sure that you don't want to have children or don't want more children, sterilization is a good choice. These are permanent and not easily reversed. Tubal ligation (getting your "tubes tied") involves closing off the fallopian tubes in a woman so that eggs can't reach the uterus. The fallopian tubes are what the eggs travel through to reach the uterus. Men can have a vasectomy. The man's vas deferens (sperm ducts) is closed off so that sperm can't go through. The picture below shows the vas deferens.

Birth control pills work mostly by preventing ovulation (the release of an egg by the ovaries). Most pills include two hormones, called estrogen and progestin. Some are just progestin only. Birth control pills come in a large variety of types. They had few side effects and are very effective. The most common side effects from birth control pills include nausea, headaches, breast swelling, small amounts of water retention or weight gain and spotting.

The pill may reduce cramping with periods and shorten the number of days of bleeding. It may also improve the regularity of periods, reduce the symptoms of premenstrual syndrome (PMS), and help prevent diseases of the breast and fallopian tubes, and cancer of the ovaries and of the lining of the uterus.
If you use the pill, you must be able to remember to take it every day. You will need to talk about all of these things with your doctor to decide if you want to try the pill. You may also still need to use condoms to stay protected from STDs.

Shots don't have the same health risks as the pill because they don't include estrogen. But they may have some side effects. These include headaches, and changes in your periods, weight and moods.

A benefit of these methods is that you don't have to think about birth control every day.

Know as natural family planning, the rhythm method requires that a woman learn when in her cycle she is fertile (usually four days before and two days after ovulation) and use another kind of birth control or not have sex during those days.

Several ways are used to keep track of ovulation, including the calendar method, the temperature method and the cervical mucus method. All of these methods require much planning. Using more than one at a time may increase how well they work.

No. When a man tries to pull out before ejaculating ("coming"), he usually leaves behind a small amount of fluid that leaks from the penis during sex. This fluid has enough sperm in it to cause a pregnancy.