Beyond pregnancy prevention

The options:
IUD
pros

• Easy to use
• Long-term protection
• Hidden
• Lightens period 
• Few or no side effects
• Choice of products
• Reversible

cons

• Medical visit
• No STI protection
• Possible side effects*

* Visit SexualityandU for more.

effectiveness at preventing pregnancy with typical use
99 %

More information on the IUD in Canada.

"Not right now":
pros

• STI protection
• Few or no side effects
• No hormones

cons

• Harder to use

effectiveness at preventing pregnancy with typical use
100% if consistently done right

other options

• Withdrawal
• Sterilization
• The Patch
• The Pill

Hormonal IUD
pros

• Easy to use
• Long-term protection
• Hidden
• Lightens period 
• Few or no side effects
• Choice of products
• Reversible

cons

• Medical visit
• No STI protection
• Possible side effects*

* Visit Bedsider for more.

effectiveness at preventing pregnancy with typical use
99 %

More information on the IUD in Canada.

The Pill
pros

• Lightens period
• Hidden
• Choice of products
• Reversible

cons

• Medical visit
• No STI protection
• Possible side effects*

* Visit Bedsider for more.

effectiveness at preventing pregnancy with typical use
92%

More information on the Pill in Canada.

The Ring
pros

• Easy to use
• Lightens period
• Reversible

cons

• Medical visit
• No STI protection
• Possible side effects*

* Visit Bedsider for more.

effectiveness at preventing pregnancy with typical use
91%

More info on the Ring in Canada.

other options

• The Patch
• The Shot

The options:
Male condom
pros

• STI protection
• Widely available
• No medical visit
• Easy to use
• No hormones
• Few or no side effects*

* Unless latex allergy, but non-latex versions available

cons

• Limited pregnancy prevention
• Use one every time
• Best with a backup method

effectiveness at preventing pregnancy with typical use
82%

Female condom
pros

• STI protection
• No medical visit
• More control for women
• Easy to use
• No hormones
• Few or no side effects
• Safe with latex allergies
• Sexual pleasure for women

cons

• Limited pregnancy prevention
• Use one every time
• Not widely available
• Best with a backup method

effectiveness at preventing pregnancy with typical use
79%

"Not right now":
pros

• STI protection
• Few or no side effects
• No hormones

cons

• Harder to use

effectiveness at preventing pregnancy with typical use
100% if consistently done right

The options:
Male condom
pros

• STI protection
• Widely available
• No medical visit
• Easy to use
• No hormones
• Few or no side effects*

* Unless latex allergy, but non-latex versions available

cons

• Limited pregnancy prevention
• Use one every time
• Best with a backup method

effectiveness at preventing pregnancy with typical use
82%

Female condom
pros

• STI protection
• No medical visit
• More control for women
• Easy to use
• No hormones
• Few or no side effects
• Safe with latex allergies
• Sexual pleasure for women

cons

• Limited pregnancy prevention
• Use one every time
• Not widely available
• Best with a backup method

effectiveness at preventing pregnancy with typical use
79%

Sponge
pros

• No hormones
• Few or no side effects
• More control for women
• Can be inserted in advance

cons

• No STI protection
• Limited protection against pregnancy
• Not widely available
• Harder to use
• Possible side effects*

* Visit Bedsider for more.

effectiveness at preventing pregnancy with typical use
76-88%

More info on the Sponge in Canada.

other options

• Spermicide
• Withdrawal
• “Not right now”
• Fertility awareness

The options:
Copper IUD
pros

• Long-term protection
• Hidden
• Few or no side effects
• Reversible
• Very effective in emergencies

cons

• Medical visit
• No STI protection
• Possible side effects*

* Visit Bedsider for more.

effectiveness at preventing pregnancy with typical use
99%

More information on the copper IUD in Canada

Male condom
pros

• STI protection
• Widely available
• No medical visit
• Easy to use
• No hormones
• Few or no side effects*

* Unless latex allergy, but non-latex versions available

cons

• Limited pregnancy prevention
• Use one every time
• Best with a backup method

effectiveness at preventing pregnancy with typical use
82%

Female condom
pros

• STI protection
• No medical visit
• More control for women
• Easy to use
• No hormones
• Few or no side effects
• Safe with latex allergies
• Sexual pleasure for women

cons

• Limited pregnancy prevention
• Use one every time
• Not widely available
• Best with a backup method

effectiveness at preventing pregnancy with typical use
79%

other options

• Withdrawal
• Sponge
• Spermicide
• Diaphragm

The options:
IUD
pros

• Easy to use
• Long-term protection
• Hidden
• Option that contains hormones lightens period
• Few or no side effects
• Choice of products
• Reversible

cons

• Medical visit
• No STI protection
• Possible side effects*

* Visit Bedsider for more.

effectiveness at preventing pregnancy with typical use
99 %

More information on the IUD in Canada.

The Shot
pros

• Easy to use
• Medium-term protection
• Hidden
• Lightens period

cons

• Medical visit
• No STI protection
• Possible side effects*

* Visit Bedsider for more.

effectiveness at preventing pregnancy with typical use
94%

More info on the Shot in Canada.

other options

• Sterilization

The options:
IUD
pros

• Easy to use
• Long-term protection
• Hidden
• Option that contains hormones lightens period
• Few or no side effects
• Choice of products
• Reversible

cons

• Medical visit
• No STI protection
• Possible side effects*

* Visit Bedsider for more.

effectiveness at preventing pregnancy with typical use
99 %

More information on the IUD in Canada.

The Ring
pros

• Easy to use
• Lightens period
• Reversible

cons

• Medical visit
• No STI protection
• Possible side effects*

* Visit Bedsider for more.

effectiveness at preventing pregnancy with typical use
91%

More info on the Ring in Canada.

other options

• The Patch
• Sterilization
• The Shot

The options:
Copper IUD
pros

• Long-term protection
• Hidden
• Few or no side effects
• Reversible
• Very effective in emergencies

cons

• Medical visit
• No STI protection
• Possible side effects*

* Visit Bedsider for more.

effectiveness at preventing pregnancy with typical use
99%

More information on the copper IUD in Canada.

EC Pills (Levonorgestrel-based)
pros

• Very effective in emergencies
• Choice of products

cons

• Protection after the fact
• Medical visit
• Not effective as a regular method
• No STI protection
• Possible side effects*

* Visit Bedsider for more.

effectiveness at preventing pregnancy with typical use
95% first 24 hours then declines slightly

More information on EC in Canada.

A guide to the male condom.

The right fit
“I used to repeatedly break condoms during sex. I always found them really uncomfortable, and found that they would break easily. My partner suggested I try a different size condom, and it solved both problems. The condoms were much more comfortable, and I haven’t had one break since.”
—Quade D., Lakehead University in Thunder Bay, Ontario

What it is & how it works Male condoms are one of the most popular forms of birth control out there. They slip over a man’s penis to prevent pregnancy and lower the risk of STIs by keeping the ejaculated sperm inside the condom.

Use condoms for STI protection with other methods of birth control. Condoms aren’t the most effective method for birth control. But unlike most forms of contraception, they can often prevent transmission of STIs.

Find the best fit in advance As Quade’s story suggests, condoms are not one-size-fits-all. The wrong size condom might not be as effective or comfortable. It’s important for men to explore their options ahead of time.

Choose lubricated condoms or add lubrication to make the experience more comfortable and pleasurable for both parties. For comfort, pick a lubricant that is water-based, unscented, and isn’t “warming” or “cooling.”

Women are responsible for condoms too Dr. K.: “Women should feel empowered to buy male or female condoms. It’s not always the [man’s] responsibility. If you want to have sex, you should have a condom too.”

A guide to the female condom.

Develop your insertion skills
“I tried it to see how it would feel. I thought it would be nice to have the condom in place beforehand so that we wouldn’t have to pause during foreplay to put on the condom. It was a bit tricky to put in at first; you need to totally relax and get a good angle on the way in.”
—Maggie C., Ryerson University in Toronto, Ontario

What it is & how it works The female condom is a pouch that is inserted into a vagina. It keeps the sperm inside the condom and out of the vagina. Unlike most male condoms, it doesn’t contain latex.

Practice in advance Dr. K.: “If you’re feeling apprehensive or intimidated, practice inserting it ahead of time. Be sure to read the instructions! Also, don’t be shy with using lubrication. With a bit of practice, you’ll be a pro.”

Use condoms for STI protection with other methods of birth control. Male and female condoms aren’t the most effective method for birth control. “But like the male condom, it does provide protection against STIs,” says Dr. Feuerstein. The female condom has the added benefit of giving women more control.

Women are responsible for condoms too Dr. K.: “Women should feel empowered to buy male or female condoms. It’s not always the[man’s] responsibility. Unfortunately the female condom is not widely available in drug stores, but is available at Amazon.ca.”

Choose lubricated condoms or add lubrication to make the experience more comfortable and pleasurable for both parties. For comfort, pick a lubricant that is water-based, unscented, and isn’t “warming” or “cooling.”

A guide to “Not right now.”

Faith in waiting
“Growing up in a relatively conservative Muslim family, from a very young age I was told not to have a girlfriend. As I grew older and began to critically analyze the people around me, I came to understand how I’d much rather remain celibate until the right person came along.”
—Dan K., Mount Royal University in Calgary, Alberta

Planning ahead
“I have chosen to remain a virgin until I meet the right person. It is a choice that I feel will keep me healthy, and I want to make sure that I am able to finish my degrees with the plans that I have made.”
—Cecilia M., Lakehead University in Thunder Bay, Ontario

What it is & how it works  Here, we’re using “not right now” to mean “no vaginal sex.” You can still be sexual in other ways—but be mindful that those other ways might introduce the risk of STIs.

You can always say “no” or “not right now”—for any reason. If you are feeling apprehensive or intimidated, this may not be the right time or partner.

Make conversation, not assumptions Regardless of your partner’s experience, culture, and viewpoints, you still need to talk about birth control, sexuality, boundaries, or other topics. Dr. K.: “Conversations, not assumptions, are key to healthy relationships.”

A guide to the IUD.

No more pills
 “I have an IUD because I don’t like the idea of having to take a pill every day. I am usually good at remembering to take it but you never know. Missing a pill increases my chances of getting pregnant. I don’t feel the IUD, it lasts for five years, and it costs less than birth control pills.”
—Alannah P., Memorial University of Newfoundland in St. John’s

What it is & how it works  This small, T-shaped piece of plastic sits in your uterus to limit the way sperm can move and prevent them from fertilizing an egg. Sounds odd, but it works like a charm.

Insertion is okay Dr. K.: “Lots of people hear stories about IUD insertion being scary. Everybody’s experience is different. The scariness will go away, but your birth control stays in place. Most patients that I place the IUD in say, ‘Oh, that wasn’t nearly as bad as I thought!’”

Your copper IUD options:

• Nova-T and Flexi-T: last for up to five years and do not contain hormones. Some women may experience increased blood flow or cramping while using this type of IUD.

Your hormonal IUD options:

• Mirena and Jaydess last for three to five years. They contain hormones. These IUDs can make your periods much lighter or stop completely.

Long acting and reversible contraception (LARC)
LARC methods are very low maintenance and can provide protection from pregnancy for years.

Also use condoms for protection from STIs.

A guide to The Ring.

Birth control talk still shocks
“I discuss my birth control options openly with people. Whenever I tell anyone that I’m on the vaginal ring, I receive a shocked look. I don’t blame them; it’s not a popular option. Most people only know about the Pill. Then they say, ‘Wait, you mean, you stick it up there?’”
—Rebecca J., Brock University, St. Catharines, Ontario

What it is & how it works  The NuvaRing is a small, flexible ring that is inserted into the vagina. It contains hormones that stop ovaries from releasing eggs. It works in a similar way to the Pill, but is much lower maintenance.

Don’t knock it till you try it Dr. K.: “All methods work for some women and not others. In a study of satisfied Pill users randomly assigned to the Patch or the Ring, 71 percent of women in the Ring group planned to continue using it after the study was completed.”

Three weeks in, one week out The Ring stays in place for three weeks. You take it out for the fourth week, which is usually when you get your period. After the fourth week you put a new ring in and start over.

Insertion diversion If you’re not okay with putting your fingers inside yourself, the Ring probably isn’t for you. It’s a lot like putting in a tampon: If you can do that, you’re good to go.

Also use condoms for protection from STIs.

A guide to the Pill.

“I travelled home for a holiday weekend when I realized I forgot my birth control at school. It was past my doctor’s office hours to get a refill prescription, so I waited eight hours in the emergency room. The doctors found me sleeping in the waiting room with drool on my shirt. They shook their head, asked me what I was on, and gave me this advice: ‘Next time, keep a pack at home.’”
—Name withheld, University of Ontario Institute of Technology in Oshawa

“I’d been with a guy for many months and he finally stayed over one night. The next morning I woke up and took my pill, and he thought I was taking the ‘morning after pill.’ I informed him, ‘Just because I am on the Pill doesn’t mean I’m safe from your STDs,’ so I continued to make him use a condom.”
—Name and university withheld

What it is & how it works  The Pill is taken once a day, at the same time every day. The Pill releases hormones that keep ovaries from releasing eggs. The hormones also thicken cervical mucus, which helps to block sperm from getting to the egg in the first place. 

Period drama  The Pill comes in 21-day or 28-day packs. Some types give you a regular period every month. Others let you have your period more rarely.

Keep emergency contraception in your cabinet—in case you forget your pill and then have sex without a condom or other barrier method.

Also use condoms for protection from STIs.

Download an app to help you remember to take your pill.

A guide to emergency contraception.

Learning the hard way (pun intended)
“While having sex, all I heard was ‘uh-oh.’ The condom broke, and I only started birth control a week before. Horrified, I went to the drug store to get Plan B. I didn’t even know what to look for! I was so embarrassed.”
—Name withheld, Memorial University of Newfoundland in St. John’s

What it is & how it works Emergency contraception (EC) pills, such as Plan B One-Step, stop a pregnancy before it starts. This means they are not the same as the abortion pill.

Copper IUDs, such as Flexi-T or Nova-T, are the most effective EC. Have a provider insert it within five days of a misstep and lower your chance of pregnancy by 99.9 percent.

Buy emergency contraception in advance Dr. K.: “A common theme in students’ stories is that everyone had to rush out to get emergency contraception in the morning. There’s no reason not to just buy it and stick it in your cabinet. In a stressful time, things would have been easier if these students had it on hand.”

Over-the-counter EC pills Plan B, NorLevo, Next Choice, and Option 2 are available without a prescription in most provinces. However, Plan B is sold behind the counter in Saskatchewan, and in Quebec, you need a prescription, which can be provided by the pharmacist. Check with your province for details on accessing emergency contraception.

A guide to withdrawal.

Back-up plan
“After having a condom break, I started taking the Pill, as it’s usually more effective. But I know it’s not one hundred percent effective, and so my partner and I also use the withdrawal method.”
—Name withheld, University of Saskatchewan in Saskatoon

Out of condoms
“I’m married. We used the pull-out method because we ran out of condoms on a Saturday morning and are not quite ready for kids.”
—Nicole L., University of Windsor in Ontario

What it is & how it works  The man pulls out before he ejaculates. The key thing to remember is this: It has to be done right—every single time—for withdrawal to be effective. And in the heat of the moment, it can be difficult to time it right.

Higher risk of pregnancy Dr. K.: “Withdrawal, the diaphragm, and the sponge are less effective than some other methods, so as primary pregnancy prevention they’re not acceptable to many couples. Everyone is different, though, and effectiveness isn’t always the number-one concern. It’s important to have a good understanding of the risks and benefits.”

A guide to the sponge.

Advance planning
“We maintained a long-distance relationship, and I didn’t want to use the Pill daily. I boarded the plane with the Sponge in place. My boyfriend met me at the airport. We had a luxurious meal at a Greek café, a few glasses of wine, went back to his apartment, joyously threw our clothes off, and celebrated our union. The disadvantage: My boyfriend reports the foam masks my natural aroma and taste. Also, wear a panty liner so it doesn’t mark your panties.”
—Solange S., Saint Mary’s University in Halifax, Nova Scotia

What it is & how it works  The Sponge is a small round piece of white plastic foam, which you insert into your vagina before you have sex. It blocks your cervix to keep sperm from getting into your uterus, and continuously releases spermicide. Think of it like a bouncer at the nightclub door to your uterus.

No foreplay interruptus  Here’s the handy thing about the Sponge—you can insert it up to 24 hours before you get busy. So there’s no need to fumble in the dark right before the big moment. But it does take a bit of practice getting it in.

Higher risk of pregnancy Dr. K.: “The Sponge is less effective than some other methods. It’s great if you combine a sponge with a condom, but it’s very difficult to rely on this method as your primary method.”

Also use condoms for protection from STIs.

A guide to the diaphragm.

Puts the woman in control
“My partner says she likes the diaphragm because there’s no stopping and putting on the condom and no hormones that can mess up her cycle. She says that it is easy to put in, easy to remove and clean up, and this way she is 100 percent certain that contraception is used and used correctly. She had an ex that routinely lied to her and was attempting to get her pregnant to force a marriage. No babies so far, and it’s a lot cheaper than buying condoms all the time.”
—Spencer M., College of Southern Idaho, Twin Falls

How it works  A diaphragm is a shallow, dome-shaped cup made of latex or silicone. It is inserted into the vagina, so it covers the cervix and keeps sperm out of the uterus.

Use it with a spermicide—or the diaphragm will not work effectively.

Higher risk of pregnancy “[Barrier methods] are not as effective as the other methods, so there is a greater percentage of people who get pregnant when using these methods,” says Dr. Feuerstein.

No foreplay interruptus Dr. K.: “Diaphragms are another method that allow women to take control of their birth control, since it can be inserted before sexual activity has begun.”

Also use condoms for protection from STIs.

A guide to The Patch.

Fits my schedule
“I prefer to use the Patch simply because I know it’s effective, and I barely have to think about it. My schedule was never the same every day so there wasn’t really a time of day that would consistently work for taking the Pill. With the Patch, you stick it on and you’re good to go. I’ve been on the Patch for over a year now, and I can proudly say I haven’t missed a patch or period while being on it. It fits my life quite well.”
—Chelsea S., University of Manitoba in Winnipeg

What it is & how it works The Patch is a thin, beige piece of plastic that looks like a square Band-Aid. You stick the Patch on your skin and it gives off hormones that prevent your ovaries from releasing eggs. The hormones also thicken your cervical mucus, which helps to block sperm from getting to the egg in the first place. Its medical name is Ortho Evra.

Less effective against pregnancy  Dr. K.: “It’s great that this patient found a method that works for her, and addresses her priority of regular bleeding.  It’s important to keep in mind that the typical failure rate is about 1 in 10, so adding barrier protection (i.e., a condom) is a good idea as well.”

Good for busy schedules “It’s a good option for people who can’t remember to take the Pill every day or their schedule varies a little bit. The Patch makes it easier to keep your hormone levels balanced and not have to worry about fluctuations due to taking your pill at the wrong time,” says Dr. Feuerstein.

Also use condoms for protection from STIs.