Birth Control
Part of a healthy and enjoyable sex life is the freedom to choose if and when to become pregnant. If you’re sexually active, it’s important to take steps to avoid unintended pregnancy by using effective birth control. There are various birth control options, and it’s important to learn more and discuss them with your health care provider or a nurse at a sexual health clinic. This way, you can choose the birth control method that works best for your body, your relationships, and your lifestyle.
Know your options
There are hormonal and non-hormonal contraceptives, so you’ll want to consider things like effectiveness, potential side-effects, and frequency of use when selecting a method of birth control. Birth control methods are less effective if used inconsistently or incorrectly, so it’s important to consider your ability to stick to a regimen of use.
The most effective methods of birth control are sterilization and intrauterine devices (IUDs). Sterilization (vasectomy or tubal ligation) is usually permanent, but IUDs are reversible and highly effective once correctly in place.
Hormone based methods including “the pill”, patches, vaginal rings, and “the shot” (injections) are very effective when used correctly. Physical barriers such as condoms, diaphragms and birth control sponges, and natural methods are less effective. The least effective birth control methods are spermicides and withdrawal by the male before ejaculation.
Remember that most methods of birth control do not protect against STIs. Therefore, it’s important to use a condom to protect against STIs.
Permanent methods of birth control
Sterilization (vasectomy for men and tubal ligation for women) is a permanent, safe, and highly effective form of birth control for people who are certain that pregnancy is not something they want. However, sterilization can be permanent, so it’s important to discuss it with your health care provider to ensure it’s the right option for you.
Emergency birth control
Commonly referred to as “the morning-after pill”, it can be used up to 72 hours after having sex without a condom or in the event of a contraception failure, such as missed birth control pills or a condom breaking. Emergency contraception is NOT a regular method of birth control.
Women may need to use emergency contraception after having sex if:
- The condom broke
- No birth control was used
- Two or more birth control pills were missed consecutively
- Late for shot or diaphragm slipped
- Sex was forced
Available over-the-counter in Canada, emergency contraception can reduce the risk of unintended pregnancy by approximately 75%, and is most effective the sooner it’s taken after having sex without using any form of birth control. Common side effects are nausea and vomiting, irregular vaginal bleeding, fatigue, headache, dizziness, and breast tenderness.
Emergency contraception will NOT affect an established pregnancy. If you think you may be pregnant, see your health care provider.
You’re in this together
No matter what type of birth control you choose, you and your sexual partner have made the decision to engage in sex together, so it’s important you discuss birth control openly and honestly to ensure you both feel comfortable, safe, and aligned in your choices.
The following resources may provide additional information about birth control:
The facts
Fertility – the ability to become pregnant. If you and your partner are trying to get pregnant, understanding fertility can be an important step to increasing your likelihood of getting pregnant.
Infertility – the inability to become pregnant can be due to many factors. In some cases, medical treatments may help. A good place to start is having a conversation with your health care provider
Understanding these factors can help you make informed choices about when to start a family, how to improve your chances of getting pregnant and when to seek help with fertility.
When you’re trying to become pregnant, having sex without using any form of birth control 2 or 3 times a week during the fertile period in the menstrual cycle is key. For healthy couples wanting to conceive, understanding how this fertile period works is more important than constantly having sex.
Figuring out when to have sex can be important when trying to become pregnant. A person with a regular 28-day cycle begins ovulating 14 days before their next period. Many people believe that it’s best to have sex once ovulation begins, but evidence shows that starting to have sex at this point may be too late. Health care providers recommend having sex, every other day, starting 3 days before ovulation begins.
For people who do not have a 28-day cycle, there are a few things you can do to determine when you’re ovulating:
- Check for a rise in basal body temperature (your resting temperature first thing in the morning, before rising, moving or eating). This could be a sign that ovulation has occurred. After a few months of daily checks, a pattern may emerge.
- Use an ovulation predictor kit. This may be more expensive than tracking your temperature, but it may provide a more accurate indication of when your ovary is about to release an egg. Kits can be purchased at a pharmacy.
- Check for cervical mucus. This is another sign of imminent ovulation. When a person is about to ovulate, it produces larger amounts of thin, clear cervical mucus. Its presence marks a potential fertile period.
Lifestyle
Lifestyle choices may impact a person’s fertility. Following these tips for better health – before you get pregnant and throughout your pregnancy – may increase your chances of a successful pregnancy:
- follow a balanced diet
- maintain a healthy weight
- exercise regularly
- manage your stress
- avoid drinking alcohol, smoking and other drugs (such as marijuana, opioids and homeopathic remedies)
Age
People become less fertile as they age. By age 40, people have a 5% chance of getting pregnant with their own eggs. The risk of miscarriage also rises with age. This is thought to be due to an increase in chromosomal abnormalities in the embryo.
Smoking
Smoking reduces the number and mobility of sperm and may also affect the reproductive system increasing the risk of miscarriage. Smoking may work against the benefits of fertility treatments. Smoking can also contribute to premature or low birth weight babies.
If you need help quitting, reach out.
Alcohol
When it comes to drinking, there is no safe level of alcohol during conception or pregnancy. Drinking alcohol:
- may make it harder to become pregnant
- may increase the risk of miscarriage
- increases the risk of birth defects
Weight
Weight can impact fertility if:
- you are inactive and overweight
- the person who is pregnant is underweight due to an eating disorder or a very low-calorie diet
Being overweight can result in lower sperm counts. People who are pregnant can also have medical problems if they are overweight.
Moderate exercise of about an hour a day will help you maintain a healthy weight. It will also improve your overall fitness.
If you need help to achieve a healthy weight before trying to get pregnant, talk to your health care provider.
Excessive exercise
Research shows that female athletes whose sports are associated with having a low body weight will have a harder time getting pregnant. This includes long distance runners and gymnasts, for example. Some of these women may experience ovulation and menstrual disruptions because of their extreme training.
Sexually transmitted infections (STIs)
Some STIs can cause infertility. Chlamydia, for example, can harm the fallopian tubes and cause swelling and tenderness of the scrotum. Before trying to get pregnant, consider getting tested for STIs. Talk to your health care provider for more information.
Common causes of infertility in women
- ovulation issues that prevent an egg from being released
- poor egg quality, including eggs that are damaged
- polycystic Ovarian Syndrome (follicles in ovaries that don’t develop into eggs)
- blocked fallopian tubes that prevent sperm from reaching the egg
- endometriosis – when cells from the lining of the uterus grow in other areas of the body, resulting in inflammation and bleeding that may lead to scarring of the fallopian tubes or interference with implantation
- problems having an erection or ejaculation
- low sperm count (which may be due to blockages that prevent sperm from being ejaculated or increased temperature in the testes that affects the number of sperm produced)
- irregular sperm shape or movement
Common causes of infertility in men
- Problems having an erection or ejaculation
- Low sperm count (which may be due to blockages that prevent sperm from being ejaculated or increased temperature in the testes that affects the number of sperm produced)
- Irregular sperm shape or movement
Fertility treatments
Fertility treatments may help people who have experienced infertility become pregnant. You can learn about the options available, for example, medicines, surgeries or assisted conception, through discussions with your health care provider.
Seeking help
Talk to your health care provider if you have had frequent sex without any form of birth control and haven’t been able to get pregnant.
You may also wish to consult a health care provider if you are looking to become pregnant and:
- are 35 or under and have tried getting pregnant for over a year
- are over 35 and have tried getting pregnant for more than 6 months
- do not have a regular period and have tried to become pregnant for 6 months
- if you are in a same-sex relationship
Treatment options
There are 3 categories of medical treatment options, depending on what is causing the infertility:
- medications
- surgery
- assisted conception
The option that’s right for you will depend on age, preference, and medical history. As always, you should discuss these matters with your health care provider.
Additional support
Trying to get pregnant can be a stressful time. You may feel that your friends and family are not able to offer you enough support. If you need more support, talk to your health care provider about counseling or joining a support group in your area.
For additional information on pre-pregnancy (the time before and between pregnancies), visit OMama.
More about abortion services
An abortion is a safe medical procedure that ends a pregnancy. Abortion services are legal in Canada and available to anyone over 12 years old. There are two types of abortion methods:
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- Medical abortion involves the use of pills to end a pregnancy and can be done up to 10 weeks after your last menstrual period.
- Surgical abortion ends a pregnancy by surgically removing pregnancy tissue from the uterus. It can be done for any pregnancy starting at six weeks after the first day of your last menstrual period, through to 25 weeks.
Both methods are covered by OHIP in Ontario.
References
Sexual Health Ontario. (n.d.). Reproductive health. Retrieved from https://www.sexualhealthontario.ca/en/reproductive-health
