People all over the world get periods. People all over the world have sex. People all over the world should, theoretically, have the right to access birth control.
Reproductive rights are human rights, but 214 million women of reproductive age worldwide still don’t have adequate access to modern contraceptives.
For many people, birth control is inaccessible because of cost or a lack of information. Everyone should have the right to make informed decisions about their reproductive health, so continue reading for a thorough breakdown of all the modern contraceptive methods out there (we guarantee there’s some you’ve never even thought of). If you’re looking for the fast facts, scroll to the very bottom to explore a handy infographic that breaks down the basics.
Hormonal Birth Control (HBC)*
Combined Hormones: These methods use the hormones estrogen and progestin to prevent pregnancy
“The Pill”
The pill remains by far the most widely used method of hormonal birth control to date. The oral contraceptive is taken daily, and prevents pregnancy by stopping ovulation each month, which prevents a fertilizable egg from being released. Users take a small estrogen-progestin pill every day at the same time for three weeks, and on the fourth week they take sugar pills and get their period. When used perfectly, it has an effectiveness rate of about 99%. Many people are first offered the pill when they begin using birth control but it isn’t the only option out there, even if some doctors act like it is. If you feel that another method may work better for you, don’t hesitate to bring it up with your doctor.
The Patch
This 1¾ inch square patch can be stuck onto the butt, stomach, arm, etc. and slowly releases estrogen and progestin through the skin and into the bloodstream. It too prevents pregnancy by stopping ovulation each month, which prevents a fertilizable egg from being released. The patch is latex-free and will stay on even if you’re swimming or exercising. Users wear the patch for three weeks, putting on a new patch at the beginning of every week. It must be moved every week to a new location on the body, or a different spot in the same location. On the fourth week, the patch is removed and the user gets their period. When used perfectly, it has an effectiveness rate of about 99%.
The Vaginal Ring
This little flexible ring is inserted into the vagina and slowly releases low doses of estrogen and progestin. Again, it prevents pregnancy by stopping ovulation each month, which prevents a fertilizable egg from being released. The ring is inserted once a month and left in the vagina for three weeks. On the fourth week, it’s removed so the user gets their period. After that, a new ring is inserted again. Most people don’t feel the ring at all once it’s inserted. When used perfectly, it has an effectiveness rate of about 99%.
Progestin-Only: These methods use only the hormone progestin to prevent pregnancy
The Progestin-Only Pill
This is a version of “the pill” that only contains the hormone progestin. These pills come in four-week packs, and all 28 pills contain hormones, unlike the combination pill which has a week of sugar pills. Progestin-only pills must be taken within the same three-hour time period each day to be fully effective. Users may get their period in the fourth week of pills, experience spotting throughout the month, or get no period at all. Progestin-only pills prevent pregnancy by stopping ovulation. When used perfectly, they have an effectiveness rate of about 99%.
The Shot
The shot is an injection of the progestin hormone given by a doctor every three months (12 weeks). It can be injected into the arm or the butt and prevents the ovaries from ovulating, or releasing a fertilizable egg every month. After about a year of use, around half of users stop getting their periods when on the shot. When used perfectly, it has an effectiveness rate of about 99.7%.
The Implant
The implant is a matchstick-sized rod that is inserted by a doctor under the skin of the upper arm and slowly releases progestin. It prevents pregnancy by stopping the ovaries from ovulating, or releasing a fertilizable egg every month. The implant can be left in for up to four years, or removed at any time by a doctor. When used perfectly, it has an effectiveness rate of about 99%.
Intrauterine Devices (IUD): These methods can be both hormonal or nonhormonal
The Copper IUD
This is a small, T-shaped plastic device wrapped in copper wire that is inserted into the uterus by a doctor. Attached are two strings that hang outside the cervix, but are not long enough to hang outside the vagina. It is nonhormonal and prevents pregnancy by changing the chemistry of the uterus so that it is hard for sperm and eggs to survive and meet. It can be left in for three, five or 10 years depending on the model, but can be removed at any time by a doctor. The copper IUD may not be recommended for people who experience heavy periods or intense cramping, as it may make these worse. When used perfectly, it has an effectiveness rate of about 99%.
The Hormonal IUD
Like the copper IUD above, this too is a small, T-shaped plastic device, however instead of copper wire it contains a band of the hormone progestin. It is inserted into the uterus by a doctor, and attached are two strings that hang outside the cervix, but are not long enough to hang outside the vagina. The hormonal IUD prevents pregnancy by changing the chemistry of the uterus so that it is hard for sperm and eggs to survive and meet, and may stop ovulation in some users. It can be left in for three or five years depending on the model, but can be removed at any time by a doctor. When used perfectly, it has an effectiveness rate of about 99.8%.
*Note: Some forms of hormonal birth control may not be recommended for people who smoke. Make sure to talk to your doctor.
Nonhormonal Birth Control (Barrier Methods)
External Condoms
The external condom is a thin rubber covering placed over an erect penis. It prevents pregnancy by stopping sperm from reaching an egg and also protects against sexually transmitted infections (STIs). When used perfectly, it has an effectiveness rate of about 97%.
Internal Condoms
The internal condom is a loose rubber pouch that that sits inside and lines the vagina during sex. This condom can lower the risk of transmitting STIs, but does not completely protect against them. It too prevents pregnancy by stopping sperm from reaching an egg. When used perfectly, it has an effectiveness rate of about 95%.
The Diaphragm
The diaphragm is a spermicide- or barrier gel-filled silicone dome that is placed inside the vagina over the cervix. Spermicide is a chemical that kills sperm on contact, while barrier gel traps sperm and makes it difficult for them to move. It prevents pregnancy by stopping the sperm from meeting an egg and killing the sperm. Most diaphragms need to be fitted to the size of your cervix (exception: Caya brand). A diaphragm filled with spermicide or barrier gel can be inserted before you plan on having sex, but if it’s been in the vagina for longer than six hours prior to sex, more spermicide/gel must be added. Users should leave the diaphragm in place for six hours after sex, but not leave it in for longer than 30 hours total. A single diaphragm can be used for up to two years. When used perfectly, a fitted diaphragm with spermicide/gel has an effectiveness rate of about 96% while a non-fitted diaphragm with spermicide/gel has an effectiveness rate of about 92%.
The Cervical Cap
The cervical cap is extremely similar to the diaphragm. The shape is slightly different, but it is still a spermicide- or barrier gel-filled silicone barrier that is placed inside the vagina over the cervix. The cap comes in different sizes depending on if you’ve gone through childbirth or not. Users should leave the cap in place for six hours after sex, but not leave it in for longer than 48 hours total. It prevents pregnancy by stopping the sperm from meeting an egg and killing the sperm. A cap filled with spermicide or barrier gel can be inserted before you plan on having sex. A single cap can be used for up to one year. When used perfectly, it has an effectiveness rate of about 86% for people who’ve never given birth and 71% for people who have given birth.
Sterilization
Sterilization is a surgical procedure meant for individuals who are certain they do not want children or any more children than they already have. For people with ovaries, tubal ligation is performed which closes the fallopian tubes, stopping sperm from reaching an egg. It is typically irreversible and does not affect the menstrual cycle. For people with testicles, the vas deferens tube, which carries sperm from the testes to the urethra, is cut and sealed, preventing sperm from entering the semen. It occasionally can be reversed. Both methods, if done perfectly, have an effectiveness rate of about 99.5%.
Spermicide
Foam and Gel
These forms of spermicide prevent pregnancy by blocking the cervix and killing sperm on contact, and must be inserted into the vagina before intercourse. They begin working immediately, but are only effective for 30 minutes, therefore they must typically be reapplied. These methods, if used alone and perfectly, have an effectiveness rate of about 82%.
Vaginal Contraceptive Film
This spermicide comes in the form of clear plastic squares of film that, once placed inside the vagina, turn into a gel within 15 minutes. They too prevent pregnancy by blocking the cervix and killing sperm on contact, and must be inserted into the vagina before intercourse. The film is effective for up to three hours after insertion. When used perfectly, it has an effectiveness rate of about 94%.
The Sponge
This soft, polyurethane foam sponge contains spermicide and is placed inside the vagina. It prevents pregnancy by blocking the cervix and killing sperm on contact, and must be inserted into the vagina before intercourse. To activate it, rinse the sponge under water until suds appear, and then insert. Users should leave the sponge in place for six hours after sex, and the sponge protects you for up to 24 hours. It should not be left in for more than 30 hours total. When used perfectly, it has an effectiveness rate of about 90%.
Natural Birth Control Methods
Abstinence
Abstinence essentially means not having intercourse, but it can have different meanings for different people. If you’re not having intercourse, there is no chance of pregnancy.
Fertility Awareness Methods (FAM)
People who menstruate are only fertile on certain days of their cycle. One cycle begins on the first day of the period and ends on the day before the next period starts. At a certain point after menstruation, an egg matures in the ovaries and is released to be fertilized. The FAM method involves being aware of your most fertile days and either using protection on those days or avoiding intercourse altogether in those periods to prevent pregnancy. There are several different FAM methods: the Justisse method, Weschler’s FAM and the Standard Days method. When used perfectly, these methods have an effectiveness rate between 78-98%.
Emergency Contraception
Emergency Contraception Pill (ECP)
Also called the morning after pill, it can be used up to five days after unprotected vaginal sex. There are two kinds of ECPs: progestin-only, and progestin-estrogen. ECPs prevent pregnancy by preventing ovulation after sperm has entered the vagina, stopping a fertilizable egg from being released to meet the sperm. ECPs are more effective the sooner after unprotected intercourse they are taken. If taken within 24 hours of unprotected vaginal sex and used perfectly, progestin-only ECPs have an effectiveness rate around 95%. If taken within 24 hours of unprotected vaginal sex and used perfectly, progestin-estrogen ECPs have an effectiveness rate around 77%.
Abortion
Abortion is a safe medical procedure that terminates, or ends, a pregnancy. Abortion is fully legal in Canada. There are two types of abortion: surgical and medical, and the methods that are available to you depend on the gestational age of the pregnancy (time since the first day of your last period) and the location you go to for the procedure. Surgical abortions involve the widening of the cervix by either medication and/or medical equipment. Gentle suction and instruments are then used to remove the pregnancy tissue from the uterus through the cervix. It is a quick procedure lasting between 2-15 minutes that requires no cutting or stitching. Medical abortions use medication to stop a pregnancy from continuing to grow, and then expelling the pregnancy tissue through the cervix. A clinic provides an initial injection or pill to either stop the pregnancy’s growth or detach the pregnancy from the walls of the uterus. Take-home medication causes contractions of the uterus to expel the pregnancy tissue. The tissue usually expels within 24 hours of taking the at-home medication, but can take longer depending on the specific medication given. Anyone over the age of 12 in Canada can choose to have an abortion in a clinic or hospital without the permission of parents, partners or family doctors. Anyone can choose to have an abortion for any reason, and the procedure is completely confidential and relatively painless. For more information, click here.
How do you know which method is right for you? It all comes down to knowing your body, your needs, and your lifestyle. No birth control is perfect and they all have their own lists of side effects, so it is important to do research and talk to your doctor. You may need to try multiple types of birth control to find one that is right for you, so don’t be afraid to voice any concerns you may have to your doctor. The first priorities should always be your health, your happiness, and your comfort.