Using a contraceptive not only prevents unplanned pregnancy, but it also promotes healthy sexuality. Some types of contraception can even lessen hormonal imbalances, regulate menstrual cycles, or relieve the discomfort caused by your cycle. Discover the various contraceptive methods and learn more about each of their features so you can make an informed choice that's right for your needs.

What exactly is contraception?

Contraception is primarily used to avoid unwanted pregnancy, but it can do a lot more than just that. For instance, it can enable you to choose the right time to have a child—or not to have one at all—depending on your desires, your health, and your life stage. Some methods can even relieve problems linked to menstruation, like painful periods, acne or irregular bleeding.

Contraception vs protection: an important distinction.

While birth control can help prevent unplanned pregnancy or regulate some of the side effects of your menstrual cycle, it doesn’t protect against sexually transmitted infections (STIs). For that, you need to use both a hormonal birth control and a condom. Condoms are the only form of birth control that prevent unwanted pregnancy while protecting against STIs like HIV, chlamydia, and syphilis.

What are the various types of contraception?

There are variety of contraceptives to meet different needs. Here’s an overview of the various methods and their main features.

Hormonal methods

Hormonal contraceptives work by using hormones to alter the natural functioning of the menstrual cycle and prevent ovulation​ (the release of an egg), thicken cervical mucus (to block the passage of sperm), and sometimes change the lining of the uterus to prevent implantation (the step during which a fertilized egg attaches itself to the wall of the uterus to begin development).

What types of hormones do hormonal contraceptives contain?

• Estrogen: a primary hormone naturally produced by the body, mainly in women, during the first part of the menstrual cycle, right before ovulation. It develops and prepares the endometrium for potential pregnancy.
• Progesterone: another hormone naturally produced by the body during the second part of the cycle (after ovulation). This hormone prevents ovulation if fertilization occurs or stabilizes and protects the endometrium if pregnancy occurs.

What are the various types of hormonal contraception?

The contraceptive pill

The contraceptive pill is widely used for preventing pregnancy. It contains synthetic hormones, usually a mixture of estrogen and progestin, which work together to block ovulation, the release of an egg from the ovaries. Contraceptive pills are taken orally, at the same time every day, usually for 21 days followed by a break or the use of placebo pills. It can also be taken continuously to prevent menstruation. When used properly, “the pill” is very effective, but it does require discipline to avoid the possibility that you forget to take it or take it later than 12 hours after the usual time.

The mini pill (progestin-only)

The mini pill, also called the progestin-only pill, is an oral hormonal contraceptive that contains progesterone only (and no estrogen, unlike the usual pill). This type of pill is taken daily without a break and is often chosen by women who don’t want to take estrogen. The schedule for taking the mini pill is stricter than with a regular birth control pill because progesterone acts for a shorter period on its own than when combined with estrogen.

The subcutaneous implant

The contraceptive implant is a small, flexible rod inserted under the skin of the arm by a healthcare professional. The rod continuously releases a hormone called progestin, providing effective protection for three years, without having to worry about taking it every day. This method can sometimes cause changes in your period, but it remains a convenient and reliable option for many women.

Contraceptive patches

The contraceptive patch is a small strip that sticks to your skin—usually on the arm, abdomen, buttocks, or back—and continuously releases hormones (estrogen and progestin) which enter the bloodstream through the skin. The patch must be changed every week for three weeks, followed by a week without the patch, which corresponds to the time frame when a woman would have her period. It’s an effective method that eliminates the need to take a pill every day.

The vaginal ring

The vaginal ring is a hormonal contraceptive that comes in the form of a small, flexible, transparent or light blue ring that’s inserted into the vagina. This method works much like the combined pill (estrogen-progestin), but the hormones are released continuously. The ring is designed to stay in place for a period of 3 weeks before being changed, and it can even be worn during sexual intercourse.

Injectable contraception

As the name implies, injectable contraception involves the injection of a long-acting type of progestin, usually every 3 months. This method is highly effective and discreet, especially for women who don’t want to use or can’t use estrogen.

The IUD with hormones

A T-shaped device, also called a hormonal IUD (intrauterine device), is a long-term contraceptive that works by continuously releasing progestin (levonorgestrel) directly into the uterus. It must be inserted by a healthcare professional, usually during menstruation, when the cervix is most dilated. Once in place, it can be effective for 3 to 8 years depending on the model.

There’s also a hormone-free (copper) IUD. The copper in the IUD creates a toxic environment for sperm, reducing their mobility. It can also provoke an inflammatory reaction in the uterus, preventing fertilization and implantation of the ovum.

Are hormonal contraceptive methods dangerous?

Hormonal contraceptives are generally safe, but as with any medication, they can have potential side effects, including mood fluctuations, headaches, nausea, fatigue, decreased libido, etc. They can also have positive effects like regulating your menstrual cycle and its symptoms. That’s why it’s so important to have a complete medical evaluation by a healthcare professional before you start hormonal contraception.

Which contraceptives stop the period?

Some women turn to hormonal contraceptives to temporarily halt their periods.

• Contraceptive pill taken continuously (without interruption).
• IUD with hormones.
• Contraceptive implants (no periods or very rare periods).
• Contraceptive injection.
• The vaginal ring (if no time is left between the replacement of each ring).
• Contraceptive patches (if no time is left between replacement).

Does hormonal contraception cause weight gain?

Weight gain depends on the woman, the type of contraception, and individual sensitivity to hormones. It’s not a given. Several mechanisms are possible:

• Water retention: estrogen can cause temporary water retention, especially at first.
• Increased appetite: certain hormones (progestins) can stimulate hunger.
• Changes in fat distribution: rare, but it can happen depending on method.
• Decreased physical activity or changes in habits coinciding with the taking of contraception.

Are there any non-hormonal methods of contraception?

Mechanical (or barrier) methods

Mechanical (or barrier) contraceptives are physical devices that prevent sperm and egg from meeting. Unlike hormonal methods, these methods don’t interfere with your menstrual cycle, and they don’t alter ovulation.

The male condom

The male condom is a latex or polyurethane sheath placed over the erect penis to block sperm and protect against STIs.

The female condom

The female condom is a flexible sheath inserted into the vagina to retain sperm and also protect against STIs.

The diaphragm

The diaphragm is a silicone cup inserted into the vagina to block the cervix. To be effective, it must be used in combination with spermicide, a contraceptive that contains a chemical capable of killing or immobilizing sperm, thus preventing them from reaching the ovum and fertilizing it.

The cervical cap

Smaller than the diaphragm, the cervical cap covers only the cervix and must also be used in combination with a spermicide.

The contraceptive sponge

The sponge is a small synthetic foam cup that is placed into the vagina, just in front of the cervix. It acts as a barrier to the cervix and contains a spermicide that neutralizes or immobilizes the sperm. It must be inserted before each sexual act, up to 24 hours before intercourse, and must be left in place for at least 6 hours after intercourse.

Spermicide

Spermicide comes in several forms (gel, cream, foam, vaginal suppository, vaginal film) and should be inserted into the vagina as close to the cervix as possible, before each sexual act. However, its effectiveness is very low when used alone. So, it’s best to combine it with another method like the diaphragm, for example.

Natural methods of contraception

Natural methods of contraception rely on observing your natural cycles and controlling the timing of sexual intercourse to avoid pregnancy. They don’t involve any medication, medical devices, or hormones, but they do require discipline, consistency, and a complete understanding of your menstrual cycle. Note: these methods don’t protect against STIs. Natural methods include:

Withdrawal

The partner pulls out before ejaculation. However, it should be noted that sperm are also present in the pre-ejaculatory fluid (especially if ejaculation has occurred previously).

Sympto-thermal method

The sympto-thermal method is a natural method of birth control that relies on noticing bodily signs to identify the fertile days during the menstrual cycle. This method is used to prevent or target pregnancy. The ‘window’ of fertility is evaluated based on the position of the cervix, the texture of vaginal discharge, and the body temperature upon waking. This method can be risky, particularly if your menstrual cycle is irregular or if other factors interfere with the results (stress, lack of sleep, illness).

Calendar method

The calendar method (or Ogino-Knaus method) is a natural form of contraception that relies on avoiding sexual intercourse during your fertile period, based solely on the average length of past menstrual cycles. This method is not very effective if your menstrual cycle is irregular.

What is the most effective method of contraception?

The effectiveness of a contraceptive method depends not only on the method itself, but also on how carefully it is used. This comparison shows the effectiveness rate if the technique is used perfectly (perfect use) and the effectiveness rate of use in real-life (typical) conditions where slip-ups may occur.

Contraceptive method	Perfect use efficiency (%)	Typical use efficiency (%)	Notes
Hormonal IUD (Intrauterine Device)	99.8%	99.8%	Very reliable, lasts 3-8 years
Copper IUD	99.4%	99.2%	Hormone-free, lasts 5-10 years
Contraceptive implant	99.95%	99.95%	Hormonal, lasts 3 years
Contraceptive pill	99.7%	91%	Daily use, requires rigor
Vaginal ring	99.7%	91%	Hormonal, changed every 3 weeks
Contraceptive patch	99.7%	91%	Hormonal, changed every week
Injectable contraception	99.8%	94%	Hormonal, injection every 1 to 3 months
Male condom	98%	85%	Protects against STIs
Female condom	95%	79%	Less used, also protects against STIs
Diaphragm (with spermicide)	94%	88%	Must be used during every sex act
Cervical cap (with spermicide)	91%	84%	Less effective in women who have given birth
Contraceptive sponge	91%	76%	Less effective in women who have given birth
Spermicide only	82%	71%	Not very effective alone, often complementary
Natural methods (withdrawal, temperature, sympto-thermal method, calendar)	96% (with extreme rigor)	76%	High variability, very user dependent

 

In case of emergency: the morning-after pill (emergency oral contraception)

The morning-after pill (or EOC for Emergency Oral Contraception) can be used in an emergency when unsafe sex has occurred (missed pill, broken condom, unprotected sex). It does not replace the usual methods of contraception and should be taken as soon as possible after unsafe sex for maximum effectiveness. If necessary, your pharmacist can prescribe the morning-after pill following a consultation.

How does the morning-after pill work?

• The morning-after pill delays or prevents ovulation if it hasn’t yet occurred.
• If ovulation has occurred, it’s not effective.
• It doesn’t prevent implantation if an embryo has already formed.
• It doesn’t protect against STIs.
• It may cause temporary side effects like headache, nausea, fatigue, bleeding outside of your period, tender breasts or abdominal pain.
• Your period usually occurs within 3 weeks of taking the morning-after pill.
• If you’re more than 7 days late, it’s recommended that you take a pregnancy test.

Which contraception should I choose?

The following questions can help you make the right choice of contraceptive:

• Do I feel able to use the chosen method rigorously, as recommended, to ensure maximum effectiveness?
• Do I want a method that’s easily reversible or longer lasting?
• What’s my personal situation (in a relationship, single, etc.)?
• How old am I? (Some methods of contraception are better for women over 35).
• Should I choose a method that also protects me against STIs?
• If any, what are the side effects?
• Do I want contraception with or without hormones?
• Do I want to continue having my period?
• Am I breastfeeding or have I recently given birth?

If you’re thinking of starting a contraceptive or changing your method, speak to your pharmacist for sound advice on choosing one that meets all your needs.

Your Jean Coutu affiliated pharmacist can:

• Prescribe* a hormonal method of contraception (the pill, patch, vaginal ring, or injection) for an initial period of 6 months. Under certain conditions, the prescription may be extended for another 6 months.
• Prescribe the morning-after pill (emergency oral contraception) without a doctor's prescription.
• Advise you and help you choose the best method depending on your state of health.
• Help you manage side effects.