Birth Control

Wondering about which type of birth control might be right for you? There are lots of different types including abstinence (not having sex ), condoms, the pill, the patch, depo, the ring, or an IUD/IUS. Emergency contraception (or ECP) is another type that can be used after sex has happened. Check out the list below for more info on each type.

Since it takes sperm and an egg to create a pregnancy, birth control is both people’s responsibility. If you’re interested in doing the type of sex where pregnancy is possible and don’t want to deal with an unplanned pregnancy, here are some ways both people can get involved:

Get free condoms at teen clinics
Chip in for birth control (if there’s a cost)
Wear a condom
Use a hormonal method of birth control (e.g. pill/patch/needle/ring)
Share information with each other about birth control
Go to a teen clinic together to get birth control supplies (e.g. pills and condoms)
Friendly reminders if your partner is on the pill

Sharing the responsibility is not only fairer, but it also helps both people feel involved and important!

Different Types of Birth Control

There are many different types of birth control to choose from. Each one comes with possible benefits and possible disadvantages when compared to the other types. Check the drop-down boxes below for an overview of the most common types of birth control. If you want to learn more in-depth information we suggest visiting a Teen Clinic, your local community health centre or talking with a public health nurse.

The History of Birth Control

Before talking more about birth control, it is important to recognize its complicated and colonial past. Having the right to choose what type of birth control, if any, you would like to use is very important. We also know one of the impacts of colonization is that this right is sometimes ignored, particularly for Indigenous people, black people and other marginalized folks.

There are many historical and current examples of forced sterilization and the use of birth control such as depo and IUDs without consent on this land. Stories continue to come out of recent experiences of Indigenous people in Canada. The creation of modern hormonal birth control also included experimentation on Indigenous Puerto Rican women. Some of them died from these experiments. A lot of the early work with birth control was tied to the eugenics movement. The eugenics movement was a form of discrimination that suggested humanity could selectively breed itself to become ‘better’. Better, by the movement, was seen as white, straight, able bodied and able minded. It pushed for birth control or sterilization to be used on people that are racialized, poor, queer and/or disabled. We think birth control can be great and that everyone deserves access to it, but knowing our shared history is important too. Choosing if and when to create a pregnancy can be a tool of empowerment but it’s the right to choose and have access that is most important. Someone should have the ability to decide for themselves if they want to use birth control, create a pregnancy or have a child and we need to support this decision.

Hormonal Birth Control

Hormonal Birth control is used by someone with ovaries in their body. More commonly used types include the pill, patch, ring, and depo. This section is basically hormonal birth control 101. Think of it as a starting place for accurate information. If you or your partner are thinking about starting hormonal birth control, you may want to talk with a health care provider (like someone at a Teen Clinic) for more in depth info.

It’s really effective at preventing pregnancy, about 92-95% effective for a typical user and higher than 99% effective when used perfectly.
It’s made from synthetic hormones that someone takes to prevent ovulation from happening.
Some types can take 2-4 weeks to start working, so you may want to plan ahead.
Youth can get it free of charge or low-cost from teen clinics or you can get a prescription from a doctor.
Like any medication it can have side effects, if one type isn’t working for you go back to the clinic and ask to try another type. Birth control isn’t one size fits all, so it may take some trial and error to find one that’s a good fit for you.
Common side effects can be lighter periods or not getting a period, spotting (bleeding in between periods), more regular periods, clearing up acne, headaches, decrease in sex drive, nausea, breast tenderness and weight changes. Mood changes can happen too. If you start taking birth control, and starting feeling more anxious or depressed (especially if you didn’t before) then it’s a good idea to go back to the clinic.
Some types should not be used by people who are heavy smokers and are over 35 years old, people with migraines, and people with depression. Speak with your health care provider if you have concerns.
Hormonal Birth control does not protects against STIs/HIV, but can be used with condoms which do.

All hormonal birth control works by trying to stop any or all of these things from happening: ovulation, fertilization and/or implantation. Check out the Bodies section to get more details on how pregnancy happens.

1) The Pill

How it’s used: Take it every day, at the same time of day, for three weeks. The fourth week (whether you’re on a 21 or 28 pill pack) is when you’d typically get your period. At the end of the fourth week, you start a new pack of pills.

Other things to consider: Can be made less effective by some medications like antibiotics, some herbal supplements, and things that coat the stomach. It’s best to let the pharmacist know what else you may be taking.

2) The Patch

How it’s used: Stick one patch on a fleshy part of the body like the upper arm, thigh, or abdomen for one week. Wear one patch per week for 3 weeks. No patch is used for the fourth week, which is when you’d typically get your period. At the end of the fourth week, you start a new patch.

Other things to consider: Skin irritation may happen if the patch is placed in the same spot often or for people with sensitive skin. The patch only comes in one colour (that peachy ‘band aid’ colour) but not everyone in the world comes in this colour. While the patch is an effective birth control option, not making a clear version that fits all skin types in an example of racism.

3) Depo-Provera (aka the shot or the needle)

How it’s used: The shot is given by a health provider every 84 days (12 weeks). The first shot is given when you are having your period.

Other things to consider: Spotting (or bleeding in between periods) is the most common side effect in the first 6-12 months of use. After one year, about half of people using Depo stop getting their period (it comes back when you go off Depo). Some people report it taking several months after stopping Depo for their period to return to normal and all side effects to wear off.

4) The NuvaRing

How it’s used: The NuvaRing is a flexible plastic ring that you insert into the vagina. It stays inside the body for three weeks. The ring is removed for the fourth week which is when you’d typically get your period. At the end of the fourth week insert a new ring.

Other things to consider: Vaginal irritation, and discomfort or discharge is a possibility for some people.

5) Nexplanon (aka the Implant)

How it’s used: Nexplanon is a tiny thin rod about the size of a matchstick. The Nexplanon implant is inserted with a special needle into the underside of the upper arm by a nurse or doctor. It can work for up to three years. At the end of three years, you return to the clinic for removal. You may choose to have a new one inserted at this time.

Other things to consider:Nexplanon costs around $350. If you have health insurance, it may be covered. There will be some irritation, including bruising, for a few days following insertion.

Condoms

Condoms block sex fluids and sperm which means they can be used for STI/HIV protection as well as pregnancy prevention.

1) Condom (for a penis) – 86-97% effective depending if they are put on correctly.

How it’s used: Can be used for oral, anal, or vaginal sex or on a sex toy. Free at teen clinics and most health centres. Click here for the Teen Talk condom demo!

2) Internal (sometimes called “Female”) Condom – 79-98% effective depending on if they are used correctly.

How it’s used: Can be used for vaginal or anal sex. Available for free or low cost at many teen clinics, or for purchase at any pharmacy. Most are made of polyurethane, which is a non-latex. Click here to get to the Teen Talk internal condom demo!

If you’re interested in learning more about condoms we have a whole other page of info for you, check it out here!

Intrauterine Device/System (IUD/IUS)

An intrauterine device or system (IUD/S) is a tiny device that’s put into the uterus to prevent pregnancy. It’s long-term, reversible, and one of the most effective birth control methods. It’s a little t-shaped device that is either hormonal or wrapped in copper. Both copper IUDs and hormonal IUDs prevent pregnancy by changing the way sperm moves so they can’t get to an egg. If sperm can’t make it to an egg, pregnancy can’t happen. Sperm basically don’t like the copper and so can’t fertilize an egg, and the hormonal IUS thickens the cervical mucus (blocking the sperm) and prevents ovulation (no egg = no pregnancy). Depending on the type, IUD/S can last up to 5 years.

How they are used: An IUD or IUS is inserted into the uterus by a health care provider. For the first few months it’s recommended that you check the strings (attached to the bottom of the IUD/S that help with removal later) to make sure the IUD/S is still in place.

Other things to consider: There is a higher upfront cost to IUD/S, but they last longer than most other types of birth control. Family health plans, social assistance programs and Treaty status can help cover the cost, but this may mean bringing parents/caregivers into the conversation. Women’s Health Clinic in downtown Winnipeg has a program that helps people access an IUD/S at a reduced cost. Common side effects with IUD/S can be changes in menstrual flow (possibly heavier with a copper IUD, lighter with a hormonal IUS) and spotting in between periods. Some people may feel more pelvic pain.

Emergency Contraception

How it’s used: What can you do if you want to prevent a pregnancy after sex has happened? ECP or emergency contraception is birth control that you can take after unprotected sex. You might have heard it called Plan B or the “morning after pill.” If you’ve recently had penis-vagina sex and are worried you might get pregnant, you can use ECP. How effective is ECP? If you use it within 72 hours after you’ve had unprotected sex it can reduce the risk of pregnancy by up to 89%. If you use it within 24 hours, it’s about 95% effective. You can use it up to 5 days after unprotected sex, but it’s most effective the sooner you take it. ECP is not an abortion pill. If a pregnancy has already happened it will not harm the fetus, pregnancy or person carrying the pregnancy. If you take ECP, but don’t get your period around its expected time, than you may want to take a pregnancy test. You can access ECP from a teen clinic any day that they are open. Even if it’s not a teen clinic day, you can try calling ahead to any Teen Clinic, and ask if you can come to get ECP. In Winnipeg it usually costs $15 if you can afford it, otherwise it’s free. If someone chooses to go to their own healthcare provider or to a walk-in clinic, it is important to call ahead and clearly ask whether they have it in stock, give it to someone your age (some healthcare providers do not prescribe the ECP to youth), and ask how much it will cost. ECP is also available at a pharmacy without a prescription, but costs anywhere from $11 to $50 depending on the store. Asking for the ‘cheapest one’ they have can be helpful as there is more then one brand and some are more expensive then others. They all work the samSome clinics will give out advance prescriptions of ECP if you ask for it (Klinic does). If you need ECP and have no money, you can call ahead to a teen clinic, let them know that you need ECP, and then go there and get it at a discount or even for free. Other things to consider: ECP is less effective if you weigh 165 lbs (75 kg) or more and may not be effective in people weighing more than 176 lbs (80 kg). If your weight is 165 lbs (75 kg) or more talk with a healthcare provider about your options. Some people might feel nauseous after taking ECP because of the high hormone dose, some people don’t notice any side effects. ECP can stop or slow down ovulation or interferes with fertilization. If someone is already pregnant, ECP will not harm the pregnancy. All Winnipeg teen clinics give out progesterone only Plan B, which is less likely to cause nausea. If the pills are thrown up or diarrhoea occurs after four hours of taking ECP the pills do not need to be taken again. If someone throws up the pill(s) within two hours of taking ECP, they should check with their doctor or pharmacist as they may need to take the pills again. Usually someone get’s their period within 3-4 weeks of taking ECP. If you don’t get your period 4 weeks after using ECP have a pregnancy test done.

Other Forms of Birth Control

Foam, VCF and Sponge:

It is recommended that foam, VCF and sponge are used with another type of birth control method. Their less effective than hormonal birth control and don’t protect against STI/HIV.

How they are used:

Foam is inserted with an applicator (similar to a tampon applicator) high up in the vagina against the cervix. Foam is anywhere from 71-85% effective.
Vaginal Contraceptive Film (VCF) is a sheet of film is folded twice and then inserted high up in the vagina against the cervix with your finger (it dissolves sort of like a breath mint sheet). The spermicide in VCF might cause skin irritation for some people. VCF is anywhere from 71-85% effective.
The Sponge comes with spermicide in it. Insert it into vagina, and push it up with a finger. Leave it in for eight hours after sex for it to be effective (removed before 12 hours). The spermicide that is used with the sponge might cause skin irritation for some people. The sponge is anywhere from 76-91% effective.

Other things to consider: Foam, spermicidal jelly, and VCF can irritate sex organs because spermicide contains nonoxynol-9 which is a bleaching chemical. Repeated daily use (like lots of sex in one day) can increase the chances of getting STI/HIV by irritating the skin making it more prone to infection.

Abstinence

The only method of birth control that 100% guarantees there won’t be a pregnancy is abstinence. Abstinence means not having sex but it can look a lot of different ways to different people. Being abstinent can mean choosing lower-risk activities where there’s no risk of sexually transmitted infections, HIV, or pregnancy. There are lots of sexy activities that people can do with a partner that are fun and completely safe. Kissing, massage, holding hands, and playing with each other’s hair can be great whether you are practicing abstinence or not!

Questions About Birth Control

How does birth control work?

It depends on the type of birth control being used. Most kinds of birth control fall under one of two types: hormonal or barrier. There is also the copper Intrauterine Device (IUD), which is unique. Hormonal methods of birth control are made of synthetic hormones. They raise hormone levels in the body so that the ovaries think they do not need to release an egg. If no egg is released, then a pregnancy cannot happen. There several different types of hormonal birth control. The other type of birth control is the barrier method. Barrier methods block the sperm from reaching the egg. If an egg and a sperm cannot meet up, then a pregnancy cannot happen. The most commonly used barrier method is condoms. Condoms have the added protection of being the only method of birth control that also provides protection from STIs and HIV. There is a type of IUD that uses copper instead of hormones. Copper switches up the environment of the uterus so sperm can’t reach an egg. If the sperm doesn’t meet up with an egg, then a pregnancy can’t happen. To learn more about birth control visit a Teen Clinic or your local health centre.

Is there birth control for someone who has a penis/males?

Yes, males or any person with a penis can use condoms for birth control. Condoms block sperm from entering another person’s body. They also have the added protection of being the only method of birth control that also provides protection from STIs and HIV. If you mean is there a hormonal method of birth control for someone who has a penis then the current answer is no. There is some cool research happening around hormonal methods as well as injections that block sperm, but it is still in the trial stage of development and is years away (if ever) from being proven safe and reliable.

What do I do if the birth control didn’t work?

No birth control method except for abstinence is 100% so there is always a risk of pregnancy if you are having penis-vagina sex. If a pregnancy has happened then you have three legal options in Canada: abortion, adoption, and parenting. We all have our own values about which option we would choose. What’s right for one person may not be right for another. When it comes to all three-pregnancy options, people have the right to decide for themselves how they feel about each option. If you decide one option is not for you, that’s okay. However, we don’t get to judge or make someone feel bad if they choose a different option then what we would. It’s about choice. Ultimately, the choice of what to do with a pregnancy is always up to the girl, woman or person who is pregnant. This is because it is their body and their life that will be most affected. Check the Pregnancy Options section to learn more.

Can my health plan/treaty/social assistance program cover the cost?

Yes, your plan can cover the cost of birth control. However, using your plan may mean talking about it with your parents or guardians. Depending on your relationship with them, you may or may not want to include them in your decision to start using birth control. That’s why teen clinics can be a great resource. Teen Clinics offer birth control for low-cost or even free. They do it on a sliding scale based on what you can (or cannot) afford. You do not need parental or guardian permission to go to a teen clinic. All their services are confidential too.

Does it matter if you're an hour or so late to take your birth control? Would it still work?

Hormonal birth control works by maintaining a certain level of hormones in the body. These hormones tell the ovaries not to release an egg. If someone is late or misses their birth control then the levels may drop enough so that the ovaries release an egg. If you’re worried about having to remember to take birth control regularly, then talk with your health care provider about different options. Some types of birth control only need to be thought about once a week (the patch), once every three weeks (the ring), once every three months (depo) or in the case of an IUD, even longer. Teen Clinics can be a great place to check out if you want to learn more about different birth control options.

Can birth control have bad side effects? If yes, then what kind?

Yes, like all medication, birth control can have side effects. Some side effects people like such as changes in acne or regulating someone’s period. Other side effects someone may not like such as mood changes, weight changes, nausea, headaches or tender breasts. If you are using birth control and it is causing side effects you do not like then it’s important to go back to your health provider to try a different type. Because all of our bodies are a little different, birth control can affect people a little differently. Sometimes you may have to try a few different types of birth control before you find one that’s a good fit. Talk with your health care provider or someone at a Teen Clinic to learn more.

Can you get birth control without parental permission?

Yes, you can get birth control without parental or guardian permission. You have the right to access birth control if you want. That’s one of the reasons Teen Clinics exist! Teen Clinics offer birth control for low-cost or even free. They do it on a sliding scale based on what you can (or cannot) afford. You do not need an appointment and all their services are confidential. Click here to find your closest Teen Clinic.

Does sex on your period affect conception?

Having sex on your period or with someone on their period is a personal choice. Some people want to do it and others don’t. Some people think you can’t get pregnant when you’re having your period, but it’s totally possible. There are more likely days and less likely days where a pregnancy can occur, but there are no days where a pregnancy cannot happen. Having unprotected sex when someone is on their period can spread an STI/HIV and can cause pregnancy. This is because the sperm can stay alive inside a partner’s body for up to five days. If the ovaries release an egg during those five days then a pregnancy could happen. On the flipside, we’ve also had people ask if sex during someone’s period increases conception. The answer to this is no. While a pregnancy is possible, the chances of conception are not increased by having sex while someone is on their period.

I heard birth control messes with your ability to create a pregnancy later on, is this true?

No this is not true. Hormonal birth control has been around for over 50 years and has not been shown to affect long-term fertility. In other words, if someone was able to become pregnant before using the pill (or other hormonal birth control), they will still be able to become pregnant after using the pill. With longer-term use, some types of birth control (like depo) may take weeks or even months before someone’s period returns to their normal. They will not be infertile (unable to create a pregnancy), but it may take a little bit of time for their body to fully readjust to not being on birth control. However, even if someone has an irregular period, they can still be ovulating; it just means they might not be able to predict when their next period will be. Talk with your health care provider or someone at a Teen Clinic to learn more.

Will birth control work if you drink, smoke or do drugs?

Hormonal birth control still works the same in the body when someone is drunk, high or smoking cigarettes. With cigarettes, there is an increased risk of heart attack or stroke, especially for people who have been on birth control and smoked for many years. If someone is using alcohol or other drugs then they may be more likely to forget to take the pill or throw it up. If it isn’t in the body when it needs to be then it can’t help prevent a pregnancy. If you’re in Winnipeg, check out Project CHOICES. Project Choices is a free program that helps women and girls explore alcohol, sex and birth control. This program is based on respect, information and support. No one will tell what to do or that you have to change, but they can give you the information you need to make the best choices for your health. It’s important to let your health care provider know that you smoke, drink or use other substances so that they can prescribe a method that is best suited for you. It’s also important to use birth control correctly if you are using and having the type of sex that can create a pregnancy (penis-vagina sex). If a pregnancy does happen, drugs or alcohol may harm the fetus including Fetal Alcohol Spectrum Disorder. If someone is using drugs or alcohol, we suggest checking out the Substance Use section to learn ways to stay safer.