Deciding What's Right for You

Birth control—without it, pregnancy can happen. That's why you need birth control you can count on.

There are lots of good options for birth control. Your best choices are those that you find easy to use—so you never go without it.

And of course, no matter what kind of birth control you use, you always need a plan for protecting yourself against sexually transmitted infections (STIs).

Your Choices

Some birth control methods work around the clock. Others work only when you use them, which means it's so very important to use them every time you have sex.

Birth control methods

• Abstinence. Not having sex (abstinence) is the most effective method of birth control and sexually transmitted infection (STI) protection.
• Long-acting reversible contraception (LARC). LARC includes implants and intrauterine devices (IUDs). LARC is the best reversible method for preventing pregnancy. "Long-acting" means that they will prevent pregnancy for years. "Reversible" means that you can have them removed if you want to get pregnant later.
  • The implant. The implant, which is about the size of a matchstick, is put under the skin on the inside of your upper arm. It releases hormones that prevent pregnancy for about 3 years. The implant does not protect against STIs.
  • Intrauterine device (IUD). The IUD is a small device that is inserted into the uterus by your doctor. There are two main types of IUDs—copper IUDs and hormonal IUDs. When an IUD is in place, it can provide birth control for 3 to 10 years, depending on the type. IUDs do not protect against STIs.
• Barrier methods. Typically, barrier methods are not highly effective at preventing pregnancy. Male or female condoms, sponge, the cap, and diaphragms are examples of barrier methods. They block the sperm from fertilizing an egg. You use one each time you have sex. Using a condom is the only barrier method that helps protect against STIs.
• The pill , the patch , and the vaginal ring . These methods are very reliable means of birth control. These methods have hormones that stop you from releasing an egg each month (ovulation). You can choose to take a pill at the same time every day, change a patch every week, or change a ring every 3 weeks. These methods do not protect against STIs.
• The shot . This method is a very reliable means of birth control. The shot contains hormones that prevent pregnancy for 3 months. Hormone shots are needed every 3 months. The shot does not protect against STIs.

Emergency contraception

Emergency contraception (EC) can be used if you've had sex without birth control you can count on. The most effective emergency contraception is prescribed by a doctor. This includes the copper IUD (inserted by a doctor) or a prescription pill. You can also get emergency contraceptive pills without a prescription at most drugstores and sexual health clinics.

If you have unprotected sex, use EC as soon as possible. If you are already pregnant and use EC pills, they will not stop a pregnancy.

How to Decide

Choosing birth control is a very personal thing. First, think through some basic facts about your birth control options. Then, focus in on what's important to you. And then, think about who you are and what your style is.

How well does each birth control method protect me?

• Some methods depend on you and how well you use them—every time. These include hormone pills or the hormone patch or ring. The same is true for the condom, sponge, diaphragm, or cap.
• Some methods work very well for long periods of time without you having to do anything. These include the hormone implant or shot, and the IUD.
• Condoms are the only method of birth control that helps protect against STIs. But using a condom is not the best way to prevent pregnancy. To avoid both STIs and pregnancy, use condoms along with another type of birth control. Condoms do not protect the entire genital area against skin-to-skin contact. Some infections can still be spread even when using condoms.
• Abstinence depends on your commitment to not have sex. Not having vaginal intercourse prevents pregnancy. And not having oral sex, anal sex, or vaginal sex prevents STIs.

Is it easy to keep with me?

• Some methods easily fit in your bag. These include hormone pills or a condom, sponge, diaphragm, or cap.
• Some methods don't have to be carried around at all. These include the hormone shot, the IUD, or the ring.

What do I think of as "easy to use"?

"Easy to use" birth control means different things to different people. What are you more comfortable with? You may want to try a method a few times. And then you may want to try some others.

• You may have no trouble making sure you have a method with you whenever you need it. Or that may be too hard to keep track of.
• It might be easy for you to put a sponge, cap, or ring into your vagina. Or that could be something you just won't do.
• Using a method every time you have sex, without error, might be easy for you. Or it may be hard to get it right. If you ever use drugs or alcohol before having sex, this is important to think about.
• "Easy" could mean you don't have to think about it, like the IUD or the hormone shot. Or maybe you're looking for something you can easily switch off of so you can change to another method.

Can I stay on a schedule?

Are you good at remembering things? Or do you tend to lose track of things like your keys or what's on your calendar?

• Can you take a daily pill or change a weekly patch? How about going to your doctor's office every 3 months for a shot?
• Or do you need something that you hardly ever have to think about, like an IUD or a hormone shot?

How to Get Birth Control

From a store

You can buy some methods of birth control without going to a doctor. You can get male condoms in grocery stores, convenience stores, or drugstores. And you can get female condoms or a sponge and spermicide from a drugstore.

You can get some types of emergency contraception without a prescription at most drugstores and sexual health clinics.

From a doctor

At a doctor's office or sexual health clinic, you can get:

• A hormone shot.
• A hormone implant.
• An IUD, including the type used for emergency contraception.
• A prescription for a diaphragm or cervical cap. Diaphragms and cervical caps are not widely available in Canada. Buying the necessary spermicidal jelly to use with them is difficult.
• A prescription for hormone pills, patches, or rings.
• A prescription for certain kinds of emergency contraception.

From abstinence

When you use abstinence for preventing pregnancy:

• Know what you want and how you feel before things get sexual. Be clear with your partner about your limits.
• Remember why you chose abstinence. Think about your reasons and why they are important to you. How you feel and what you believe matter.
• Think ahead. Try to avoid getting into situations where staying abstinent could be hard.
• Don't misuse alcohol or drugs. Alcohol and drugs can affect your decisions. They can make you let down your guard and forget why you decided to be abstinent.
• Get support from someone you trust. It really helps. Share your decision, and talk about any challenges you're having staying abstinent.

Your local sexual health clinic may have a teen support group where you can talk with other teens about abstinence.

Myth or Truth?

"A friend told me that you can't get pregnant if you haven't had a period at all, or even lately."

Don't believe it! You make an egg, or ovulate, and then have a period. And ovulation can happen at any time. There's no day of the month when it's safe to have sex without birth control.

"I heard a guy say that having birth control means you'll say yes to sex at any time."

Having protection against pregnancy and STIs means that it's there when you need it. But being prepared doesn't mean having to say yes unless you're comfortable with it.

"My sister told me you don't need birth control if you just douche after having sex."

Flushing water into the vagina, or douching, after sex does not prevent pregnancy.

"I need to feel safe with my sex partner and with what we're doing together. It's got to be okay to say 'no' or 'stop' at any time."

This should always be true. It's important that you be able to say "no" or "stop" at any time.

"I should be able to count on my partner to have a condom."

Every time? Anyone can be forgetful. It's best that you count on yourself. But for a built-in backup plan, you and your partner can agree to both keep protection with you.

"I worry that when I first go to a doctor for birth control, I'll need to have a pelvic examination."

Most teens don't have a pelvic examination when they first go for birth control. But if you already have a health problem that needs to be checked, you might. If you do need a pelvic examination and you're nervous about it, talk to your doctor about it ahead of time.

"Not having sex is the best way to prevent pregnancy and any STI."

That's right. Abstinence prevents pregnancy and STIs.