Is it better to be on the pill? The patch? The injectable? The vaginal ring?

With so many different forms of birth control methods available, you may be wondering what is more appropriate for you to be on. While there are many different factors to consider, this article will walk you through an overview of all the different forms of birth control from the most effective to least effective method. 

What birth control options are available here in Canada?

When it comes to the most effective methods of birth control, one may consider the implant(ie. Nexplanon), hormonal intrauterine device(Ie.Mirena,Kyleena) copper intrauterine device (Ie.Mona Lisa Copper IUD) and the vasectomy/sterilization procedure.

The percentage of unintended pregnancies out of every 100 women within the first year of typical use of each method respectively is 0.05%, 0.2%, 0.8% 0.15% for male sterilization and 0.5% for female sterilization [1]. As you can see these are one of the most reliable methods for birth control however they are a lot more invasive and even irreversible in some cases.

Why to use IUDs?

The implants and IUDs are good options for those who know that having a child is out of the picture for a good couple years. The surgical procedure of vasectomy is a good option for those who don’t want to consider pregnancies for good. This is mainly permanent but can sometimes be reversed.  

How reliable are birth control pills, injectables and vaginal rings?

The next couple methods are more common, less invasive but still quite reliable. These methods include the injectable (6%)(ie Depo-provera), the pill (9%)(ie. Alesse, linessa, marvelon,Lolo etc), the patch (9%) (ie.Evra), the vaginal ring (9%) (Ie.Nuvaring) and the diaphragm (12%), according to the Center’s For Disease Control and Prevention (Click here to visit their website). As a reminder, the percentages indicated next to the method represent the percentage of unintended pregnancies within the first year of typical use of each contraceptive method. Each method would require a different level of adherence.

What are some differences about using pills, injections or patches?

For example the injections happen once every 3 months. The pills are required to be taken daily. The patch and the ring require you to remember to switch them out on time. Depending on your lifestyle and medical conditions, one may be a better choice than the other. 

How reliable are condoms to prevent pregnancy?

Lastly, these next methods are a bit less reliable when used alone compared to the others. They include the male condom (18%), female condom (21%), withdrawal (22%), the sponge (12-24%), fertility awareness based methods (24%) and spermicide (28%). [1] As a standalone, these methods are a bit less reliable, however these methods can sometimes be used in combination with another method to increase the effectiveness.

Do you need to use condoms if on the pill?

For example, it is always recommended to use a condom even if you are already on a different form of birth control. This not only increases the effectiveness of birth control but condoms are the only form of birth control that will also prevent some sexually transmitted diseases by acting like a barrier. Please speak to your health provider about what methods can be combined. 

Perfect use Vs Typical Use- What’s the Difference?

Now that we have walked through some of the most common forms of birth control, let’s review more context behind the percentages of unintended pregnancies beside each method. When it comes to comparing birth control, it is worthwhile to know the difference between perfect use and typical use. Perfect use of birth control is when you manage to use the contraceptive method correctly ALL the time. On the other hand, typical use takes into account human error. For example, in this article I stated that using the hormonal pills as a birth control has a 9% chance of unintended pregnancies per 100 women within a year of typical use. However, if you manage to use the pill perfectly as prescribed every day, the perfect use percentage is actually 0.3%- making this method even more reliable. 

In conclusion, there are many forms of birth control available. Speak to your healthcare provider to figure out what is best for you. As healthcare providers, when it comes to picking one form over another, we take into account the ability for you to adhere to the medication, accessibility, medical conditions and contraindications and many other factors into consideration.  

Recommended reading

• Weight Loss Medications & Injections – Are they for you?(Opens in a new browser tab)
• Hormonal Contraception and Risk of Chlamydia(Opens in a new browser tab)
• All about the Birth Control Patch(Opens in a new browser tab)
• Is the Birth Control Patch (Evra) Safe?(Opens in a new browser tab)
• NuvaRing: How Effective Is the Birth Control Ring?(Opens in a new browser tab)

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