Birth control: What works best for you?

his story was originally titled "Birth Control: What works best for you" in the August 2009 issue. Subscribe to Canadian Living today and never miss an issue!

Choice can be liberating – but sometimes knowing what to choose can be confusing. Take contraceptive methods, for example. These days we have many alternatives, from a pill to an IUS. While these advancements can improve the lives of women, the myriad options available can be daunting. Here's information to help you pick the method that's best for you.

Hormonal methods
Oral contraceptives (the pill)
A popular method of birth control, most oral contraceptives contain estrogen and a progestin. They thicken your cervical mucus so sperm can't pass through, and also thin the lining of your uterus to prevent an egg from being implanted.

Benefits and drawbacks: The pill is 99.9 per cent effective if used as directed. It regulates your menstrual cycle, decreases cramping and can reduce acne. It must be taken daily. The pill can cause nausea, bloating, breast tenderness, weight gain and headaches, and may also increase your risk of breast cancer and blood clots.

Our expert says: "Do not take the pill if you have a family or personal history of abnormal blood clotting, have hepatitis or mono, or have had breast or endometrial cancer," says Dr. Jerilynn Prior, scientific director at the Centre for Menstrual Cycle and Ovulation Research, and a professor of medicine in the division of endocrinology and metabolism at the University of British Columbia in Vancouver. "Don't take the pill if you have vascular migraines that are associated with auras," adds Dr. Arthur Zaltz, an obstetrician at Sunnybrook Health Sciences Centre in Toronto.

Seasonale birth control pill
You take this extended-regimen pill once a day for three months, at the end of which you have your period. It contains a progestin and estrogen, and Prior points out that since you are on this pill for more days than with other pills, you are getting more estrogen.

Benefits and drawbacks: It's 99 per cent effective if used as directed. You will menstruate only once every three months, but you'll be more likely to have spotting or breakthrough bleeding. Potential side-effects include nausea, vomiting, weight gain, breast tenderness, difficulty wearing contact lenses and an increased risk of blood clots. It's worth noting that the Society for Menstrual Cycle Research says further study on the potential health risks and long-term safety of cycle- stopping contraception is still needed.

Our expert says: "The main thing that women dislike is the unexpected bleeding, as opposed to a regular monthly period," says Prior. "Though there is evidence this improves within a year."

Progestin-only pill (POP)
POPs are for women who can't take estrogen for medical reasons. (Check with your doctor.) These pills work in the same manner as other monthly oral contraceptives.

Benefits and drawbacks: POPs are 90 per cent effective if used as directed. There are no estrogen-related side-effects, but they may cause unpredictable spotting and must be taken at the same time every day, within a three-hour interval.

Our expert says: "POPs are a good choice for women who are breast-feeding," says Zaltz.

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