1. Contraceptive Methods
For use in Grade 8 through CALM (10-12) only.
Although reasonable efforts were made to confirm the accuracy of the information contained in this presentation, Alberta Health Services does not make any representation or warranty, express, implied or statutory, as to the accuracy, reliability, completeness or applicability of such information. In no event will Alberta Health Services be responsible or liable for any error or consequence arising from the use of the information contained in this presentation. ©2012 Alberta Health Services

2. Ground Rules We respect: That any question is OK That it is OK to pass
That we all have different points of view
Each other by listening
The right to privacy
That we all need to be listened to

3. Why Do Unintended Pregnancies Happen?
Embarrassed to talk about sex with partner or to get birth control supplies
Not knowing or understanding about using birth control to prevent pregnancy
Individual or religious beliefs about birth control
Birth control method not used correctly or consistently
Spontaneous act and not prepared
Use of substances that affect decision making (alcohol/drugs)
Difficulties accessing health care
Birth control supplies are too expensive

4. Abstinence How does it work?
Abstinence means different things to different people
Abstinence can mean not having any physical contact
Abstinence can also mean having some physical contact but no sexual activity that involves the genitals (e.g., masturbation, sexual intercourse)
How does it work?
To be abstinent, you and your partner have to set some limits. These limits are different for everyone
You can’t get pregnant or get a sexually transmitted infection (STI) if you are abstinent - with no genital to genital, skin to genital and body fluid to genital contact
You CAN get pregnant without having sexual intercourse if sperm is near the opening of the vagina. You can get some STIs by touching the genital area of your partner

5. Unintended Pregnancies Per 1000 women during first year of use
Adapted from Trussell et al., 2004

6. Male Condom
Provides a barrier for skin to skin contact and body fluids which can help protect against pregnancy and STI
Available at pharmacies, grocery stores and health clinics
Use a condom for oral, vaginal and anal sex or when sharing sex toys
Most condoms are latex. Non-latex types include polyurethane, and polyisoprene (synthetic rubber)
Check expiry date and keep in dark, cool place
Do not use with oil-based products like Vaseline, baby oil or hand cream. This increases the chance of the condom breaking
Use a new condom every time you have sex. Never use two condoms at once

7. Male Condom Demonstration
Click here for
demonstration

8. Female Condom
Provides a barrier for skin to skin contact and body fluids which can help protect against pregnancy and STI
Available at pharmacies, grocery stores and health clinics
Inserted prior to any vaginal contact. Can be inserted up to 8 hours prior to intercourse
Soft thin plastic quickly warms to body temperature, which allows for natural feeling and sensitivity
Safe to use for people with latex allergies
Can use water and/or oil based lubricants
Do not use with the male condom, this increases the chance that both will break
Use a new condom every time you have sex

9. Female Condom Demonstration
Click here for
demonstration

10. Hormonal Contraception (Pill/Patch/Vaginal Ring)
How do they work?
Stop the release of a mature egg
Thicken cervical mucus making it difficult for sperm to get to the egg
Change the lining of the uterus making implantation difficult

11. Things to Consider…
With perfect use, hormonal birth control is 99% effective
With typical use, it is 92-97% effective
Makes your period more regular, with less bleeding and pain
Protects you against some types of cancers (ovary and uterus)
Does not protect you from sexually transmitted infections (STIs)

12. Side Effects
Side effects that may occur during the first few months include :
irregular bleeding, spotting
Nausea, mood swings
Bloating, breast tenderness
Headaches
Most symptoms are normal and will decrease or stop in the first 2-3 months
In rare cases, women using hormonal contraception can develop blood clots. Talk to your doctor about whether hormonal birth control is right for you

13. Common myths and misconceptions about hormonal contraception
It causes weight gain
It causes acne
It causes cancer
It causes infertility
It causes birth defects
You need to take breaks from it
All smokers should not be taking it
All women over age 35 should not use hormonal contraception
No need for condoms if are using hormonal contraception

14. Birth Control Pills (BCP)
Combined oral contraceptive pills contain two hormones; estrogen and progestin
One hormone pill is taken at the same time each day to prevent pregnancy
Traditional cycles of BCP are 21 days of hormones followed by a 7 day hormone free break
New regimes include:
24 days of hormones followed by a 4 day hormone free break
84 days of hormones followed by a 7 day hormone free break
- The pill contains hormones that keeps the body from releasing an egg.
- If used correctly is 98% effective in preventing pregnancy. No STI protection.
- Take one pill at the same time every day.
- Some females take the pill to regulate their menstruation (period), reduce cramps or decrease acne.
- The cost is approx. $16.00 for a month supply, $7 at the THC or FPC and cheaper if you have a drug plan. Need a Dr. prescription.
Ask the students:
What kinds of things have you heard about the pill that concerns you?

15. Birth Control Patch
Hormonal contraceptive patch worn on the skin that contains two hormones; estrogen and progestin
A patch is worn for one week at a time. A new patch is put on once per week for three weeks. The fourth week is a hormone free break
There might be a higher risk of getting pregnant for women who weigh more than 195 lbs
May cause skin irritation
- Works like the pill.
- Approximately 98-99% effective.
- Wear one patch for a week, then change it every week for 3 weeks. The 4th week you wear no patch and get your period.
- Good for people who forget to take a pill everyday.
- About $17 a month with a prescription or $10 at the THC/FPC.

16. Vaginal Contraceptive Ring
Hormonal contraceptive ring is worn inside the woman’s vagina. It contains two hormones; estrogen and progestin
A ring is worn for three weeks (21 days). The ring is removed for one week. The fourth week is hormone free
May cause vaginal discharge or irritation
- Works like the pill and the patch.
% effective.
- Insert the ring inside the vagina for 3 weeks, then remove it and use nothing for 7 days while menstruating.
- Good for people who forget to take a pill everyday.
- The cost is about $24 a month with a prescription and $10 at the THC/FPC.

17. Continuous and Extended Use of Hormonal Contraception
Traditional use (28 day cycle)
21 days of active hormones followed by
7 days of hormone free pills or hormone free break
(period begins during the hormone free break)
Continuous use
uninterrupted use of hormonal contraception. No planned hormone free break
Extended use
prolonged use (2 or more cycles) of hormonal contraception with planned hormone free breaks, no longer than 7 days
Which products can be used for continuous or extended use?
any combined hormonal product with < 50 ug ethinyl estradiol
Most types of birth control pills, vaginal ring, contraceptive patch

18. Emergency Contraception (Morning After Pill, Emergency Contraception)
Used to prevent pregnancy after unprotected sex or contraceptive failure (ie. condom breaking or forgetting to take birth control)
If taken within 24 hours of unprotected sex prevents 95% of possible pregnancies
Can be taken up to 120 hours (5 days) after unprotected sex preventing 58% of possible pregnancies
Does not affect a pregnancy that has already implanted
Available by prescription from a doctor, sexual and reproductive health clinic or some pharmacies (call ahead to see if they offer this service)
- Prevents the ovaries from releasing an egg or prevents implantation of the fertilized egg on the uterus lining.
% effective – can be taken up to 5 days after unprotected sexual intercourse; most effective within the first 24 hours – minimal side effects.
- Take 2 hormone pills that are like the BC pill.
- Cost is $15 at THC/FPC, $28 at family Dr., $28-40 without prescription at the pharmacy (usually a pharmacist consultation is need). Soon some pharmacies may offer EC without consultation soon.

19. Birth Control Injection (Depo- Provera®, “The Shot”)
Progestin injection into arm or hip every 12 weeks by a health professional
Is 99.7% effective
Stops body from releasing an egg each month
After 12 months of use, 55% of women stop having periods. After 24 months, 68% of women stop having periods
May cause irregular spotting/bleeding and delay the return of regular cycles after stopping injections
Can increase bone mineral loss. Getting regular weight bearing exercise and Calcium+ and Vitamin D in your diet is important
- Inhibits the release of an egg.
- 99.7% effective.
- Receive an injection (shot) every 3 months in your arm or hip.
- Good for people who forget to take a pill every day. Most will stop having periods after 6 months – 1 year of use.
- While on Depo Provera, the strength of your bones can be reduced. This is proven to reverse after you come off this method. While you take it , you need to make sure there is enough calcium and Vit. D in your diet to keep your bones strong.
- Should not use this method if you are planning to get pregnant quickly after you stop taking Depo. Can take 1-2 years to get pregnant.
- Costs $21 at the THC/FPC or $36 with a prescription for a 3 month supply.

20. Contraceptive Spermicides
Vaginal spermicides are products containing an ingredient (Nonoxynol 9) that kills sperm on contact
Can be purchased at pharmacies and grocery stores
Inserted into the vagina before sex to help prevent pregnancy
Effectiveness varies greatly. The failure rate is about 26%
Spermicide should be used with a condom every time
It is an effective method of birth control when used with condoms
Spermicides can cause vaginal irritation which can increase the risk of getting STIs including HIV
- Work to kill sperm before they reach the egg.
- When used with a condom are 97% effective. Never use this method alone. Always use with a condom.
- Foam needs to be inserted in the vagina about ½ hour prior to intercourse. A gel called Advantage 24 can be inserted up to 24 hours in advance.
- You do not need a prescription. You can buy it at a drugstore/pharmacy over the counter. They cost $13-22 at the pharmacy and $10-15 at the THC/FPC.

21. Copper IntraUterine Device (IUD)
Long-acting contraceptive; can be left in place for 3 to 5 years
98.7% effective
Does not contain hormones
Copper affects how sperm move and helps prevent embryo implantation
Needs to be inserted by a trained health professional

22. Mirena IntraUterine System (IUS)
Contains a hormone called levonorgestrel (progestin)
99% effective
Long acting contraceptive, can be left in place for 5 years
Hormone acts on the lining of the uterus and thickens the cervical mucus making it difficult for sperm to reach the egg. May prevent ovulation
Decrease in menstrual blood loss by 74-97%
Needs to be inserted by a trained health professional

24. Safer Sex The only safe sex is no sex (abstinence)
If you choose to be sexually active:
Talk to your partner about your sexual health histories
Choose to protect yourself from both pregnancy and sexually transmitted infections (STIs)
Limit your number of partners
Get tested regularly for STIs
Get more information

25. Key Messages Hormonal birth control does not protect against STIs
Use a condom AND another form of birth control
Talk to your partner about your sexual history and safer sex practices

26. Where can I go for help? School Counsellor Teacher School Nurse
Walk-in Clinic
Family Doctor
Sexual Health Clinic