Birth control and STIs: Important things to know

If you’re ready to have sex, it’s important to learn about birth control and sexually transmitted infections (STIs).

What is birth control?

Birth control, also known as contraception, helps prevent unplanned pregnancies. There are many different types of birth control available. Some you can buy over the counter at a pharmacy and some require a prescription or assistance from a doctor.

Different kinds of birth control suit different age groups and lifestyles. It’s important that you and your partner choose the right method for both of you. No matter what type you choose, it will be most effective if you use it properly and consistently

Types of birth control

Contraceptive methods have six categories including:

Hormonal contraception

This type of birth control uses synthetic female hormones to stop pregnancy by preventing the ovaries from releasing eggs. It also thickens the mucus around the cervix to prevent sperm from entering the uterus and thins the lining of the uterus to prevent eggs from attaching.

Many young women choose hormonal contraception because it’s safe, effective, convenient and reversible (you can get pregnant if you stop using it). However, it’s important to remember that these methods don’t protect against sexually transmitted infections (STIs), so it’s best to still use condoms.

There are several types of hormonal contraception, available to women with a prescription from a doctor, including:

  • Oral contraceptive pill: the pill is one of the most prescribed methods of birth control for young women. When taken properly, it’s also one of the most effective. With perfect usage, the pill can be 99% effective. With typical usage (e.g. missing a pill), the pill can be 91% effective. It’s most effective if you take it at the same time every day. The pill usually comes in four-week packs: three weeks of hormone pills and one week of non-hormone pills or no pills at all (during that week, you have your period).
  • Injectable contraception: the birth control shot is widely prescribed to young women and is one of the most effective birth control options. With perfect usage, the birth control shot can be 99% effective. With typical usage (e.g. being a few days late for the shot), the birth control shot can be 94% effective. Women who choose this method receive four injections a year from a health-care professional.
  • Contraceptive patch: this is a small, square patch that you stick to your skin (on your stomach, buttocks, back or upper arm). It slowly releases hormones into your bloodstream. You wear one patch per week for three weeks, changing patches on the same day each week. In the fourth week, you don’t wear a patch (during that week, you have your period). With perfect usage, the contraceptive patch can be 99% effective. With typical usage (e.g. putting a patch on late), the contraceptive patch can be 91% effective.
  • Vaginal ring: this is a small, flexible, plastic ring that you insert into your vagina (once it’s in, you won’t feel it). It slowly releases hormones over three weeks. At the beginning of the fourth week, you remove the ring and have your period. At the end of that week, you insert a new ring. With perfect usage, the vaginal ring can be 99% effective. With typical usage (e.g. the ring isn’t inserted correctly), the vaginal ring can be 91% effective.
  • Intrauterine contraception (IUC): also called an intrauterine device or IUD, this is a small, T-shaped device inserted into the uterus by a health-care professional. It’s 99% effective at preventing pregnancy and is the most effective form of birth control available. Some IUDs can remain in the uterus for up to 10 years before needing to be replaced.

Side effects

Some women experience side effects when they use hormonal contraception. These can include irregular bleeding or spotting, breast tenderness, nausea, headaches and other symptoms. Hormonal contraception can also cause beneficial side effects such as decreased acne and premenstrual symptoms. If you have questions about side effects, you should talk to a doctor or pharmacist.

Condoms

Condoms are the only contraceptive method that helps protect against both pregnancy and STIs.

Male condoms are worn over the penis during sexual activity, creating a physical barrier that prevents sperm from entering the vagina. They’re available in different textures and sizes. Most are made of latex, but there are different materials for people who are allergic to latex. (Note that condoms made of sheep intestine don’t protect against STIs.) With perfect usage, male condoms can be 98% effective. With typical usage (e.g. the condom slips), condoms can be 82% effective.

Female condoms are placed inside the vagina. They are made of a polymer sheath and two flexible rings. It can be inserted up to eight hours before sex. Female condoms should only be used once. With perfect usage, female condoms can be 95% effective. With typical usage (e.g. the condom breaks), female condoms can be 79% effective.

You can buy condoms at drugstores without a prescription. Condoms should only be used once. Never use two at the same time and don’t use condoms that have expired (check the package for the expiry date). Condoms can sometimes break or slip. You may want to combine condoms with another contraceptive method (e.g. spermicide) to reduce the chances of pregnancy.

Other barrier methods

Like condoms, other barrier methods of birth control help prevent sperm from entering the cervix including:

  • Spermicide: spermicide contains a sperm-killing chemical called nonoxynol-9. It’s available in different forms including cream, foam, gel, film and suppository. (Note that cream is for use with diaphragms only.) Spermicide is one of the least reliable methods of birth control, so it’s best to use it with another contraceptive (condom, sponge, diaphragm, etc.). With perfect usage, spermicide can be 85% effective. With typical usage (e.g. not enough spermicide is used), spermicide can be 71% effective. Nonoxynol-9 doesn’t protect against STIs; some studies have shown it may increase the risk of HIV transmission in those already at high risk.
  • Sponge: the sponge is a small piece of foam that contains spermicide. It’s inserted into the vagina and over the cervix, creating a physical barrier to block and kill sperm. The sponge can be inserted up to 24 hours before sex. It must be left in for six hours after sex (no more than a total of 30 hours). You can have sex multiple times while using the same sponge, but then it must be thrown away. Sponges are less effective than other methods of birth control, so it’s a good idea to use them with another method such as a condom. With perfect usage, the sponge can be 91% effective. With typical usage (e.g. the sponge is removed too early), the sponge can be 76% effective. Sponges don’t protect against STIs and may be less effective for women who have given birth in the past.
  • Diaphragm: this is a soft, flexible, reusable cap made of latex, nylon or silicone that blocks sperm from entering the cervix. It must be used with spermicide. The diaphragm can be inserted up to two hours before sex. It should be left in place for at least six hours after sex (no more than a total of 24 hours). Diaphragms are less effective than other contraceptives, so it’s a good idea to combine them with another method such as a condom. With perfect usage, diaphragms can be 94% effective. With typical usage (e.g. the diaphragm isn’t inserted correctly), diaphragms can be 88% effective.
  • Cervical cap: this is a silicone cap worn over the cervix to block sperm from entering. It must be used with spermicide. A cervical cap can be inserted up to two hours before sex. It must be left in place for at least six hours after sex (no more than a total of 48 hours). Cervical caps are available from pharmacies with a prescription. Cervical caps are less effective than other contraceptives, so it’s a good idea to use another method such as a condom. With perfect usage, cervical caps can be 86% effective. With typical usage (e.g. the cervical cap doesn’t stay in place), cervical caps can be 71% effective. Cervical caps may be less effective for women who have given birth in the past.

Withdrawal (the pull-out method)

Withdrawal means that a male pulls his penis out of his female partner’s vagina, and away from her genitals, before he ejaculates. This is a risky and unreliable method of birth control. It requires a lot of self-control. Males also can’t control the release of pre-ejaculate fluid, which can contain sperm. With perfect usage, withdrawal can be 96% effective. With typical usage (e.g. the penis isn’t pulled out at the right time), withdrawal can be 73% effective. Withdrawal doesn’t protect against STIs.

Abstinence

Abstinence means not having sex, specifically vaginal intercourse, to prevent the possibility of pregnancy. To be extra careful, you can also avoid contact between the vagina and a male partner’s ejaculate or pre-ejaculate. Abstinence is the only method of birth control that’s 100% effective.

Surgery

Surgery is another alternative to prevent pregnancy. People who choose surgery are usually certain they don’t want to have children (or more children) and no longer want to worry about birth control. Surgery doesn’t protect against STIs.

  • Tubal ligation and tubal occlusion: one procedure for women is tubal ligation. It disconnects the fallopian tubes from the uterus, which prevents eggs from reaching the uterus. This is a permanent surgery. Another procedure for women is tubal occlusion. A micro-insert is placed in each fallopian tube to form a barrier for eggs. This is also a permanent procedure.
  • Vasectomy: this procedure for men involves removing or blocking the vas deferens — the tube that transports sperm to the penis — so that no sperm is released.

Each contraceptive method has its pros and cons. If you have questions about birth control, you can talk to a safe adult such as a doctor. You can also call a Kids Help Phone counsellor at 1-800-668-6868 if you need support.

What are sexually transmitted infections (STIs)?

Sexually transmitted infections (STIs) are spread through sexual contact. Some STIs can be cured with medications and others have no treatment or cure. If you’re sexually active, it’s important to protect yourself and your partner from STIs.

Types of sexually transmitted infections (STIs)

There are many different sexually transmitted infections (STIs). Here are some common types:

Chlamydia

What it is: bacterial infection. Most chlamydia infections occur in people ages 15 to 24.
How it’s transmitted: unprotected oral, vaginal or anal sex with an infected partner.
Symptoms: many people have no symptoms. If there are symptoms, women may experience vaginal discharge, vaginal bleeding after sex or between periods or pain during sex. Men may have clear or milky discharge from the penis or pain or swelling in the testicles. Both men and women may feel burning or pain while urinating. Chlamydia can also affect the eyes, throat and anus.
Prevention: condoms, or condoms or dental dams during oral sex.
Treatment: antibiotics and retesting after six months.

Genital herpes

What it is: viral infection.
How it’s transmitted: unprotected vaginal or anal sex.
Symptoms: most people have no symptoms or mild symptoms. If there are symptoms, they can include flu-like symptoms (sore muscles, headache, fever, etc.), swollen lymph nodes, genital ulcers, itchy and painful genital sores, pain while urinating or inflammation in the nervous system. After the first infection, the herpes virus stays in the nerve cells. It can become active again, triggered by stress or other factors.
Prevention: condoms, and avoiding sex with partners who have symptoms or active sores.
Treatment: there is no cure for herpes, but medications can help make outbreaks shorter and less severe.

Human papilloma virus (HPV) — including genital warts

What it is: viral infection. Human papilloma virus (HPV) is the most common STI in the world. There are more than 100 types of HPV. Some cause genital warts and others may eventually cause cancer.
How it’s transmitted: oral, vaginal or anal sex, or skin-to-skin genital contact, with an infected partner.
Symptoms: with the types of HPV that cause genital warts, some people have no symptoms. Others experience warts on the genitals, itchiness and discomfort during sex. With the types of HPV that cause cervical cancer, often there are no symptoms. However, some women may experience bleeding after sex or between periods. A Pap test — a test for women that involves removing a small amount of cells from the cervix and looking at them under a microscope — can detect pre-cancerous changes caused by HPV. HPV is also linked to cancers of the penis, anus, vulva and throat.
Prevention: condoms and HPV vaccination (the vaccine is approved in Canada for males ages nine to 26 and females ages nine to 45).
Treatment: doctors can prescribe creams or injections for genital warts, but they won’t cure the virus. These HPV flare-ups usually clear within two years, but persistent infection or reinfection is possible.

Gonorrhea

What it is: bacterial infection. Gonorrhea is also known as “the clap.”
How it’s transmitted: unprotected oral, vaginal or anal sex with an infected partner.
Symptoms: women may experience increased vaginal discharge, vaginal bleeding after sex or between periods, pain during sex or pain in the abdomen or lower back. Men may experience yellowish-green discharge from the penis, pain or swelling in the testicles or an itchy penis. Both women and men may have pain during urination. Gonorrhea can also affect the rectum, eyes and throat.
Prevention: condoms, or condoms or dental dams during oral sex.
Treatment: antibiotics and retesting after six months.

Hepatitis B

What it is: viral infection that affects the liver.
How it’s transmitted: oral, vaginal or anal sex with an infected partner, or sharing needles or household items (toothbrush, razor, nail clippers, etc.) with an infected person.
Symptoms: many people have no symptoms. Others experience flu-like symptoms such as joint pain, rash, fever, fatigue, nausea and vomiting, decreased appetite or, rarely, yellowing of the skin and eyes.
Prevention: hepatitis B vaccine.
Treatment: there is no cure for hepatitis B. Most people (95%) recover within six months of infection, but some people (5%) develop a chronic infection that requires treatment.

HIV-AIDS

What it is: human immunodeficiency virus (HIV) is a viral infection that attacks the immune system. It can develop into acquired immune deficiency syndrome (AIDS).
How it’s transmitted: oral, vaginal or anal sex with an infected partner or shared needles including tattoo needles.
Symptoms: flu-like symptoms such as fatigue, rash, oral or genital ulcers, sore throat, headaches, nausea or vomiting, muscle aches or diarrhea. These disappear after a few weeks. It can take several more years for chronic symptoms to develop. If HIV progresses into AIDS, it can cause cancers, dementia and death.
Prevention: condoms and avoiding the sharing of needles.
Treatment: there is no cure for HIV, but medications and treatment can help control it and prevent it from progressing into AIDS.

Syphilis

What it is: bacterial infection.
How it’s transmitted: oral, vaginal or anal sex with an infected partner, or contact with sores and rashes of an infected person.
Symptoms: syphilis has several stages. At first, symptoms are less severe — a sore at the point of infection, followed by flu-like symptoms such as muscle and joint pain, fever, swollen glands, headaches, rashes or hair loss. They may disappear, but the infection remains, symptoms may return, and the bacteria can multiply in the body. If syphilis isn’t treated, it can eventually cause serious health problems that can lead to death.
Prevention: condoms, or condoms or dental dams during oral sex.
Treatment: penicillin injections.

Trichomoniasis

What it is: infection caused by the parasite Trichomonas vaginalis.
How it’s transmitted: unprotected sexual activity.
Symptoms: there may be no symptoms. Men may experience pain or burning while urinating, irritation in the penis or discharge from the penis. Women may experience vaginal irritation and itchiness, vaginal bleeding or spotting, pain or burning while urinating, vaginal discharge that is yellowish-green or off-white, foul-smelling and frothy, or pain during sex.
Prevention: condoms.
Treatment: oral antibiotics.

If you have questions about STIs, you can talk to a safe adult such as a doctor.


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