Private Nurse Practitioner Services
NP Megan Dunn
Family Planning & Birth Control Options
Approximately 40% of pregnancies in Canada are unintended. If you are sexually active and are not planning for pregnancy, there are many different options available for birth control. Hormonal contraceptives generally work by preventing the ovaries from releasing eggs, changing the cervical mucus to prevent sperm from travelling beyond the cervix, and/or thinning the lining of the uterus to prevent implantation.
The Nurse Practitioner can help you decide which type is right for you. Things to consider when choosing a birth control include:
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How effective is the method?
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Is it convenient? Do I have to remember to use it? If so, will I remember to use it?
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Do I have to use/take it every day?
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Is this method reversible? Can I get pregnant immediately after stopping it?
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Will this method cause me to bleed more or less? Will the bleeding I have while using the method be predictable or not predictable?
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Are there side effects or potential complications?
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Is this method affordable?
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Will it be difficult to discontinue this method if I choose to do so?
Subdermal Implant (Nexplanon)
Nexplanon subdermal implant (etonogestrel) is a highly effective long-acting reversible contraception. The implant is a small, flexible rod that is placed just below the skin in the upper arm. The Nurse Practitioner does the insertion during a quick office visit. A low dose of progestin is slowly released to prevent pregnancy for up to 3 years. It can be effective within 24 hours of insertion. It can be removed at any time, and fertility can quickly return once removed.
Intrauterine Device (IUD)
Intrauterine devices or systems are another highly effective form of long-acting reversible contraception. They can remain in place for 3-5 years, and sometimes longer. They can be removed at any time. If you would like your current IUD removed or want to have a string check, please book an in-person appointment. An initial appointment is only required if you would like to be assessed for, and prescribed another form of contraception. We are not inserting IUDs at this time, but can refer as needed.
Oral Contraceptive Pill
Generally speaking, there are two types of birth control pills - combined oral contraceptives (COC), which contain estrogen and progestin, and progestin-only contraceptives (POC). The pill is effective at preventing pregnancy soon after initiation, and fertility can return quickly after stopping. The pill is taken daily, ideally at or around the same time - this is especially important for progestin-only pills.
Progestin-only contraception may be a good option for patients who have contraindications to combined oral contraceptives, such as women who are breastfeeding or at increased risk of blood clots.
Contraceptive Patch
Contraceptive skin patches contain two hormones, estrogen and progestin, similar to combined oral contraceptives, and may be preferred by patients because you do not have to take them every day. You wear the patch for one week on the upper arm, shoulder, upper back, or hip. After one week, you remove the old patch and apply a new patch; you repeat this for three weeks. During the fourth week, you do not wear a patch and will have bleeding during this time. Each new patch should be started on the same day of the week.
Vaginal Ring
Contraceptive vaginal rings are another form of combined contraception, containing estrogen and progestin. A flexible plastic ring is inserted vaginally, where hormones are slowly absorbed into the body. You wear the ring inside the vagina for three weeks, followed by one week when you do not wear the ring; bleeding occurs during the fourth week. With NuvaRing and its generics, a new ring is placed every four weeks. The ring is usually not noticeable, and it is easy for most people to insert and remove.
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Contraceptive Injection
Depo-Provera is a progestin-containing, long-lasting injectable birth control. Depo-Provera is injected deep into a muscle, such as the buttock or upper arm, once every three months. It is very effective at preventing pregnancy but return to fertility can take up to 18 months after stopping, so is not recommended for people who may wish to become pregnant in the next 1-2 years.
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