The facts about birth control pills in Canada

Birth control pills are a form of round-the-clock contraception. You only need to take one pill once a day to be protected from unwanted pregnancy. Birth control pills can also help with certain health conditions.

As with any birth control method, it’s important to remember that the pill is not always 100% effective. The pill is 91-99% effective when taken perfectly. That means you’re taking your pill at the same time every day, not skipping days, and using alternative forms of non-hormonal birth control as barriers in case a pill is missed and to protect against STIs.

Whatever your reasons for wanting to try the pill, your healthcare provider can help guide you in the right direction. Here’s some basic information on birth control pills in Canada so you can prepare for a conversation with your provider.

What are birth control pills and how do they work?

The birth control pill is one form of hormonal contraception. Usually, people refer to it as just “the pill.” Birth control prevents pregnancy when taken every day by stopping ovulation and thickening the cervical mucus.

This thickening of cervical mucous makes it hard for sperm to reach an egg. In short, the pill, along with other forms of hormonal contraception, either prevents ovulation or an embryo from being fertilized.

What kinds of birth control pills are there?

There are two main categories of birth control pills:

Combination pills — these contain synthetic versions of the hormones estrogen and progestin. The majority of pills you receive in a 28-day package contain active hormones, while a small number of pills are inactive.

You don’t have to take the inactive pills, as they are only placebos. However, many women find it helpful to take the inactive pills to keep them in their routine.

There are a few types of combination pills:

Monophasic — each package of pills covers a one-month cycle, and each active pill contains the same amount of hormones.
Multiphasic — each package covers a one-month cycle, but active pills contain different levels of hormones.
Extended-cycle — these pills are typically used in 13-week cycles. There are 12 weeks of active pills and one week of inactive pills.

Progestin-only pills — this type of pill, known as the mini-pill, contains no estrogen. Instead, its main active hormone is progestin. Every pill in a progestin-only pack is active. Progestin-only pills may be a good choice for women who can’t take estrogen for health reasons.

Can birth control pills regulate your period?

Combination pills can regulate your period. With a 28-day pack, you’ll get a set of inactive pills — your period arrives during that window. For the 21-day pack, you get a week free of pills for your period to come. This way, you’ll always know when it’s time for your period. Progestin-only pills, however, won’t regulate your menstrual cycle since there are no inactive pills.

The combination pill can also be helpful to regulate your period if you experience PCOS. Keep in mind though if you’ve missed a birth control pill or two, you might experience spotting. If you want to regulate your period on birth control, you’ll need to take your pill each day.

When should I take birth control pills and how quickly do they become effective?

You should always talk to a doctor before starting your first pack of combination pills, however, there are several ways to start:

Take your pill as soon as you get your first pack. Take the next six days consecutively and use a backup method of birth control, like a condom, during those first seven days.
To avoid having your period on a weekend, start your pack on a Sunday. During the first seven days of taking your pills, use another method of birth control.
Take your first pill on the fifth day of your period — this way you’ll be protected from pregnancy and may not need a backup method of birth control.

Progestin-only pills will protect you from pregnancy in 48 hours, whether you’re on your period or not.

What would happen if I forget to take my birth control pill, what should I do?

There’s a chance — although it’s very low — that you could get pregnant if you miss one pill. Your risk for this is a bit higher if you’re taking progestin-only pills.

If you forget to take your oral contraceptive and are wondering what to do if you miss a birth control pill, simply take it as soon as you remember — unless it’s close to the time of your next dose. If this is the case, only take your next dose, never double up. From there, continue taking your pills as usual.

If you’ve missed two days of pills and have had unprotected sex in the last five days, you should think about using emergency contraception, like the morning-after pill. Emergency contraception contains the hormone levonorgestrel, which prevents or delays ovulation. These pills have been shown to be 87% to 90% effective if taken within 72 hours of having unprotected sex.

If you’re feeling unsure and don’t know what to do, it’s best to speak to a doctor for further advice.

To help prevent a missed birth control pill, schedule taking it at the same time every day so it’s part of your routine. You can also put a reminder in your phone as a backup just in case.

How safe is birth control and are there severe side effects of taking birth control pills?

Birth control is regarded as safe, but like many medications, there can be side effects. You and your doctor can work together to examine your medical history and determine the right pill for you.

Some side effects women experience are:

Nausea
Tender breasts
Headaches
Abdominal cramping
Breakthrough bleeding
Decreased libido
Increased vaginal discharge

It’s fairly normal to experience side effects when you’re first taking the pill. Doctors recommend that you persevere through minor symptoms for three months. If symptoms persist after that point, it’s worth reexamining the pill you’re taking.

While rare, there’s a link between birth control pills and blood clots. This is because estrogen can heighten your blood’s ability to clot. High blood pressure is another long-term side effect of birth control, which can lead to a heart attack or stroke. As well, a cyst or tubal pregnancy are other serious long-term side effects of birth control.

If you’re experiencing these more serious side effects, it’s time to speak to a doctor. These symptoms can be remembered by the acronym “ACHES”.

A — Abdominal pain
C — Chest pain
H — Headaches (severe)
E — Eye problems (blurred vision)
S — Swelling or aching legs

Breast cancer, liver tumours, and gallbladder disease are also rare but more serious side effects of the pill. Smoking and being over the age of 35 increases your risk of these side effects. It should also be noted that if you already have risk factors for heart disease or high blood pressure that isn’t yet under control, you should avoid birth control that contains estrogen.

How do you get birth control pills in Canada?

You can get a prescription for birth control pills from your family doctor. You might be thinking “how can I get birth control pills if I don’t have a family doctor?” You may also get a prescription from:

A sexual health clinic
A walk-in clinic
An online doctor’s visit

Can you buy birth control pills over the counter in Canada?

The answer is no, the combination and progestin-only pill can only be obtained with a doctor’s prescription. That’s because different pill brands contain unique hormone levels, which aren’t right for every woman. You need a healthcare provider to help choose which pill makes the most sense for your medical history and physiology. Your provider will also follow up to make sure you’re not experiencing dangerous side effects.

You can purchase emergency contraceptives — also known as “the morning-after” pill — in Canada over the counter, such as Plan B.

Does the morning-after pill affect birth control?

No, the morning-after pill doesn’t affect the birth control pill. If you’ve missed two or more birth control pills, have had intercourse, and worry you may be pregnant, it’s safe to take both as directed. If you need to take the morning-after pill, you should continue to take your birth control pill as normal.

Birth control brands in Canada

There’s no “best” birth control brand in Canada. Your provider will recommend which pills make sense for your body and medical history. The following is a list of birth control pills available in Canada:

Combination pills:

Alesse
Apri
Aviane
Loestrin
Yasmin
Yaz
Seasonique
Indayo
Mirvala

Progestin-only pills:

Ortho Micronor
Movisse

Note that this list is not exhaustive and frequently changes due to shortages, backorders, and increased options of generic choices.

How much do birth control pills cost?

After you’ve spoken to your doctor comes the question of cost. How much are birth control pills in Canada? The answer depends, but, on average:

Pickup from the pharmacy — $20 to $35/month
Sexual health clinics — $7 to $23/month

Many health insurance providers will cover the cost of birth control pills. It’s worth checking with your personal or work benefits to see if you can get reduced-cost birth control.

Your privacy in accessing birth control

Unfortunately, there’s still a stigma around asking for birth control, especially in younger patients.

If you’re a youth, you can get birth control without a parent or guardian’s permission. Your doctor and clinic assistants are bound by confidentiality to not disclose anything about your visit. In fact, they can’t even confirm you were at the doctor’s office.

Some women prefer to speak to a doctor about their contraceptive needs from home. It’s a lot quicker and more comfortable than going the walk-in clinic route.

If you’re looking to try birth control pills, you can speak to one of our doctors about a birth control prescription in Canada from your phone, tablet, or computer. That way, you can get personalized medical attention without having to leave home. Prescriptions are sent to your device — from there, you can either pick up your birth control pills at a pharmacy of your choice or have them delivered to your door at no additional cost.

The birth control pill isn’t just a means of contraception. Some women take it to control acne, combat anemia, and even prevent endometrial and ovarian cancer. Whatever your reasons for investigating the pill, it’s always great to have more bodily autonomy. Make sure to speak with a doctor about finding the right pill for you, so you can have maximum freedom and minimum side effects.