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CONTRACEPTION BIRTH CONTROL OPTIONS SUMMARY %Range Protection Against METHOD Of Effectiveness STI Abstinence 100 Yes Vasectomy 99+ No Depo-Provera (Injectable) 99+ No Tubal Ligation 99+ No Birth Control Patch (Evra) 99 No Intrauterine Device (IUD) 98 – 99 No Combination Birth Control Pill 97 – 99 No Mini Pill (Progesterone only) 95 – 99 No Male Condom 86 – 97 Yes Natural Family Planning 80 – 99 No Diaphragm with Spermicide 80 – 94 No Cervical Cap with Spermicide (Lea’s Shield) 80 – 91 No Protectaid Sponge 80 No Female Condom 79 – 95 Yes Emergency Contraception (Morning After Pill) 75 - 98 No Spermicidal Foam 75 No Vaginal Contraceptive Film 72 No Chance 15 No The range of effectiveness, or how well it works, represents the typical use or “real life use” (the lower number) versus the perfect use (the higher number) over the period of one year. CONTRACEPTION The Pill $11.00 - $16.00 per month Depo-Provera $40.00 - $50.00 for three months Evra Patch $18.00/month Vaginal Ring $17.00/month Morning After Pill $27.00 I.U.D.: Copper T $195.00 (5 years) Mirena $370.00 (5 years) Condoms: Latex $6.00 - $11.00 per dozen Polyurethane $15.00 - $16.00 per package of 5 Female Condom $10.00 - $14.00 per package of 3 Cervical Cap $60.00 for device at FPC Lea’s Shield $50.00 Diaphragm $50.00 for device and Jelly $20.00 Foam $12.00 - $20.00 with applicator Advantage 24 Gel $11.00 per package of 3 Sponge $11.00 per box of 4 Vaginal Contraceptive Film $9.00 per package of 6 FACTS ABOUT TEENAGE PREGNANCY 90% are unplanned 1 out of 10 teenage women will be pregnant before 18 50% will end in abortion 85 – 90% of teens who of teens who deliver a baby choose to parent Over half of teens that parent do not finish school 2 out of 3 women who become mothers as teens spend their lives in poverty Birth Control Pill Advantages very effective at preventing pregnancy your period is regular and sometimes lighter you may bleed less during you period you don't have to interrupt sex the woman controls this method of birth control may decrease menstrual cramps or pain may help control the pain associated with endometriosis Disadvantages you are not protected against sexually transmitted infections you need a prescription you must remember to take it at the same time every day you may have side effects women with some health conditions cannot take birth control pills (see side effects page for details) Spermicidal Foam • For vaginal intercourse, your choice of spermicide is inserted into the vagina ahead of time. The spermicidal chemicals may cause genital irritation, particularly N-9. If you experience inflammation or a burning sensation, look for a spermicide with octoxynol or a lower amount of N-9. The various spermicides are listed below and include information about their N-9 content: • Foam Spermicidal foam is the same consistency of mousse hair-styling products. Shake the can of foam vigorously for at least 30 seconds. Press the tip of the applicator on the nozzle of the can, press down and fill the applicator. Insert the applicator into the vagina approximately three inches and depress the plunger to squirt the foam out. It will be active immediately. Foam has a concentration of N-9 of about 12.5%, which may lead to genital irritation. The applicator may be washed with mild soap and water, stored in a clean, dry place and used again. Diaphragm The diaphragm is a latex cap that covers the cervix and prevents sperm from getting inside. The diaphragm should always be used in combination with a foam spermicide, placed inside the diaphragm, to offer protection from pregnancy. Benefits It offers women privacy and control, because they can insert it before sex. If used perfectly, the failure rate is 4-8%. In other words, if 100 women use it correctly for one year, four to eight of them will become pregnant. Disadvantages Some women find diaphragms difficult to insert at first, and others find that it doesn't fit them right. There is also a chance of developing a urinary tract infection while using it. Does not protect against sexually transmitted infections(STIs). Where to find it You can make an appointment with your doctor to have a diaphragm fitted properly to your body. Average cost is about $40. • The diaphragm is a latex dome with a flexible steel ring around its edge that is positioned in the vagina, over the cervix (non-latex diaphragms also available) • Requires a prescription and needs to be sized by a healthcare professional. Available in pharmacies, family planning clinics and online. • Block the entry to the uterus so sperm cannot enter and fertilize an egg • Must be left in the vagina for 6-8 hours after intercourse • Spermicide should be reapplied for each act of intercourse • The diaphragm is 94% effective when used perfectly • With typical use, it is 84% effective • Contains no hormones • Can be used by breastfeeding women • Some protection against certain sexually transmitted infections • Can be inserted several hours before intercourse • Must be available at time of intercourse • Requires proper insertion technique • Does not protect against certain sexually transmitted infections • Diaphragm may increase the risk of recurrent urinary tract infections • May be dislodged during intercourse (consider morning after pill) • Some people may be allergic to spermicides Depo-Provera • An injection that is given in the arm or buttocks 4 times per year (every 12-13 weeks) • It contains only one hormone (a progestin) and does not contain estrogen. It can be used by women who cannot take contraceptive methods with estrogen, for example women over 35 who smoke. • Requires a prescription and the injection has to be given by a healthcare professional • Prevents the ovary from releasing an egg • Thickens the cervical mucus making it difficult for sperm to get through • Causes changes in the lining of the uterus • The “shot” is 99.7% effective when used perfectly • With typical use, it is 97% effective • Effective and reversible (not permanent) • Does not contain estrogen • Only 4 times per year • May be suitable for breastfeeding women • May stop having periods (amenorrhea). After 1 year, over 50% of users will stop having periods, and after 2 years, over 66% of women will stop having periods • Improves symptoms of endometriosis • Decreases the risk of endometrial cancer • Irregular bleeding is a common side effect • Causes a decrease in bone mineral density. This appears to be reversible when the injection is stopped • May cause weight gain • Delay in getting pregnant when it is stopped. May take up to 9 months after the last injection for the ovaries to start releasing an egg again. • Does not protect against sexually transmitted infections (STIs) Sponge • A soft foam sponge that contains a spermicide to disable sperm. • Available in stores, pharmacies and online • Sponge is placed inside the vagina over the cervix where it acts as a barrier, absorbing and disabling sperm. It is effective for up to 12 hours. • The sponge is 91% effective for women who have not given birth (nulliparous) and 80% effective for women who have previously given birth (parous) when used perfectly. • With typical use, it is 84% effective for nulliparous women and 68% for parous women • Does not contain hormones • Can be used by women who smoke or are breastfeeding • Does not protect against certain sexually transmitted infections • Sponge users may experience vaginal infection or irritation • If the sponge is left in the vagina for excessive periods of time, symptoms of toxic shock may appear • Some people may be allergic to spermicides Rhythm Method • The rhythm method is one of the first fertility awareness methods to be widely practiced. It is one of the oldest methods of natural birth control and by far one of the best-known forms of fertility awareness. Unfortunately, it is not necessarily the most reliable method of preventing a pregnancy. • Theory and Practice The rhythm method is based on three ideas. Firstly, that women ovulate 14 days before menstruation begins, give or take two days. Secondly, that sperm can survive inside a woman for three days. And lastly, that an egg can only be fertilized within 24 hours of being released from the ovaries. • Based on these assumptions, the rhythm method requires a woman to count back 14 days from the first day of her period. This will presumably be the day on which she ovulated and will ovulate the following month. In order to avoid pregnancy, she will need to abstain from sex or use another form of birth control, like condoms, around this time. • Problems While this method is fairly simple to follow, it is not necessarily applicable to all women. The first problem lies in the assumption that ovulation will always occur at the same time every month. While it would make life a lot easier for women if this were true, the reality is that the majority of women ovulate at a different time every month. Although they may follow a similar pattern, no woman has a menstrual cycle that is identical every month. • Another issue with the rhythm method is the belief that sperm are only viable inside a woman for up to three days. It has been found that sperm may be able to survive for as much as seven days inside a woman. Therefore, it would be necessary to avoid having sex for at least a week prior to when a woman believes ovulation will occur. • Moreover, this type of contraception offers absolutely no protection against sexually transmitted diseases. Therefore, it will still be necessary to use a condom if you think you may be at risk of an STD. • Effectiveness The rhythm method has an average failure rate of 13 to 20%. It is not recommended for women who have irregular cycles or who do not have menstrual cycles that are exactly the same number of days every month. Patch The Ortho Evra Contraceptive Patch is the first weekly form of birth control. It is a discreet and reversible type of prescription contraception. It is a 4 x 4 cm, thin, smooth, beige, plastic patch that sticks to a woman’s skin. How It Is Used: A new patch is put on once a week, for 3 consecutive weeks each month. You will have to change your contraceptive patch on the same day each week at any hour. No patch is used in the fourth week when a woman will typically get her period. The patch can be worn on 1 of 4 areas of the body: upper outer arm, abdomen, buttocks, or upper torso (front and back, excluding the breasts). The patch is versatile as a woman can choose to wear the patch in a different area of her body each week. Many women will change their patch location weekly, depending on wardrobe choices and what feels best to them. How It Works : The patch is designed to continuously release a steady flow of synthetic estrogen and progestin through the skin and into the bloodstream to protect against pregnancy for 7 days (which is why a woman must replace it after each week). The Ortho Evra patch contains the same hormones found in the Pill. Like other combined hormonal methods, the patch: Helps prevent ovulation (release of an egg) Thickens cervical mucus so that sperm have more difficulty swimming through the uterus Causes changes in the lining of the uterus to reduce the likelihood of implantation Advantages: The patch is simple, convenient, and safe It doesn't involve taking a daily pill, so it’s one less thing to think about each day The patch is comfortable and discreet It is reversible – the ability to become pregnant returns after stopping use You can do everything you normally do, and know that the patch is right there, doing its job The Ortho Evra Patch does not interfere with having sex and can allow for more spontaneity Many who use the patch report having regular, lighter, and shorter periods Ortho Evra easily adheres to the skin and does not prohibit activities such as bathing, showering, swimming, and exercising Disadvantages: • There is a low incidence of side effects for those women who choose to use the patch. These side effects will usually disappear after 2 to 3 months of use and may include: Mood changes • Headaches • Bleeding between periods • Breast tenderness • Nausea (sometimes with vomiting) • Other disadvantages associated with the patch are: Changes in sexual desire • Women with a history of depression may not be able to continue to use the patch if their depression worsens • Skin reaction at the site of application Special Warning: • Hormones from patches applied to the skin get into the bloodstream and are removed from the body differently than those from pills taken by mouth. Women using the patch are exposed to about 60 percent more estrogen than if using a typical birth control pill • Generally, increased estrogen exposure could increase the risk of side effects • The risk of blood clots in the legs and/or the lungs may be higher with the patch compared to a typical birth control pill of 35 mcg of estrogen The effectiveness of the Ortho Evra Patch can also be lowered due to user error. A woman may be more at risk for pregnancy if: • The patch falls off and is not replaced within 24 hours • A woman forgets to change the patch each week • If the patch is not stored at room temperature • If the patch is not kept keep sealed until it is applied • The woman tries to reapply a patch that is no longer sticky, has been stuck to itself or another surface, has other material stuck to it, or has become loose/ fallen off before Condom A soft disposable sheath that fits over the erect penis • Available in different sizes, shapes, thicknesses, colours, and flavours • Most are latex but non-latex condoms are also available (polyurethane, silicone, lambskin) • Available in stores, pharmacies and online • Physical barrier acts to prevent direct genital contact and the exchange of genital fluids • A new condom is used for each act of intercourse • The condom is 98% effective when used perfectly • With typical use, it is 85% effective • Available without a prescription • Latex condoms protect against sexually transmitted infections • May help to avoid premature ejaculation • Must be stored and handled properly • Must be available at time of intercourse and may reduce spontaneity • May slip or break (consider the morning after pill) • May reduce sensitivity for either partner Spermicide • Spermicides come in several other forms, including creams, jellies, tablets, suppositories, foams and film. • Available in stores, pharmacies and online • Spermicides are inserted into the vagina, and contain ingredients that disable sperm. They can be used together with other forms of contraception. • Spermicide is 82% effective when used perfectly • With typical use, it is 71% effective • Spermicides are very effective when used with a barrier method. • Does not contain hormones • Can be used by women who smoke or are breastfeeding • Spermicide may also provide lubrication • Does not protect against sexually transmitted infections • Some people may be allergic to spermicides WHAT IS IT? HOW DOES IT WORK? EFFECTIVENESS ADVANTAGES DISADVANTAGES • A soft disposable sheath that fits over the erect penis • Available in different sizes, shapes, thicknesses, colours, and flavours • Most are latex but non-latex condoms are also available (polyurethane, silicone, lambskin) • Available in stores, pharmacies and online • Physical barrier acts to prevent direct genital contact and the exchange of genital fluids • A new condom is used for each act of intercourse • The condom is 98% effective when used perfectly • With typical use, it is 85% effective • Available without a prescription • Latex condoms protect against sexually transmitted infections • May help to avoid premature ejaculation • Must be stored and handled properly • Must be available at time of intercourse and may reduce spontaneity • May slip or break (consider the morning after pill) • May reduce sensitivity for either partner Female Condom • A soft, disposable, polyurethane sheath • Available online and in some stores and pharmacies • Placed in the vagina before vaginal intercourse. • Lines the vagina and prevents direct genital contact and exchange of body fluids • A new condom should be used for each act of intercourse • The female condom is 95% effective when used perfectly • With typical use, it is 79% effective • Available without a prescription • Protects against some sexually transmitted infections • Must be available at time of intercourse • Needs to be inserted properly • More expensive than male condoms • Makes a noise during intercourse. • May slip or break. Natural Family Planning • Natural family planning methods rely on a woman’s knowledge and awareness of her body and menstrual cycle to avoid pregnancy. • They do not rely on contraceptive devices, hormones or barrier methods to provide contraception. • There are several methods: Calendar, Ovulation, Sympto-Thermal, Post-Ovulation • Instructions and materials available in pharmacies. Contact SERENA Canada for expert advice • A woman monitors her monthly cycle by tracking the days on a calendar and/or by taking her temperature and/or by monitoring changes to her cervical mucus • This information helps her determine when her body releases an egg (ovulates); Ovulation is when she is most likely to become pregnant from intercourse • Intercourse is avoided during this fertile period • Depends heavily on the method used, motivation, and experience • The sympto-thermal method is 98% effective when used perfectly. Other natural family planning methods are not as effective. • The typical use failure rate is 25% Cont.. • Women become familiar with their body and menstrual cycles • Information can also be used later to plan a pregnancy • Inexpensive and natural • Requires willpower, periodic abstinence, and motivation • Takes time and effort to learn to use the method properly • Does not prevent STIs • Reduces spontaneity Withdrawl Coitus interruptus, also known as withdrawal or the pull-out method, is a method of contraception in which a couple has sexual intercourse, but semen is ejaculated outside of and away from the vagina. Coitus interruptus may also more generally refer to any extraction of the penis prior to ejaculation during intercourse. This method has been widely used for at least 2,000 years and was used by an estimated 38 million couples worldwide in 1991 Advantages The advantage of coitus interruptus is that it can be used by people who have objections to or do not have access to other forms of contraception. (Some men prefer it so they can avoid possible adverse effects of hormonal contraceptives on their partners.) Some women also prefer this method over hormonal contraception to avoid adverse effects such as depression, mood swings, vaginal dryness, decreased libido, and headaches, among others. It has no direct monetary cost, requires no artificial devices, has no physical side effects, can be practiced without a prescription or medical consultation, and provides no barriers to stimulation. Disadvantages Compared to the common reversible methods of IUDs, hormonal contraceptives, and male condoms, coitus interruptus is less effective at preventing pregnancy. As a result, it is also less cost-effective than many more effective methods: although the method itself has little direct cost, users have a greater chance of incurring the risks and expenses of pregnancy and child-birth. Only models that assume all couples practice perfect use of the method find cost savings associated with the choice of withdrawal as a birth control method.[ The method is largely ineffective in the prevention of STDs, like HIV, since pre-ejaculate may carry viral particles or bacteria which may infect the partner if this fluid comes in contact with mucous membranes. However, a reduction in the volume of bodily fluids exchanged during intercourse may reduce the likelihood of disease transmission compared to using no method due to the smaller number of pathogens present. The method may be difficult for some couples to use. The interruption of intercourse may leave some couples sexually frustrated or dissatisfied. Morning After Pill Emergency Contraception After Sex If you've had unprotected intercourse and don't want to get pregnant, you still have a method of birth control at your disposal: emergency contraception (EC). Unlike other forms of contraception, EC can be used after intercourse to prevent pregnancy. After an unprotected sexual encounter, you have a window of between 3 and 5 days in which to use EC, although the sooner you use it, the better it works. There are three methods of EC in current use: a single dose of contraceptive pills called Plan B, a series of two doses of contraceptive pills called the Yuzpe method, and insertion of an IUD. All of these methods are easy to use, and up to 99 per cent of women who use them are able to avoid an unwanted pregnancy. Of course, the majority of these women would not have been pregnant in the first place. Emergency contraceptives work by altering the cervical mucus so that it becomes "hostile" to sperm. They also thin the lining of the uterus, making it very difficult for a fertilized egg to implant. However, in the unlikely event that implantation does occur, EC does not interrupt the pregnancy or put the fetus at risk. Here are some situations in which Emergency Contraception may be appropriate: You had intercourse unexpectedly or without contraception You were forced to have sex or awoke to realize you were having sex Your partner didn't "pull out" in time You had a contraceptive accident, such as a broken condom or slipped diaphragm You forgot to take your birth-control pills for two or more days before having sex While very safe, EC can cause side effects such as nausea or vomiting. These effects are much less common with Plan B than with the Yuzpe method. If you vomit within an hour of taking EC, you'll need to retake the dose. How to get it You can get EC (or a prescription for EC) from your doctor, a health centre, a walk-in clinic, a birth control/sexual health clinic or directly from your pharmacist. You can obtain the product in advance and store it for use in case of an emergency, but remember that you should not rely on EC as your primary method of birth control, as it's less effective than regular contraceptive methods and offers no protection against sexually transmitted infections. Call the Canadian Federation for Sexual Health’s bilingual hotline (formerly Planned Parenthood Federation of Canada), 1-888-270-7444, for guidance about getting ECs in your area. Another method of emergency contraception is the insertion of an intrauterine device (IUD) within 7 days of unprotected intercourse. The IUD works by preventing the implantation of a fertilized egg and is very effective: only one out of 1,000 women who use this method will get pregnant. A drawback to using an IUD is that it might be possible to spread a sexually transmitted infection (STI) into your reproductive tract. For this reason, emergency IUDs are best suited to women who've had unprotected sex within the context of a long-term, monogamous relationship. Your doctor or local family planning clinic can help you access this form of contraception. Billings Method The Billings ovulation method (BOM) is a method which women use to monitor their fertility, by identifying when they are fertile and when they are infertile during each menstrual cycle. Users pay attention to the sensation at their vulva, and the appearance of any vaginal discharge. This information can be used to achieve or avoid pregnancy during regular or irregular cycles, breastfeeding, and peri-menopause. Described by the BOM organization as "Natural Fertility Regulation", this method may be used as a form of fertility awareness or natural family planning, as well as a way to monitor gynecological health. In trials method related pregnancy rates have ranged between 0% to 2.9%. In a recent trial in China 992 couples using the Billings Method were compared to 662 couples using the IUD. The method-related pregnancy rate amongst Billings users was zero and the total pregnancy rate was 0.5%. In studies up to the 1980s teaching related pregnancies ranged between 0% to 6%. Total pregnancy rates vary between 1 and 25%. Reasons for a higher total pregnancy rate include misunderstanding the method, risk taking, ambivalence toward pregnancy, and deciding to become pregnant. You can take courses to learn this method. You must keep good track of your vaginal discharge. It is cheap and requires nothing for you to purchase. You can read up on the method on the internet. Effectiveness ranges form 75-97%. You can buy tools to help you. IUD The Mirena intrauterine device (IUD) is a small, "T-shaped" contraceptive device made of flexible plastic and must be inserted by a qualified health-care professional (such as an ob/gyn or nurse practitioner). Mirena releases a low amount of progestin levonorgestrel continuously over a 5-year period as a way to prevent pregnancy. How It Works: • The Mirena IUD helps prevent sperm from joining with an egg by affecting how the sperm move. Basically, it interferes with the movement of the sperm toward the egg. The hormonal component in Mirena makes it more effective than the ParaGard IUD. The Mirena IUD also: Thickens cervical mucus so that sperm have more difficulty swimming through the uterus • Changes the lining of the uterus, which reduces the likelihood of implantation • For some women, it may also prevent ovulation from occurring • Mirena is effective immediately if inserted within 7 days after the start of your period. If you have Mirena inserted at any other time during your menstrual cycle, use another method of birth control during the first week after insertion. Pregnancy protection will begin after 7 days. Advantages: • It can provide continuous pregnancy prevention for 5 years and can be removed anytime within that 5-year period • Convenient and hassle-free – once inserted, you don’t have to do anything • According to Planned Parenthood, IUDs are the most popular form of reversible birth control in the world • An IUD is the most inexpensive long-term reversible method of contraception • IUDs can improve a woman's sex life by allowing for spontaneity • A good alternative option for women who cannot tolerate estrogen-based contraceptives • After removing the IUD, a woman’s ability to become pregnant returns quickly • It is an extremely private and discreet birth control method. Nobody can tell if you are using it, and there is no packaging or other evidence of use that may embarrass some woman • The Mirena IUD can reduce menstrual cramps and the amount of bleeding that accompanies a woman’s period. Typically, women using Mirena may see that their menstrual flow is reduced by 90 percent. In approximately 20 percent of Mirena users, their flow stops altogether within one year. This could lower one’s risk for anemia Disadvantages: • Although most women do not experience any trouble adjusting to an IUD, some women may have heavy bleeding and cramping during the first few weeks or months after insertion. However, doctors can prescribe medication that can lessen cramps and bleeding during menstruation. • It is not unusual for some spotting to occur between periods during the first few months of IUD use. • Some women may endure cramping or backache for several days or weeks after the IUD is inserted. • For some women, the unpredictable bleeding between periods does not stop after the first few months. The most common reason that women request Mirena removal is because of this irregular bleeding profile. Mirena is not recommended for women who: •Have ever had PID •Currently have an untreated pelvic infection •May be pregnant •Have or may have a STD •Have/had breast cancer •Have had a pelvic infection in the past three months following either childbirth or an abortion •Might have cancer of the cervix or uterus •Are already using an IUD •Have an abnormally shaped uterus •Have liver disease or a liver tumor •Have unexplained bleeding from the uterus •Have more than one sexual partner, or a sexual partner who has more than one sexual partner •Have had, or are at risk of having, an ectopic pregnancy •Are allergic to levonorgestrel, silicone or polyethylene •Have a condition that changes the shape of the uterus (such as large fibroid or tumor) •Get infections easily, including women with immune-system problems, •leukemia, AIDS, or who abuse intravenous drugs. Abstinence What Is It? • Abstinence is not having sex. A person who decides to practice abstinence has decided not to have sex. How Does It Work? • If two people don't have sex, then sperm can't fertilize an egg and there's no possibility of a pregnancy. Some forms of birth control depend on barriers that prevent the sperm from reaching the egg (such as condoms or diaphragms). Others interfere with the menstrual cycle (as birth control pills do). With abstinence, no barriers or pills are necessary because the person is not having sex. • You don't have to be a virgin to practice abstinence. Sometimes people who have been having sex decide not to continue having sex. Even if a person has been having sex, he or she can still choose abstinence to prevent pregnancy and sexually transmitted diseases (STDs). How Well Does It Work? • Abstinence is 100% effective in preventing pregnancy. Although many birth control methods can have high rates of success if used properly, they can fail occasionally. Practicing abstinence ensures that a girl won't become pregnant because there's no opportunity for sperm to fertilize an egg. Protection Against STDs • Abstinence protects people against STDs. Some STDs spread through oral-genital sex, anal sex, or even intimate skin-to-skin contact without actual penetration (genital warts and herpes can be spread this way). So only avoiding all types of intimate genital contact can prevent STDs. Avoiding all types of intimate genital contact — including anal and oral sex — is complete abstinence. •Only complete and consistent abstinence can totally prevent pregnancy and protect against STDs. Because a person does not have any type of intimate sexual contact when he or she practices complete abstinence, there is no risk of passing on a sexually transmitted infection. Consistent abstinence means that someone practices abstinence all the time. Having sex even once means that the person risks getting an infection. •Abstinence does not prevent AIDS and hepatitis B infections that come from nonsexual activities like using contaminated needles for doing drugs, tattooing, or taking steroids. How Do You Do It? •Not having sex may seem easy because it's not doing anything. But peer pressure and things you see on TV and in the movies can make the decision to practice abstinence more difficult. •If it seems like everybody else is having sex, some people may feel they have to do it, too, just to be accepted. Don't let kidding or pressure from friends, a girlfriend, a boyfriend, or even the media push you into something that's not right for you. The truth is that most teens are not having sex. •A couple can still have a relationship without having sex. If you've made a decision not to have sex, it's an important personal choice and the people who care about you should respect that. •You may have questions about making this choice or about other methods of birth control. Your doctor or nurse — or an adult you trust, such as a parent, teacher, or counselor — can help provide some answers. 100% only way to not get pregnant and to not get an STI!
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