Substantial proportions of reproductive-aged women in Canada are current or former users of oral contraceptives

Canadian women spend a significant portion of their lives at risk of an unintended pregnancy. Oral contraceptives (OCs) have been legally available in Canada since 1969. OCs are a type of effective and reversible contraception that helps women manage their fertility, which can lead to opportunities for education and employment.

OCs also have non-contraceptive benefits, including better cycle regulation; reduced menstrual cramping; improved perimenopausal and endometriosis symptoms; decreased menstrual flow, acne and body and facial hair growth. Use of OCs is also associated with a reduced risk of some cancers (e.g., endometrial and ovarian).

By combining data from multiple cycles of the Canadian Health Measures Survey, from the 2007-to-2009 cycle to the 2018-to-2019 cycle, the study "Oral contraceptive use in Canada" sought to identify the types of OCs used (by estrogen dose and progestin type). Further, for the first time, this study examines lifetime OC use and the duration of this use, for both current and former OC users.

Percentage of women aged 15 to 49 years using oral contraceptives

On average, 15.9% of non-pregnant women aged 15 to 49 years had used OCs in the 30 days preceding the study, while 53.9% reported using them formerly. The majority of both current (67.5%) and former (52.8%) OC users reported having used them for at least four years.

Most (98.6%) of these women used OCs containing estrogen and progestin. Use of lower-dose formulations has become more common in Canada, with usage increasing to 48.7% over the study period compared with 33.9% from 2007 to 2011.

Sociodemographic characteristics of women using contraceptives

Over the study period, women aged 15 to 39 years were more likely to have used OCs in the 30 days preceding the study than those aged 40 to 49 years. Additionally, use of OCs was higher for women who had not had children and who were currently sexually active.

Non-racialized and non-Indigenous women were more likely than racialized women to be current (past 30 days) users of OCs. Acceptability of contraception and method preference also varied by country or region of birth, as do cultural attitudes and religious beliefs. Unmet contraceptive needs may also have contributed to lowering OC rates in some populations because of language barriers, unfamiliarity with the Canadian health care system, health care provider attitudes or difficulties accessing health care.

Given the enactment of the first phase of the national universal pharmacare program in October 2024, which provides insurance coverage for contraceptives, these estimates will provide important benchmarking information on OC use in Canada, allowing for future evaluations of the impact of this national medication coverage policy change.