Contraception Chapter 6

©2008 McGraw-Hill Companies. All Rights Reserved. Contraceptives Definition. Preventing conception by blocking the female’s egg from uniting with the male’s sperm, thereby preventing pregnancy. Modern contraception are much more predictable and effective than in the past. Many play a role in the prevention against sexually transmitted diseases Chapter 6 ©2008 McGraw-Hill Companies. All Rights Reserved.

Principles of Contraception Based on the physiology of reproduction Types: Barrier, Hormonal, Natural Methods, and Surgical Factors affecting choice Advantages and disadvantages Effectiveness Chapter 6 ©2008 McGraw-Hill Companies. All Rights Reserved.

Oral contraceptives (OCs): “The Pill” Estrogen and progesterone taken orally Mimics the hormonal activity of the corpus luteum Most common is the combination pill Extended-cycle pill “Minipill” Advantages Disadvantages Side effects Effectiveness: Chapter 6 ©2008 McGraw-Hill Companies. All Rights Reserved.

Contraceptive Skin Patch Thin 13/4 inch square patch Releases estrogen and progestin slowly into the bloodstream. Prevention the same way as OCs Worn for one week, replaced on the same day for 3 consecutive weeks. Fourth week no patch Advantages Disadvantages Effectiveness Chapter 6 ©2008 McGraw-Hill Companies. All Rights Reserved.

Vaginal Contraceptive Ring The NuvaRing Resembles the rim of a diaphragm and is molded with progestin and estrogen 2 inch ring slowly releases the hormones During fourth week, remove the ring and use a new ring after the fourth week. Advantages Disadvantages Effectiveness Chapter 6 ©2008 McGraw-Hill Companies. All Rights Reserved.

Contraceptive Implants Norplant; Jadelle (Norplant II); Implanon (2006) Hormonal method 6 flexible matchstick capsules Protection for 5 years Progestin inhibits ovulation Advantages Disadvantages Side effects Effectiveness: Chapter 6 ©2008 McGraw-Hill Companies. All Rights Reserved.

Injectable Contraceptive Depo-Provera, Lunelle (2002 voluntary recall) Hormonal treatment Injectable progestin every 12 weeks Advantages Disadvantage Side effects period will subside - ovaries will not release egg It may take 12 months before cycle will return Effectiveness Chapter 6 ©2008 McGraw-Hill Companies. All Rights Reserved.

Emergency Contraceptive Postcoital Pill, Morning After Pill, Plan B (OTC) Use a EPT kit Most common is the two dose regimen Prevents uterine implantation Needs to be taken within 72 hours. Best used within 24 hours Intrauterine Device Chapter 6 ©2008 McGraw-Hill Companies. All Rights Reserved.

Intrauterine Device (IUD) T-380A (ParaGard) 10 years of protection Copper Levonorgestral (Mirena) 5 years of protection Release small amounts of progestin Not exactly sure how it prevents pregnancy Advantages Disadvantages Effectiveness Chapter 6 ©2008 McGraw-Hill Companies. All Rights Reserved.

©2008 McGraw-Hill Companies. All Rights Reserved. Chapter 6 ©2008 McGraw-Hill Companies. All Rights Reserved.

©2008 McGraw-Hill Companies. All Rights Reserved. Male Condoms Thin latex sheaths Protection against STD’s Advantages Disadvantages Effectiveness Use with spermicide Chapter 6 ©2008 McGraw-Hill Companies. All Rights Reserved.

©2008 McGraw-Hill Companies. All Rights Reserved. Chapter 6 ©2008 McGraw-Hill Companies. All Rights Reserved.

©2008 McGraw-Hill Companies. All Rights Reserved. Female Condom Reality Brand Polyurethane sheath with two flexible rings Advantages Disadvantage Effectiveness Chapter 6 ©2008 McGraw-Hill Companies. All Rights Reserved.

©2008 McGraw-Hill Companies. All Rights Reserved. Chapter 6 ©2008 McGraw-Hill Companies. All Rights Reserved.

The Diaphragm with Spermicide Dome shaped cup of thin rubber stretched over a collapsible metal ring. Custom fit Following intercourse Advantages Disadvantages Toxic shock syndrome (TSS) Effectiveness Lea’s Shield Chapter 6 ©2008 McGraw-Hill Companies. All Rights Reserved.

©2008 McGraw-Hill Companies. All Rights Reserved. Chapter 6 ©2008 McGraw-Hill Companies. All Rights Reserved.

©2008 McGraw-Hill Companies. All Rights Reserved. Cervical Cap Small rubber or plastic cap Must use foam kit Advantages Disadvantage Chapter 6 ©2008 McGraw-Hill Companies. All Rights Reserved.

©2008 McGraw-Hill Companies. All Rights Reserved. Contraceptive Sponge Why they were withdrawn from the market Round, absorbent device about 2 inches in diameter Advantages Disadvantages Effectiveness Chapter 6 ©2008 McGraw-Hill Companies. All Rights Reserved.

©2008 McGraw-Hill Companies. All Rights Reserved. Vaginal Spermicide How it works Advantages Disadvantages Effectiveness Chapter 6 ©2008 McGraw-Hill Companies. All Rights Reserved.

©2008 McGraw-Hill Companies. All Rights Reserved. Chapter 6 ©2008 McGraw-Hill Companies. All Rights Reserved.

Abstinence, Fertility Awareness, and Withdrawal Without intercourse or sexual activities Benefits: more self respect and respect for others. Security that you are being pursued for sexual reasons. Less worry about STDs and Pregnancy. Chapter 6 ©2008 McGraw-Hill Companies. All Rights Reserved.

The Fertility Awareness Method (FAM) Calendar method Temperature method Mucus method Withdrawal Combining methods Chapter 6 ©2008 McGraw-Hill Companies. All Rights Reserved.

©2008 McGraw-Hill Companies. All Rights Reserved. Chapter 6 ©2008 McGraw-Hill Companies. All Rights Reserved.

Male Sterilization: Vasectomy Severing of the vasa deferentia May return to work in 2 days Semen tested in 12 weeks or 20 ejaculations Reversal varies between 80% to 50%, depending on the report. Complication rate Effectiveness Chapter 6 ©2008 McGraw-Hill Companies. All Rights Reserved.

©2008 McGraw-Hill Companies. All Rights Reserved. Chapter 6 ©2008 McGraw-Hill Companies. All Rights Reserved.

©2008 McGraw-Hill Companies. All Rights Reserved. Female Sterilization Tubal sterilization (laparoscopy) is most common Essure system (2002) Sprng-like metallic implants causing scarring blocking the Fallopian tubes Hysterectomy Surgical cases Complication rate Reversibility Chapter 6 ©2008 McGraw-Hill Companies. All Rights Reserved.

©2008 McGraw-Hill Companies. All Rights Reserved. Chapter 6 ©2008 McGraw-Hill Companies. All Rights Reserved.

Issues in Contraception When is it Okay to Begin Having Sexual Relations? Society’s approach Changing of attitudes with the changing of time. Answering personal questions. Contraception and Gender Differences Sexuality and Contraception Education for Teenagers Chapter 6 ©2008 McGraw-Hill Companies. All Rights Reserved.

Which Contraceptive Method is Right for You? Appropriate method of birth control Individual health risks Implications of unplanned pregnancy Risks of STDs Convenience and comfort level Type of relationship Ease and Cost Religious or other philosophical beliefs Chapter 6 ©2008 McGraw-Hill Companies. All Rights Reserved.

Contraception Chapter 6