Contraception

Contraceptive effectiveness Sterilization Sterilization Estrogen-Progestin pills Estrogen-Progestin pills Depo-Provera Depo-Provera Male condoms Male condoms Diaphragm with spermicide Diaphragm with spermicide Withdrawal Withdrawal No method (85% chance of pregnancy) No method (85% chance of pregnancy)

The transdermal patch Estrogen and progestin Estrogen and progestin 1 patch a week for 3 weeks on & 1 week off 1 patch a week for 3 weeks on & 1 week off 99% effective (similar to pill) 99% effective (similar to pill) Prevent ovulation Increase cervical mucus Prevent ovulation Increase cervical mucus /about_ortho_evra/about_ ortho_evra.html /about_ortho_evra/about_ ortho_evra.html /about_ortho_evra/about_ ortho_evra.html /about_ortho_evra/about_ ortho_evra.html

NuvaRing (Vaginal ring) Estrogen hormone ring Estrogen hormone ring Insert in vagina Insert in vagina Worn 3 out of 4 weeks Worn 3 out of 4 weeks Position not critical Position not critical Low dose hormone = low side effects Low dose hormone = low side effects

New contraceptives Seasonique Seasonique Now available Now available One period every 3 months One period every 3 months Seasonale (old version) Seasonale (old version) 7 inactive pills every 84 pills 7 inactive pills every 84 pills Seasoneque (new version) Seasoneque (new version) 7 estrogen pills every 84 pills 7 estrogen pills every 84 pills 4 periods a year 4 periods a year More stable hormone levels More stable hormone levels More vaginal bleeding & spotting than normal 28 day pills. More vaginal bleeding & spotting than normal 28 day pills.

Depo-Provera Progestin only Progestin only Injection Injection Once every 12 weeks (3months) Once every 12 weeks (3months)

IUD in uterus

Paragard IUD (Currently used) New FDA labeling New FDA labeling Can be used by women as young as 16 who have never had a baby Can be used by women as young as 16 who have never had a baby Women with a history of STD’s or PID can use it. Women with a history of STD’s or PID can use it. Good for 10 years Good for 10 years

Intrauterine Device - IUD Danger signs = PAINS Danger signs = PAINS Period late or no period Period late or no period Abdominal pain Abdominal pain Increased temperature, fever, chills Increased temperature, fever, chills Nasty discharge Nasty discharge Foul smelling Foul smelling Spotting, bleeding, heavy periods, clots Spotting, bleeding, heavy periods, clots

IUD effectiveness due to: Copper Copper Progesterone Progesterone Irritation in uterus Irritation in uterus Makes implantation unlikely Makes implantation unlikely

Male Condoms With Nonoxynol-9 With Nonoxynol-9 Advantages: Advantages: Additional protection against STD’s Additional protection against STD’s Also during fellatio Also during fellatio Diminished sensation and delay ejaculation Diminished sensation and delay ejaculation Disadvantages Disadvantages Some people are allergic to latex condoms Some people are allergic to latex condoms

Female condoms

Emergency contraception Plan “B” Not for routine use Not for routine use Take up to 72 hrs. (3days) after sex Take up to 72 hrs. (3days) after sex Progesterone only (no estrogen) Progesterone only (no estrogen) Reduces chances of pregnancy by 89% (7 out of 8 women who would have gotten pregnant will not.) Reduces chances of pregnancy by 89% (7 out of 8 women who would have gotten pregnant will not.)

Plan “B” cont. It works better the earlier you take it It works better the earlier you take it In WA. State you can get it from a pharmacy without a prescription. In WA. State you can get it from a pharmacy without a prescription. American College of Obstetricians and Gynecologists you get it before sex “just in case”. American College of Obstetricians and Gynecologists you get it before sex “just in case”. Dosage: Dosage: 2 tablets, 1-ASAP and 1 – 12 hrs later. 2 tablets, 1-ASAP and 1 – 12 hrs later.

Oral contraceptives Advantages Advantages Very effective (99%+) Very effective (99%+) Disadvantages Disadvantages Decrease sexual motivation Decrease sexual motivation Water weight gain Water weight gain Problems with blood clots (in some users) Problems with blood clots (in some users)

Types of pills Constant dose combination pill Constant dose combination pill Most common Most common Multiphasic pill Multiphasic pill Both types prevent conception by inhibiting ovulation Both types prevent conception by inhibiting ovulation Mini pill Mini pill Progestin only Progestin only

Medications that reduce the effectiveness of the pill. St.John’s Wort St.John’s Wort Ampicillin Ampicillin Tetracycline Tetracycline

When to use a backup method of birth control During the first cycle of the pill During the first cycle of the pill When taking antibiotics When taking antibiotics When first learning to use a new method of birth control When first learning to use a new method of birth control

New Contraceptives Implanton Implanton Available early 2007 Available early 2007 Only implantable contraceptive sold in USA Only implantable contraceptive sold in USA 99% effective 99% effective Good for 3 years Good for 3 years Progestin only (Avoids blood clots) Progestin only (Avoids blood clots) Irregular menstrual bleeding Irregular menstrual bleeding

New contraceptives Lybrel Lybrel No periods at all No periods at all Not yet approved by the FDA Not yet approved by the FDA More clinical trials needed More clinical trials needed Estrogen & progestin Estrogen & progestin Designed to be taken continually Designed to be taken continually Not all women will be “period free”. Not all women will be “period free”.

Essure Intrafallopian insert

Danger signs for pill users = ACHES Abdominal pain Abdominal pain Chest Pain Chest Pain Heart attack Heart attack Headaches Headaches Eye problems Eye problems Blurred vision Blurred vision Light flashes Light flashes Blindness Blindness Severe leg pain Severe leg pain Blood clot in leg Blood clot in leg

Diaphragm One of the least effective birth control methods One of the least effective birth control methods

Cervical cap

Spermicide

Basal Body Temp. (Rhythm Method)Male sterilization (Vasectomy)

Female sterilization

Female Sterilization (Cont.)