1. Reproductive Choices

2. Learning objectives
What is meant by the ‘failure rate’ of contraceptives?
Distinguish between ‘perfect use failure rate’ and ‘actual use failure rate’. What is meant by each?
Understand how each method of birth control discussed in class works.
Understand how each method of birth control may fail and why.
What are the fertile and infertile periods of a menstrual cycle?
What are permanent methods of sterilization. Why might you choose to use them or avoid them?

3. Failure rates
‘Perfect use’
‘Typical use’

4. Abstinence Avoidance of copulation • • The only birth control method
that
is 100% effective!

6. Barrier Contraceptives • Block the meeting of egg and sperm by
means of a physical or chemical barrier

7. Condoms • Male condom - Pre-lubricated, spermicide best
- Check expiration dates
treated are
- If lubrication is used, it MUST BE water-
based

8. •
Female condom
- External ring, internal ring with polyurethane sheath in between
- May be more effective than male condom at preventing pregnancies & infections

9. Male / Female Condoms • 15-20% failure rate (5% when used spermicide)
No side effects (except latex allergies)
with • •
Do protect against
STIs

10. Contraceptive Sponge • Polyurethane laced with spermicide foam •
Covers entrance to
cervix
Can be inserted up to 24 hours before sex •

11. Vaginal Spermicide Designed to kill • sperm and potential pathogens
Foams, creams, jellies, suppositories
Some meant to be
used with other
methods, some
used alone • •

12. Contraceptive Film (VCF)
Vaginal
Contraceptive Film (VCF) •
Thin, 2”-square film
laced with
spermicide
Folded and inserted, dissolves into gel •

13. Spermicides • NEARLY 100% effective when paired with a condom •
20-50% failure
alone
Prevent some
infections
rate •

14. Prescription Barrier Methods
Diaphragm – rubber “bowl” that covers cervix and holds spermicide
Cervical cap – smaller
& thicker than
diaphragm
FemCap – Non-latex
Methods • • •

15. Prescription Barrier Methods • Can be inserted
several hours before sex
Must be left in for 6 hours after
No hormones or side
effects
6-16% failure rate • • •

16. Hormonal Contraceptives•
Mimic hormones
produced during pregnancy which can:
- Block hormones that
stimulate ovulation
- Make cervix hostile to sperm
- Prevent implantation of egg
**DO NOT protect against STIs** •

17. Oral Contraceptives • “The pill” 28-day packs are most common (21
hormones, 7
Combination
with
without)
(estrogen •
+ progestin) or minipills
(progestin only)
Must be taken at same time each day •

18. Oral Contraceptives • Up to 99% effective Reduced risk of some cancers
Side effects: nausea, weight gain, decreased sex drive
Risks for smokers,
those with high BP,
diabetes, seizure
disorders • •

19. Ortho Evra Patch • Transdermal (through the skin) Continuous low dose
of estrogen and
progestin
Looks like a band- aid, but waterproof
Increased risk of heart attack and stroke • • •

20. NuvaRing • Ring made of flexible plastic that is inserted into vagina
Slowly releases estrogen and progestin • •
Stays in place for 3
weeks, removed for 1

21. Contraceptive Injection • Ex: Depo-Provera
Progestin only – prevents implantation
Shot given every 3
months
Cannot use for more than
2 years – bone mineral
loss
Increased risk of chlamydia and gonorrhea • • •

22. Emergency Contraception • Reactive (rather than
proactive) hormonal contraception
Ex: Plan B (“morning after pill”)
Prevents ovulation or
implantation
Non-prescription if over 18 • • •

23. Intrauterine Device (IUD)
Molded plastic or copper that is inserted into uterus
Interferes with implantation (hormones) or kills sperm (copper)
Old model associated with serious complications
Last 1-10 years
% effective

24. Mirena Intrauterine System • IUD + continuous
low-dose of progestin (so it’s partly a hormonal method)
Effective for 5 years
99% effective •

25. Fertility Awareness Method • “Rhythm method” Woman tracks her
cycle for at least
months
20% failure rate
Complies with Roman Catholic Church 8 •

26. Male Sterilization (Vasectomy) Severing of vas deferens
Short, in-office procedure to block flow of sperm
Reversal is about
50% effective • • •

27. Female Sterilization (Tubal ligation or Tubal occlusion) •
Cutting, tying, or
blocking fallopian
tubes
Outpatient surgery
using laproscopy
Can sometimes be
reversed • •