1. Contraception
Chapter 6

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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.

3. 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
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4. 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
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5. 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
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6. 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.

7. 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.

8. 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.

9. 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
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10. 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.

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Chapter 6
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Male Condoms
Thin latex sheaths
Protection against STD’s
Advantages
Disadvantages
Effectiveness
Use with spermicide
Chapter 6
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Chapter 6
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Female Condom
Reality Brand
Polyurethane sheath with two flexible rings
Advantages
Disadvantage
Effectiveness
Chapter 6
©2008 McGraw-Hill Companies. All Rights Reserved.

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

16. 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
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Chapter 6
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Cervical Cap
Small rubber or plastic cap
Must use foam kit
Advantages
Disadvantage
Chapter 6
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Contraceptive Sponge
Why they were withdrawn from the market
Round, absorbent device about 2 inches in diameter
Advantages
Disadvantages
Effectiveness
Chapter 6
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Vaginal Spermicide
How it works
Advantages
Disadvantages
Effectiveness
Chapter 6
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Chapter 6
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22. 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
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23. The Fertility Awareness Method (FAM)
Calendar method
Temperature method
Mucus method
Withdrawal
Combining methods
Chapter 6
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Chapter 6
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25. 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
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Chapter 6
©2008 McGraw-Hill Companies. All Rights Reserved.

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

29. 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
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30. 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.

31. Contraception
Chapter 6