1. Operational Obstetrics & Gynecology · Bureau of Medicine and Surgery · 2000 Slide 1 Contraception CAPT Mike Hughey, MC, USNR

2. Operational Obstetrics & Gynecology · Bureau of Medicine and Surgery · 2000 Slide 2 Condom 98% effective Protects against some STDs

3. Operational Obstetrics & Gynecology · Bureau of Medicine and Surgery · 2000 Slide 3 Female Condom 95% effective Protects against some STDs Noisy Use extra lubrication

4. Operational Obstetrics & Gynecology · Bureau of Medicine and Surgery · 2000 Slide 4 Diaphragm 95% effective Requires fitting, manual dexterity Leave in place 6 hours after intercourse Use with contraceptive jelly/cream

5. Operational Obstetrics & Gynecology · Bureau of Medicine and Surgery · 2000 Slide 5 Foam 80-85% effective Works immediately Effective for an hour Over the counter No douching for 6 hours after intercourse 20% have burning (reaction)

6. Operational Obstetrics & Gynecology · Bureau of Medicine and Surgery · 2000 Slide 6 Film 80-85% effective Works 10 min after insertion Effective for an hour Over the counter No douching for 6 hours after intercourse 20% have burning (reaction)

7. Operational Obstetrics & Gynecology · Bureau of Medicine and Surgery · 2000 Slide 7 Suppository 80-85% effective Works 10 min after insertion Effective for an hour Over the counter No douching for 6 hours after intercourse 20% have burning (reaction)

8. Operational Obstetrics & Gynecology · Bureau of Medicine and Surgery · 2000 Slide 8 BCPs 99.5% effective Lighter, predictable periods Milder cramps Protects against uterine, ovarian cancer Protects against benign breast disease Low risk of side-effects Must take a pill each day

9. Operational Obstetrics & Gynecology · Bureau of Medicine and Surgery · 2000 Slide 9 IUD 98-99% effective Lasts 10 years Heavier, crampier periods Risk of infection/PID Risk of ectopic pregnancy Good candidate: –multiparous –monogamous

10. Operational Obstetrics & Gynecology · Bureau of Medicine and Surgery · 2000 Slide 10 DMPA 99% effective Lasts 3 months IM injection Amenorrhea, spotting Weight gain Ovulation returns in 4.5 months Average 10 months to conception

11. Operational Obstetrics & Gynecology · Bureau of Medicine and Surgery · 2000 Slide 11 Rhythm Avoid unprotected IC day #9-19 70-80% effective Assumes ovulation about day #14

12. Operational Obstetrics & Gynecology · Bureau of Medicine and Surgery · 2000 Slide 12 Withdrawal 80-90% effective Always available Requires motivation, sense of timing Some sperm present in pre- ejaculatory fluid Psychological issues

13. Operational Obstetrics & Gynecology · Bureau of Medicine and Surgery · 2000 Slide 13 Tubal Ligation & Vasectomy Surgical sterilization Permanent, irreversible >99% effective

14. Operational Obstetrics & Gynecology · Bureau of Medicine and Surgery · 2000 Slide 14