1. Contraception © Robert J. Atkins, Ph.D.

3. What are my chances of getting pregnant without contraceptives? No method = 85% chance of pregnancy over a year No method = 85% chance of pregnancy over a year

4. Should I use 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)

5. What types of pills are there? 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

6. What medications can reduce the effectiveness of the pill? St.John’s Wort St.John’s Wort Ampicillin Ampicillin Tetracycline Tetracycline

7. What if I only want a period every three months?

8. Seasonale & Seasonique One period every 3 months (4 per year) One period every 3 months (4 per year) Seasonale Seasonale 7 placebo pills every 84 pills 7 placebo pills every 84 pills Seasonique Seasonique 7 estrogen pills every 84 pills 7 estrogen pills every 84 pills More stable hormone levels More stable hormone levels

9. What if I want no periods at all? Lybrel Lybrel No periods at all No periods at all 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”.

10. What if I have unprotected sex?

11. What is 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.)

12. 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”. The “Ask me” program. American College of Obstetricians and Gynecologists you get it before sex “just in case”. The “Ask me” program. Dosage: Dosage: 2 tablets, 1-ASAP and 1 – 12 hrs later. 2 tablets, 1-ASAP and 1 – 12 hrs later.

13. Do you remember? What are the advantages and disadvantages of oral contraceptives? What are the advantages and disadvantages of oral contraceptives? What medications can reduce the effectiveness of the pill? What medications can reduce the effectiveness of the pill? What if I only want a period every three months? What if I only want a period every three months? What can I do after unprotected sex? What can I do after unprotected sex?

14. What is the transdermal patch? Ortho Evra Ortho Evra Slow release of hormones Estrogen and progestin Slow release of hormones 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

15. What is the shot? Depo-Provera Depo-Provera Progestin only Progestin only Injection Injection Once every 12 weeks (3months) Once every 12 weeks (3months)

16. What is the Mirena IUD? Releases hormone progestin Uterine irritation

17. Why do IUDs work? Copper Copper (Paragard) (Paragard) Progesterone Progesterone Mirena Mirena Irritation in uterus Irritation in uterus Makes implantation unlikely Makes implantation unlikely

18. What is Implanon? 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

19. What is NuvaRing? Vaginal ring Vaginal ring Slowly releases hormone (Estrogen) into bloodstream Slowly releases hormone (Estrogen) into bloodstream 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

20. What is the cervical cap?

21. What are the female condoms?

22. Do you remember? What is the transdermal patch? What is the transdermal patch? What is the shot? What is the shot? Why do IUDs work? Why do IUDs work? What does the vaginal ring do? What does the vaginal ring do?

23. What is one of the least effective methods? Diaphragm and spermicide Diaphragm and spermicide One of the least effective methods One of the least effective methods

24. Can I use spermicide by itself?

25. What IUD uses copper and has no hormones? Paragard Paragard 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

26. Paragard IUD in uterus

27. What is the Essure Intra-fallopian insert?

28. What should I look out for if I have an an 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

29. What about male Condoms? 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

30. What about male sterilization? (Vasectomy)

31. What about the Pro-Vas clip? New New A plastic and metal clip closes the vas A plastic and metal clip closes the vas Effectiveness compared to vasectomy is unknown. Effectiveness compared to vasectomy is unknown.

32. What about female sterilization (Tubal ligation)

33. What about the rhythm method? (Basal Body Temp.)

34. When should I 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

35. Do you remember? What is one of the least effective methods? What is one of the least effective methods? What pains should I watch for with an IUD? What pains should I watch for with an IUD? What are the advantages and disadvantages of male condoms? What are the advantages and disadvantages of male condoms? When should I use a backup method of birth control? When should I use a backup method of birth control?