Contraceptive Methods

1. Contraceptive Methods Ana Corona, FNP-Student University of Phoenix 2001

2. Contraceptive Barrier Methods

3. Contraceptive Barrier Methods • Mechanical barrier methods are best suited for women who find using a method near or at the time of intercourse acceptable. • Can learn the insertion technique, and have sufficient privacy for insertion and removal. • The methods can be very effective when used correctly. • Accidental pregnancy rates are high compared to many other methods. • Barriers can also provide important protection from sexually transmitted diseases.

4. Spermicidal Foam • Contraceptive chemical barrier method. • Foam is a vaginal spermicide which is placed into the vagina using an applicator. • It has two contraceptive effects: • it kills or destroys sperm • it prevents sperm from reaching the egg by blocking the opening to the cervical canal. • 89% effective in preventing pregnancy

5. Advantages Foam gives the woman control over contraception. It is available over the counter without a visit to a clinician. It can be put into the vagina up to 20 minutes before sexual intercourse and is effective immediately. Has a few side effects and is considered to be safe. It has an antiviral action that helps protect against STDs. May decrease the incidence of cervical cancer. There are no hormones involved. Foam adds lubrication and moisture. Disadvantages Foam can be irritating to the vagina or penis. It may be messy. It may not be protective against HIV (the virus that causes AIDS). Some women do not like putting an applicator into the vagina. The container carrying the foam is large and may be embarrassing to carry around. Unpleasant odor or taste. Having to wait 20 to 30 minutes after insertion before having intercourse. Spermicidal Foam: Advantages and Disadvantages

6. Female Condom • The new female condom was approved by the FDA in 1993. • It is a sheath made of thin, transparent, soft plastic that is inserted in the vagina before sex. • It has two rings: a flexible removable ring at the closed end to aid with insertion. • A larger flexible ring that stays outside the vagina at the open end to help protect the external genitalia. • 97% effectiveness in preventing pregnancy.

7. Advantages Offers women control over condom use. Covers the external genitalia, it potentially provides additional disease protection over vaginal barrier methods. There is no contact between semen and vagina. Easy to buy in drugstores or supermarkets. Can be used by people allergic to latex or spermicide. Does not require fitting by a health care professional Disadvantages Insertion can be rather difficult and actual use may be awkward. Consistent and correct use is necessary. May be noisy May irritate vagina or penis. May slip into vagina during intercourse. Female Condom: Advantages and Disadvantages

8. Condoms • A condom is a rubber or animal-skin sheath that prevents deposition of semen in the vagina. • 95% effective in preventing pregnancy

9. Advantages Inexpensive and easy to get. Lightweight and disposable. Does not require a prescription. Condoms may help a man stay erect longer. Prevention of STDs May prevent cervical cancer. Disadvantages Some men and women feel that the condom dulls sensation. The interruption of sexual foreplay to apply the condom. Possible allergic reaction to rubber or latex. The Condom: Advantages and Disadvantages

10. The Diaphragm • Is a dome-shaped latex cap that is first coated with a spermicidal gel or cream and then placed high in the vagina before intercourse. • It is a physical barrier to sperm entering the cervix • It holds the spermicidal cream or gel against the cervix • Immobilizes sperm near the cervical canal. • They are available by prescription and need to be fitted by a clinician. • 98% effective in preventing pregnancy.

11. Advantages: It has none of the systemic side effects of the hormonal methods. It may help protect against sexually transmitted diseases, especially if nonoxynol-9 is used as the spermicide. Can be used during menstrual cycle for the purpose of blocking menstrual blood flow when having intercourse. May protect against cervical cancer. Effective immediately upon insertion. Inexpensive Disadvantages: May predispose to urinary tract infections for some women. Women or men may be allergic to the latex in the diaphragm. May become dislodged during intercourse. Women experience pain, bleeding, vaginal discharge, or constipation. Predispose to toxic shock syndrome (If left in place longer than the recommended 6 to 8 hours after intercourse). Difficulty with learning or executing its proper insertion and care. The Diaphragm: Advantages and Disadvantages

12. The Cervical Cap • It is a small thimble shaped cup that fits over the cervix to mechanically block sperm from entering the cervical canal. • It must be used with spermicide jelly for maximum effectiveness. • It is made of latex • It has a narrow groove around the inside rim which helps to create a seal over the cervix. • The cap needs to be fitted by a clinician. • 96% effective in preventing pregnancy.

13. Advantages: Insertion is not related to time of intercourse. More comfortable and less messy than the diaphragm. It may be left in place longer than the diaphragm without additional application of spermicidal agent. May protect against STDs, PID, and cervical cancer. Disadvantages: Women may have allergic reaction to the spermicide or the rubber cap. Insertion and removal is difficult. May become dislodged during intercourse. Vaginal odor can occur. Should not be used in women who have cervical lacerations, cervical malformations, cervicitis or an abnormal papanicolaou smear. The Cervical Cap: Advantages and Disadvantages

14. The Intrauterine Device (IUD) • Are small plastic devices that are inserted into the uterus and remain in place for varying lengths of time depending on the type used. • Are composed of either an inert substance or a medicated substance such as copper or progestogen. • The IUD stimulates an inflammatory reaction in the uterus, causing both cellular and biochemical changes in the endometrium and uterine fluids. • In response, an increase in the number of neutrophils, plasma cells and mononuclear cells, appears to cause an attack on the invading foreign body. • These cells are able to engulf the sperm or the fertilized ovum, thus preventing pregnancy. • 97% effective in preventing pregnancy

15. Advantages: Is not related in any way to the time of sexual intercourse. Does not require partner cooperation. Makes fewest demands on the user. Has no general systemic effects. Does not interfere with lactation. Disadvantages: Women may experience long heavy menstrual cycle. Midcycle bleeding may also occur. May experience pain during intercourse. Expulsion of an IUD may be partial or complete and may be apparent or undetected. Perforation of the uterus is a rare but potential serious complication that may be cause by an IUD. Pelvic Inflammatory disease has been reported to occur at an incidence two to four times greater than for non-IUD users. High risk for an ectopic pregnancy. The IUD: Advantages and Disadvantages

16. Any Questions?