Contraception

1. Contraception Chapter 6

2. Contraceptives • Definition: • Conception: the fusion of an ovum and sperm that creates a fertilized egg. • Contraception: 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

3. Principles of Contraception • Based on the physiology of reproduction. • Ovulation: the release of the egg. • Types of contraception: • Barrier, Hormonal, Natural Methods, and Surgical • Factors affecting choice • Advantages and disadvantages • Effectiveness • Contraceptive failure rate • Continuation rate

4. Oral contraceptives (OCs): “The Pill” • Estrogen and progesterone taken orally • Mimics the hormonal activity of the corpus luteum • Corpus luteum secretes high levels of progesterone and estrogen to suppress ovulation. • Combination pill • Most common • 1-month packet containing estrogen and progetin • Extended-cycle pill • Lybrel • “Minipill” • Advantages • Disadvantages • Side effects • Effectiveness:

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 1 week, replaced on the same day for 3 consecutive weeks. Fourth week no patch • Advantages • Disadvantages • Effectiveness

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

7. Table 6-2 contraceptive Risks

8. Contraceptive Implants • Implanon(2006) • Hormonal method • Single implant • Effective for 3 years • Inhibits ovulations and affects the development of the uterine lining. • Advantages • Disadvantages • Side effects • Effectiveness:

9. Injectable Contraceptive • Depo-Provera • 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

10. 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 • 2006 – FDA approved Plan B as a OTC • Intrauterine Device

11. 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

13. Male Condoms • Thin latex sheaths • Protection against STD’s • Advantages • Disadvantages • Effectiveness • Use with spermicide

15. Female Condom • Reality Brand • Polyurethane sheath with two flexible rings • Advantages • Disadvantage • Effectiveness

17. The Diaphragm with Spermicidal jelly or cream • Dome shaped cup of thin rubber stretched over a collapsible metal ring. • Custom fit • Following intercourse • Advantages • Disadvantages • Toxic shock syndrome (TSS) • Effectiveness

19. Lea’s Shield • One-size-fits-all diaphragm-like device • Available by prescription • Can be used by women allergic to latex • Advantages • Disadvantages • Effectiveness

20. FEMCap • Small rubber or plastic cap • Must use foam kit • Advantages • Disadvantage • Effectiveness

21. Contraceptive Sponge • Round, absorbent device about 2 inches in diameter • Presaturated with the same spermicide that is used in contraceptive creams and foams • Advantages • Disadvantages • Toxic shock syndrome (TSS) • Effectiveness

22. Vaginal Spermicide • Foams, creams, jellies • Spermicidal suppository • Vaginal Contraceptive Film (VCF) • How it works • Must wait 6 hours post if the women wants to douche. • Advantages • Disadvantages • Effectiveness

24. Abstinence, Fertility Awareness, and Withdrawal • Abstinence • 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.

25. The Fertility Awareness Method (FAM) • FAM • Calendar method • Temperature method • Mucus method • Withdrawal • Coitus interrutus • Combining methods

27. Table 6-3 Contraception Methods and STD Protection

28. Male Sterilization: Vasectomy • Severing of the vas deferens • 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

30. Female Sterilization • Tubal sterilization (laparoscopy) is most common also know as tubal ligation • Essure system (2002) • Tiny spring-like metallic implants causing scarring blocking the Fallopian tubes • Hysterectomy • Surgical cases • Complication rate • Reversibility

32. Table 6-4 Contraceptive Effectiveness

33. 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

34. Which Contraceptive Method is Right for You? • Appropriate method of birth control • Health risks • Implications of unplanned pregnancy • STD risk • Convenience and comfort level • Type of relationship • Ease and cost of obtaining and maintaining each method • Religious or philosophical beliefs

35. Contraception Chapter 6