Professional Documents
Culture Documents
METHODS OF CONTRACEPTION
BEHAVIORAL ALTERNATIVES
BEHAVIORAL ALTERNATIVES
Total abstinence
Abstinence is 100% effective in
preventing pregnancy
AVERAGE COST: No cost
Advantages:
- almost 100% effective
- protection against STD's
- free
- no prescription is needed
ADVANTAGES:
- effective immediately
- does not interfere with intercourse
- no side effects
- no cost
- gives infants passive immunity
- decreased post-partum bleeding
DISADVANTAGES:
- offers no STD protection
- highly effective only until period returns or up to 6
months
- may need to use a lubricant because of vaginal dryness
- must feed on demand and at least 6-10 times a day
including night feedings
- not reliable if period has returned.
FINGER TESTING
Sensation
at Vulva
Finger Test
Appearance
Moist
or
Sticky
Early Mucus
Scanty
Thick
White
Sticky
Holds its shape
Wetter
Transitional Mucus
Increasing Amounts
Thinner
Cloudy
Slightly Stretchy
Slippery
DETERMINATION OF LH SURGE
BARRIER CONTRACEPTION
MECHANICAL
MALE CONDOM
Male Condom Is penile sheath made of latex or polyurethane or animal membrane
that serves as a barrier.
Mechanism of action: Prevents sperm from reaching the cervix. The addition of a
vaginal spermicide makes the method very effective. EFFECTIVENESS: 80-90%
(INCREASES IF USED WITH SPERMACIDE);
Advantages:
Widespread availability
Low cost
Protection against STD
No prescription needed
Safe
Fertility returns upon discontinued use
Disadvantages:
manufacturing defects;
if withdrawal of the penis occurs after detumescence, semen may leak into the
vagina
both partners may complain of decreased sensation during intercourse
woman may be allergic to spermacidal or latex.
can be used only once
may interfere with spontaneity
FEMALE CONDOM
Female condom is a latex or polyurethane membrane (bag)
that can be inserted into the vagina. It has a higher rate of
pregnancy than the male condom. EFFECTIVENESS: 75-85%
AVERAGE
ADVANTAGES:
Protects against some sexually transmitted diseases
No prescription needed
Fertility returns immediately upon discontinued use
Can be inserted anytime - up to eight hours before
intercourse
Medically safe
DISADVANTAGES
Decreased vaginal sensation
May be difficult to insert
VAGINAL DIAPHRAGM
Vaginal diaphragm is a soft, rubber dome that forms
a barrier to prevent sperm from reaching the cervix.
It covers the cervix and is held securely in place
behind the pubic bone and rear wall of the vagina.
They are made in various sizes and for maximum
safety must be used with a spermicide jelly or
cream. EFFECTIVENESS: 85%
ADVANTAGES
Safe
Fertility returns immediately with discontinued use
Can be inserted 2-3 hours before lovemaking
May reduce the risk of cervical cancer
Some STD protection
VAGINAL DIAPHRAGM
DISADVANTAGES
Must be fitted by a health care professional
Needs prescription
Must be left in place 6-8 hours after intercourse but no
more than 24 hours
Must be used each time
May become dislodged
Some women may be allergic to spermicides, latex
Must be replaced periodically
Must apply spermicide with each new act of intercourse
May have an increase in urinary tract infections
May decrease spontaneity
CHEMICAL CONTRACEPTIVES
SPERMICIDES
Spermicides contain a chemical called nonoxynol-9. It comes in the form of
cream (only for use with diaphragms), gel, foam, film, or suppository. All of
these agents require insertion into the vagina before each coitus. By
inserting spermicide in the vagina, in front of the cervix, it destroys sperm
on contact. EFFECTIVENESS: 80%
ADVANTAGES
Available without a prescription
No known risk to general health
Fertility returns immediately upon discontinued use
Some protection from bacterial infections and pelvic inflammatory
disease
DISADVANTAGES:
Less effective than other methods
Must wait 8 hours before taking a bath or douche
Usually last only one hour
Side effects: Vvginal irritation, some women are allergic to spermicides
Need insertion at least ten minutes before intercourse
Nonoxynol-9 does not protect against STIs
CONTRACEPTIVE SPONGE
The sponge is a soft, round barrier device that is about two inches in diameter. It is
made of solid polyurethane foam, contains spermicide, and has a nylon loop attached
to the bottom for removal. The sponge must first be moistened with water and then the
woman inserts it into her vagina before intercourse. It covers the cervix (opening to the
uterus), and it blocks sperm from entering it. The sponge also releases a spermicide
that can immobilize sperm, thus, preventing the sperm from reaching an egg.
EFFECTIVENESS: 75 85%
ADVANTAGES
Fertility returns immediately upon discontinued use
Can be inserted several hours prior to intercourse
It provides 12-hour protection
It contains three types of spermicide and does not appear to be allergenic nor as
irritating as previous sponges
Does not require a prescription
May protect against some STD's
Does not require insertion of a new sponge for each act of intercourse
DISADVANTAGES:
Cannot be used by women allergic to nonoxyl-9 or those who have had toxic shock
syndrome
a higher risk of vaginal yeast infections
HORMONAL CONTRACEPTIVES
COMBINED ORAL CONTRACEPTIVES
The Mini-Pill Progestin-Only Pills (POP), are estrogenfree oral contraceptive pills taken daily to prevent
pregnancy.
The estrogen-free mini-pill has fewer unwanted sideeffects than traditional combined oral contraceptives.
Mini-pils are less effective and can cause irregular
menstruation.
Popular brands of progestin-only pills include Micronor,
Nora-BE (0.35 mg norethindrone).
Estrogen-free oral contraceptives are available by
prescription only.
The mimi-pil always comes in 28-day packs, and all
the pills within a pack contain the same progestin.
Average Failure Rate: 1 - 13%
PROGESTIN-ONLY ORAL
CONTRACEPTIVES
BENEFITS
May be recommended to breastfeeding women
Mini-pills are also considered safer than combined OCs,
as many of the vascular risks are greatly reduced with
the omission of the estrogen component. That means
less risk for older women, smokers, and those with heart
problems.
SIDE EFFECTS
ectopic pregnancy
depression
menstrual cycle disturbances
Oral contraceptives do not protect against STDs
oral contraceptives increase the risk of acquiring HIV
from an infected partner
CONTRACEPTIVE PATCH
The contraceptive patch (Evra) is a 4 cm x 4 cm beige patch that sticks to a
woman's skin and continuously releases the hormones estrogen and a progestin into
the bloodstream. Each patch is worn on the skin for seven days. One patch is worn
each week for 3 weeks. The Patch should be changed on the same day each week
(called the "Patch Change Day"). The patch can be worn on the buttocks, back or
upper arms, but not on the breasts.
Mechanism of action
The Patch prevents pregnancy by stopping the ovaries from releasing an egg,
and it may also thicken the cervical mucus and make the uterine lining thin.
It is completely reversible
Disadvantages
In addition to preventing pregnancy, the ring has the added benefit of making a
woman's periods more regular, lighter, and possibly less crampy. It is thought to
have similar benefits as the birth control pill, such as treating PMS,
endometriosis and acne, and preventing ovarian and endometrial cancers but
these haven't been studied. It is completely reversible.
Side Effects
the vaginal ring is thought to increase the risk of heart attack and stroke,
especially among smokers
Contraindications:
NORPLANT IMPLANTS
Implanon is a type of long-term birth control that is inserted under the skin by a doctor. The implant consists of
one to six match-sized plastic rods which are surgically placed under the skin of a woman's upper arm.
Implanon contains a synthetic progestin hormone called etonogestrel. Implanon is effective for up to 3-5 years.
Average Failure Rate: less than 1%
Mechanism of action:
The primary way is by stopping release of an egg from the ovaries. Implanon also changes the mucus in the
cervix and this may keep sperm from reaching the egg. Implanon also has post-fertilization mechanisms,
whereby the hormone changes the lining of the uterus, making it harder for a fertilized egg to implant and
develop.
ADVANTAGES
The birth control effect is immediate
Works up to five years or until removed
Capsules can be removed anytime
Fertility returns immediately upon removal of implants
Helps protect against uterine cancer
Can be safely used after childbirth and while breast-feeding
Does not interfere with intercourse
DISADVANTAGES
Cannot be used by women with liver disease, breast cancer, unexplained uterine bleeding, blood clots
May not be good for women with high blood pressure, gall bladder disease, elevated cholesterol, irregular
periods, light periods, headaches, heart disease, seizure disorders.
Cannot be used by women who have a history of certain types of high blood pressure, breast cancer,
unexplained vaginal bleeding, liver growths, blood clots in veins, possible pregnancy
increased risk of ectopic pregnancy
implant does not offer any protection from STDs
Side effects: irregular bleeding, prolonged periods, light periods, hair loss, decreased interest in sex, acne,
depression, prolonged time between periods, weight gain, breast pain, headache
INTRAUTERINE DEVICE
COPPER T IUD
This IUD is a non-hormonal birth control and contains copper. The IUD may prevent
pregnancy by interfering with: sperm movement (the ability of the sperm to fertilize the egg)
or implantation (nesting of a fertilized egg into the lining of the uterus).
EFFECTIVENESS: Copper-T IUD - 99%
ADVANTAGES
Requires no attention except for monthly checks for the string
Fertility returns immediately upon removal
Does not interfere with lovemaking
Can be used while breast-feeding
DISADVANTAGES
Does not protect against STD's
Should not be used by women who have: never had children or still want children; an
allergy to copper
Should not be used by women who have a history of decreased immune problems; multiple
sex partners; a history of pelvic inflammatory disease (PID) or tubal pregnancy
Have an increase risk for tubal pregnancy, PID, infertility
Side effects possible: cramps, backache, spotting, heavy periods
May be expelled
IUD's can be inserted by a qualified physician:
Days 1 to 7 of the menstrual cycle
Postpartum - Copper T 380A immediately to up to 48 hours after delivery, or 4-6 weeks.
Post abortion - immediately to 7 days if no infection is present
EMERGENCY CONTRACEPTION
Emergency contraception refers to back-up methods for
contraceptive emergencies which women can use within the first few
days after unprotected intercourse to prevent an unwanted
pregnancy. Emergency contraceptives are not suitable for regular use.
Forms of EC include:
Emergency contraceptive pills (ECPs)or the "morning-after
pill"are drugs that act both to prevent ovulation or fertilization
and possibly post-fertilization implantation of a blastocyst (embryo).
Intrauterine devices (IUDs)usually used as a primary
contraception method, but sometimes used as emergency
contraception.
An alternative to emergency
contraceptive pills is the copper-T
intrauterine device (IUD) which can be
used up to 5 days after unprotected
intercourse to prevent pregnancy.
Insertion of an IUD is more effective than
use of Emergency Contraceptive Pills.
ONLY THE COPPER T CAN BE USED
FOR EMERGENCY CONTRACEPTION
PERMANENT CONTRACEPTION
TUBAL LIGATION
In tubal ligation the two fallopian tubes which transport the eggs from
the ovaries to the uterus are disconnected either by cutting or by
applying cautery, clips or silastic rings.A tubal ligation is generally
considered permanent. EFFECTIVENESS: 99%
Benefits
It's the most effective method of contraception that is controlled by
women. It is ideal for women who don't want to have any more kids.
Disadvantages
Surgical procedure required
Permanent
There are two main methods of Tubal Ligation used today
A laparoscopic tubal ligation can be done anytime when a woman is
not pregnant There are three ways to block the tube: Cautery
(Burning); Applying Clips (Hulka Clips); Applying Silastic Rings
Postpartum Tubal Ligations are done within two days of delivery
because the top of the uterus is at the level of the belly button at
that time.
PERMANENT CONTRACEPTION
MALE STERILIZATION (VASECTOMY)
A Vasectomy interrupts the travel through the Vas Deferens by
blocking it. Thus, if sperm cannot reach the egg, there is no
pregnancy. Sterilization is considered to be an irreversible,
permanent method of contraception. Rejoining the vas deferens is
very difficult, specialized surgery and moderately successful at best.
Vasectomy can prevent pregnancy it cannot protect against Sexually
Transmitted Diseases.
EFFECTIVENESS: 99%+
ADVANTAGES:
doesn't interfere with erection or ejaculation
no known side effects
doesn't interfere with spontaneity
DISADVANTAGES:
permanent
surgical procedure required
some discomfort at the time of procedure
REFERENCES