1. Your Contraceptive Choices

2. Most Widely Used in US Pill 30.6% Tubal Ligation 27.0% Male Condom
Birth Control Method
Pill
Tubal Ligation
Male Condom
Vasectomy
Injectable
Withdrawal
IUD
Natural family planning
Implant
Other
Diaphragm
% of total
30.6%
27.0%
18.0%
9.2%
5.3%
4.0%
2.0%
1.6%
1.2%
.9%
.3%

3. Abstinence What it is and How it works
Abstinence means choosing not to have sex.
What’s Your Definition?
Refraining from all sexual behavior, including masturbation
Refraining from sexual behavior involving genital contact
Refraining from penetrative sexual practices
Many more definitions out there…it’s not enough to ask
“Have you had sex before?”
Cost: Free!!! Emotionally and financially!
Its the only thing that is 100% effective for preventing pregnancy and STIs

4. Advantages & Disadvantages of ABSTINENCE
100% prevents sexually transmitted infections and pregnancy
No medical or hormonal side effects
Postpone emotional and physical risks
Less likely to become infertile
Free! ($0)
Disadvantages
May be difficult to abstain
May not be prepared with back-up method if or when you choose to become sexually active

5. WITHDRAWAL What is it? How does it work?
Pseudo-contraceptive method practice
The man pulls his penis out of the vagina before he ejaculates to keep the sperm from joining the egg

6. Advantages and Disadvantages of Withdrawal
Full personal control over use; no need for special medical procedures or exams
Better than using no method at all
No side effects
Free
Disadvantages
High failure rate
Must rely totally on partner to pull out in time – woman has no control
Inexperienced or young partner may not be able to withdraw in time
Pre-ejaculate -- possibility for sperm
No protection against any STIs

7. Effectiveness and Cost
73% effective (27 out of 100 women using this for one year will get pregnant)
It is Free ($0) since you do not use any devices

8. Spermicides What they are and how they work
A method that a woman inserts into the vagina before having sex
Contain chemicals (Active ingredient: nonoxynol-9) that kill sperm and/or block sperm from entering cervix
Forms: Gel, foam, cream, film, suppository, or tablet
Used alone OR as part of another barrier method
Time sensitive – usually requires 15 min wait before sex for spermicide to activate; must reapply/effective for only an hour
Don’t wash it away – especially not for at least 6 hours after having sex.

9. Advantages and Disadvantages of Spermicides
Full personal control over use
No need for special procedure or exam
Doesn’t contain hormones
Side effects are uncommon; almost anyone can use them
Available without a prescription and in most drug stores; relatively inexpensive
Disadvantages
Need to plan ahead – must have available when you have sex
Must reinsert often (every hour)
Doesn’t provide protection from any STI’s
Not as effective as other methods
Some have allergic or chemical reaction to ingredients in it
Side effects may include increased urinary tract infections or irritation

10. Effectiveness
71% effective (29 out of 100 women using it for 1 year will get pregnant)

11. Approximately $.30 - $1.00 per act of sex
Cost
Approximately $.30 - $1.00 per act of sex
Film (12 sheets) – approx. $9.25
Foam (container) -- $12.00
Suppositories (12) -- $4.00
Gel or Cream (tube) -- $12.00

12. The Female Condom What is it and How it works
Thin, loose-fitting and flexible plastic (polyurethane) tube worn inside the vagina
A soft ring at the closed end covers the cervix and keeps sperm from entering the vagina (fits like diaphram)
Outer ring covers the labia on the outside of the vagina – hangs out about 1 inch when inserted
One time use only – throw away after you use it and it is replaced with a new one before your next act of sex.

13. Advantages and Disadvantages of the Female Condom
Difficult to use
Can break or leak
More expensive then the male condom
Does not contain spermicide
Advantages
Available without a prescription
No hormonal side effects
Can be used for people with latex sensitivities
Prevents STIs: chlamydia, gonorrhea, herpes, HPV, and HIV
Stays in place regardless of penis hardness – cannot fall off

14. Side Effects There are no physical side effects
There is a chance though that it will break or slip during intercourse
DO NOT USE WITH MALE CONDOM!!!
(The friction will cause both to break)

15. 79% effective Effectiveness (21 out of 100 women
using this for one year
will get pregnant.)

16. Cost
About $2.50-$3.00 per package/condom

17. The Male Condom What is it and How does it work?
Keep sperm from entering the vagina during intercourse
It is a thin layer of latex (plastic) that covers the penis; polyurethane and tactylon (plastic) are available as well.
Rolled onto an erect penis
Once man ejaculates, must hold on to base of condom and remove himself from woman; gently pull off condom and discard
Removal must be done immediately before penis becomes soft (flaccid) to prevent spilling of semen.
A new one must be used before next sex act.

18. Advantages & Disadvantages of Male Condoms
Can sometimes break
Need to plan ahead; have available when you have sex
Latex and/or Spermicide Allergies – other brands or types of plastic available for those who suffer
Loss of sensation
Advantages
Easy to buy
Inexpensive
Full personal control over use; no special procedures or exams
Side effects uncommon
Helps prevent pregnancy and most STIs
Can be used with other methods

19. Condom Not Recommended For:
Women or Men who are uncomfortable touching the penis
Those who have an allergy to latex (rubber) or spermicide.
Avanti and Trojan Supra brands have a polyurethane male condom (best) or natural membrane condoms (lamb skin)
Only 1-2% of women and men have such allergies

20. Effectiveness 85% effective (15 out of 100 couples using
condoms for one year will get pregnant.)
Up to 95% effective when used with vaginal spermicide
Nearly 100% if used with withdrawal

21. Family Planning Centers may give them away or charge very little
$$ Cost $$
$.30 - $1.00 each
Family Planning Centers may give them away or charge very little

22. Mini Pills What are they and How do they Work?
A special kind of oral contraceptive pill
Taken daily (one pill)
Contains the hormone progestin which works to prevent pregnancy by
stopping ovulation and/or
thickening the cervical mucus
to stop the sperm from passing through

23. Advantages and Disadvantages of Mini Pills
Studied for more than 30 years; long-term safety well known
Stops monthly periods or causes extremely light periods
Contains no estrogen
Alternative for women over 35 who smoke
Decreased menstrual cramps and pain; relief from acne and facial hair
Decreased risk of endometrial cancer, ovarian cancer, and PID (pelvic inflammatory disease)
Immediate reversibility
Disadvantages
Must take them every day at the same time
Effectiveness is compromised easier if taken with other medications because dose is very low
Does not protect against STIs
Not recommended for women who:
Have impaired liver function
Known or suspected breast cancer
Abnormal vaginal bleeding in medical history
Don’t have access to healthcare provider as they require a prescription

24. Effectiveness 95% effective
(5 out of 100 woman using it for one year will get pregnant)
Increased
effectiveness if
used with other
barrier methods

25. Cost
$17.00 – $25.00 per monthly pill pack
$35-$125 for exam

26. Depo-Provera What it is and how does it work?
A high dose shot of the hormone progestin (no estrogen used) that prevents pregnancy for about 3 months
Stops ovulation and/or thickens cervical mucus to keep sperm from joining egg; get shot within first 5 days of period to improve effectiveness the first 3 months
Must receive shot every 12 weeks; given in arm or buttocks

27. Advantages and Disadvantages of Depo-Provera
Stops monthly periods or have extremely light periods
Contains no estrogen
Safe, highly effective, long-lasting protection – no need for action before, during or after sex
Reduces menstrual cramps and pain
Can be used right after birth and while breast feeding
Alternative to women who are over 35 and smoke
Decreased risk of endometrial and ovarian cancer, and PID
Disadvantages
Must receive shot every 3 months
Irregular or late periods, spotting may occur. After a year most stop having periods; safe – most welcome it.
Bloating, weight gain, headaches, depression, loss of interest in sex, hair loss, and abdominal pain
May result in bone loss during use; density returns to normal when you stop using it
Side effects can’t be reversed until wears off
May cause delay in pregnancy after shot is stopped
Does not protect against STIs

28. Depo-Provera Not Recommended for women who are:
Are uncomfortable with needles/injections
Plan to get pregnant within 5 years
Have impaired liver function or liver tumors
Have known or suspected breast cancer
Have abnormal vaginal bleeding
Have depression in their medical history
Don’t have access to health care provider – requires a prescription and must be injected by a health care provider

29. Effectiveness and Cost
97% (3 out of 100 women using the injection for one year will get pregnant)
$30 - $75 for each injection
Average initial exam costs around $35-$125
Follow-up visits $20-$40

30. IUD What is it and How does it work?
A small plastic device inserted into (and removed from) the uterus by a health care provider
Contains copper (ParaGard) or hormone progestin (Mirena) that keep the sperm from joining the egg
Mirena thickens cervical mucus and thins endometrium; may make sperm less active and less likely to live in fallopian tube
ParaGard prevents sperm from going through the uterus and into fallopian tubes; in rare instances, prevents implantation into uterus

31. Advantages and Disadvantages of IUD
Immediately and highly effective
Longest lasting of any method; cost-effective if used for its full term of effectiveness
Easily removed by provider at any time
Convenient: no action needed before, during or after sex; requires no daily attention
Women who are breast-feeding can use this
Disadvantages
Doesn’t prevent against STIs
Requires health care provider visits for insertion and removal
Small risk of pelvic infection for first few weeks after insertion; higher risk if woman has multiple sexual partners.
Possible risk to future fertility
For some, insertion can be painful
May increase cramps and bleeding during monthly periods
Expensive if used for only a short amount of time

32. Effectiveness
Mirena (hormonal) – replaced every 5 years
99.9% effective
(1 woman out of 1,000 using the device for one year will get pregnant)
Copper (ParaGard) – replaced every 10 years
99.2% % effective
(6-8 woman out of 1,000 using the device for one year will get pregnant)

33. COST $175-$400 (exam, insertion, and follow-up visit)
Mirena (hormonal) - $300-$400 every 5 years
ParaGard (copper) - $200-$300 every 10 years

34. Emergency Contraceptives What it is and How it Works
Used after contraceptive device fails or after unprotected sex
Prevents pregnancy by inhibiting ovulation, fertilization, or implantation
Regimen of combined oral contraceptive pills (ECPs – emergency contraceptive pills)
Plan B: first tablet taken ASAP within 3 days of sex, second tablet must be taken 12 hours later.
OR - IUD - Insertion of copper-releasing IUD within 5 days of unprotected sex

35. Advantages and Disadvantages of Emergency Contraceptives
Only methods a couple can use to prevent pregnancy after unprotected sex or after an “accident”
Provides emergency treatment for victims of sexual assault who were not protected by an effective method at the time
Disadvantages
Not as effective at preventing pregnancy as other birth control methods
Possibility of short term side effects like nausea, vomiting, and menstrual changes at next period
Does not protect against STIs

36. Effectiveness
92-98% effective with pills
(8 out of 100 who have unprotected sex during first part of cycle will become pregnant)
(1-2 women out of 100 will become pregnant after taking Plan B)
99% effective after ParaGard IUD insertion
(1 woman out of 100 will become pregnant after insertion )

37. Cost Approximately $25 for Plan B
Available to women and girls age 17 and older without a prescription at most pharmacies. You must show proof of age.
For girls ages 16 and younger, Plan B is available only with a doctor’s prescription.
ParaGard (copper) IUD - $200-$300 $175-$400 (exam, insertion, and follow-up visit)

38. Advantages and Disadvantages of Sterilization
Generally more reliable than other birth control methods
Disadvantages
Requires outpatient surgery
Leaves small scars and may involve stitches.
Can be expensive
Does not protect against STIs

39. 99.7%- 99.8% tubal ligation for women
Effectiveness
Both procedures require at least 3 months before either are effective to the rates below:
99.7%- 99.8% tubal ligation for women
99.85%-99.9% vasectomy for men

40. Not Recommended for women who:
Plan to get pregnant in the future
Want the choice of getting pregnant at some point in their lives
Do not have access to a health care provider – sterilization requires outpatient surgery

41. Cost Approximately $1,300-$3,500 for Essure or tubal ligation
Approximately $250-$1,000for vasectomy

42. MYTHS about birth control and contraceptives
A woman will not get pregnant the first time she has sex
A woman can only get pregnant once a month
A woman will not get pregnant if her partner pulls out
A woman will not get pregnant if she urinates or douches after sexual activity.