1. A Comprehensive Understanding of Contraceptives July 8, 2015

2. Overview: Method Types ●Natural o Abstinence o Fertility Awareness o Withdrawal ●Barrier o Condoms (Male and Female) o Diaphragm or Cervical Cap o Sponge ●Hormonal o Birth Control Pills o The Patch o Vaginal Ring o Emergency Contraception o Implant o Depo-Provera o IUD  Mirena, Copper ●Sterilization o Tubal Ligation o Vasectomy

3. Natural Method: Abstinence ●Cost: Free ●Efficacy: 100% ●Description: No sexual intercourse

5. Fertility Awareness ●Cost: $12-$17 (thermometer and OV test) ●Efficacy: 75% ●Description: No sex during fertile days OR use of barrier during fertile days ●Requires knowledge of menstrual cycle and careful calculations

6. Withdrawal (Pulling Out) ●Cost: Free ●Efficacy: o Perfect use- 4% failure rate o Typical use- 27% failure rate ●Description: Male dependent

7. Barrier: Condoms ●Serves as a physical barrier ●Types: Male and Female

8. Male Condoms ●Cost: $.50-1 per condom ●Efficacy: 87-98% o Breakage: Oil-based lubricants, withdrawal mistakes ●Description: Thin sheath worn over the erect penis

9. Male Condoms ●Prevents pregnancy and the spread of STI’s ●Available in: o Latex o Polyurethane o Lambskin (less effective for STI)

11. Female Condoms ●Cost: ~$3.50 per condom ●Efficiency: o Perfect Use- 5% failure rate o Typical Use- 21% failure rate

12. Female Condoms ●Description: Available in Polyurethane and Nitrile ●Prevents pregnancy and the spread of STI’s

14. Diaphragm or Cervical Cap ●Cost: Up to $300 (for fitting and cap) ●Description: o Used with spermicide to help prevent pregnancy o Need to be fitted by a doctor o Leave in place for 6-8 hours after sex o Remove it within 24 hours of insertion (diaphragm) and 48 hours (cap) ●Efficiency o Diaphragm: 80-94% o Cervical Cap: 68-91% *Not a very commonly used method

16. Sponge ●Cost: $3-5 (1 time use) ●Efficiency: 87% ●Description: o Soft, polyurethane foam o Has ‘dimple” to keep in place o Can be inserted 24 hours before intercourse o Remove 6 hours after sex

18. Overview of Hormonal Method ●Oral Contraceptive Pills ●Ring ●Patch ●Emergency Contraception ●LARC Methods o Implant o Depo-Provera o IUD (Copper, Mirena)

19. How Do Hormonal Methods Work? ●Inhibit follicle-stimulating and luteinizing hormones (FSH and LH), which prevent follicular development, growth of the endometrial lining, and ovulation

20. Basic Mechanism: Estrogen ●Inhibit egg release ●Stabilize uterus lining

21. Basic Mechanism: Progesterone ●Thicken cervical mucus ●Thin uterus lining ●Prevents ovulation ●Decreases cilia movement in tubes

22. Oral Contraceptive Pills (OCP)/ Birth Control Pills ●Cost: $0-$50 per month ●Efficacy: 92-97% ●Description: Take a pill everyday to prevent pregnancy ●Various types with different estrogen/ progestin dosages ●± 154 brands

23. Birth Control Pill Side Effects ●Side Effects May Include: o Breast tenderness o Water retention o Change in mood o Formation of gallstones o Nausea o Increased risk of blood clotting

24. What Are Some Other Reasons to Take Birth Control Pills? ●Potential benefits: o Improvement in acne o Decreased cramps o Steady menstrual cycles o Menstrual suppression  Control of menstrual cycle  Problem?: more likely to have spotting the longer you suppress your cycles

25. The Patch ●Cost: $0-85 per month ●Efficacy: 92% ●Description: Beige color, very thin

26. The Patch ●Placed on the abdomen, buttocks, upper torso, or upper arm ●Hormones are in the middle layer and are absorbed through the skin ●Change the patch every week

27. Vaginal Ring ●Cost: $0-75 per month ●Efficacy: 92% ●Description: Soft, flexible, and transparent ring

28. Vaginal Ring ●Placed inside the vagina for 3 weeks and then taken out for one week to allow a menstrual cycle to occur

29. Emergency Contraception - “Plan B” ●Cost: $10-50 per dose ●Efficiency: 75-95% o Only effective if used prior to ovulation ●Description: o Effective up to 120 hours after intercourse o Delays or inhibits ovulation and fertilization

30. Overview of LARC Methods ●LARC: Long-Acting Reversible Contraception o Depo-Provera o IUD (Mirena, Copper) o Implanon ●Why LARC?: Reduces unintended pregnancy, teen pregnancy, and abortion. Minimal maintenance - more effective!

31. Implant ●Efficacy: 99% ●Description: o Rod inserted underneath skin of upper arm o Offers protection from pregnancy for 3 years

32. Depo-Provera ●Efficacy: 99% ●Description: o Given a shot of hormones that prevents pregnancy for up to 3 months o Must get an injection every 3 months

33. Mirena Intrauterine Device (IUD) ●Efficacy: 99% ●Description: o Check for STIs before placed o Cramping then stops o After 6 months - no bleeding o Immediately reversible o Mirena: hormone releasing IUD, lasts up to 6 years Uterus

34. Copper Intrauterine Device (IUD) ●Efficacy: 99% ●Description: o Lasts up to 11 years o Copper coiled plastic frame that continuously bathes the uterus with copper - producing an inflammatory reaction and preventing fertilization

35. Sterilization: Tubal Ligation

36. Sterilization: Vasectomy

37. Additional Resource ●http://bedsider. org/methodshttp://bedsider. org/methods