2 Most Widely Used in US Pill 30.6% Tubal Ligation 27.0% Male Condom Birth Control MethodPillTubal LigationMale CondomVasectomyInjectableWithdrawalIUDNatural family planningImplantOtherDiaphragm% of total30.6%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 masturbationRefraining from sexual behavior involving genital contactRefraining from penetrative sexual practicesMany 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 pregnancyNo medical or hormonal side effectsPostpone emotional and physical risksLess likely to become infertileFree! ($0)DisadvantagesMay be difficult to abstainMay 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 practiceThe 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 examsBetter than using no method at allNo side effectsFreeDisadvantagesHigh failure rateMust rely totally on partner to pull out in time – woman has no controlInexperienced or young partner may not be able to withdraw in timePre-ejaculate -- possibility for spermNo 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 sexContain chemicals (Active ingredient: nonoxynol-9) that kill sperm and/or block sperm from entering cervixForms: Gel, foam, cream, film, suppository, or tabletUsed alone OR as part of another barrier methodTime sensitive – usually requires 15 min wait before sex for spermicide to activate; must reapply/effective for only an hourDon’t wash it away – especially not for at least 6 hours after having sex.
9 Advantages and Disadvantages of Spermicides Full personal control over useNo need for special procedure or examDoesn’t contain hormonesSide effects are uncommon; almost anyone can use themAvailable without a prescription and in most drug stores; relatively inexpensiveDisadvantagesNeed to plan ahead – must have available when you have sexMust reinsert often (every hour)Doesn’t provide protection from any STI’sNot as effective as other methodsSome have allergic or chemical reaction to ingredients in itSide effects may include increased urinary tract infections or irritation
10 Effectiveness71% effective (29 out of 100 women using it for 1 year will get pregnant)
11 Approximately $.30 - $1.00 per act of sex CostApproximately $.30 - $1.00 per act of sexFilm (12 sheets) – approx. $9.25Foam (container) -- $12.00Suppositories (12) -- $4.00Gel 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 vaginaA 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 insertedOne 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 useCan break or leakMore expensive then the male condomDoes not contain spermicideAdvantagesAvailable without a prescriptionNo hormonal side effectsCan be used for people with latex sensitivitiesPrevents STIs: chlamydia, gonorrhea, herpes, HPV, and HIVStays 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 intercourseDO 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 yearwill get pregnant.)
17 The Male Condom What is it and How does it work? Keep sperm from entering the vagina during intercourseIt is a thin layer of latex (plastic) that covers the penis; polyurethane and tactylon (plastic) are available as well.Rolled onto an erect penisOnce man ejaculates, must hold on to base of condom and remove himself from woman; gently pull off condom and discardRemoval 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 breakNeed to plan ahead; have available when you have sexLatex and/or Spermicide Allergies – other brands or types of plastic available for those who sufferLoss of sensationAdvantagesEasy to buyInexpensiveFull personal control over use; no special procedures or examsSide effects uncommonHelps prevent pregnancy and most STIsCan be used with other methods
19 Condom Not Recommended For: Women or Men who are uncomfortable touching the penisThose 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 spermicideNearly 100% if used with withdrawal
21 Family Planning Centers may give them away or charge very little $$ Cost $$$.30 - $1.00 eachFamily 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 pillTaken daily (one pill)Contains the hormone progestin which works to prevent pregnancy bystopping ovulation and/orthickening the cervical mucusto stop the sperm from passing through
23 Advantages and Disadvantages of Mini Pills Studied for more than 30 years; long-term safety well knownStops monthly periods or causes extremely light periodsContains no estrogenAlternative for women over 35 who smokeDecreased menstrual cramps and pain; relief from acne and facial hairDecreased risk of endometrial cancer, ovarian cancer, and PID (pelvic inflammatory disease)Immediate reversibilityDisadvantagesMust take them every day at the same timeEffectiveness is compromised easier if taken with other medications because dose is very lowDoes not protect against STIsNot recommended for women who:Have impaired liver functionKnown or suspected breast cancerAbnormal vaginal bleeding in medical historyDon’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)Increasedeffectiveness ifused with otherbarrier 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 monthsStops 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 monthsMust receive shot every 12 weeks; given in arm or buttocks
27 Advantages and Disadvantages of Depo-Provera Stops monthly periods or have extremely light periodsContains no estrogenSafe, highly effective, long-lasting protection – no need for action before, during or after sexReduces menstrual cramps and painCan be used right after birth and while breast feedingAlternative to women who are over 35 and smokeDecreased risk of endometrial and ovarian cancer, and PIDDisadvantagesMust receive shot every 3 monthsIrregular 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 painMay result in bone loss during use; density returns to normal when you stop using itSide effects can’t be reversed until wears offMay cause delay in pregnancy after shot is stoppedDoes not protect against STIs
28 Depo-Provera Not Recommended for women who are: Are uncomfortable with needles/injectionsPlan to get pregnant within 5 yearsHave impaired liver function or liver tumorsHave known or suspected breast cancerHave abnormal vaginal bleedingHave depression in their medical historyDon’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 injectionAverage initial exam costs around $35-$125Follow-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 providerContains copper (ParaGard) or hormone progestin (Mirena) that keep the sperm from joining the eggMirena thickens cervical mucus and thins endometrium; may make sperm less active and less likely to live in fallopian tubeParaGard 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 effectiveLongest lasting of any method; cost-effective if used for its full term of effectivenessEasily removed by provider at any timeConvenient: no action needed before, during or after sex; requires no daily attentionWomen who are breast-feeding can use thisDisadvantagesDoesn’t prevent against STIsRequires health care provider visits for insertion and removalSmall risk of pelvic infection for first few weeks after insertion; higher risk if woman has multiple sexual partners.Possible risk to future fertilityFor some, insertion can be painfulMay increase cramps and bleeding during monthly periodsExpensive if used for only a short amount of time
32 EffectivenessMirena (hormonal) – replaced every 5 years99.9% effective(1 woman out of 1,000 using the device for one year will get pregnant)Copper (ParaGard) – replaced every 10 years99.2% % 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 yearsParaGard (copper) - $200-$300 every 10 years
34 Emergency Contraceptives What it is and How it Works Used after contraceptive device fails or after unprotected sexPrevents pregnancy by inhibiting ovulation, fertilization, or implantationRegimen 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 timeDisadvantagesNot as effective at preventing pregnancy as other birth control methodsPossibility of short term side effects like nausea, vomiting, and menstrual changes at next periodDoes not protect against STIs
36 Effectiveness92-98% 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 methodsDisadvantagesRequires outpatient surgeryLeaves small scars and may involve stitches.Can be expensiveDoes not protect against STIs
39 99.7%- 99.8% tubal ligation for women EffectivenessBoth procedures require at least 3 months before either are effective to the rates below:99.7%- 99.8% tubal ligation for women99.85%-99.9% vasectomy for men
40 Not Recommended for women who: Plan to get pregnant in the futureWant the choice of getting pregnant at some point in their livesDo 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 sexA woman can only get pregnant once a monthA woman will not get pregnant if her partner pulls outA woman will not get pregnant if she urinates or douches after sexual activity.
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