Over the Counter Contraceptive Methods Male & Female Condoms, The Sponge, and Spermicide

What is a Male Condom? OTC, barrier methods, reversible Made of thin latex or plastic worn on the penis during intercourse to collect semen Available dry or lubricated

How well do they work? Perfect use: 98% Typical use: 85% Good protection against HIV and reduces risk of other STDs such as gonorrhea, syphilis, chlamydia, HPV, and herpes

Male condoms continued… Advantages: allows men to share responsibility, no side effects, easy to get, can be used with other methods, can help relieve premature ejaculation, STD protection Disadvantages: They can break, feeling may be reduced, interrupts lovemaking Cost: $0.50 or less, sometimes FREE

The Female Condom Plastic pouch w/ flexible rings at each end Inserted into the vagina like a diaphragm Ring at the open end stays outside

The female condom continued… Effectiveness: 79% - 95% Advantages: no fittings, can be used by people allergic to latex Disadvantages: Irritation, slip into vagina, noisy Cost: $2.50

The Sponge Reserve for 1,000 mg of nonoxynol-9, that is released into the vagina over 24 hour Polyurethane foam traps and absorbs semen Acts as a physical barrier between sperm and the cervix

The sponge continued… Thoroughly wet sponge w/water before insertion, leave in place for six hours after sex Effectiveness: 84% to 91% Adv: 24 hour protection, no hormones, not messy, easy to purchase/use Disadv: irritation, no STD protection Cost: pkg of 3 or 12 ($9 - $35)

Spermicide Foams, creams, jellies, film , suppositories Inserted into vagina 10 minutes before intercourse (lasts approximately 1 hour) Block entrance to uterus and immobilizes sperm

Spermicide continued… Effectiveness: 71% - 85% Adv: Easy to obtain, no prescriptions or fittings Disadv: Messy, no STD protection, Irritation Cost: $8 - $16

APPLICATION

Other Rx, Behavioral, and Surgical Contraceptive Methods Diaphragm, Cervical Cap, Abstinence, Withdrawal, Outercourse, Tubal Ligation, and Vasectomy

The Diaphragm & Cervical Cap Reversible, prescription, barrier methods of birth control Soft latex or silicone barriers that fit over the cervix Used with a spermicide cream or jelly

Diaphragm Shallow dome shaped cup with a flexible rim Fits securely in the vagina to cover the cervix

Cervical Cap Thimble shaped and smaller than the diaphragm Fits securely onto the cervix

How do they work? Put 1 TBS of spermicide, then insert into the vagina to cover the cervix before intercourse Blocks entrance to the uterus while spermicide immobilizes sperm, preventing it from joining an egg Diaphragm: left in place for up to 24 hours Cervical Cap: left in place for up to 48 hours

Diaphragm and CC continued… Effectiveness: Diaph = 94% & CC = 91% Advantages: No effect on natural hormones, easily transported, does not interrupt sex play, and cannot be felt by either partner Disadvantages: Require a fitting/refitting, insertion may be difficult, no STD protection Cost: Exam = $50 - $200, Supplies = $15 -$50, and Spermicide = $8 - $17 per kit

Continuous Abstinence Not having intercourse with a partner Effectiveness: 100% Advantages: no medical or hormonal side effects Disadvantages: people may find it difficult to abstain for long periods of time and its often ended without being prepared Cost: FREE!

Withdrawal A man pulls his penis out of the vagina before he ejaculates Effectiveness: 73% - 96% Advantages: can be used when no other method is available Disadvantages: requires great self control, not for sexually inexperienced, men who ejaculate prematurely, or teens Cost: Free

Outercourse Sex play without intercourse (kissing, masturbation, massage, body-to-body rubbing, fantasy, and oral sex play) Effectiveness: nearly 100% for pregnancy, but STDs are still quite possible Advantages: no medical or hormonal side effects, increase intimacy between partners can be used when no other BC method is available Disadvantages: outercourse may lead to unintended intercourse Cost: Free

Hormonal Contraceptives

Implants Norplant (most effective method of BC) Six plastic implants inserted under skin of upper arm Effectiveness: Over 99% for up to 7 years Advantages: Continuous long-lasting Disadvantages: Irregular bleeding, acne, skin rash, change in appetite, weight gain, depression, no protection against STD’s Cost: $500-$750 and $100-$200 for removal No longer available, but new and improved Norplant Approved by the US in mid-2006 , NO LONGER AVAILABLE!! Dangerous Side effects….

The Shot Depo-Provera & Lunelle Injected into the buttock or arm every 12 weeks Effectiveness: Over 99% for 12 weeks Advantages: Effective for 12 weeks, no medicine to take every day, helps prevent cancer of the lining of the uterus Disadvantages: Irregular or total loss of bleeding, change of appetite, weight gain, depression, loss of BMD Cost: $50 for injection + office visit ($35-$125) NEW: Depo-subQ Provera 104 (less invasive)

The Pill Taken daily in a monthly series Effectiveness: Over 99% w/ perfect use for 1 month Advantages: Regular and shorter periods, reduced menstrual flow and cramping, less acne, fewer symptoms of PMS, many pills to choose from Disadvantages: Must take pill every day (same time), no protection from STD’s, weight gain, irregular bleeding, nausea, changes in mood Cost: $20-$35 a month (per pack) Seasonale: 84 day regimen with 7 days off Lybrel: 365 day regimen; possibly available in 2006 Long term effects are unknown

THE PILL CASE

The Ring Nuva Ring Small, flexible ring inserted into the vagina for 3 weeks and taken out for the 4th week Effectiveness: Over 99% with perfect use for 1 month Advantages: does not involve taking a daily pill, does not require a “fitting,” does not require the use of spermicide Disadvantages: increased vaginal discharge, vaginal irritation or infection, irregular bleeding, weight gain, no protection against STD’s Cost: $20-$35 a month (similar to The Pill)

The Patch Ortho Evra Thin, plastic patch that is applied to the buttocks, stomach, upper outer arm, or upper torso once a week for 3 weeks, then 1 week off Effectiveness: Over 99% w/perfect use for 1 mo Advantages: Does not involve a daily pill, regular and shorter periods, less acne, less cramping Disadvantages: Skin reactions, problems with contact lens use- a change in vision or ability to wear contact lenses, irregular bleeding, STD’s Cost: Similar to other monthly methods ($20-$35 a month)

The IUD Para Gard & Mirena Para Gard contains copper and Mirena contains natural hormones Prevent fertilization of an egg by affecting the way the sperm or eggs move Effectiveness: Over 99% for 10 years with Para Gard and 5 years with Mirena Advantages: Long term protection that does not involve a daily pill Disadvantages: Cramping may be greater, periods may be heavier and last longer, no STD protection Cost: $175-$400 for exam, insertion, and follow-up