Your Contraceptive Choices

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…its not enough to ask “Have you had sex before?” Saying No… It doesn’t work if you only practice abstinence occasionally! Cost: Free!!! Emotionally and financially! Its the only thing that is 100% effective for preventing pregnancy and STIs

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

WITHDRAWAL What is it? How does it work? The man pulls his penis out of the vagina before he ejaculates to keep the sperm from joining the egg 81% effective with typical use 96% effective with perfect use

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 Free Disadvantages 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

Periodic Abstinence What it is and How it Works Identifying days when pregnancy is most likely to result and abstaining from sex (also called Natural Family Planning or Rhythm Method) Includes measuring basal body temperature, charting cycle on calendar, cervical mucus, and symptothermal methods Called fertility awareness if using barriers or withdrawal method during fertile time

Effectiveness Calendar method – 87% - typical use 95% - perfect use Basal body temperature – 80% - typical use 98% - perfect use Cervical mucus – 80% - typical use 97% - perfect use Symptothermal – 80% – typical use

Advantages and Disadvantages of Periodic Abstinence Full personal control over use; no need for special medical procedures or examinations No side effects Free ($0) Disadvantages Does not protect against STIs Not good for women who: Have irregular cycles or menstrual problems Inability to interpret fertility signs correctly Have persistent reproductive system tract infections that affect the signs of fertility Have partner unwilling to practice periodic abstinence

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.

Effectiveness 86% – typical use 97% - perfect use Nearly 100% if used with withdrawal

Advantages & Disadvantages of Male Condoms 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 Disadvantages 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

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

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

The Female Condom What is it and How does it Work 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 One time use only – thrown away after you use it and replaced with a new one before your next act of sex.

Effectiveness 79% with typical use 95% with perfect use

Advantages and Disadvantages of the Female Condom 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 Disadvantages Difficult to use Can break or leak More expensive then the male condom Does not contain spermicide

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)

About $2.50 per package/condom Cost About $2.50 per package/condom

Birth Control Pills What are they and How do they Work? A combined oral contraceptive pill that releases the hormones estrogen and progestin The pill is taken once a day Helps to stop the release of the egg, stops sperm from entering cervix, and changes lining of the uterus to prevent egg from implanting.

Advantages and Disadvantages of Birth Control Pills Studied for over 30 years – long-term safety well known Periods become more regular Less menstrual cramping, facial hair, acne, and menstrual flow Reduces risk of ovarian and womb cancer and infections of tubes and ovaries Strengthens bones by regulating hormones Some protection from PID Disadvantages Must be taken daily; hard to remember to take Side effects include irregular bleeding, weight gain or loss, changes in mood, nausea, breast tenderness and headaches Increased health risks when used with smoking Slight increase in the risk of blood clots Does not protect against STIs

Birth Control Not Recommended for Women who: Cannot take estrogen due to current health status Smoke Over age 35 Have blood clots, impaired liver function or liver tumors, known or suspected breast cancer, vaginal bleeding, high blood pressure, gallbladder disease or severe headaches in their medical history Do not have access to health care provider – requires a prescription from the provider

Effectiveness 92% - typical use 99.7% - perfect use Increased effectiveness if used with other barrier methods

Cost $17.00-$21.00 for monthly pill packs $35-$125.00 for exam, if needed

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

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

Effectiveness 95% - typical use 99.5% - perfect use Increased effectiveness if used with other barrier methods

Cost $17.00 – $25.00 per monthly pill pack $35.00-$125.00 for exam, if needed

Other Types Spermicides/ Sponge Diaphragm or Cervical Cap Depo-Provera Lunelle IUD Emergency Contraceptives Implanon CONTRACEPTIVE PATCH NuvaRing Male and Female Sterilization

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

Good Resources www.plannedparenthood.org www.ivilliage.com www.metrokc.gov/health/famplan/birthcontrol/ www.plannedparenthood.org www.ivilliage.com