Contraception Choices Adolescent Clinic NNMC

Objective   Discuss the different options   Important counseling points   Review by playing a game

Options n Abstinence n Timing schemes n Barrier methods n Hormonal preparations MethodTypical UsePerfect Use Implant0.09 Injection-combo0.1 Injection- progestin 0.3 IUD OCP-combo OCP-progestin Patch-0.1 Vaginal ring-0.65 Male condom Diaphragm/Cerv cap Withdrawal Periodic abstinence Female condom Spermicides No method85.0

Abstinence/Timing n n While some groups encourage “The rhythm method” as a form of birth control we do not recommend it n n Temperature, cervical mucus and record keeping are needed to do it right.

Barrier n 2nd most popular n STD protection n Inexpensive n Failure rate: 3-18% n Proper wear important

Hormonal n Combination OCPs –Monophasic –Biphasic –Triphasic –Failure rate 0.1% (2-6%) n Progestin only –Failure rate 0.5% (3-10%)

Depo-Provera, DMPA n Depo medroxyprogesterone acetate –Prevents egg release –Failure rate: 0.3% –Shot every 3 months

The Patch n Ortho Evra n Combination preparation n 20% bleeding in first cycle n Change patch once per week n May not be as effective if >90kg

Vaginal Ring n NuvaRing n Combination preparation n Worn for 3 weeks at a time n Low breakthrough bleeding rate

Vaginal Ring n NuvaRing –Low failure rate –Can wear during menses –Can wear during intercourse –Can remove for intercourse –Does not have to be fitted –Vaginal position does not matter –No increased risk of infection

Choosing a Method What myths have you heard? What side effects have you heard about?

Common Myths n 2/3 women believe OCPs unsafe n Causes cancer n Causes heart disease n Leads to infertility n Body needs break from OCPs n ALL FALSE

Advantages n Less dysmenorrhea n Shorter, lighter menses n Less Mittelschmerz n Acne & hirsutism improved n Prevents ovarian & endometrial cancer n Reduction in PID

Possible side effects n Nausea/vomiting n Edema/leg cramps n Bloating n Vascular headaches n Clear vaginal d/c n Cystic breast changes n Chloasma Chloasma n Androgenic –Oily skin –Hirsutism –Acne –Increased appetite n Mastalgia n Inreased breast size n Bloating n Depression ESTROGENPROGESTERONE

Do not use if: n n You have had a blood clot n n You have had cancer n n You have liver disease n You have high blood pressure n You are on seizure medicine n You have bad migraines

If you miss a pill n n Missed pills n n 2 per day until caught up n n Condoms if miss >2 pills per month

Headaches n n Contact us if you get frequent headaches or headaches during the reminder pills

Some things that can Interact n n Seizure medicine n n St. John’s Wort n n Rifampin, griseofulvin n n Vitamin C – –Irregular bleeding

Time to Play……

1,000, , , ,000 50,000 25,000 10,000 5,000 1, A. Oral Sex B. Intercourse C. Adultery D. Coveting Which is not sexual activity $100

1,000, , , ,000 50,000 25,000 10,000 5,000 1, A. Oral Sex B. Intercourse C. Adultery D. Coveting Which is not sexual activity $100

1,000, , , ,000 50,000 25,000 10,000 5,000 1, A. Monogamy B. Abstinence C. Withdrawal D. Rhythm Method What is the best way to prevent pregnancy $500

1,000, , , ,000 50,000 25,000 10,000 5,000 1, A. Monogamy B. Abstinence C. Withdrawal D. Rhythm Method What is the best way to prevent pregnancy $500

1,000, , , ,000 50,000 25,000 10,000 5,000 1, A. 1 month B. 3 months C. 1 year D. Never Most OCP side effects resolve by $1,000

1,000, , , ,000 50,000 25,000 10,000 5,000 1, A. 1 month B. 3 months C. 1 year D. Never Most OCP side effect resolve by $1,000

1,000, , , ,000 50,000 25,000 10,000 5,000 1, A. Weight gain B. No period C. Thin bones D. Acne Depo causes this side effect, and thus a 2 year use recommendation $5000

1,000, , , ,000 50,000 25,000 10,000 5,000 1, A. Weight gain B. No period C. Thin bones D. Acne $5000 Depo causes this side effect, and thus a 2 year use recommendation

1,000, , , ,000 50,000 25,000 10,000 5,000 1, A. The Pill B. The Patch C. The Shot D. The Ring The easiest method of birth control to keep private $10,000

1,000, , , ,000 50,000 25,000 10,000 5,000 1, A. The Pill B. The Patch C. The Shot D. The Ring $10,000 The easiest method of birth control to keep private

1,000, , , ,000 50,000 25,000 10,000 5,000 1, A. Monthly B. 6 months C. 3 months D. Annually How often does a patient need Depo Provera $25,000

1,000, , , ,000 50,000 25,000 10,000 5,000 1, A. Monthly B. 6 months C. 3 months D. Annually $25,000 How often does a patient need Depo Provera

$50,000 A. Rashes B. Falling off C. Pregnancies D. Clots 1,000, , , ,000 50,000 25,000 10,000 5,000 1, What side effect of the Patch is in the news

$50,000 A. Rashes B. Falling off C. Pregnancies D. Clots 1,000, , , ,000 50,000 25,000 10,000 5,000 1, What side effect of the Patch is in the news

1,000, , , ,000 50,000 25,000 10,000 5,000 1, A. 1% B. 10% C. 5% D. 25% What percent of teens get pregnant each year $100,000

1,000, , , ,000 50,000 25,000 10,000 5,000 1, A. 1% B. 10% C. 5% D. 25% What percent of teens get pregnant each year $100,000

1,000, , , ,000 50,000 25,000 10,000 5,000 1, $250,000 A. Condom B. Diaphragm C. Dental dam D. Female condom Which item does not decrease STIs?

1,000, , , ,000 50,000 25,000 10,000 5,000 1, $250,000 A. Condom B. Diaphragm C. Dental dam D. Female condom Which item does not decrease STIs?

1,000, , , ,000 50,000 25,000 10,000 5,000 1, A. 15% B. 85% C. 50% D. 99% What percent of teens not using birth control become pregnant in a year $500,000

1,000, , , ,000 50,000 25,000 10,000 5,000 1, A. 15% B. 85% C. 50% D. 99% $500,000 What percent of teens not using birth control become pregnant in a year

1,000, , , ,000 50,000 25,000 10,000 5,000 1, A. 20 B. 50 C. 35 D. 67 What percentage of 10 th grade girls have had sex $1,000,000

1,000, , , ,000 50,000 25,000 10,000 5,000 1, A. 20 B. 50 C. 35 D. 67 $1,000,000 What percentage of 10 th grade girls have had sex

Conclusion n We are here to help you in any way we can n Please feel free to contact us with any questions or concerns you have

Questions?