CONTRACEPTION THE ACTIVE PREVENTION OF PREGNANCY

Total Abstinence – How it works  No sexual contact until marriage Oral Anal Vaginal

Abstinence  Only 100% method  Protects against STI  No physical side effects  Can be used any time  Nothing to purchase  Requires commitment and self-control by both partners  Social pressure to engage in intercourse  Many people fail to use protection when abstinence ends

Abstinence Effectiveness  Perfect Use: 100% IF used consistently and correctly  Typical Use: Unknown, depends on the user

Abstinence Withdrawal  Nothing to purchase  Available as a last resort, *can always say NO  Dependent completely on the male partner  Requires great control  May affect pleasure  No STI protection  Not a method recommended for adolescents

Abstinence Withdrawal – How it works  Sexual Intercourse – Male withdraws his penis and ejaculates outside of the vagina.

Withdrawal Effectiveness  Varies: failure rate increases if the male does not predict and control ejaculation correctly  <75%

Rhythm – How it Works  Tracking a female’s menstrual cycle.  Not having intercourse while an egg is in the fallopian tubes

Effectiveness  Not advised for teens due to changing cycles  Extremely dangerous  Consult Dr.  About 50%

Barrier vs Chemical

Male Condom – How it Works  Barrier Method  Latex sheath placed over the penis  Catches & holds seminal fluid in ‘reservoir tip’

Mechanical Male Condom Also protects against STI Male involvement Inexpensive Over the Counter (otc) May help delay ejaculation  May leak or break if used incorrectly  Requires preparation and planning  Expire  Storage  1 time use only

Male Condom Effectiveness  Perfect Use: 98% if used correctly and consistently  Typical Use: 85%

Mechanical Female Condom  Barrier Method  Latex sheath placed inside vagina, closed end at cervix, open end outside.  Penis is placed into it and it prevents fluid entering vaginal canal

Mechanical Female Condom  Also protects against STI  Available OTC  Alternative for people with latex allergies  Requires high level of comfort with one’s body  May be difficult to insert  May become dislodged during intercourse  Requires preparation and planning  Expire  Storage  1 time use only

Female Condom Effectiveness  Perfect Use: 95% if used correctly and consistently  Typical Use: 79%

Mechanical Diaphragm/Cervical Cap  Barrier method placed over the cervix. Blocks sperm cells from entering  Spermicide affects the way sperm cells move

Mechanical Diaphragm/Cervical Cap  Barrier method that covers the cervix  Used with spermicide  Must be fitted by Dr.

Mechanical Diaphragm/Cervical Cap  Can be inserted in advance of intercourse  Can remain in place for multiple acts  Used with spermicide  Reusable  Requires high level of comfort with one’s body  Requires fitting by clinician  May be difficult to insert  Limited STI protection, possible irritation by spermicide that could facilitate STI transmission

Diaphragm/Cervical Cap Effectiveness  Perfect Use: 91% cap 94% diaphragm If used correctly and consistently  Typical Use: 84%

Diaphragms / Caps

Chemical / Mechanical IntraUterin Device  Affects way sperm cells move  T shaped device inserted into the uterus  Alters the uterine lining preventing a fertilized egg from implanting  *2 types, hormonal and non- hormonal Hormonal method prevents ovulation

IUD  Can stay in place for up to 10 years.  Nothing to apply or insert at time of intercourse  No STI protection  Dr must insert and remove  Cost  Rare complications

Effectiveness  Perfect/typical use: 99%  $500-$1,000

Chemical / Mechanical Sponge – How it Works  Barrier placed against cervix that contains spermicide  One time use only

Chemical / Mechanical Vaginal Sponge  Inserted in advance of intercourse  2 methods of protection  Difficult to insert or remove  May become dislodged  Difficult to find in stores  May cause irritation  Cost, $9-15 for pack of 3

Sponge - Effectiveness  Perfect Use: 91%  Typical Use: 88%

Chemical Birth Control Pill – How it Works  Hormonal method that prevents ovulation  Pill taken by mouth each day of cycle. No egg, no possibility of pregnancy

Chemical The Birth Control Pill  Nothing to apply or insert at time of intercourse  More regular, Shorter periods  Ability to become pregnant returns quickly when use is stopped  Protects against painful, heavy, or irregular periods  Must remember to take daily  Possible side effects: nausea, breast tenderness, weight gain or loss  Rare but serious health risks (Blood clots, heart attack, & stroke - these risks are higher for women over 35 who smoke)  No STI protection

The Pill Effectiveness  Perfect Use: 99+%  Typical Use: 92%

Chemical Patch – How it Works  A hormonal patch worn on the skin for 3 weeks preventing ovulation  Not worn for 1 week, menstruation

Chemical Birth Control Patch  Continuous protection against pregnancy for 1 month  Nothing to apply or insert at time of intercourse  Must remember to replace patch weekly and not wear it the week of menstruation  Visible  Not available in all skin tones  No STI protection

The Patch Effectiveness  Perfect Use: 99+%  Typical Use: 92%

Chemical Vaginal Ring – How it Works  The vaginal ring is a small, flexible ring a woman inserts into her vagina once a month to prevent pregnancy. It is left in place for three weeks and taken out for the remaining week each month. The vaginal ring is commonly called NuvaRing, its brand name.

Chemical Vaginal Ring  Nothing to apply or insert at time of intercourse  Can regulate menstrual cycle  Hormonal  Cost - $  No STI protection  Nausea  Weight gain/loss  Risky for those over 35 who smoke

Chemical Vaginal Ring  Perfect use: 99%  Typical use: 91%

Chemical Spermicide - How It Works  Contraceptive foams block the entrance to the uterus with bubbles and contain a spermicide that immobilizes sperm.  Contraceptive creams, jellies, film, and suppositories melt into a thick liquid throughout the vagina. They block the entrance to the uterus and contain spermicide that immobilizes sperm.

Chemical Spermicides  Available otc in a variety of forms (creams, foams, gels, suppositories)  Adds lubrication  Timing: must insert close to each intercourse  May cause allergic reaction  Possibility of irritation that could facilitate STI transmission  No STI Protection

Spermicide Effectiveness  Perfect Use: 85% if used correctly and consistently  Typical Use: 71%

Chemical Injection – How it Works  An injection by a Doctor once every 3 months that is a hormonal method that prevents pregnancy

Chemical Injection  Continuous protection against pregnancy for 3 months  Nothing to apply or insert at time of intercourse  Menstruation stops for over half of women (some may not consider this an advantage)  Private  Requires injection  Must remember to get shot  Side effects: weight gain, irregular periods, headaches  Return to fertility may take several months  NO STI protection

Injection Effectiveness  Perfect Use: 99+%  Typical Use: 97%  Cost: $ per year

Chemical Norplant – How it Works  The progestin in the birth control implant works by keeping a woman's ovaries from releasing eggs — ovulation.  The hormone in the implant also prevents pregnancy by thickening a woman's cervical mucus. The mucus blocks sperm and keeps it from joining with an egg.

Implant  The ability to become pregnant returns quickly when you stop using the implant.  It can be used while breastfeeding.  It can be used by women who cannot take estrogen.  It gives continuous long- lasting birth control without sterilization.  There is no medicine to take every day.  Nothing needs to be put in place before vaginal intercourse.  headache  rarely, an infection or pain in the arm  nausea  pain at the insertion site  weight gain

Norplant – Effectiveness  Typical/Perfect Use: 99%

Chemical Emergency Contraceptive – How It Works  Prevents ovulation  Thins the lining of the uterus  Thickens cervical mucus to act as a barrier method  Must be taken within 120 hours (5 days) of unprotected sex or sex where an ‘accident’ happened - ***the sooner the better.***  Emergency contraception should not be used as a form of ongoing birth control because there are other forms of birth control that are a lot more effective.

Chemical Emergency Contraception Pill  Relatively safe  No known reports of serious side effects  Its Plan B, not ‘THE method’  Nausea  breast tenderness  irregular bleeding  dizziness  headaches  If you use the morning-after pill frequently, it may cause your period to be irregular.

ECP Cost  The cost of emergency contraception varies a great deal. It may cost anywhere from $10 to $70. If you are not 17 and need a prescription, the health center visit may cost up to $250, depending on where you live.

ECP- Effectiveness  89% effective  Pill only protects against pregnancy for prior acts. Will not protect against future situations. Risk increases over time.  If the female does not have her period within three weeks she should consider a pregnancy test.

Permanent Vasectomy – How it Works  Vasectomy is a form of birth control for men that is meant to be permanent.  During vasectomy, a health care provider closes or blocks the tubes that carry sperm. When the tubes are closed, sperm cannot leave a man's body and cause pregnancy.

Vasectomy  Permanent – feel that family is ‘complete’  Non-hormonal  Surgery – bruising, soreness, risk of infection  Cost - $350 - $1,000  Rare complications with surgery

Vasectomy effectiveness  99+%  However, vasectomy is not immediately effective. Sperm remains beyond the blocked tubes

Permanent Tubal Ligation – How it works  During a sterilization procedure, a health care provider closes or blocks a woman's fallopian tubes. Closing the tubes can be done in several ways.  One way is by tying and cutting the tubes — this is called tubal ligation. The fallopian tubes also can be sealed using an instrument with an electrical current. They also can be closed with clips, clamps, or rings. Sometimes, a small piece of the tube is removed.  Sometimes, tiny inserts are put in the tubes. Tissue grows around them and blocks the tubes. The brand names for these types of sterilization are Adiana and Essure.

Female Sterilization  Permanent  Safe & Highly effective  Cost - $1,500 - $6,000  Surgery  Rare complications  Family changes

Female Sterilization  Sterilization is nearly 100 percent effective.  For every 1,000 women who have Essure, fewer than 3 will become pregnant.  For every 1,000 women who have traditional incision methods, about 5 will become pregnant.  For every 1,000 women who have Adiana, fewer than 20 will become pregnant.  Most kinds of sterilization for women are effective right away. But it takes about three months before Adiana and Essure are effective.