Contraception HEALTH CLASS Ramsey High School

What Doesn’t Work Withdrawal: pulling your penis out of the vagina before ejaculation will not prevent a pregnancy Rhythm: Avoiding intercourse during ovulation will not prevent a pregnancy Douching: Cleaning your vagina immediately after intercourse will not prevent a pregnancy

Contraception Intentional prevention of conception through the use of various devices, agents, drugs, sexual practices, or surgical procedures.

Questions How will it fit into your lifestyle? How effective will it be? How safe will it be? How affordable will it be? Is it reversible? Does it protect against STDs

Over-the-Counter Abstinence Condom Female Condom Spermicides Sponge

Abstinence How It works Abstaining from sex (do not take part in) –Vaginal, anal, oral

Effectiveness 100% –In preventing pregnancy and Sexually Transmitted Diseases (STDs)

Advantages Prevents pregnancy and STDs Finding other ways to be intimate with your partner Talking, listening, sharing, being honest, respecting each others thoughts and feelings

Disadvantages Peer pressure May be hard for some people to abstain

Availability/Cost Costs nothing Available to everyone

Condom How it works -latex or lambskin sheath that serve as a barrier preventing the passage of sperm as well as disease carrying organisms. -prevents vaginal fluids from entering the male’s urethral opening.

Effectiveness 82%-98% More protection is possible if condoms are used with a spermicide.

Advantages Does not alter hormonal balance Readily available Allows men to share responsibility for birth control and STD prevention No side effects (unless latex allergy)

Disadvantages Must stop intercourse to apply condom May lessen sexual sensations Can slip off or tear

Availability/Cost Over-the-counter –Drug stores, super markets, family planning clinics, college health centers. Less than $.50-$2.00/each F.Y.I. – CAN ONLY BE USED ONCE Also check expiration dates

Female Condom How It Works Serves as a barrier method Polyurethane (plastic) pouch with flexible rings at each end Used to line the vagina during intercourse Collects semen

Effectiveness 79%-95% Can be used with spermicides

Advantages Allows woman to share responsibility in preventing STD’s Do not need an erection to stay in place

Disadvantages Vaginal irritation May slip into the vagina during intercourse Bulky, hard to insert Less effective than male condom in preventing pregnancy and STD’s noisy

Availability/Cost OTC –Drug stores, family planning clinics, some super markets Costs about $2.50/each

Spermicides How It Works Chemical agent that immobilizes sperm (nonoxynol-9) Coats the cervical opening Comes in a variety of preparations –Foams, creams, jellies, film & suppositories

Effectiveness 71%-85% Using a condom increases effectiveness

Advantages No prescription required Do not have to interrupt intercourse –Can be inserted beforehand

Disadvantages High failure rate Some brands may irritate the penis or vagina No STD protection Can be messy (leakage)

Availability/Cost OTC –Drug stores, some super markets, family planning clinics $8.00—foam/gel refills cost about $4-$8

The Sponge How It Works Made of polyurethane foam and contains spermicide –Serves as a barrier covering the cervix –Releases spermicide –Traps and absorbs sperm

Effectiveness 84%-91% –Women who have never given birth 68%-80% –Women who have given birth *must be left in for 6 hrs after intercourse

Advantages Does not interrupt intercourse –Can be inserted hrs ahead of time Can be worn up to 30 hours No prescription

Disadvantages No STD protection Can get messy Insertion/removal can be difficult Vaginal irritation Increased of TSS

Availability/Cost OTC 3-pack--$7.50-$9.00

Prescription Methods The Pill The Patch—Ortho Evra The Ring—Nuva Ring Diaphragm, caps, shields The Shot—Depo Provera IUD-Intrauterine Device

The Pill 2 types—combination and progestin-only Combination-pills contain both synthetic estrogen and progestin (like hormones produced in the ovaries). Progestin-only-contains synthetic form of progestin

How it Works Keeps the ovaries from releasing an agg (ovulation) Thickens cervical mucus-prevents the passage of sperm Hormone also affects lining of the uterus- prevents implantation

Effectiveness 92%-99% Failure rate increases if: –Pills are started too late in the cycle –2 or more pills are missed in a row –Pills are taken in wrong order –Taken with antibiotics and other meds.

Advantages Protection for 1 month Nothing to do right before intercourse to protect against pregnancy Regulates menstrual cycle Less acne Protection against some cancers Fewer non-cancerous breast growths REQUIRES REGULAR CHECK-UPS

Disadvantages No STD protection Must take daily pill Weight gain/loss Breast tenderness Nausea Changes in mood Health risks

Availability/Cost By prescription only Exam ranges from $35-$125 Monthly packages $20-$35

The Patch—Ortho Evra How It Works Same as the pill Thin beige, plastic patch applied to the skin Change patch once a week for 3 weeks Do not wear anything for 4 th week

Effectiveness 99% Failure rate increases –Patch becomes loose or falls off for more than 24 hours –Same patch is left on for more than 1 week

Advantages (specific to The Patch) Does not involve taking a pill everyday

Disadvantages (specific to The Patch) Skin reaction at site of application No STD protection

Availability/Cost Prescription only Exam $35-$125 Patches--$20-$35

Diaphragm, Caps, Shields How It Works Soft latex or silicone barriers that are intended to fit securely in the vagina to cover the cervix Holds spermicide in place

Effectiveness (varies with method) Diaphragm—84%-94% Shield—85% Fem Cap –86% (before childbirth) –71% (after childbirth)

Advantages No interruption—can be inserted hours ahead of time Can be easily carried (purse,pocket) No hormones –Can be used during breast feeding

Disadvantages Insertion can be difficult Can be pushed out of place Vaginal irritation Can be messy

Availability/Cost Prescription only Exam $50-$200 Prescription barrier methods $15-$75 Spermicide $8-$17

The Shot—Depo Provera How it works Shot of synthetic progesterone (similar to that produced in the ovaries) –Keeps the ovaries from releasing an egg (ovulation) –May thicken cervical mucus –Prevents implantation (uterine lining)

Effectiveness 97%-99%

Advantages Can be used by women who cannot take estrogen Nothing to put in place Protection against pregnancy for 12 wks Reduces menstrual cramps Helps prevent cancer (uterine lining)

Disadvantages No STD protection Irregular bleeding (most common) Takes 12 wks-more than a yr to conceive after last shot Inconvenient (shot every 3 months) Less common side effects Research update

Availability/Cost Exam $35-$125 Injections cost $30-$75 Subsequent visits $20-$40 plus injection

IUD—Intrauterine Device (2 types) Small devices made of plastic –ParaGard-also contains copper –Mirena-releases Progestin

How It Works Usually prevents fertilization Seem to affect the way the egg and sperm move –Immobilizes sperm, egg moves faster through fallopian tubes. Affect the lining of the uterus (prevents implantation)

Effectiveness 99%-over 99% Effectiveness is increased by checking IUD string regularly

Advantages Highly effective Basically maintenance-free Long term protection –ParaGard-12 yrs –Mirena-5 yrs No interruption Ability to conceive returns quickly when us is stopped

Disadvantages Insertion can be painful (like severe menstrual cramps) Side effects—excessive cramping, irregular bleeding Risk of PID No STD protection

Availability/Cost Prescription only –Exam insertion, follow-up--$175-$400

Nuva Ring How it works: ring is placed in the vagina for 3 weeks, releases hormones that stop the ovaries from releasing eggs

Effectiveness 99% as long as ring is properly used

Advantages Do not have to take a pill or use a patch Lasts for 3 weeks

Disadvantages Could cause vaginal discharge

Cost/Availability Need a prescription Costs $30-75 for 3 month supply

Emergency Contraception Needs to be used within 120 hours of sex Will stop egg from being released, and will stop fertilized egg from implanting in the uterus

Effectiveness 99% as long as pill is taken within 120 hours of intercourse

Advantages Safe and effective Only contraceptive method that can work after intercourse

Disadvantages Nausea and vomiting for a couple days after use Frequent use could cause irregular periods

Cost and Availability $30 to $65 Available at most pharmacies over the counter, no age limit