1. Contraception
Chapter 6

2. Definition: Contraception
Contraception: preventing conception by blocking the female’s egg from uniting with the male’s sperm

3. Principles of Contraception
Effectiveness
Contraceptive failure rate- % of women experiencing an unintended pregnancy in the 1st yr. of contraceptive use
Continuation rate- % of people who continue to use the method after a specified period of time

4. Principles of Contraception
Based on the physiology of reproduction
Types of contraception:
Hormonal
Barrier
Natural methods
Surgical
Factors affecting choice
Advantages and disadvantages

5. hormonal Methods

6. Oral Contraceptives: The Pill
Hormonal contraceptive
Mimics the corpus luteum
Secretes estrogen & progestin (Combination pill) to suppress ovulation
Most common type of birth control
Advantages: Easy to use, effective (99.9%), fertility returns after use
Disadvantages : no protection against STD’s, exp. symptoms of pregnancy, prescription required, stroke, blood clots in older women who smoke

7. Contraceptive Skin Patch
Hormonal contraceptive
Releases estrogen and progestin into bloodstream
Prevents pregnancy the same way as OCs
Worn for 1 week, replaced on the same day for 3 consecutive weeks. 4th wk. no patch
Advantages: same as OC’s, week long protection
Disadvantages: same as OCs

8. Vaginal Contraceptive Ring
Hormonal contraceptive
Flexible vaginal ring molded w/ progestin and estrogen
Slowly releases hormones into bloodstream
Worn for 3 wks., removed at start of 4th wk. (ring free) new ring inserted same day, following wk.
Advantages : 1 month of protection, no daily/weekly action required
Disadvantages : similar to OCs and patch

9. Contraceptive Implants
Hormonal contraceptive
Placed under skin of upper arm/leg
Delivers progestin over a period
of 4 years
Advantages: Highly effective, no further action required after insertion, contains no estrogen, so no estrogen related side effects
Disadvantages: no protection against STDs, menstrual irregularities, uncomfortable appearance

10. Injectable Contraceptives
Depo-Provera
Injectable progestin every 12 weeks
Provides protection like implants
Advantages: Highly effective, requires little action on part of user ; No estrogen- related side effects, minor injection
Disadvantages: visit to health care facility every 3 months, weight gain, infertility after stopping use

11. Emergency Contraception
“Morning-after Pill”, Plan B
Should not be used as a contraceptive but can be used if birth control has failed, if forced to have sex, etc.
Most common is the two dose regimen
May inhibit/delay ovulation or altering the transport of sperm/egg; does not affect a fertilized, implanted egg
Needs to be taken within 72 hours. Best used within 24 hours

12. The Intrauterine Device (IUD)
Small plastic device placed in the uterus
ParaGard (copper; protects up to10 yrs.)
Mirena (protects up to 5 yrs.)
Releases small amounts of progestin
May work by thickening cervical mucus, or thins lining of uterus
Advantages: highly reliable, once inserted a simple check of string is all that’s needed; reduced risk of endometrial cancer; fertility restored after use
Disadvantages: heavy menstrual flow, uterine cramping, backache, spontaneous expulsion, may puncture uterine wall

13. Figure 6.1 An IUD properly positioned in the uterus
Figure 6-1: An IUD (Copper T-380A) properly positioned in the uterus.

14. Barrier methods

15. Barrier Methods

16. Male Condoms Thin latex, or polyurethane
Most widely used barrier method
Advantages: Protects against pregnancy and STD’s, easy to purchase, no prescription
Disadvantages: Most common complaints are reduced sensitivity and interfering with sexual intercourse

17. Female Condoms Polyurethane sheath with two flexible rings
Advantages: offers potentially more protection against genital warts and herpes b/c it covers base of penis
Disadvantage: more expensive, more difficult to use

18. Figure 6.3 The female condom
Figure 6-3 The female condom properly positioned

19. Natural Methods

20. Abstinence Abstinence
Without sexual intercourse for a chosen period of time
Benefits
More self respect and respect for others
Security that you are not being pursued for sexual reasons.
Less worry about STDs and Pregnancy.

21. The Fertility Awareness Method
Only one egg released each month
Lives for ~ 24 hrs. unless fertilized
Sperm can live in the body for 6-7 days
Only 8 days/month when conception can happen
FAM
Calendar method
A woman releases an egg days before her next period
Temperature method
A woman’s BT drops slightly before ovulation and rises slightly after
Withdrawal
Coitus interruptus

22. surgical Methods

23. Vasectomy Severing of the vas deferentia
Semen still produced, but w/o sperm
Takes ~ 30 min. and can return to work in 2 days.

24. Tubal Sterilization
Tubal sterilization (laparoscopy) is most commonly known as tubal ligation
An invasive surgical procedure that can have severe side effects like heavy bleeding, weight gain, decreased sex drive, etc.

25. Figure 6.8 Tubal sterilization

26. Which Contraceptive Method is Right for You?
Key considerations include:
Health risks
Implications of an unplanned pregnancy
STD risk
Convenience and comfort level
Type of relationship
Ease and cost of obtaining and maintaining each method
Religious or philosophical beliefs