2. BIRTH CONTROL METHODS At some point in your lives you will choose to be sexually active. It is wise and responsible to know what choices are available to prevent pregnancy, and Sexually Transmitted Infections and AIDS. Due to the fact that at this time in your lives you are not financially or emotionally capable of dealing with a child ABSTINENCE IS THE BEST CHOICE.

3. Directions 1. Get out a sheet of binder paper 2. Fold it in half 3. Fold it in half again 4. You should have 4 squares or 4 quadrants on your paper. 5. Title the top of each square the following ….. (one title per square) 1. What would you say? 2. How do I put on a condom? 3. Condom comebacks 4. STI Protection

4. Statistics on Teens and Pregnancy  Fewer than ½ of all high school students report having had sexual intercourse.  A sexually active teenager who does not use contraceptives has a 85% chance of becoming pregnant within one year. Kaiser Family Foundation: U.S. Teen Sexual Activity. Jan 2005 Guttmacher Institute: Facts on American Teens’ Sexual and Reproductive Health. Sept. 2006

5. Behavioral Methods

6. Sexual Abstinence  Abstinence is not having any type of sex: vaginal, anal, or oral.  What are some ways to stay abstinent?  Advantages: No STI, No Pregnancy, No worry, parents won’t be angry  Disadvantages  Effectiveness – 100%

7. What Would You Say!  How would you respond if someone said this to you… Respond in the square on your binder paper ** You are suppose to respond 4 of the 8 in the negative.** 1. “If you loved me, you’d say yes.” 2. “You owe me.” 3. “You don’t know what your missing.” 4. “I’ll leave you.” 5. “Are you afraid” 6. “Only a child would say no.” 7. “Don’t you want to see how it feels” 8. “Just try it and if you don’t like it, I’ll stop.”

8. WITHDRAWAL Male removes his penis from the female’s vagina before he ejaculates  Health concerns: pregnancy, STI’s  Advantages: free, no prescription/medicine  Disadvantages – pregnancy, STI, self control, trust, pre cum  Effectiveness – 55% - 60%

9. Barrier Method How does it work: Block the sperm from meeting the egg. Block the sperm from meeting the egg.

10. MALE CONDOM A thin piece of latex that fits over the erect penis and catches semen and pre-cum, Advantages –  Helps protect against HIV and other STDs  Used only when needed Disadvantages –  Must be put on right before intercourse  Some people say the feeling is reduced  Can break Health concerns – Some people might be allergic to latex Some people might be allergic to latex Effectiveness – 85-98% - best when used with spermicide OVER – THE – COUNTER $.50 and up

11. Condom Line Up!

12. How Do I Put on A Condom? 1. Get condoms 2. Talk to your partner 3. Check expiration date & pillow test 4. Arousal 5. Open condom 6. Check which way it unrolls 7. Add water base lubricant 8. Pinch the tip and roll onto penis 9. Sex 10. Orgasm and/or ejaculation 11. Hold onto the base of the condom 12. Pull out 13. Tie end of condom and throw away in trash

13. Condom demo video http://www.teachingsexualhealth.ca/teacher/ resources/malecondomdemo.html http://www.teachingsexualhealth.ca/teacher/ resources/malecondomdemo.html

14. FEMALE CONDOM Polyurethane pouch that is inserted into the vagina – flexible ring keeps it in place Advantages –  Helps protect against HIV & other STDs  Used only when needed  Can be used by people with latex allergies Disadvantages –  Takes practice putting it in  may reduce feeling  More expensive than male condoms Health concerns – None Effectiveness 79-95% OVER THE COUNTER – $2.50

15. Dental Dam  A thin piece of latex that is held over the genitals during oral sex. Dental Dam Demonstration Video

16. Condom Come Backs How would you respond if someone said this to you… Respond to 4 of the 5 in the square on your binder paper 1. “It doesn’t feel good.” 2. “Just this once.” 3. “They don’t fit.” 4. “It ruins the mood.” 5. “You worried about catching something?”

17. Hormonal Methods How it works:  Stops the release of an egg.  Thickens cervical mucus, thus blocking sperm from entering the uterus.

18. THE PILL A pill with hormones are taken once a day. Advantages –  Simple and easy to use.  Does not interfere with sex.  Less cramping during period.  Less acne.  Protects against certain cancers and osteoporosis.  Can be used with condoms. Disadvantages –  No protections against HIV or STIs  Must remember to take every day.  Possible side effects: mood changes, depression, nausea, breast tenderness and other discomforts

19. The Pill continued - Health Concerns –  Few problems for young women  Small chance of blood clots, heart attack, stroke  Headaches, weight gain or loss, water retention Effectiveness – 92-99% Prescription –$20 - $35 per pack per month  must see a doctor  available at clinics

20. The Pill

21. Seasonique®.  A new pill  Allows women to have only 4 periods a year.  Approved by the FDA in September 2003.  Instead of 21 active pills and 7 reminder pills, it has 84 active pills and 7 reminder pills.  Bleeding and spotting is more common with Seasonale.  Effectiveness – 99.7% when use correctly  Prescription

22. LYBREL® is the first and only FDA- approved low dose combination birth control pill you take 365 days a year, without placebos. Stops periods completely, but women will sometimes experience break through bleeding.Stops periods completely, but women will sometimes experience break through bleeding.

23. STI Review Curable vs. not Curable Condom effectiveness

24. The Patch - Ortho Evra®  It is a thin, beige, plastic patch that sticks to the skin.  A new patch is placed on the skin of the buttocks, stomach, upper outer arm, or upper torso once a week for 3 out of 4 weeks.  No patch is used in the 4 th week.  The Patch works best when it is changed on the same day of the week for 3 weeks in a row.  The Patch releases synthetic estrogen and progestin.

25. The Patch - Ortho Evra® Advantages – Same as the pill Disadvantages – No protection against STIs & HIV Health Concerns – Same as the pill, may cause higher risk of blood clots than the pill Effectiveness – 99% Prescription: $30 - $40 for month supply

26. The Patch

27. The Ring-- NuvaRing® It is a small, flexible ring that is inserted into the vagina once a month. It is a small, flexible ring that is inserted into the vagina once a month. It is left in place for 3 weeks and taken out for the last week. It is left in place for 3 weeks and taken out for the last week. The Ring releases synthetic estrogen and progestin. The Ring releases synthetic estrogen and progestin. The Ring is simple, safe and convenient. The Ring is simple, safe and convenient.

28. The Ring-- NuvaRing® Advantages – Same as the pill, usually decrease size and length of periods decrease cramps Disadvantages – Similar to the pill, may cause vaginal irritation Health Concerns – Does not protect against STIs & HIV Effectiveness – 99% Prescription: $30 - $35 per month

29. The Ring

30. Implant--Implanon ®  It is a thin, flexible plastic implant about the size of a cardboard matchstick  It is inserted under the skin of the upper arm  It is inserted under the skin of the upper arm  Only contains progestin

31. Implant--Implanon ® Advantages – convenient, no need to remember to take a pill, works for up to 3 years Disadvantages – Most common negative side effect is irregular bleeding  Health concerns – does not protect against STIs & HIV  Effectiveness – 99.9%  Prescription

32. The Shot – Depo Provera Injection of hormones every 12 weeks. Advantages –  Lasts 3 months  May cause lighter period  May protect against certain ovarian and uterine cancer Disadvantages –  No protections against HIV or STIs  May cause weight gain, irregular bleeding, mood swings… Health concerns - May cause loss of bone density Effectiveness – 99% Prescription: $30 - $75 per injection

33. Depo-Provera

34. IUD – Intra Uterine Device T – shaped insert that doctors place into uterus Advantages – lasts several years is effective immediately can be removed at any time Disadvantages – No protection against HIV or STDs insertion may be painful may increase menstrual flow or cause spotting may slip out of uterus. Some clinics will not prescribe to teens Health concerns – may cause pelvic infection, especially if user has an STI, may cause ectopic pregnancy, or pregnancy outside uterus Effectiveness – over 99%$175 - $500 Prescription - IMPLANT CHEMICAL OR HORMONAL

35. IUD

36. Emergency Contraception Also called EC, the "morning-after pill," or Plan B. Also called EC, the "morning-after pill," or Plan B. They can reduce the risk of pregnancy after unprotected intercourse. They can reduce the risk of pregnancy after unprotected intercourse. You do not need a prescription for EC in California if you are 17 or older. Under 17 needs to see Doc. You do not need a prescription for EC in California if you are 17 or older. Under 17 needs to see Doc. EC can reduce the risk of pregnancy up to 120 hours after unprotected vaginal intercourse. EC can reduce the risk of pregnancy up to 120 hours after unprotected vaginal intercourse. They work best when taken within 72 hours They work best when taken within 72 hours EC does not protect against STIs EC does not protect against STIs If taken with 72 hours they are 75% to 89% effective$10 - $35 If taken with 72 hours they are 75% to 89% effective$10 - $35

37. STI Protection  List the birth control methods that will help protect you from sexually transmitted infections.  Respond in the square on your binder paper

38. Spermicide Chemical (nonoxynol-9) that kills sperm Best when used with condoms, diaphragm & cervical cap Advantages – Lubrication may increase pleasure Disadvantages – No protection against HIV & STIs, Can be messy, Must be inserted right before intercourse Health concerns – Possible allergic reaction Possible allergic reaction Frequent use may increase risk of HIV Frequent use may increase risk of HIV Effectiveness – 71-85%$4 - $8 OVER THE COUNTER - - CHEMICAL METHOD

39. REVIEW Types of Birth Control Use posters - behavioral, hormonal, barrier, chemical.

40. Today’s SPONGE Soft polyurethane foam sponge, containing spermicide nonoxynol-9, is inserted into the vagina before intercourse. (It must be wet and made foamy before using). Advantages – Can be placed in vagina up to 24 hours before intercourse Disadvantages – No protection against HIV & STIs, must be removed within 30 hours of insertion Health Risks – May cause allergic reaction, Increased risk of toxic shock syndrome Increased risk of toxic shock syndrome Effectiveness – 84%-91% effective for women who have never given birth. 68%-80% for women who have given birth) OVER THE COUNTER - - CHEMICAL METHOD $7.50 - $9 for a 3 pack

41. DIAPHRAGM & CERVICAL CAP Rubber cup or dome that acts as a barrier, blocking the sperm from passing through the cervix. Used with spermicide. Leave in for 6-8 hours after sex. Needs to be fitted by Doc. Advantages – Can be placed in vagina: cervical cap – 48 hours before sex Diaphragm – 2 hours before sex Disadvantages – Can be messy. Can become dislodged during sex. Might need refitting after childbirth or weight change. Health Risks - Allergy to spermicides. Not recommended if you have had TSS Effectiveness – cervical cap 68-91%, diaphragm 86-94% Prescription - - BARRIER METHOD

42. Draw how the hormonal method works. Draw this picture and how hormonal method works. Draw in the square on your binder paper

43. According to the National Campaign to Prevent Teen Pregnancy 1 Of teenage girls nationally who get pregnant: 57% give birth 29% undergo abortion 14% experience a miscarriage

44. Most commonly used Birth Control Methods by teens  Hormonal Methods Birth Control Pills (92%-99% effective) Birth Control Pills (92%-99% effective) The Shot: Depo Provera (over 99.9% effective) The Shot: Depo Provera (over 99.9% effective) The Patch (99% effective) The Patch (99% effective) The Ring (99% effective) The Ring (99% effective) IUD (99% effective) IUD (99% effective) Emergency Contraception (75%-89% effective within the first 72 hrs). Most effective within 12 hrs of unprotected sex. Emergency Contraception (75%-89% effective within the first 72 hrs). Most effective within 12 hrs of unprotected sex.

45. Most commonly used Birth Control Methods by teens  Barrier Methods *help protect against STDs Male Condom (85%-98% effective) Male Condom (85%-98% effective) Female Condom (79%-95% effective) Female Condom (79%-95% effective)  Behavioral Abstinence (100% effective) *protects against STDs Abstinence (100% effective) *protects against STDs Withdraw/Pull-Out (73% effective) Withdraw/Pull-Out (73% effective) No Method (90% chance of pregnancy within a year) No Method (90% chance of pregnancy within a year)

46. Contraceptive Use Among Teens  About 1 in 6 teenage women practicing contraception combine two methods, primarily the condom and another method. 2  Teen pregnancy rates are dropping!! While 20% of the decline is because of decreased sexual activity, 80% is due to more effective contraceptive practices. 2  39% of 12th graders have NOT had sex. 3  A woman who wants only two children will need to use birth control for at least 20 years of her life. 4  98% of all women who have ever had intercourse have used at least one contraceptive method. 3