Contraception CAPT Mike Hughey MC USNR Operational Obstetrics

Contraception CAPT Mike Hughey, MC, USNR Operational Obstetrics & Gynecology · Bureau of Medicine and Surgery · 2000 Slide

Condom • 98% effective • Protects against some STDs Operational Obstetrics & Gynecology · Bureau of Medicine and Surgery · 2000 Slide 2

Female Condom • • 95% effective Protects against some STDs Noisy Use extra lubrication Operational Obstetrics & Gynecology · Bureau of Medicine and Surgery · 2000 Slide 3

Diaphragm • 95% effective • Requires fitting, manual dexterity • Leave in place 6 hours after intercourse • Use with contraceptive jelly/cream Operational Obstetrics & Gynecology · Bureau of Medicine and Surgery · 2000 Slide 4

Foam • • • 80 -85% effective Works immediately Effective for an hour Over the counter No douching for 6 hours after intercourse • 20% have burning (reaction) Operational Obstetrics & Gynecology · Bureau of Medicine and Surgery · 2000 Slide 5

Film • • • 80 -85% effective Works 10 min after insertion Effective for an hour Over the counter No douching for 6 hours after intercourse • 20% have burning (reaction) Operational Obstetrics & Gynecology · Bureau of Medicine and Surgery · 2000 Slide 6

Suppository • • • 80 -85% effective Works 10 min after insertion Effective for an hour Over the counter No douching for 6 hours after intercourse • 20% have burning (reaction) Operational Obstetrics & Gynecology · Bureau of Medicine and Surgery · 2000 Slide 7

BCPs • • 99. 5% effective Lighter, predictable periods Milder cramps Protects against uterine, ovarian cancer • Protects against benign breast disease • Low risk of side-effects • Must take a pill each day Operational Obstetrics & Gynecology · Bureau of Medicine and Surgery · 2000 Slide 8

IUD • • • 98 -99% effective Lasts 10 years Heavier, crampier periods Risk of infection/PID Risk of ectopic pregnancy Good candidate: – multiparous – monogamous Operational Obstetrics & Gynecology · Bureau of Medicine and Surgery · 2000 Slide 9

DMPA • • 99% effective Lasts 3 months IM injection Amenorrhea, spotting Weight gain Ovulation returns in 4. 5 months Average 10 months to conception Operational Obstetrics & Gynecology · Bureau of Medicine and Surgery · 2000 Slide 10

Rhythm • Avoid unprotected IC day #9 -19 • 70 -80% effective • Assumes ovulation about day #14 Operational Obstetrics & Gynecology · Bureau of Medicine and Surgery · 2000 Slide 11

Withdrawal • 80 -90% effective • Always available • Requires motivation, sense of timing • Some sperm present in preejaculatory fluid • Psychological issues Operational Obstetrics & Gynecology · Bureau of Medicine and Surgery · 2000 Slide 12

Tubal Ligation & Vasectomy • Surgical sterilization • Permanent, irreversible • >99% effective Operational Obstetrics & Gynecology · Bureau of Medicine and Surgery · 2000 Slide 13

Operational Obstetrics & Gynecology · Bureau of Medicine and Surgery · 2000 Slide 14