CONTRACEPTION EFFECTIVENESS Different types of contraception 1 ABSTINENCE

CONTRACEPTION EFFECTIVENESS Different types of contraception 1

ABSTINENCE Calendar method Hit and miss method ◦ Body temperature Withdrawl method Barrier Method ◦ ◦ Spermicides Condoms Diaphragm Cervical Cap Hormonal ◦ Oral Contraceptives ◦ Norplant ◦ Depo- Provera IUD Emergency Contraception (plan b) Sterilization CONTRACEPTIVE CHOICES 2

This is the only sure method of birth control to prevent an unintended pregnancy or unwanted STD’s Abstinence from intercourse does not necessarily equate with being nonsexual It is possible to attain a level of intimacy without risking pregnancy Many young adults decide to delay sexual intercourse for a variety of reasons ABSTINENCE 3

Also referred to as the rhythm method This requires abstinence during ovulation Should be supplemented with another option if pregnancy cannot be tolerated This could be effective if a women knew the exact day of her ovulation To be safest abstinence is necessary from day 11 to 21 of woman’s cycle The egg can by fertilized anytime between the release by the ovary and its exit from the fallopian tube There is a 30% failure rate CALENDAR METHOD 4

Designed to determine when a woman is ovulating BBT drops slightly 1 to 2 days before ovulation Then rises sharply by approximately ½-1 degrees during ovulation Sexual activity should be stopped for 4 to 5 days before and after temperature changes Intercourse before ovulation carries a greater risk than post ovulation Sperm can remain viable for up to 72 hours BASAL BODY TEMPERATURE METHOD 5

Also referred to as coitus interruptus Leads to many unintended pregnancies Pre ejaculate carries sperm that may be released before withdrawal This method requires an unreasonable amount of self control by both partners Has an extremely high failure rate WITHDRAWAL CONTRACEPTION AND PREGNANCY

Barrier methods have become increasingly popular because of the protection they provide against HIV and other STD’s High failure rates among young women SPERMACIDES CONDOMS DIAPHRAGMS CERVICLE CAPS BARRIER METHODS 7

Are a chemical method of contraceptive use Come in a variety foams, creams, and gels Prevent contraception by killing sperm before they reach uterus Can be used alone or with another barrier method Highly effective when used with a condom Contain nonoxynol-9 which is somewhat effective in preventing gonorrhea, HIV, Chlamydia, herpes simplex 2, Need to be reapplied before every sexual act to insure effectiveness SPERMACIDES

Increased use of latex types Protect against HIV, herpes simplex 2, Chlamydia, and cytomegalovirus Reduce transmission of gonorrhea, HBV 2, trichomonas vaginalis Is 86 -90% effective when used alone and 98% effective when used with spermicide Use can cause possible allergic reaction MALE CONDOM

One size fits all barrier method Consists of a pre-lubricated pouch One ring is inserted into the vagina to cover the cervix The other ring partially covers the labia Lab tests demonstrate that the HIV and other STD viruses cannot permeate the polyurethane pouch Controlled by the woman Failure rate is @ 26% usually user failure FEMALE CONDOM

An oval dome shaped device with a flexible spring at the outer edge Needs to be fitted by a clinician A spermicide is applied into the dome and a small amount is spread around the rim Should be left in place for 6 -8 hrs after intercourse and then removed Failure rate ranges from 15 -20% DIAPHRAGM

It is designed to fit tightly over the cervix Should be filled with spermicide before intercourse A clinician must fit the cap to fit each woman Can remain in place up to 48 hrs. with no additional spermicide The smaller size makes it more difficult to ensure coverage of cervix CERVICAL CAP

THEY INCLUDE: Oral contraceptives Norplant Depo-Provera They provide no protection against HIV and other STI’s HORMONAL METHODS

They are the second most popular form of birth control in the US Most women use the pill with both synthetic estrogen and a derivative of progesterone A progestin only pill is available to women who cannot take estrogen They provide protection against ovarian and endometrial cancer Risks of ectopic pregnancy and PID are lowered Reduced menstrual flow with shorter periods Side effects include nausea, breast soreness, fluid retention, breast cancer, CVD, and liver cancer, and death ORAL CONTRACEPTIVES

A progestin only implant (levonorgestrel) Consists of flexible, matchstick-like capsules filled with LVG Inserted under the skin of the upper arm Dissipate after 5 years and need to be removed and replaced Suppresses ovulation Major side effects include irregular menstrual periods Headaches, nausea, dizziness, acne, hair loss, increase in facial or body hair and breast tenderness NORPLANT

Most widely used progestin injection Injected into the gluteal or deltoid muscle every 3 months Like Norplant is has a very low failure rate and also suppresses ovulation Side effects include amenorrhea, weight gain, headache, nervousness, dizziness, stomach cramps and decreased sex drive DEPO-PROVERA

Device placed in the uterus Small, plastic, T-shaped device with a string attached to the end Prevents sperm from reaching the egg ◦ Disrupts the lining of the uterus Intrauterine Device

Advantages It can prevent pregnancy for up to 5 to 10 years It's inexpensive. It's convenient An IUD can be removed by your doctor at any time. It starts working right away. Disadvantages Bleeding and pain for a couple of weeks after the IUD is inserted. May experience heavier period if you are using the copper IUD. Rarely, the uterus can be injured when the IUD is put inside. The IUD does not protect you from any sexually transmitted infections (STIs). Advantages / Disadvantages IUD

The morning-after pill — a form of emergency birth control — is used to prevent a woman from becoming pregnant after she has had unprotected sex. Human conception rarely occurs immediately after intercourse. Instead, it occurs as long as several days later, after ovulation. During the time between intercourse and conception, sperm continue to travel through the fallopian tube until the egg appears. Taking emergency birth control the "morning after" isn't too late to prevent pregnancy. Emergency Contraception – Plan B CONTRACEPTION AND PREGNANCY 20

The active ingredients in morning-after pills are similar to those in birth control pills, except in higher doses. Some morning-after pills contain only one hormone, levonorgestrel (Plan B), and others contain two, progestin and estrogen. Progestin prevents the sperm from reaching the egg and keeps a fertilized egg from attaching to the wall of the uterus (implantation). Estrogen stops the ovaries from releasing eggs (ovulation) that can be fertilized by sperm. The morning-after pill is designed to be taken within 72 hours of intercourse with a second dose taken 12 hours later. According to the manufacturer, the morning-after pill is more than 80 percent effective in preventing pregnancy after a single act of unprotected sex. Plan B continued CONTRACEPTION AND PREGNANCY 21

Method Hormonal Methods: ◦ ◦ Implant (Norplant) Hormone Shot (Depo-Provera) Combined Pill (Estrogen/Progestin) Minipill (Progestin only) Male Latex Condom 1 Diaphragm 2 Cervical Cap (no previous births) 2 Cervical Cap (previous births) 2 Female Condom 26% Natural Methods: ◦ Withdrawal ◦ Natural Family Planning (calendar, temperature, cervical mucus) 15% 20% 40% 26 % Spermicide: ◦ (gel, foam, suppository, film) 0. 8% 2% Barrier Methods: ◦ ◦ ◦ 0. 09% 0. 3% 5% 5 -7% Intrauterine Devices (IUDs): ◦ Copper T ◦ Progesterone T Typical Use Rate of Pregnancy No Method: 45% and higher 25 -30% 85%