CONTRACEPTIVES What are the options CONDOMS Male Condoms

CONTRACEPTIVES What are the options?

CONDOMS Male Condoms Internal Condom (Female) • Latex or Polyurethane • Worn by male partner • Used for vaginal, anal, or oral intercourse • 85 -98% effective (dependent on reliability of user) • Cheap and often FREE! • Polyurethane • Worn internally by female partner or by male during anal intercourse • Used for vaginal or anal intercourse • 79 -98% effective (dependent on reliability of user) • Cheap and often FREE!

MALE CONDOM Benefits • Reduced risk of pregnancy • Protects against STI transmission (HIV, Chlamydia, Gonorrhea, Hepatitis B) • Protects against STIs during oral sex • Cheap and often free! • Safe for breastfeeding moms • Lots of choice (flavoured, coloured, ribbed…)

MALE CONDOM Risks • Only protects skin that’s covered • Often teens are unaware of the condoms “life span”: – Not in wallet!!! Pressure, heat, and friction can puncture or weaken latex (if kept in wallet or glove compartment, life span is only 2 weeks!) – If stored properly (in a drawer where temperature isn’t fluctuating), life span is up to four years. – It’s better to spend the extra money on new condoms when you aren’t sure rather than stress about a potential pregnancy or STI! • Flavoured variety can cause yeast infections because of sugar content

INTERNAL/FEMALE CONDOM Benefits It may look funny… But it works! Non-latex (polyurethane) No rubbery smell Warms with friction Good to use if guy complains about wearing a condom • Safe for breastfeeding moms • •

SPERMICIDE 71 -82% effective • Foam, jelly, sponge, etc. • Safe for breastfeeding moms • Rarely recommended: – It is now known that because spermicides are chemicals, they also act as irritants – Increased risk of infection because the chemicals irritate mucous membranes – Never to be used for anal sex or oral sex

DIAPHRAGM & CERVICAL CAP 84 -94% effective Positives: • Can be inserted up to 1 hour before intercourse • Costs $70 and lasts 5 -7 years • Safe for breastfeeding moms Negatives: • Not very popular • Difficult to access (must be fitted by doctor) • Must be used in combination with spermicide • Must cover cervix (put in by woman – therefore must be comfortable with own anatomy) • Must be left in 6 -8 hours afterward • Can be messy

HORMONAL METHODS All average at $15 -$20 per month Combined (estrogen & progestin): • Oral Contraceptives - “The Pill” • Transdermal Contraceptives – “The Patch” • Transvaginal Contraceptives – “ The Ring” Progestin Only: • Progestin Only Pills – “POPs” • Depo-Provera Injection – “The Shot” • Intrauterine System – “Mirena” (IUS) NO STI PROTECTION!!

Info re: PAP SMEARS • Should not simply be made to have one because they are using hormonal contraceptives – important to know that all sexually active women should have it! Why? • Use of birth control is not associated with CERVICAL CANCER sexual activity is! (especially early sexual activity) • Sexual activity does not CAUSE cervical cancer but sexual activity combined with HPV can lead to cervical cancer if not treated early IMPORTANT NOTE!!! • A pap smear does not mean you have been tested for STIs!

COMBINED METHODS pill, patch, ring 92 -99. 3% effective 3 weeks on – 1 week off Same method of action…different delivery systems Many reasons for taking besides just contraception: • Periods lighter, more regular, less dysmenorrhea • May decrease acne • Required in combination with some medications (ex. Acutane)

THE PILL • Most popular in North America Difficult to use: must take one pill each day at the same time (2 hour window) for 3 weeks and then take 1 week off – If you miss a pill, take it AS SOON as you remember – If you are concerned about how late you are taking it, call the nurses line • Many different formulations with varying hormone levels – side effects can be adjusted by changing dosages • Does not cause weight gain (can causes increased appetite) • Does not make breasts bigger • Semi-private • Takes birth control away from the bedroom.

THE PATCH • Worn on upper body or buttocks (not breasts = not private) • Can be worn in the shower or while swimming • Change once a week for three weeks and then have one week off • Do not put on same area two weeks in a row • Do not move once it’s on – it must stay where it is placed • Not good for women who are overweight • Not overly private

THE RING • Worn inside the vagina – MOST PRIVATE • Can be worn during sex • Doesn’t require much thought because it stays in for three weeks and comes out for one week (no…it will not fall out!)

CONTINUOUS USE of hormonal methods • • used to skip periods Pill, patch, and ring can all be used continuously or with shorter hormone-free intervals Less periods per year and therefore less period symptoms Safe: no build up of menstrual fluid (less side effects over time) Can time periods around big life events like grad, weddings, vacations New products available to support this: – SEASONALE: 84 hormone pills plus 7 placebo pills (can use any monophasic pill, patch or ring this way) – YAZ: 24 hormone pills plus 4 placebo pills MORE RISK INVOLVED IF A WOMAN FORGETS TO START RETAKING PILL AFTER 7 DAYS OFF!!!

POPs (Progestin-Only Pills) 92 -99. 7% effective Micronor • Most difficult/unforgiving to use – if pill is more than three hours late, must use “back up” birth control for at least 7 days • Take one pill every day (28 day pack – no placebo) • No period because no placebo • Spotting is a common side-effect • Safe for breastfeeding women (should not effect milk supply) • Safe for women who cannot take estrogen

DEPO-PROVERA 97 -99. 3% effective • Progestin only injection • One shot every 10 -13 weeks • Very private, good for girls who’s culture is not accepting of sexual activity, good for street kids • Safe for breastfeeding women (should not effect milk supply) • If side effects occur, they are around for 3 full months! • Slow return to fertility (3 months – 1 year) • Calcium intake is important – Reports of bone density loss (but is said to return once off Depo) – Not associated with increased risk of fractures

IUDs (Intrauterine Devices) Copper or Minera IUDs & IUSs are safe & effective • • Can be used by women who’ve never been pregnant Safe for breastfeeding women Does not cause infertility (STIs do!) Does not increase risk of contracting STIs (same risk) Does not increase risk of ectopic pregnancy Must be inserted by a medical professional Some pain, discomfort, and bleeding with insertion Very effective in preventing pregnancy

IUDs (more info) Minera (IUS) Copper (IUD) 99. 8% effective 99. 2 -99. 4% effective • Releases progestin onto lining of uterus • No hormones • Thins lining of uterus so that periods eventually cease • Changes p. H level in uterus (acts as a spermicide) • Good for five years • Good for 7 -10 years • Quick return to fertility • Mild increase in menstrual flow and cramps • Approximately $350 • Quick return to fertility • Approximately $70 -$100

Things that DON’T work!!! • Wishful thinking • Creative positions • Tight underwear • Swimming pools or hot tubs • Douching • Withdrawal Even with birth control – PULL OUT!!! Less risk.

ORAL SEX It’s not as “safe” as you think. • Some may use it as a way to decline vaginal intercourse • Some use it to maintain “abstinence” – but what is abstinence? ? ? • Oral sex can still pass on STIs: – – – Herpes Syphillus Gonorrhea HIV Hepatitis B/C

Help for those UH OH! times… Plan B & Norlevo • Sometimes referred to as “the morning after pill” • Now available at drug stores without a prescription but behind the counter so you must ask for it (approximately $30 – no age limit) • Take 2 pills immediately within 5 days of the unprotected sex (the earlier, the better) • Only 75% effective!!!! (do not use as form of birth control!) • Does not affect an already established pregnancy – will not cause an abortion or harm a developing pregnancy

Where to access more information • • • www. sexualityandu. ca www. cfsh. ca www. optionsforsexualhealth. org 1 -800 -SEX-SENSE www. managingcontraception. com