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CONTRACEPTION
Chapter 6
CONTRACEPTION
 Definition:

Contraception: preventing conception by
blocking the female’s egg from uniting
with the male’s sperm
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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
PRINCIPLES OF CONTRACEPTION
 Based
on the physiology of reproduction
 Types
of contraception:
Hormonal
 Barrier
 Natural methods
 Surgical

 Factors

affecting choice
Advantages and disadvantages
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HORMONAL
METHODS
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
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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

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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

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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
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INJECTABLE CONTRACEPTIVES
 Depo-Provera

Injectable progestin every 12 weeks



Provides protection like implants
Advantages: Highly effective, requires
little action on part of user ; No estrogenrelated side effects, minor injection
Disadvantages: visit to health care
facility every 3 months, weight gain,
infertility after stopping use
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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
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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
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FIGURE 6.1 AN IUD PROPERLY POSITIONED
IN THE UTERUS
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BARRIER METHODS
BARRIER
METHODS
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
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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
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FIGURE 6.3 THE FEMALE CONDOM
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NATURAL
METHODS
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.

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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


Temperature method


A woman releases an egg 14-16 days before her next
period
A woman’s BT drops slightly before ovulation and
rises slightly after
Withdrawal

Coitus interruptus
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SURGICAL
METHODS
Vasectomy
•Severing of the vas
deferentia
•Semen still
produced, but w/o
sperm
•Takes ~ 30 min. and
can return to work
in 2 days.
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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.
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FIGURE 6.8 TUBAL STERILIZATION
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WHICH CONTRACEPTIVE METHOD IS
RIGHT FOR YOU?

Key considerations include:
1.
2.
3.
4.
5.
6.
7.
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
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