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Transcript
CONTRACEPTION
Chapter 6
CONTRACEPTION
 Definition:

Contraception: preventing conception by
blocking the female’s egg from uniting
with the male’s sperm
2
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
4
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
6
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

7
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

8
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
9
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
10
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
11
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
12
FIGURE 6.1 AN IUD PROPERLY POSITIONED
IN THE UTERUS
13
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
16
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
17
FIGURE 6.3 THE FEMALE CONDOM
18
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.

20
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
21
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.
23
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.
24
FIGURE 6.8 TUBAL STERILIZATION
25
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
26