Download Birth Control Methods/Forms

Birth Control Methods/Forms
Mrs. Farver
Health
Key Turning Points in History
• 1937: America Medical Association
ends the 25 year opposition to
contraception; recognized that
birth control needs to be taught
in medical school.
• 1960: BIRTH CONTROL PILL becomes
available in the in the U.S.
• 1966: Griswold Decision: Supreme
Court declares laws prohibiting
sale and use of contraceptive are
unconstitutional.
Hormonal Birth Control
• Requires a Prescription from a Doctor
– Exception is morning after pill if you are 18 or older
• Suppresses ovulation
– Uses doses of estrogen and progestin
to regulate cycle an assure no
release of the egg from the ovary
• Thickens cervical mucus
• Thins endometrium
• Slows tubal motility
Hormonal – The Pill (oral contraception)
• 21 day, 28 day, or seasonal packs
• 1 pill is taken daily
• Time sensitive, the pill is to be
taken at the same time every day
Effectiveness:
• Perfect Use Failure Rate in First Year:
0.1% (of every 1,000 women who take pills
for one year 1 will become pregnant in
the first year)
• Typical Use Failure Rate in First Year: 5
% (of every 1,000 women who take pills
for one year 5 will become pregnant in
the first year)
The Pill (cont.)
ADVANTAGES
 Regulates menses
 Decreases blood
loss/ menstrual
cramps
 No disruption at
time of intercourse
 Decrease risk of
ovarian/endometrial
cancer
 Treatment for acne
DISADVANTAGES
 Mood Changes,
depression, anxiety
 Daily pill taking
may be stressful
 No Protection
against STI
(Sexually
Transmitted
Infections),
including HIV
 Nausea, breast
tenderness,
especially in the
first few cycles
 Weight gain
Hormonal – Ortho Evra (The Patch)
• 1 Patch a week, for 3 weeks
• 4th week patch free, Menstruation
• Usually worn lower abdomen or
buttocks
Effectiveness:
• Perfect Use Failure Rate in First
Year: 1 women of every 1,000 women
will become pregnant in the first year
• Overall Failure Rate: ?
Ortho Evra Cont.
Advantages:
 Menstrual (Similar
to the Pills)
 Nothing to do on a
daily basis
 No disruption at
time of intercourse
Disadvantages:
 Mood Changes,
depression, anxiety
 No Protection
against STI
(Sexually
Transmitted
Infections),
including HIV
 Nausea, breast
tenderness,
especially in the
first few cycles
 Weight gain
 Cannot use if
breastfeeding
Ortho Evra – The Patch
Special Considerations:
• Avoid placing the patch on exactly the
same site two consecutive weeks
• NEVER PLACE PATCH ON THE BREAST!!!
• Location of patch should not be altered
mid-week
• No band aide, tattoos or decals on top
of patch as it may alter absorption of
hormones
• It is unknown if tanning beds interfere
with efficacy
• Avoid placing lotion/creams/powders
on site
Hormonal – Nuva Ring
• Thin flexible transparent ring
• Left in place in the vagina for
three weeks and removed for a week
to allow a menstrual period the
fourth week.
• Maintains a steady low
release rate while in place.
Effectiveness:
• Overall pregnancy rate:
1.2 per 100 women
Nuva Ring
Advantages:
 Only TWO TASKS:
Insertion/Removal
1x month
 Steady even
hormonal levels
in blood are
achieved
 Privacy/No
visible patch or
pill packages
 95% of women say
they cannot feel
device
Disadvantages:
 Some women
dislike
placing/removing
objects into/out
of their vagina
 Adverse side
effects similar
to the pill
 Could Fall Out
Hormonal - Depo
Provera “The Shot”
• Injected intra-muscularly into the
deltoid or gluteus-maximums
every 11 to 13 weeks.
• Progestin only
• Four times a year
Effectiveness:
• Perfect use failure rate in first
year: 0.3%
• Typical use failure rate in first
year: 3%
DEPO Continued
Advantages:




Less menstrual blood loss
and anemia
After one year 50% of
users will develop
amenorrhea
80% will develop
amenorrhea in 5 years
Only need to remember 1x
every three months
Disadvantages:







Irregular menses during
first several months
Unpredictable spotting
and bleeding
Possible weight gain:
Progressive-Significant
(5.4 1st year, after 5
years 16.5)
Patient fear of pregnancy
or build up of menses in
uterus if not explained
well
Decreased libido
Fear of needles
Return to fertility is
long average 10 months
from last injection
Hormonal and Non-Hormonal –
Intrauterine Device (IUD)
Paraguard or Mirena
• T-shaped device with two
flexible arms that bend down
for insertion but open into the
uterus.
• Two straw-colored strings
protrude through the
cervix into the
vaginal canal
IUD – Mirena (Hormonal)
Mechanism: Mirena
• Progestin Only
• Causes cervical mucus to become
thicker then by preventing
sperm from moving up the
reproductive track
• Prevents implantation
• Cumulative 5 year failure rate:
.7%
IUD - Mirena
Advantages:
 After 3-4 months it
decreases menstrual
blood loss more than
70%
 Amenorrhea: 20% by 1
year, 60% by 5 years
 Reduced risk PID,
ectopic pregnancy by
60%
 As effective, or more
effective than female
sterilization
 Long lasting method,
up to 5 years
 Immediate return to
fertility
Disadvantages:
 Possible expulsion
 Acne, Headaches,
discomfort after
insertion or removal
 Risk of PID increased
 Ovarian cysts, most
regress spontaneously
IUD – Paraguard (Non-Hormonal)
Mechanism: Paragard
• Works by preventing
fertilization
• Works primarily as a
spermicide,Copper ions inhibit
sperm motility so they rarely
reach the tube
• Cumulative 10 year failure
rate:2.1-2.8%
IUD - Paraguard
Advantages:
 Effective long term
(10 years)
contraception from a
single decision.
 Requires no action at
time of intercourse
 Cost effective
 Rapid return to
fertility
 Good option for women
who cannot use
hormones
 95% user satisfaction,
the highest of any
other contraceptive
currently begin used
by women.
Disadvantages:
 Blood loss during
menstruation increased
by 35% and increase
cramping
 Must check strings
monthly after
menstruation
 Requires office
procedure for
insertion and removal,
can be uncomfortable
• Increase risk of
infection PID
• Uterine perforation
• May be expelled
Hormonal - Implanon
• Progestin only
• Thin, flexible, plastic implant
about the size of a matchstick.
• Inserted under the skin by the
bicep muscle.
• Implanted in the arm for
3 years.
• Constantly releases progestin
into the bloodstream
• Suppresses ovulation
Implanon
Advantages:
• Insertion only takes a
few minutes
• Protection against
pregnancy is immediate
if you get the implant
during the 1st five
days of your period
• Ability to get
pregnant is immediate
after removal
• Gives continuous longlasting birth control
without sterilization
• No medicine to take
every day
Disadvantages:
• Irregular bleeding is
the most common side
effect
• Periods become lighter
and may stop
altogether or periods
may become heavier and
last longer
• Some women will have
longer heavier periods
• Acne, change in
appetite, or sex drive
• Pain at the site of
insertion
Emergency Hormonal Contraception –
Plan B (Morning After Pill)
Description:
 Progestin Only (More effective less side
effects than combine EC)
 ASAP, but can be used up to 120 hours, sooner
is better
 Pills must be taken 12 hours apart
 Over-the-counter for women ages 18 and over
 FDA recently passed a ruling allowing EC to
be OTC for women beginning at 17 years
of age, but it has not gone effect as
of yet
• There is no limit to the number times in a
year a woman can use EC, but it is not to be
used in place of birth control (it is also
expensive).
Plan B – Morning After Pill
Advantages
 Opportunity to
prevent pregnancy
after, rape,
mistake or method
failure
 Reduces anxiety
 Process attaining
EC may initiate
women to use
ongoing
Disadvantages
 Time limitation
 Next menses may be
early
 Notable changes in
flow for next
menses
 Not as effective as
other forms of
birth control
 Can be more
expensive
 23% experience
nausea few
experience vomiting
Non-Hormonal Birth Control
• Cervical Cap/Diaphragm – Need a doctor to size
for you
• Male Condom
• Female Condom
• Spermicide
• Withdrawal Method
• Natural Family Planning
• Abstinence – the only 100% effective birth
control