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Contraception HEALTH CLASS Ramsey High School What Doesn’t Work • Withdrawal: pulling your penis out of the vagina before ejaculation will not prevent a pregnancy • Rhythm: Avoiding intercourse during ovulation will not prevent a pregnancy • Douching: Cleaning your vagina immediately after intercourse will not prevent a pregnancy Contraception • Intentional prevention of conception through the use of various devices, agents, drugs, sexual practices, or surgical procedures. Questions • How will it fit into your lifestyle? • How effective will it be? • How safe will it be? • How affordable will it be? • Is it reversible? • Does it protect against STDs Over-the-Counter • Abstinence • Condom • Female Condom • Spermicides • Sponge Abstinence How It works • Abstaining from sex (do not take part in) – Vaginal, anal, oral Effectiveness • 100% –In preventing pregnancy and Sexually Transmitted Diseases (STDs) Advantages • Prevents pregnancy and STDs • Finding other ways to be intimate with your partner •Talking, listening, sharing, being honest, respecting each others thoughts and feelings Disadvantages • Peer pressure • May be hard for some people to abstain Availability/Cost • Costs nothing • Available to everyone Condom How it works -latex or lambskin sheath that serve as a barrier preventing the passage of sperm as well as disease carrying organisms. -prevents vaginal fluids from entering the male’s urethral opening. Effectiveness • 82%-98% • More protection is possible if condoms are used with a spermicide. Advantages • Does not alter hormonal balance • Readily available • Allows men to share responsibility for birth control and STD prevention • No side effects (unless latex allergy) Disadvantages • Must stop intercourse to apply condom • May lessen sexual sensations • Can slip off or tear Availability/Cost • Over-the-counter – Drug stores, super markets, family planning clinics, college health centers. • Less than $.50-$2.00/each • F.Y.I. – CAN ONLY BE USED ONCE •Also check expiration dates Female Condom How It Works • Serves as a barrier method • Polyurethane (plastic) pouch with flexible rings at each end • Used to line the vagina during intercourse • Collects semen Effectiveness • 79%-95% • Can be used with spermicides Advantages • Allows woman to share responsibility in preventing STD’s • Do not need an erection to stay in place Disadvantages • Vaginal irritation • May slip into the vagina during intercourse • Bulky, hard to insert • Less effective than male condom in preventing pregnancy and STD’s • noisy Availability/Cost • OTC – Drug stores, family planning clinics, some super markets • Costs about $2.50/each Spermicides How It Works • Chemical agent that immobilizes sperm (nonoxynol-9) • Coats the cervical opening • Comes in a variety of preparations – Foams, creams, jellies, film & suppositories Effectiveness • 71%-85% • Using a condom increases effectiveness Advantages • No prescription required • Do not have to interrupt intercourse – Can be inserted beforehand Disadvantages • High failure rate • Some brands may irritate the penis or vagina • No STD protection • Can be messy (leakage) Availability/Cost • OTC – Drug stores, some super markets, family planning clinics • $8.00—foam/gel refills cost about $4-$8 The Sponge How It Works • Made of polyurethane foam and contains spermicide – Serves as a barrier covering the cervix – Releases spermicide – Traps and absorbs sperm Effectiveness • 84%-91% – Women who have never given birth • 68%-80% – Women who have given birth *must be left in for 6 hrs after intercourse Advantages • Does not interrupt intercourse – Can be inserted hrs ahead of time • Can be worn up to 30 hours • No prescription Disadvantages • No STD protection • Can get messy • Insertion/removal can be difficult • Vaginal irritation • Increased of TSS Availability/Cost • OTC • 3-pack--$7.50-$9.00 Prescription Methods • The Pill • The Patch—Ortho Evra • The Ring—Nuva Ring • Diaphragm, caps, shields • The Shot—Depo Provera • IUD-Intrauterine Device The Pill 2 types—combination and progestin-only Combination-pills contain both synthetic estrogen and progestin (like hormones produced in the ovaries). Progestin-only-contains synthetic form of progestin How it Works • Keeps the ovaries from releasing an agg (ovulation) • Thickens cervical mucus-prevents the passage of sperm • Hormone also affects lining of the uterusprevents implantation Effectiveness • 92%-99% • Failure rate increases if: – – – – Pills are started too late in the cycle 2 or more pills are missed in a row Pills are taken in wrong order Taken with antibiotics and other meds. Advantages • Protection for 1 month • Nothing to do right before intercourse to protect against pregnancy • Regulates menstrual cycle • Less acne • Protection against some cancers • Fewer non-cancerous breast growths • REQUIRES REGULAR CHECK-UPS Disadvantages • No STD protection • Must take daily pill • Weight gain/loss • Breast tenderness • Nausea • Changes in mood • Health risks Availability/Cost • By prescription only • Exam ranges from $35-$125 • Monthly packages $20-$35 The Patch—Ortho Evra How It Works • Same as the pill • Thin beige, plastic patch applied to the skin • Change patch once a week for 3 weeks • Do not wear anything for 4th week Effectiveness • 99% • Failure rate increases – Patch becomes loose or falls off for more than 24 hours – Same patch is left on for more than 1 week Advantages (specific to The Patch) • Does not involve taking a pill everyday Disadvantages (specific to The Patch) • Skin reaction at site of application • No STD protection Availability/Cost • Prescription only • Exam $35-$125 • Patches--$20-$35 Diaphragm, Caps, Shields How It Works • Soft latex or silicone barriers that are intended to fit securely in the vagina to cover the cervix • Holds spermicide in place Effectiveness (varies with method) • Diaphragm—84%-94% • Shield—85% • Fem Cap – 86% (before childbirth) – 71% (after childbirth) Advantages • No interruption—can be inserted hours ahead of time • Can be easily carried (purse,pocket) • No hormones – Can be used during breast feeding Disadvantages • • • • Insertion can be difficult Can be pushed out of place Vaginal irritation Can be messy Availability/Cost • • • • Prescription only Exam $50-$200 Prescription barrier methods $15-$75 Spermicide $8-$17 The Shot—Depo Provera How it works • Shot of synthetic progesterone (similar to that produced in the ovaries) – Keeps the ovaries from releasing an egg (ovulation) – May thicken cervical mucus – Prevents implantation (uterine lining) Effectiveness • 97%-99% Advantages • Can be used by women who cannot take estrogen • Nothing to put in place • Protection against pregnancy for 12 wks • Reduces menstrual cramps • Helps prevent cancer (uterine lining) Disadvantages • No STD protection • Irregular bleeding (most common) • Takes 12 wks-more than a yr to conceive after last shot • Inconvenient (shot every 3 months) • Less common side effects • Research update Availability/Cost • Exam $35-$125 • Injections cost $30-$75 • Subsequent visits $20-$40 plus injection IUD—Intrauterine Device (2 types) • Small devices made of plastic – ParaGard-also contains copper – Mirena-releases Progestin How It Works • Usually prevents fertilization • Seem to affect the way the egg and sperm move – Immobilizes sperm, egg moves faster through fallopian tubes. • Affect the lining of the uterus (prevents implantation) Effectiveness • 99%-over 99% • Effectiveness is increased by checking IUD string regularly Advantages • Highly effective • Basically maintenance-free • Long term protection – ParaGard-12 yrs – Mirena-5 yrs • No interruption • Ability to conceive returns quickly when us is stopped Disadvantages • Insertion can be painful (like severe menstrual cramps) • Side effects—excessive cramping, irregular bleeding • Risk of PID • No STD protection Availability/Cost • Prescription only – Exam insertion, follow-up--$175-$400 Nuva Ring • How it works: ring is placed in the vagina for 3 weeks, releases hormones that stop the ovaries from releasing eggs Effectiveness • 99% as long as ring is properly used Advantages • Do not have to take a pill or use a patch • Lasts for 3 weeks Disadvantages • Could cause vaginal discharge Cost/Availability • Need a prescription • Costs $30-75 for 3 month supply Emergency Contraception • Needs to be used within 120 hours of sex • Will stop egg from being released, and will stop fertilized egg from implanting in the uterus Effectiveness • 99% as long as pill is taken within 120 hours of intercourse Advantages • Safe and effective • Only contraceptive method that can work after intercourse Disadvantages • Nausea and vomiting for a couple days after use • Frequent use could cause irregular periods Cost and Availability • $30 to $65 • Available at most pharmacies over the counter, no age limit