hs 12

coitus interruptus

pullout method; practiced in many cultures

coitus obstructus

putting pressure on balls so that you cum into bladder; method from ancient India

coitus reservatus

total avoidance of ejaculation; shaker communities used it; from Hindu medicine

douching

flushing out the inside of the vagina with a water; also penis; used since ancient greek times

suppository (aka pessary)

object or elixir placed in vagina to kill sperm/block cervix; crocodile ding, grass, cloth, etc.

sea sponges

Used to block the sperm from entering the cervix; used by ancient Jews; considered highly effective til 1800's

condom

made from fish bladder, animal intestines, cloth; used to protect against diseases; popular contraceptive device; 3,000 years old

breastfeeding

stops ppl from being able to get pregnant. is a reliable form of contraception if you aredoingthis exclusively.ifyour menstrual periods have not resumed, and if your baby is less than 6 months old. Popular in Kung bushmen, and Zambia of papua new guinea.

True or False: The US is more on the liberal side regarding sex.

False

Margaret Sanger

- invented the term "birth control"
- worked to decriminalize contraception
- believed in sexual rights and free love
- planned parenthood result of her work (opened first BC clinic in 1916, ultimately allowed for prescriptions of bc in 1938)

Andrew Comstock

- Comstock Act (1873): made it illegal to distribute info about contraception devices because they were considered immoral and obscene
- passed through congress w wide support from powerful individuals, political parties, and religious institutions

1960's

- 1960: the first oral contraception (Envoid) was approved by the FDA
- 60's: In the United States, the first intrauterine devices (IUDs) were developed and sold.
- 1965: supreme court of the United States (SCOTUS) rules that restrictions on birth control in Comstock laws were unconstitutional

1972

- birth control was legalized for all citizens, irrespective of marital status

1992

- emergency contraception became widely available as a result of public awareness campaigns
- Available methods continue to expand rapidly; but worldwide, not all women have access

Birth control myths (debunked)

- You can get pregnant on birth control
- Pregnancy occurs when sperm and egg unite
- Douching is not an effective method of contraception
- You can get pregnant having sex for the first time

UCD campus data

- % students who had pregnancy impact their performance went down
- % students who got unintended pregnancy went up in recent years
- % emergency contraception went down
- % students using contraception went down

what factors need to be considered when choosing a contraceptive method?

- If you want to have kids one day
- Effectiveness of different birth control methods
- Prevention of STI transmission
- Health history
- Comfort level
- Your own sexual behavior

Risk Factors of: abstinence

requires self-discipline; partner agreement; strong commitment; risk of unprotected intercourse if commitment wanes

Risk Factors of: Fluid-free sexual behaviors

requires self-discipline; partner agreement; strong commitment; risk of unprotected intercourse if commitment wanes

Risk Factors of: external condom

possible reduced male sensitivity; possible interruption of sexual "moment"; latex may cause irritation (less likely with polyurethane condoms). May not protect against scabies or pubic lice

Risk Factors of: internal condom

some irritation and allergic reactions reported; can be noisy and distracting during intercourse

Risk Factors of: Diaphragm with spermicide

possible skin irritation from spermicide or latex; may cause increased risk of female UTIs

Risk Factors of: cervical cap with spermicide

low effectiveness; increase risk of UTIs; if left in place longer than 48 hours or used during menstruation can cause toxic shock syndrome; low effectiveness for women who have previously given birth

Risk Factors of: Lea's shield

must be used with spermicide for full protection; relatively expensive; must be replaced every 6 months; not recommended for women with abnormal cervical cells in Pap test

Risk Factors of: contraceptive sponge

low effectiveness for women who have previously given birth; possible temporary skin irritation due to spermicide

Risk Factors of: vaginal spermicide

possible temporary skin irritation due to spermicides

Risk Factors of: combination pills (estrogen + progestin)

associated with missed periods; spotting between periods; weight gain; increased breast size; nausea; headaches; depression. Rare: cardiovascular disease. Not recommended for women over 35 who smoke. Most minor side effects decrease after the first couple of months of use.

Risk Factors of: minipills (progestin only)

same as combination pills

Risk Factors of: 90-day pills (seasonal )

same as combination pills

Risk Factors of: implants

higher initial cost; headaches; menstrual irregularities; breast tenderness; rare cases of prolonged periods

Risk Factors of: injectable (depo-provera)

return of fertility may take up to a year; return visits every 3 months; menstrual irregularities; significant weight gain; breast tenderness; possible loss of bone mass (recovers when discontinued); cannot use for extended periods of time

Risk Factors of: contraceptive patch (ortho evra)

breast tenderness and enlargement; headache; nausea; spotting or breakthrough bleeding; abdominal cramps and bloating; may expose women to levels of hormones 60% higher than most oral contraceptives. Serious risks: blood clots, stroke, heart attack especially for women over 35 who smoke. May not be as effective for overweight women

Risk Factors of: Emergency contraceptive pills (ella, plan B, etc.)

should not be used if woman is already pregnant; nausea; vomiting; lower abdominal pain; fatigue; headache; dizziness; breast tenderness; and menstrual timing changes in month of use

Risk Factors of: progestin IUD

increased risk of PID; may cause menstrual problems; more risk for women who have never had children; requires trained personnel for insertion and withdrawal

Risk Factors of: sterilization (tubal ligation)

surgical procedure; expensive surgery; permanent; reversibility difficult and expensive; risks that accompany surgery: anesthesia, hemorrhage, organ damage

Risk Factors of: sterilization (vasectomy)

permanent; minor surgical procedure; expensive at time of surgery; can be reversible

Risk Factors of: Calendar (rhythm)

requires careful record keeping; unforgiving of imperfect use; irregular menstrual cycle makes use more difficult

What are the health issues to take into consideration regarding contraceptives?

Unintended pregnancy, blood clots, cholesterol levels, migraine headaches, high blood pressure, cardiovascular disease, cancer

What is the difference between typical use vs. perfect use?

Typical use means how well the method works when real people in real life use it, whereas perfect use means how well the method works when it's used in a clinical trial.

Understand failure (or unintended pregnancy) rate (-\> typical vs. perfect use failure rates).

- Typical failure rate: the typical number of people who become pregnant accidentally with a particular method
- Perfect-use failure rate: failure rate of a contraceptive method that is used regularly and correctly.

Which contraceptive method(s) is/are most and least effective?

- Surgical \= most effective
- natural methods \= least effective

What needs to happen for pregnancy to occur?

- Ovulation
- Fertilization
- Implantation in the uterus

How does birth control generally work?

Depends on the method used:
1. Prevents the ovaries from releasing an egg (ovulation)
2. Prevents sperm from fertilizing an egg
3. Prevents the fertilized egg from implanting into the uterus

What methods protect against pregnancy and STD/STIs?

Abstinence (continuous, selective, fluid-free sexual behavior) and Barrier methods (external male condoms, internal female condom)

Different types of abstinence

continuous, selective, fluid free sexual behavior

continuous abstinence

completely refraining from any intercourse

selective abstinence

avoiding any behavior that could lead to pregnancies and transmission of STIs

fluid free sexual behavior abstinence

avoid sharing/mixing bodily fluids

what is required to maintain abstinence?

strong commitment and clear communication between partners

What methods protect against pregnancy, but not against STD/STIs?

Cervical barrier methods

Spermicides

Hormonal methods

Intrauterine device/ contraceptive (IUD or IUC)

Surgical methods

Fertility awareness methods aka natural methods

Preventing sperm production/development

Vasalgel

Why is fertility awareness not a very effective method?

Lots of room for mistakes

Hormones may alter the signs for fertility

Which method is the most effective at preventing pregnancies?

Surgical

What does LARC mean?

Long- Acting Reversible Contraceptive
(Most effective long acting hormonal implant) Ex. IUD and implants

What type of methods would condoms be?

barrier

What types of external condoms does protects against STI's?

latex or polyurethane

how would an internal condom be used?

Placed inwards (female) and prevents the sperm from reaching the egg. Worn in a vagina or anus during sexual activity

List and Define different types of lubricants

Water-based - easiest to clean and compatible with condoms

Silicone-based- last longer but harder to clean

Oil-based - bad for vagina health and should not used with condoms and very messy to clean up

Things to remember when using lubricants and condoms?

Need to use them lessen friction (avoid tears) and help keep the condom from breaking or pulling off

Never use oil based lubricants with latex condoms

List and Define natural methods of contraception

Standard Days Method (SDM)
See which day fertile, decide not have sex on those days

Two Day Method
If secretion from cervix occurred two days in row, that is a sign of ovulation, so don't have sex

Basal Body Temperature Method
Check and track temperature of body in the morning and comparing over time, changes in temperature can indicate when ovulation is occuring

Define contraceptive technologies

either physical or surgical methods

Define natural contraception

it is based on your own prediction on when you will be firtile

how do hormonal contraceptives prevent pregnancy?

prevent ovulation

thicken cervical mucus (vagina becomes more hostile to sperm)

alters uterine lining to prevent implantation (in case egg fertilizes, it cannot implant into uterus

What are the side effects of hormonal BC?

Breast tenderness, headaches, anxiety, low libido, breakthrough bleeding, blood clots, heart attack, stroke, weight gain, acne, mood changes, depression

List and oral contraceptives

Combination pills: estrogen + progestin
Minipill: progestin only

Define combination pills (estrogen + progestin)

Monophasic: same level of hormones (estrogen+progestin) through the pack

Biphasic: 2 levels of hormonal combination of estrogen and progestin throughout the pack

Triphasic: 3 levels of hormonal combination of estrogen + progestin throughout the pack

Hormonal implants

long-acting reversible contraceptives, contain progestin, 3 year protection

injectable contraception

shot that lasts for about 3 months, Injected into arm or buttocks, Every 12 weeks, Prevents pregnancy by inhibiting ovulation

vaginal ring

99% perfect use, 91% typical use, can leave in vagina for 3 weeks

List Top 3 Emergency contraceptions

Paragard IUD

Ella

Plan B

Paragard IUD

almost 100%, need to be use within 5 days of sex, placed in the uterus by a health care provider, LARC, use progestin

Ella

less effective if over 195 lbs, works better if used ASAP, take the pill

Plan B

less effective over 165 lbs, works better if used ASAP (up to 3 days), take the pill(s)

Which hormonal method may require getting an X-ray and why?

IUD (copper) because you need to know its location and if it is placed in the right place

What happens if a female is already pregnant and takes an emergency contraception?

Nothing. EC only prevents fertilized egg from implanting into uterus and can not abort pregnancies.

Pros and Cons: Hormonal Implants

Pros:
- Successive rate with typical use: 99%
- Long-term method of birth control (protects against pregnancy for 3 years after insertion - can be removed by a health-care provider when you want to or you can wait for 3 years when it's time for a change of implant
- Very effective against pregnancy
- May cause light or no menstrual periods

Cons:
- Doesn't protect against STIs
- Requires minor surgery and insertion of the tiny rod(s) underneath the skin
- Requires minor surgery to remove device
- Can cause side effects such as irregular menstrual periods, depression, nervousness, hair loss, and weight gain
- Could get infection at area where rod is implanted

Pros and Cons: Intra-Uterine Device (IUD)

Pros:
- Success Rate with Typical Use: 99%
- Very effective against pregnancy
- Provide protection against pregnancy as long as in place in the uterus - protects as soon as inserted (so don't need to remember to use contraception if you have sexual intercourse)
- Doesn't need daily attention - just need to make sure in place at least once a month at time of menstrual period
- Comfortable - you and your partner cannot feel the IUD, although you partner may feel the string
- May lessen menstrual flow and can be used to treat heavy periods

Cons:
- Need to be inserted by a healthcare provider
- Slightly higher risk of infection in the first 20 days after insertion
- The copper IUD can have side effects such as menstrual cramping, longer and/or heavier menstrual periods, and spotting between menstrual periods
- Doesn't protect against STIs

Pros and Cons: Depo-Provera hormonal Injection

Pros:
- Success Rate with Typical Use: 96%
- Each injection provides 3 months of protection against pregnancy
- Very effective against pregnancy if used correctly
- Many women stop getting their periods while getting injections (this is not a medical problem and periods usually return 6-18 months after you stop taking injections
- Helps protect against uterine cancer
- Doesn't interrupt sexual activity

Cons:
- Doesn't protect against STIs
- Need to see your health-care provider every 3 months for an injection
- Depending on your insurance, your birth control may be free or there may be a co-pay
- May have side effects such as weight gain, tiredness, and possibly a decrease in bone density
- Many women have very irregular menstrual bleeding or spotting for the first 3-6 months and sometimes longer

Pros and Cons: Birth Control Pills

Pros:
- Success rate with typical use: 93%
- Very effective against pregnancy if used correctly
- Makes menstrual periods more regular and lighter
- Decreases menstrual cramps and acne
- Makes you less likely to get ovarian and uterine cancer, pelvic inflammatory disease, ovarian cysts, and anemia

Cons:
- Doesn't protect against STIs
- Depending on your insurance, your birth control may be free or there may be a co-pay
- Need to remember to take every day at the same time
- Can't be used by women with certain medical problems or by women taking certain medications
- Can occasionally cause side effects such as nausea, increased appetite, headaches, and, very rarely, blood clots
- Need a prescription

Pros and Cons: Hormone Patch (Ortho-Evra)

Pros:
- Success rate with typical use: 91%
- Very effective against pregnancy if used correctly
- Makes menstrual periods more regular and lighter
- Decreases menstrual cramps and acne
- Makes you less likely to get ovarian and uterine cancer, pelvic inflammatory disease, ovarian cysts, and anemia
- Doesn't interrupt sexual activity

Cons:
- Doesn't protect against STIs; Still need condoms to lower the risk of STIs
- Can't be used by women with certain medical problems or by women taking certain medications
- Can occasionally cause side effects such as nausea, increased appetite, headaches, and irregular bleeding in the first few cycles
- Increased risk of blood clots
- Need a prescription

Pros and Cons: Vaginal Hormonal Ring

Pros:
- Success rate with typical use: 93% (NuvaRing), 97% (Annovera)
- Very effective against pregnancy if used correctly
- Makes menstrual periods more regular and lighter
- Decreases menstrual cramps and acne
- Makes you less likely to get an ovarian and uterine cancer, pelvic inflammatory disease, ovarian cysts, and anemia
- Doesn't interrupt sexual activity

Cons:
- Doesn't protect against STIs
- Still need condoms to lower the risk of STIs
- Can't be used by women with certain medical problems or by women taking certain medications
- Can occasionally cause side effects such as nausea, increased appetite, headaches
Increased risk of blood clots

Pros and Cons: Diaphragm

Pros:
Success Rate with Typical Use: 83%
Can be put in place right before intercourse or 2-3 hours before intercourse
Don't need to take out between acts of sexual intercourse (protects against pregnancy for about 6 hours, but need to reapply spermicide)

Cons:
Doesn't protect against STIs
Need to get fitted by a healthcare provider and need a prescription
May be difficult to find
Can't take out until 6 hours after intercourse
Cost $25-45 plus the cost of spermicidal gel
May get moved out of place during sexual intercourse
Some women may be allergic to the diaphragm or to the spermicide
Need to be re-fitted after a 10 lbs weight gain/loss and after pregnancy
Can be messy
Need to reapply spermicide with each act of sexual intercourse
Can cause an increase in urinary tract infections

Pros and Cons: Cervical Cap

Pros:
Can insert several hours before sexual intercourse
Can leave in place 24-48 hours, will give protected sex for up to 48 hours
Use less spermicide with the cap than with the diaphragm, no need to apply more spermicide with each act of intercourse

Cons:
Doesn't protect against STIs
Cost $30-50, plus the cost of spermicidal gel
Need to be fitted by a healthcare provider and need a prescription
Limited sizes available
Can't take out until 6-8 hours after intercourse
May get moved out of place
Some women may be allergic to material of cap or to spermicide
Can't be used by women with a history of abnormal Pap tests
Can cause increased urinary tract infections

Pros and Cons: Male Condoms

Pros:
Success rate with typical use: 87%
Lowers risk of STIs
Contraception that provides the most protection against sexually transmitted infections (latex condoms are best)
Don't cost much (50 cents each), can buy at almost any drug store (don't need a prescription)
Men feel they can "last longer" when using a condom
Allow men to have an active part in preventing pregnancy

Cons:
Have to use a new one every time you have sexual intercourse (can only be used once)
May disrupt/interrupt sexual activity as it needs to be put on just before penetration
Women may be allergic to latex
difficulty maintaining erections
can tear, break,or slip off
reduce sensitivity

Pros and Cons: Female Condom

Pros:
Success Rate with Typical Use: 79%
Provide protection against STIs (new product, so not clear how much protection given) and pregnancy
Can be inserted well before intercourse so less interruption of sexual activity
Male does not need to withdraw right after ejaculation, as he does with a male condom

Cons:
May move or be uncomfortable
Can only use for one act of sexual intercourse
Cost about $2.50 each
Allergic reaction
only some protect against STIs

Which two contraception methods/devices should never be used together?

Internal and external condoms

What is the correct way to use an external condom?

1) Carefully open and remove condom from wrapper
2) Place the condom on the head of the erect, hard penis. If uncircumcised, pull back the foreskin first.
3) Pinch air out of the tip of the condom
4) Unroll the condom all the way down the penis.
5) After sex but before pulling out, hold the condom at the base. Then pull out, while holding the condom in place.
6) Carefully remove the condom and throw it in the trash.

What is the correct way to use an internal condom?

1) Carefully open and remove the internal condom from the package to prevent tearing.
2) The thick, inner ring with a closed end is used for placing in the vagina and holds the condom in place. The thin, outer ring remains outside of the body, covering the vaginal opening.
3) Find a comfortable position. While holding the outside of the condom at the closed end, squeeze the sides of the inner ring together with your thumb and forefinger and insert into vagina. It is similar to inserting a tampon.
4) Using your finger, push the inner ring as far up as it will go until it rests against the cervix. The condom will expand naturally and you may not feel it.
Be sure the condom is not twisted. The thin, outer ring should remain outside of the vagina.
5) Guide partner's penis into opening of internal condom. Stop intercourse if you feel penis slip between the condom and the walls of vagina or if the outer ring is pushed into the vagina.

What is the correct way to use a dental dam?

1) Carefully open the dental dam and remove from the package.
2) Place the dental dam flat to cover the vaginal opening or anus.
3) Throw away the used dental dam in the trash.

True or False: Contraceptives terminate pregnancies

False

abortifacients vs contraceptives

contraceptives prevent pregnancies while abortifacients end pregnancies

what is the relationship between sexual health, positive decision making , and communication skills?

it is a cycle; good communication leads to positive decision making which leads to good sexual health which leads to positive decision making which leads to good communication

Vasalgel

blocks sperm in the vas deferens; reversible by unblocking the gel barricade

List and Define male contraception

Abstinence: no sex \=\> no pregnancy

Spermicides: no sperm for fertilization

Hormonal method (male contraceptive pill)

Barrier method \=\> prevents sperm from getting to the egg
External condom
Vasalgel

Preventing sperm production (nestorone/testosterone transdermal gel in development)

Vasectomy \=\> sperm cannot move out of the male body

why is contraception the responsibility of both sexes?

Fertilization is needed for pregnancy

reproductive coercion

behavior related to reproductive health that is used to maintain power and control in a relationship

list different types of reproductive coercion

Refusing to use a condom or other form of contraception. Lying about using a method of birth control, such as getting a vasectomy. Sabotaging birth control methods, such as tampering with birth control pills or poking a hole in a condom. Hiding or destroying contraception. Stealthing

Stealthing is considered to be a form of \_________ in some countries. AND What are the legal consequences of this?

Sexual assault/violence; sued (civil offense)

Why are reproductive rights under threat?

In U.S., women's access to abortion is under greater threat than it has been since abortion was legalized (government control on when and where and funding issues). This can lead to an increase in illegal and unsafe abortions.

Define and describe pronatalism

- a belief system that promotes childbearing
- it is a set of beliefs that is so ingrained in us that we do not question it
- it is accepted that all typical adults want and should have children
- motherhood is a core part of current gender expectations and a woman who choses not to have children is often seen as deviant and is stigmatized

How do you prepare a body for a healthy pregnancy?

Take 400 micrograms of folic acid every day for at least 3 months before getting pregnant to help prevent birth defects
Stop smoking and drinking alcohol
Make sure that any preexisting medical conditions are under control
Talk to your health care provider about any over-the-counter medication or prescriptions you are taking (including dietary or herbal supplements)
Avoid toxic substances, materials, and chemicals that can cause infections