Contraception Methods

Abstinence

Not having any sexual contact that will put you at risk for an STI or unintended pregnancy

Effectiveness of Abstinence

100%

Advantages of Abstinence

No medical or hormonal side effects

Possible Problems of Abstinence

Offers no protection once an individual decides to become sexually active

Cost of Abstinence

Free

Fertility Awareness-Based Methods (FAM)

Done by charting a women’s menstrual cycle to detect certain physical signs to help predict days when pregnancy is possible. Three methods that are most effective when used together: checking basal body temperature daily, checking cervical mucus daily called ovulation method, recording menstrual cycles on a calender

Effectiveness of FAM

76-95% (no protection from STIs)

Advantages of FAM

• No medical or hormonal side effects

• Calendars, charts, and thermometers are easy to purchase

Possible Problems of FAM

• Requires research and professional training to be done most effectively where approximately 34% of users experience an unintended pregnancy in the first year of using 

• Record-keeping must be exact

• Body temperature may be affected by illness or lack of sleep

• Cannot use with irregular periods or temperature probles

Cost of FAM

price of supplies, free classes often available in health and church centers

Withdrawal

Happens when a man removes his penis from his partner before ejaculating

Effectiveness of Withdrawal

80% (no protection from STIs)

Advantages of Withdrawal

can be used when no other method is available

Possible Problems of Withdrawal

• requires self-control, experience, and trust

• not for men who ejaculate prematurely

• not recommended for sexually inexperienced men

Cost of Withdrawal

Free

External (Male) Condoms

cover the penis with a sheath before intercourse to keep the sperm from joining the egg, also prevent skin-to-skin contact and the exchange of some bodily fluids, can be made of thin latex, polyurethane, or animal tissue

Effectiveness of Male Condoms

87%-98% - latex or plastic condoms good protection from STIs

Advantages of Male Condoms

• Easy to buy in drugstores, supermarkets, etc.

• Can be used with other methods to reduce risk of infection

• May prevent premature ejaculation

• Can make into a dental dam for oral sex with women

Possible Problems with External Condoms

• Uncooperative partners

• Interruption of activities (needs to be put on after erection, but before penetration - take off while still erect)

• Latex allergies

• Loss of sensation

• Breakage

Cost of External Condoms

• Latex from $1 each for plain

• Up to $3 for fancy'

• Polyurethane $2

• Polyisoprene $4

Internal (Female) Condoms

Inserted deep inside the vagina and work in the same ways the male condom does to prevent pregnancy and STIs - made out of polyisoprene or nitrile; can be used vaginal and anal sex; do not use an external and internal condom together

Effectiveness of Internal Condoms

79-95% (protection from STIs)

Advantages of Internal Condoms

• Easy to buy in drugstores, supermarkets, etc.

• Can be inserted up to 8 hours before intercourse

• Erection not necessary to keep female condom in place

• External ring of condom may stimulate clitoris

Possible Problems of Internal Condoms

• May slip into vagina during intercourse

• May be difficult to insert

Cost of Internal Condoms

$4 each

Diaphragms and Cervical Caps

Shallow latex cups that are inserted to cover the cervix; Clinicians will initially fit the diaphragm to a woman’s body and show patients how to coat the diaphragm with spermicide to increase effectiveness

Effectiveness of Diaphragms and Cervical Caps

• no protection from STIs

• 83-94% - diaphragm

• 85-91% - cervical cap for women who have not delivered vaginally

• 70-80% - cervical cap for women who have delivered vaginally

Advantage of Diaphragms and Cervical Caps

• no major health concerns

• can be inserted a couple of hours before intercourse

• can last several years (recommended replacing diaphragm once a year)

Possible Problems of Diaphragms and Cervical Caps

• should not be used during vaginal bleeding or infection

• increased risk of bladder infection

• should be left at least 6 hours after intercourse (diaphragm can stay up to 24 hours; cervical cap up to 48 hours)

• may be difficult for some women to use

• requires a prescription which can be a barrier for some people

Cost of Diaphragms and Cervical Caps

• $60-75 for diaphragm or cervical cap (replace one a year)

• $50 - 125 for examination 

• $4-8 for spermicide

Sponge

A round polyurethane sponge about 2 in in diameter that has a pouch in the center that fits over the cervix; filled with spermicide to increase effectiveness; should also use an external condom for STI protection

Effectiveness of Sponge

• no protection from STIs

• 94% - perfect use for women who have not delivered vaginally

• 80% - typical use and for women who have delivered vaginally

Advantages of Sponges

• No major health concerns

• Can be inserted up to 24 hours before intercourse and can be used repeatedly during the 24 hours

• Doesn’t require a prescription

Possible Problems of Sponge

• Should not be used during vaginal bleeding or infection

• One size fits all - may not fit for some women especially after giving birth

• Leave in place for at least 6 hours after

Cost of Sponges

$3-5 per sponge

Intrauterine Device (IUD) or Intrauterine Contraceptive (IUC)

A small plastic T that is placed instead the uterus by a clinician; IUD may contain copper or hormone (progestin) that work in several ways; interferes with the movement of sperm and egg to prevent contraception

Effectiveness of IUD and IUC

98-99% (no protection from STIs)

Advantages of IUD and IUC

• Intercourse may be more spontaneous 

• Copper IUDs may be left in place for 10 years

• Hormonal IUDs may reduce menstrual cramps and may be left in place fro 3-6 years

• Quick return to fertility

• Recommended for teens

Possible Problems of IUD and IUC

• Increased cramping

• Spotting between menstrual periods

• Heavier and longer periods

Cost of IUD and IUC

$300 - $1000 for exam, insertion, and follow-up visit

Oral Contraceptives (Birth Control Pills)

• Prescribed by a clinician and come in many different forms

• Pills should be taken once per day at the same time every day, and one pill pack lasts an entire month

• Combination pills contain estrogen and progestin (a synthetic form of progesterone)

• Combination pills prevent ovulation (90-95% of the time)

• Both types thicken cervical mucus to keep sperm from joining the egg

• Both types also prevent egg, if fertilized, from implanting in the uterus

• Inhibits capacitation of the sperm and disrupts egg’s transport

Effectiveness of Pill

91-99.7% (no protection of STIs)

Advantages of Pill

• Intercourse may be more spontaneous 

• Menstruation becomes more regular

• Menstrual cramping, acne, iron deficiency anemia, premenstrual tension and menstrual flow may be lessened

• Protects against ovarian and endometrial cancers, pelvis inflammatory disease, non-cancerous growths of the breast, ovarian cysts, and may protect against osteoporosis and rheumatoid arthritis

• Fewer tubal pregnancies

Possible Problems of Pill

• must be taken daily

• rare but serious health risks include blood clots, heart attack, and stroke

• side effects include temporary irregular bleeding, loss of monthly period, weight gain or loss, depression, nausea, breast tenderness, and other discomforts

• if you want to get pregnant go off the pills and use another form of birth control for 2-3 months

• some medications can reduce effectiveness

Cost of Pill

$25-55 per pill pack

Depo-Provera

A hormonal injection that is given every 12-13 weeks, starts working quickly

Effectiveness of Depo-Provera

94-99.8%

Advantages of Depo-Provera

• Protects against pregnancy for 3 months

• Intercourse may be more spontaneous

• Reduces menstrual cramps

• Approximately half of women strop menstruating completely after one year of use

• Can be used by some women who cannot take oral contraceptives

• Protects against endometrial cancer and iron deficiency anemia

• Can be used while breast-feeding immediately after delivery

Possible Problems of Depo-Provera

• Return to fertility may take several months 

• Side effects can include irregular bleeding, weight gain, headaches, depression, abdominal pain, decreased sex drive, and temporary/reversible decrease in bone density

• Women who have had breast cancer should not use

Cost of Depo-Provera

$250-400 per year

OrthoEvra Patch

A small hormonal patch that is changed one a week - worn in four places: buttock, abdomen, upper shoulder, or upper outer arm

Effectiveness of OrthoEvra Patch

91-99%

Advantages of OrthoEvra Patch

• Each patch protects against pregnancy for 1 week 

• Intercourse may be more spontaneous

• Protects against ovarian and endometrial cancers, pelvic inflammatory disease, non-cancerous growths of the breast, ovarian cysts, and may protect against osteoporosis

• Fertility returns quickly

Possible Problems of OrthoEvra Patch

• If it comes loose or falls off, must be replaced within 24 hours

• Must remember to change once a week

• Risk of heart attack and stroke similar to the pill

• Side effects include mild skin reactions, temporary irregular bleeding, weight gain or loss, changes in mood, nausea, breast tenderness, and theoretically the higher levels of estrogen than in pills may increase the change of blood clots

• Some medications can reduce its effectiveness

Cost of OrthoEvra Patch

$35-80 a month

NuvaRing

A small flexible ring inserted into the vagina once a month (stays in for 3 weeks, then taken out and thrown away - wait once a week); the exact position doesn’t matter, usually up out of the way, neither partner feels it

Effectiveness of NuvaRing

91-99%

Advantages of NuvaRing

• Protects against pregnancy for 1 month

• Intercourse may be more spontaneous

• No fitting necessary

• Lower does of estrogen than the path and the pill

• Consistent release of hormones means that women has more control over fertility

• Protects against ovarian and endometrial cancers, pelvis inflammatory disease, non-cancerous growths of the breast, ovarian cysts, and may protect against osteoporosis

Possible Problems of NuvaRing

• If it slips out, must be replaced within 3 hours

• Side effects include temporary irregular bleeding, changes in mood, nausea, breast tenderness, and headaches

• There may be a higher risk of blood clots due to the use of desogesterel

• Some medications can reduce its effectivenss

Cost of NuvaRing

$30-80 a month

Implants

One cylindrical capsule, placed in the upper arm. The capsule constantly releases small amounts of progestin that prevents ovulation and thicken cervical mucus (to keep sperm from joining with the egg)

Effectiveness of Implants

99.95% (no protection from STIs)

Advantage of Implants

• Protects against pregnancy for up to 4 years

• No daily pill

• Can use while breast feeding after 6 weeks post-delivery

• Can be used by some women who are unable to use oral contraceptives

Possible Problems of Implants

• Side effects include irregular bleeding and other discomforts, including headaches, depression, and weight change

• Possible scarring and/or discoloration of the skin at insertion sitre

• Possibility that implants may be visible beneath the skin

• Although less than 1% chance of pregnancy, but more likely to be ectopic

Cost of Implant

• $400-1000 for exam, implant, and insertion

• $75-150 for removal

Sterilization

A permanent method of contraception that includes vasectomies for men and laparoscopy for women. These procedures all block tubes which transport sperm or eggs, respectively

Effectiveness of Serilization

99.9-100% (no protection from STIs)

Advantages of Sterilization

• Permanent protections against pregnancy

• No lasting side effects

• No effect on sexual pleasure

Possible Problems of Sterilization

• Mild bleeding or infection after operation

• Regret permanency of decision - Reversibility cannot be guaranteed

Cost of Sterilization

• $2000-6000 for women

• $350-1000 for vasectomy

Emergency Contraception Pill

• Work up to 72 hours after unprotected sex

• The sooner a women starts EC, the more effective it may be

• Pill is high level of progestin and reduces a woman’s risk of pregnancy by 87%

• Nausea, vomiting, and cramping are common side effects

• Not an abortion pill; if woman is already pregnant, it will not abort an established pregnancy or harm developing fetus

• Costs about $40

Emergency IUD Insertion

• Prevents implantation if used within 5 days of unprotected sex 

• Up to 99% effective

• Do not need a prescription and can get if 17 or older

• Can be left in place for up to 10 years to prevent pregnancies