BIOL80A Final| Contraception and Birth Control

what is contraception/birth control?

intervention used to prevent pregnancy

what are hormonal contraceptives?

birth control options that use hormones to prevent pregnancy (e.g., pills, patch, ring, injection, implant, hormonal IUD).

what are intrauterine devices (IUDs)?

T-shaped devices inserted into the uterus for long-term pregnancy prevention; contain either a hormone or copper

what are barrier devices?

physical methods used to prevent sperm from reaching an egg (e.g., condoms* diaphragm, cervical cap, sponge)

what are fertility awareness methods?

tracking one’s menstrual cycle to avoid intercourse during the fertile period to prevent pregnancy

what is sterilization?

a permanent surgical procedure to prevent pregnancy (e.g., tubal ligation for females or vasectomy for males).

which form of birth control also protects against most sexually transmitted diseases (STDs)?

the condom* is the only form of birth control that offers this protection

what hormones are found in hormonal contraceptives?

either a combination of estrogen + progesterone, or progesterone alone

what are common administration routes for hormonal contraceptives?

oral pills, vaginal ring, transdermal patch, subdermal implant, intramuscular injection, and hormonal IUD

what are some examples of oral hormonal contraceptives?

birth control pill and the morning-after pill (emergency contraception)

what is an example of a vaginal hormonal contraceptive?

vaginal ring (NuvaRing)

what is an example of a transdermal hormonal contraceptive?

patch

what is an example of a subdermal implant?

implanon

what is an example of an injectable hormonal contraceptive?

depo-provera

what is an example of a hormonal IUD?

mirena

how does hormonal birth control prevent pregnancy?

it prevents ovulation

how do some progesterone-only methods prevent pregnancy?

thicken cervical mucus and/or thing endometrial lining to reduce implantation likelihood

are hormonal contraceptives reversible?

yes— fertility usually returns within 1-6 months after stopping

what is the typical effectiveness (percentage) of hormonal contraceptives?

about 91% overall

what is the perfect-use effectiveness (percentage) of hormonal contraceptives?

up to 99%

what are some common side effects of hormonal contraceptives?

irregular bleeding, breast tenderness, nausea, headaches, mood changes

what are the serious risks of hormonal contraceptives?

blood clots, cardiovascular/circulatory issues and drug interactions

what are the benefits of hormonal contraceptives?

improve acne, PMDD symptoms, menorrhagia, and dysmenorrhea (including endometriosis or fibroids).

how do hormonal contraceptives use the negative feedback system?

maintain low, steady estrogen/progesterone levels that suppress GnRH, FSH, and LH.

what is the effect of constant low estrogen on GnRH?

decreases GnRH production by the hypothalamus

what is the effect of low estrogen on FSH and follicle development?

less fsh —> no dominant follicle —> estrogen remains low

what is the effect of low estrogen on the uterine lining?

prevents the uterine lining from growing/thickening

what is the effect of low estrogen on LH and ovulation?

less LH —> no LH surge, no ovulation; cervical mucus remains thick

what is the effect of constant low progesterone?

inhibits hypothalamus and pituitary, keeping GnRH, FSH, and LH low

how does low progesterone affect the uterine lining?

makes it less hospitable for implantation

what causes a withdrawal bleed in hormonal contraceptive cycles?

sudden drop in estrogen and progesterone during placebo pills or removal of ring/patch

what is an intrauterine device (IUD)?

a small, t-shaped plastic device inserted into the uterus by a healthcare providor for long-term, reversible, contraception, preventing pregnancy highly effectively (99-100%)

what are the two main types of IUDs?

hormonal (ex., mirena; releases progesterone)

copper-releasing (e.g., ParaGard; releases copper ions)

how does a hormonal IUD work?

thickens cervical mucus (blocking sperm), thins uterine lining, and restricts sperm movement; last 3-8 years can treat heavy periods

how does a copper IUD (ParaGard) work?

copper ions create an environment toxic to sperm, preventing fertilization; lasts up to 10 years, works immediately

what are the key benefits of IUDs?

highly effective (>99%), long-acting & low maintenance (“don’t need to think about it”), reversible; fertility returns quickly after removal, cost-effective long-term, hormonal IUDs treat heavy periods

what are some common side effects of IUDs?

irregular periods initially, then light/no periods (hormonal); cramps, heavier/longer periods, spotting (copper); general pain, acne, headaches, bloating, nausea

what are some serious risks or contraindications for IUDs?

increased pelvic infection risk (avoid with PID); rare risks: expulsion, ectopic pregnancy, uterine perforation; should not be used with existing pelvic infection

what is emergency contraception (EC)?

methods (pills, copper IUD) used shortly after unprotected sex/contraceptive failure to prevent pregnancy, working mainly by delaying ovulation

when should emergency contraception (EC) be used?

as soon as possible after unprotected sex (or condom failure); pills within 3-5 days, IUD within 5 days, as effectiveness decreases over time

what is the “morning-after pill” (plan B)?

a common oral EC pill (levonorgestrel) that lowers pregnancy risk by 75-89%, available over the counter

what’s the most effective emergency contraception (EC) method?

the copper IUD (ParaGard), inserted by a provider within 5 days, is highly effective (near 99% for pregnancy prevention)

what is copper IUD (ParaGard) as an emergency contraceptive (EC)?

a non-hormonal device placed in the uterus within 5 days of unprotected sex, stopping sperm/egg from meeting, very effective

does emergency contraception (EC) cause abortion?

no, EC prevents pregnancy (ovulation/fertilization); it does not end an established pregnancy

what is unprotected sex/contraceptive failure?

situations needing EC, like forgotten pills, condom breaks, or no birth control used, where pregnancy risk increased significantly (esp. near ovulation)

how much does emergency contraception lower pregnancy risk?

varies; plan B lowers risk by 75-89%, copper IUD by ~99% (0.1% chance of pregnancy after)

what are barrier methods?

contraceptives that physically block the sperm’s access to a woman’s uterus and/or egg

what are some examples of barrier methods?

condoms, diaphragms, cervical caps, contraceptive gels, contraceptive sponges, and spermicides (foams, creams, and suppositories)

what are condoms (male & female)?

thin, lubricated sheaths (often made of latex, polyurethane or silicone) that cover an erect penis or line the vaginal canal

what are spermicides?

sperm-killing substances available as foams, creams, gels, films or suppositories

when should barrier contraceptives be used?

they should be used by the woman or her partner each time they have sex

Effectiveness of condoms (used alone)?

~82% effective in preventing pregnancy

Which type of condom provides protection against STDs/HIV?

Only latex condoms help protect against common sexually transmitted diseases, including HIV infection

Risks/Side Effects of non-latex condoms?

More likely to slip/break; may cause allergic reactions or irritation

what are the effectiveness of spermicides when used alone?

79-88% effective in preventing pregnancy. most effective when used along with another barrier device (e.g. condom of diaphragm)

what are the risks/side effects of spermicides?

may cause allergic reactions, irritation, and increased risk for urinary tract infections (UTIs)

what is a diaphragm?

A small, dome-shaped latex cup with a flexible ring that fits over the cervix, acting as a physical barrier against sperm. It is usually filled with spermicide, self-inserted before intercourse, and left in place for several hours after. reusable

what is a cervical cap?

A thimble-shaped latex cup, smaller than a diaphragm, that fits over the cervix and requires spermicidal cream or gel. It is only available in 3 sizes and requires a prescription and fitting by a provider. reusable

what is a sponge?

A round, disposable device made of soft polyurethane foam and coated with spermicide. It fits over the cervix and must be inserted before and removed after intercourse. disposable

how effective is the diaphragm?

approximately 85% effective when used with spermicide

how effective is the cervical cap?

70-85% effective (depending on whether a woman has given birth)

how effective is the sponge?

~85% effective

does the diaphragm require prescription/fitting?

yes, size/fit and proper placement are important and require fitting

does the cervical cap require prescription/fitting?

yes, requires a prescription, pelvic examination, and fitting by a provider

does a sponge require prescription/fitting?

no, it is disposable and over the counter

what are fertility awareness methods?

cycle-based methods that rely on tracking the changes in the body that signal fertility.

why is it good to monitor certain changes in your body?

a women is only fertile during part of the menstrual cycle, so monitoring certain changes can help predict the fertile phase

what precautions should one take during the fertile phase?

abstaining from intercourse or using barrier methods

how effective are fertility awareness methods?

75-88% effective

what are some fertility awareness methods?

calendar method, basal body temperature, mucus method, symptothermal method

how does the calendar method work?

sexual intercourse is avoided on days “10 through 17” of the menstrual cycle (this can be better informed by using cycle tracking app)

how does the basal body temperature work?

morning body temperature rises sharply just after ovulation

how does the mucus method work?

this method is based on the women’s observation of secretions (cevical mucus) from the vagina, specifically around ovulation (becomes clear and more elastic with increasing estrogen before ovulation— spinnbarkeit, and opaque, thick and sticky with increasing progesterone after ovulation)

how does the symptothermal method work?

a combination of body temperature at rest (basal body temperature), observation of cervical mucus, and use of the calendar method

why are there high risks of pregnancy?

women ovulate at different times in their cycle and these methods require knowledge/training, commitment to constant, close monitoring and discipline on the part of the women and their sexual partner

what is female sterilization (“tubal ligation”)?

a procedure that blocks the fallopian tubes and thereby prevent sperm from reaching and fertilizing the eggs

what happens to ovaries and eggs during female sterilization?

the ovaries continue to function normally, but the eggs they release harmlessly degrade

does sterilization immediately cause a woman to enter menopause?

no, sterilization itself does not cause menopause, menstruation typically continues as before

what does post-sterilization menstruation mean?

menstruation usually continues with very little difference in length, regularity, flow, or cramping

is there any relationship between tubal ligation and the timing of menopause?

yes, there is a correlation between having a tubal ligation and experiencing earlier menopause

what methods are used to block fallopian tubes?

tubes may be cut, burned and sealed (cauterization), or clamped off with a small clip or ring

what is a hysterectomy?

surgical removal of the uterus, which also results in sterility, but is usually done to treat a disorder or disease

is sterilization considered a permanent form of birth control?

yes

what is the chance of a sexually active women of reproductive age becoming pregnant in one year without using contraception?

85% chance

which category of birth control methods has a failure rate of less than 1% with typical use?

the most effective methods, which include IUDs, progestin implants, and tubal ligation (female sterilization)

what are intrauterine devices (IUDs)?

a type of highly effective contraception with a failure rate of less than 1% with typical use

how effective is a male latex condom with typical use?

about 82% effective

how effective is a male latex condom with perfect use?

about 98% effective

how effective are birth control pills with typical use?

about 91% effective

how effective are birth control pills with perfect use?

about 99% effective