Contraception Study Notes

Unit 7: Contraception Overview

  • Concept Definitions:
    • Conception: Successful fertilization and implantation.
    • Contraception: Methods against conception, also known as birth control or family planning.
    • Cultural Considerations: Some cultures and individuals may discourage or limit contraceptive methods for moral or religious reasons.

Effectiveness of Contraceptive Methods

  • Effectiveness Measurement:
    • Reported as a percentage; e.g., a method is 98% effective means 2 out of 100 couples will conceive in a year.
  • Groupings of Methods:
    • Methods are grouped by effectiveness:
    • Most Effective (99%+ effective)
    • Very Effective (90-99% effective)
    • Reasonably Effective (75%+ effective)
    • Not Super Effective (~70-80% effective)

Most Effective Methods

  • Types:
    • Abstinence:
    • Refraining from penis-vagina intercourse, considered 100% effective.
    • Abstinence-only education isn't shown to reduce rates of activity, pregnancy, or STIs.
    • Vasectomy:
    • Male sterilization; severing of the vas deferens.
    • Sperm produced but absorbed as waste.
    • >99% effective, outpatient procedure, cheaper and safer than female sterilization.
    • New techniques: No-needle and No-scalpel methods.
    • Tubal Ligation:
    • Female sterilization; fallopian tubes are severed.
    • Eggs ovulated but cannot reach uterus.
    • >99% effective, surgical under anesthesia, possibly reversible.
    • IUDs:
    • Copper or hormonal, >99% effective.
    • Disrupt sperm motility (copper) or prevent ovulation (hormonal).
    • Long-lasting (copper: up to 12 years, hormonal: 3-5 years).

Very Effective Methods

  • Hormonal Contraceptives:
    • Types:
    • Oral pills, patches, rings, injections, IUDs.
    • Actions:
    • Thickening of cervical mucus and inhibition of ovulation.
    • Combined vs. Progestogen-only:
    • Combined: 92-99% effective, suppress ovulation completely.
    • Progestogen-only: 90-97% effective, reduces ovulation frequency.
    • Benefits:
    • No risk of miscarriage, supports during lactation, reduces ovarian and endometrial cancer risks, manages symptoms like endometriosis and acne.
    • Concerns:
    • Slightly increased risk of blood clots; lower than risks associated with pregnancy.

Reasonably Effective Methods

  • Barriers:
    • Condoms:
    • 85-98% effective, prevent sperm from meeting egg.
    • Available as male and female options; effective against STIs.
    • Other Barriers:
    • Diaphragms, sponges, cervical caps ~70-90% effective depending on various factors.
  • Fertility Awareness:
    • Involves abstaining during fertile periods; based on cycle tracking.

Not Super Effective Methods

  • Methods:
    • Spermicide:
    • Kills sperm, ~72% effective.
    • Withdrawal:
    • Coitus interruptus; ~73% effective due to pre-ejaculate sperm.
    • Free and suitable for those rejecting other methods.

New Research

  • Ongoing advancements in male contraception options besides vasectomy and condoms.

  • Candidates include:

    • RISUG: Reversible inhibition of sperm; injections serve for immobilizing sperm, effective for >99%.
    • Research into male hormonal contraceptives targeting spermatogenesis without testosterone interference.
    • Female Options: Continued improvement on current methods, easier hormonal delivery, and temporary fallopian tube blockers.

  • Combination Techniques:

    • Encourage combining various methods for enhanced effectiveness (e.g., spermicide + condoms).
    • Caution against harmful methods (e.g., douching, unverified herbal remedies).