Chapter 6

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  • Insert Table 6-4 Contraceptive Effectiveness
  • Figure 6-1: An IUD (Copper T-380A) properly positioned in the uterus.
  • Figure 6-2 Use of the male condom
  • Figure 6-3 The female condom properly positioned
  • Figure 6-4 Use of the diaphragm
  • Figure 6-5 The application of spermicide
  • Insert Table 6-3 Contraception Methods and STD Protection
  • Insert Table 6-2 contraceptive Risks
  • Figure 6-7 Vasectomy
  • Figure 6-8 Tubal sterilization
  • Chapter 6

    1. 1. Chapter 6© 2012 McGraw-Hill Companies. All Rights Reserved.
    2. 2.  Definitions:  Birth control: managing fertility and preventing unwanted pregnancy  Conception: the fusion of an ovum and sperm that creates a fertilized egg (zygote)  Contraception: preventing conception by blocking the female’s egg from uniting with the male’s sperm, thereby preventing pregnancy  Modern contraception is much more predictable and effective than in the past  Many contraceptives play a role in the prevention against sexually transmitted diseases © 2012 McGraw-Hill Companies. All Rights Reserved. 2
    3. 3.  Types of contraception  Barrier  Hormonal  Natural methods  Surgical methods Factors affecting choice  Advantages  Disadvantages Effectiveness  Contraceptive failure rate  Continuation rate © 2012 McGraw-Hill Companies. All Rights Reserved. 3
    4. 4.  Reversible contraception Estrogen and progesterone taken orally Mimics the hormonal activity of the corpus luteum  Corpus luteum secretes high levels of progesterone and estrogen to suppress ovulation Combination pill  Most common  1-month packet containing estrogen and progestins Extended-cycle pill  Seasonale, Seasonique, Lybrel Minipill Advantages Disadvantages Side effects Effectiveness © 2012 McGraw-Hill Companies. All Rights Reserved. 4
    5. 5.  Thin, 1-3/4 inch square patch Releases estrogen and progestin slowly into the bloodstream Prevention the same way as OCs Worn for 1 week, replaced on the same day for 3 consecutive weeks; no patch fourth week Advantages Disadvantages Effectiveness © 2012 McGraw-Hill Companies. All Rights Reserved. 5
    6. 6.  The NuvaRing Resembles the rim of a diaphragm and is molded with progestin and estrogen 2 inch ring slowly releases the hormones Prevents pregnancy the same way as OCs During fourth week, remove the ring, and use a new ring after the fourth week Advantages Disadvantages Effectiveness © 2012 McGraw-Hill Companies. All Rights Reserved. 6
    7. 7. Table 6.2 Risks of Contraception, Pregnancy, and Abortion© 2012 McGraw-Hill Companies. All Rights Reserved. 7
    8. 8.  Implanon (approved for use in the U.S. in 2006)  Hormonal method  Single implant  Effective for 3 years  Inhibits ovulation and affects the development of the uterine lining  Advantages  Disadvantages  Side effects  Effectiveness – the most effective method!© 2012 McGraw-Hill Companies. All Rights Reserved. 8
    9. 9.  Depo-Provera  Hormonal treatment  Injectable progestin usually given every 12 weeks  Advantages  Disadvantages o Can cause a reduction in bone density  Side effects  It may take 12 months before cycle returns  Effectiveness © 2012 McGraw-Hill Companies. All Rights Reserved. 9
    10. 10.  T-380A (ParaGard) up to 10 years of protection  Copper Levonorgestral (Mirena) up to 5 years of protection  Release small amounts of progestin Not exactly sure how it prevents pregnancy Advantages Disadvantages Effectiveness © 2012 McGraw-Hill Companies. All Rights Reserved. 10
    11. 11. © 2012 McGraw-Hill Companies. All Rights Reserved. 11
    12. 12.  Thin sheaths, almost all latex in the U.S. Protection against STDs Advantages Disadvantages Effectiveness  Use with spermicide © 2012 McGraw-Hill Companies. All Rights Reserved. 12
    13. 13. © 2012 McGraw-Hill Companies. All Rights Reserved. 13
    14. 14.  Called the “FC2” Synthetic, non-latex rubber sheath with two flexible rings Can be inserted up to 8 hours before intercourse Advantages Disadvantages Effectiveness © 2012 McGraw-Hill Companies. All Rights Reserved. 14
    15. 15. © 2012 McGraw-Hill Companies. All Rights Reserved. 15
    16. 16.  Dome-shaped cup of latex or silicone stretched over a collapsible metal ring  Custom fit by a doctor; available by prescription  Following intercourse, diaphragm must be left in place for at least 6 hours  Advantages  Disadvantages  Toxic shock syndrome (TSS)  Effectiveness© 2012 McGraw-Hill Companies. All Rights Reserved. 16
    17. 17. © 2012 McGraw-Hill Companies. All Rights Reserved. 17
    18. 18.  One-size-fits-alldiaphragm-like device Available by prescription Can be used by women allergic to latex Advantages Disadvantages Effectiveness © 2012 McGraw-Hill Companies. All Rights Reserved. 18
    19. 19.  Small silicone cap that fits snugly over the cervix Held in place by suction Must be fitted by a doctor Must place spermicide in the cup and on brim Must replace FemCap annually Advantages Disadvantage Effectiveness © 2012 McGraw-Hill Companies. All Rights Reserved. 19
    20. 20.  Round, absorbent device about 2 inches in diameter that fits over the cervix Presaturated with the same spermicide that is used in contraceptive creams and foams Advantages Disadvantages  Toxic shock syndrome (TSS) Effectiveness © 2012 McGraw-Hill Companies. All Rights Reserved. 20
    21. 21.  Foams, creams, jellies  Spermicidal suppository  Vaginal Contraceptive Film (VCF) Must be placed near the cervical entrance no more than 60 minutes before intercourse Must wait 6 hours post if user wants to douche Advantages Disadvantages Effectiveness © 2012 McGraw-Hill Companies. All Rights Reserved. 21
    22. 22. © 2012 McGraw-Hill Companies. All Rights Reserved. 22
    23. 23. Table 6.3 ContraceptiveMethods And STD Protection© 2012 McGraw-Hill Companies. All Rights Reserved. 23
    24. 24.  Abstinence  The choice not to engage in sexual intercourse Fertility awareness-based methods  Abstain from intercourse during the fertile phase of menstrual cycle  Methods: • Calendar methods • Temperature methods • Mucus methods Withdrawal  Penis removed from vagina before ejaculation © 2012 McGraw-Hill Companies. All Rights Reserved. 24
    25. 25.  Used after unprotected sexual intercourse Plan B, Plan B One-Step, Next Choice (OTC)  Most effective if taken within 12 hours afterwards  Can be taken up to 120 hours after intercourse  OTC for over age 17  Possible side effects: • Nausea • Stomach pain • Headache • Dizziness • Breast tenderness © 2012 McGraw-Hill Companies. All Rights Reserved. 25
    26. 26. Table 6.4 Contraceptives: From Most Effective toLeast (Percent of Women Experiencing UnintendedPregnancy Within the First Year of Use) © 2012 McGraw-Hill Companies. All Rights Reserved. 26
    27. 27.  Permanent contraception Vasectomy requires severing of the vas deferens May return to work in 2 days Semen tested in about 12 weeks Costs $400 to $1,000 in the U.S. Effectiveness © 2012 McGraw-Hill Companies. All Rights Reserved. 27
    28. 28. © 2012 McGraw-Hill Companies. All Rights Reserved. 28
    29. 29.  Tubal sterilization (tubal ligation) is most commonly performed by laparoscopy Essure system (2002)  Tiny, spring-like, metallic implants causing scarring that blocks the fallopian tubes Hysterectomy (removal of uterus) Complication rate 6-11% Reversibility © 2012 McGraw-Hill Companies. All Rights Reserved. 29
    30. 30. © 2012 McGraw-Hill Companies. All Rights Reserved. 30
    31. 31.  When is it OK to begin having sexual relations?  Society’s approach  Changing of attitudes with the changing of time  Answering personal questions Contraception and Gender Differences Sexuality and Contraception Education for Teenagers © 2012 McGraw-Hill Companies. All Rights Reserved. 31
    32. 32.  Key considerations include: 1. Health risks 2. Implications of unplanned pregnancy 3. STD risk 4. Convenience and comfort level 5. Type of relationship 6. Ease and cost of obtaining and maintaining each method 7. Religious or philosophical beliefs 8. Potential noncontraceptive benefits© 2012 McGraw-Hill Companies. All Rights Reserved. 32
    33. 33. Chapter 6© 2012 McGraw-Hill Companies. All Rights Reserved.

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