The Philippine Family Planning Program (DOCX)

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GROUP 2
Content Focus
Family Planning in the Philippines
Methods used to prevent population
Advantages and disadvantages to the users
THE PHILIPPINE FAMILY PLANNING PROGRAM (PFPP)
The Evolution of the Philippine FP Program
The FP Program has been implemented for about 38 years which started from a
demographic perspective to a health intervention oriented program.
In 1970's to mid-80's, PFPP started as a family planning service delivery
component to achieve fertility reduction to a contraceptive-oriented
approach. During 1986 to 1992, the program was reoriented from mere fertility
reduction to a health intervention by improving the health of women and
children. In 1993 to 1997 - the family planning program underwent another shift
that emphasized integration with other RH programs giving importance of
recognizing choice and rights of FP users. This shift was in line with the country's
commitments made in the International Conference on Population and
Development (ICPD), held in Cairo in 1994 and the Fourth World Conference on
Women, held in Beijing in 1995.
In 1998 to present - the Philippines has adopted and developed an RH policy
and framework with the goal of providing universal access to RH services with
family planning as the flagship program.
Implicit in this last condition is the right of men and women to be informed and
to have access to safe, effective, affordable, and acceptable methods of
family planning of their choice, and the right of access to appropriate health-
care services that will enable women to go safely through pregnancy and
childbirth and provide couples with and the freedom to decide if, when, and
how often to do so.
Four (4) Pillars / Guiding Principles of the PFPP
1. Responsible Parenthood is the will and ability to respond to the needs and
aspirations of the family. It promotes the freedom of responsible parents to
decide on the timing and size of their families in pursuit of a better life.
2. Respect for life. The 1987 Constitution protects the life of the unborn from
the moment of conception. FP aims to prevent abortions thereby saving
lives of both women and children.
3. Birth Spacing. Proper spacing of 3 to 5 years from recent pregnancy
enables women to recover from pregnancy and to improve their well-
being, the health of the child, and the relationship between husband and
wife, and between parents and children.
4. Informed choice. Couples and individuals are fully informed on the different
modern FP methods. Couples and individuals decide and may choose the
methods that they will use based on informed choice and to exercise
responsible parenthood in accordance with their religious and ethical
values and cultural background, subject to conformity with universally
recognized international human rights.

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PFPP COMPONENTS:
RESPONSIBLE PARENTHOOD / FAMILY PLANNING PROGRAM
General Objectives
Help couples/parents and individuals to achieve their desired number, timing
and spacing of children through responsible parenthood and to contribute in
improving maternal, neonatal and child health, and nutrition (MNCHN)
conditions
Specific Objectives:
 Reduce the unmet need of 2.2 million women by 2016
 Attain desired total fertility rate of couples at 2.4-2.96
 Increase Contraceptive Prevalence Rate from 50.7 % to 63 %;
 Reduce family planning unmet need from 22 % to 11%
 Reduce Maternal Mortality Rate from 162 to 52.2 deaths per 100,000 live
births
Program Strategies:
Contribute to the promotion of the Kalusugan Pangkalahatan through the
National Strategy to Reduce Unmet need for Modern Family Planning (DOH AO)
 The delivery of additional FP services shall be executed based on the
estimates of unmet need for FP in the following beneficiaries:
 NHTS-PR poor households living in MDG 12 areas
 NHTS-PR poor households living the priority 609 municipalities;
 All other NHTS-PR poor households not included in items 1 & 2 above
National Strategy to Reduce Unmet need for Modern Family Planning (DOH AO)
 The procurement and distribution of commodities will be streamlined
 LGUs shall take the lead in implementing FP programs and services with
assistance through grants, commodities, facility enhancement, technical
assistance, and capacity building from DOH
 FP services are to be provided to poor families with zero co-payment on
their part
 Social and behavioral change communication activities will be customized
and delivered at the interpersonal level
 Each province or city-wide health system shall carry out measures to
reduce unmet need for modern FP
Role of Popcom
 Identify the medium and long term quantifiable estimates to reduce unmet
need for modern FP
 As lead technical resource for FP advocacy particularly for LGU officials
and LGU capacity for demand generation
 Take the lead in designing and conducting demand-generation activities
based on the communication plan for LGUs
 Shall launch advocacy and IEC campaigns on FP with emphasis on
interpersonal communication to families through mechanisms like the
Community Health Teams
 Provide technical and operations support in the monitoring and reporting of
progress in reducing unmet need for modern FP

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Role of Local Government Units (LGUs)
 Execute the major steps needed to reduce unmet need
 Ensure demand generation initiatives
 Support the institutionalization of the participation of community-based
volunteers in the locality for demand generation by providing incentives for
their follow-ups
 Allot budget for the translation to local dialects the IEC materials
 Mobilize and support local population officers/workers and barangay
service point officers (BSPOs) or their designates to be the focal/resource
persons in the conduct of the RP/FP module of the 4Ps FDS, as well as to be
in-charge of overall reporting and monitoring of all RP/FP classes
 Ensure contraceptive self-reliance
Other Program Strategies
Other contributions to the promotion of the Kalusugan Pangkalahatan
 Conduct RP/FP classes
 Organize and mobilize community-based health volunteers for MNCHN
 Track and provide FP services to couples who have unmet need for family
planning
 Follow up couples and supply/resupply FP commodities
 Facilitate PhilHealth accreditation of local health facilities and advocacy
for the enrolment of poor families to the PhilHealth Sponsored Program.
 Strengthen and expand participation of NGOs and the private sector in the
provision of RP/FP information and services through public-private
partnership
 Continuing capacity building of service providers, population workers and
volunteers on RP/RH/FP
 Implement vigorous communication and advocacy campaign for policy
and budget support from national and local executives for RP/RH/FP
program and to improve the consciousness of the public on RP/RH/FP issues
 Pursue continuing advocacy for the enactment and implementation of
national and local responsible parenthood and family planning policies
(e.g.RH Bill)
 Establish knowledge and database system for policy and program and
plan formulation
 Promote responsible parenthood through RPM/FP classes and Pre-Marriage
Counselling Program
 Promote, operationalize, and sustain men's involvement in RP/RH/FP
 Conduct of operations research and documentation of good practices for
replication
 Strengthen the On-line Reporting System on RP/FP and work for its
harmonization with existing health database systems
Design and implement innovative strategies to address the socio-economic
factors hindering the exercise of reproductive rights of poor couples
 Integration of entrepreneurship or livelihood strategies in RPM program
 Integration of RPM with ALS among less educated women
 Integration of RPM in poverty reduction strategies

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ADOLESCENT HEALTH AND YOUTH DEVELOPMENT PROGRAM
General Objectives
Promote healthy lifestyle and responsible sexuality and assist the youth to avoid
early sexual engagement, teenage pregnancies, early marriages, sexually
transmitted infections and other psycho-social concerns.
Specific Objectives
 Reduce the incidence of pregnancy among 15-19 age group;
 Reduce the incidence of early sexual involvement and early
marriages;
 Reduce the incidence of other reproductive health problems that
includes sexually transmitted infections (STIs)and HIV/AIDS, particularly
the reduction of HIV positive cases among young males; and
 Reduce the incidence of physical and sexual violence and other
forms of violence among the young people, particularly among
married young females ages 15-24.
Program Strategies
 Development of a harmonized master plan for AHYD
 Advocate for the implementation existing policies that ensure the
promotion of an enabling environment for the adolescent and youth
including access to quality health care and services.
 Design and implementation of policies and programs to address
emerging issues among young people ( cybersex, suicide, sex
trafficking)
 Advocate for the establishment of more teen health quarters, drop-in
centers, "t ambayans", and the likes at the community, work place
and schools
 Continued skills development among parents on ASRH concerns
 Develop life planning skills focused on goal setting and leadership
among the young people
 Creation of opportunities for youth to re-channel and optimize their
energies to more productive activities (e.g livelihood).
 Up-scaling the mode of information and education that will be
imparted to the young people that is age-sex appropriate, values-
laden, and anchored on the rights-based approach
 Federation/organization of the young people to lead advocacy
activities and ensuring their participations in the planning and
formulation of programs/projects/policies
 Continuous conduct of researches on adolescent/youth health and
development concerns such as the YAFSS
 Harmonization, updating, and maintenance of a database on
adolescent/youth health and development that is age and sex
disaggregated.
POPDEV INTEGRATION
General Objectives
Contribute to policies and programs that will assist government to attain
population growth and distribution consistent with economic activities and
sustainable development.
Specific Objectives

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 Contribute in achieving a well managed population growth and
distribution consistent with the country's social and economic
development
 Contribute in achievement of other socio-economic outcomes such
as reduction of poverty incidence, malnutrition, infant and child
mortality, unemployment rate and improvement of other
development concerns by addressing population concerns
 Promote and integrate population dimensions in national, regional,
sectoral, and local development initiatives to contribute to effective
population management and sustainable development policies and
programs
 Develop enabling environment for government at all levels to
manage effects of rapid urbanization
Program Strategies
 Development and conduct of communication strategies (IEC, social
mobilization, BCC) to raise appreciation on population issues
 Enabling national, local and sectoral key stakeholders in integrating
population dimensions in planning and policy development;
 Advocacy and capacity-building for enacting, designing,
implementing, and monitoring population-related policies and
programs at all levels
 Design and conduct of researches and studies and establishment of
database systems on POPDEV for planning and policy development
 Development of monitoring and evaluation tool for POPDEV
integration in development planning
 Enabling regional and local executives, planners, and other
stakeholders in efficient urban planning and management
FAMILY PLANNING METHODS
A couple can practice family planning in various ways depending on their
family planning goal - spacing of children, completing the number of children or
aspiring to have more children. These are:
Temporary Methods
1. Natural Family Planning (NFP) or Fertility-Based (FAB) methods.
Natural Family Planning (NFP) is an educational process of determining the
fertile and infertile periods of a woman by observing physiologic signs and
symptoms of the menstrual cycle so that intercourse may be timed to avoid or
achieve.
Fertility Awareness refers to the recognition of fertile and infertile phases of a
woman's reproduc-tive cycle.
Importance:
To understand that men and women are not only gifted with the ability to
reproduce, but with the ability and capacity to understand and fully appreciate
our fertility. That the human body is, by itself, already equipped with mechanisms
for the natural management of fertility. Empowers the person to make a truly
healthy, informed and responsible decision on his/her family life aspirations.

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Fertility is the capacity of a person to conceive and bear children. It is part of
being a man and a woman; and is an integral element in human sexuality.
Men are always fert ile
 A boy achieves his reproductive capability with puberty around age 12-14,
on the aver-age.
 At puberty the testicles produce sperm cells under the influence of the
hormone testos-terone.
 Barring injury to his reproductive system or illness, a normally healthy man
continues to produce sperm cells throughout his entire life.
 Approximately 50,000 new sperm cells are produce each minute, with as
many as 100 million produced each day.
 There are 300-500 million sperm cells in a normal ejaculation.
 Production of sperm continues throughout his entire life.
 If it were up to the man, pregnancy would result with every act of
intercourse.
Women are at most t imes infert ile
 Girls achieve reproductive capability earlier than boys, on average
menarche starts at 10-12 years of age.
 With puberty menstrual cycles begin usually quite irregularly.
 The ovum or egg is the woman's component to fertility, stored in the two
ovaries.
 All the eggs a woman will ever have are present at her birth, approximately
200,000 - 400,000 in number.
 The egg lives for a day.
 Women of reproductive age become fertile for just a few days at a time
during each monthly cycle, when the egg is mature and is released.
 Her fertility ends at menopause, when a woman's menstruation stops.
Human Sexuality is a function of the entire personality of an individual. It
develops continuously from birth into adulthood and beyond.
It includes;
 how he/she feels about himself/herself
 how he/she feels about being a man or a woman
 how he/she relates to the opposite sex
 It also includes genital, reproductive and other physical and physiological
processes associated with sexual contact and child bearing.
Combined Fertility or joint fertility is the equal contribution of the male (sperm)
and female (egg) in the decision and ability has a child.
THE TYPES OF SCIENTIFIC NFP METHODS ARE:
 Mucus/Ovulation or Billings Ovulation Method
 Basal Body Temperatur (BBT)
 Symptothermal Method (STM)
 Standard Days Method (SDM)
WHO CAN PRACTICE NFP?
 Women or couples of any reproductive age (15-49 years old) and parity
 Women or couples with religious or philosophical reasons for not using other
methods

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 Women or couples who are unable to use other methods
 Women or couples willing and motivated to observe, record and interpret
fertility signs.
THE ADVANTAGES OF NFP:
 no chemical agents taken nor objects placed in the body
 no invasive procedures like injections or surgery
 no side effects, high method effectiveness either for spacing or achieving a
pregnancy
 no contraindications
 free/inexpensive
 medical supervision is not required
 provides value-based marital bonding
THE DISADVANTAGES OF NFP:
 requires daily observation and charting
 uncooperative husband
 requires training
 requires abstinence during the fertile phase to avoid pregnancy
 does not protect against sexually transmitted diseases
MUCUS/OVULATION OR BILLINGS OVULATION METHOD
- is the daily observation of the naturally occurring changes of cervical mucus
during the different phases of a woman's menstrual cy-cle. The sensation of
wetness or dryness are observed throughout the day and recorded in the chart.
During dry days, it is safe to have lovemaking every other night , during wet days,
avoid lovemaking to prevent pregnancy.
Mechanism of Act ion
Cervical mucus is to the woman what seminal fluid is to man. This special
substance lodge itself at the cervical crypts that function as a filtering
mechanism against the entry of abnor-mal sperm into the cervix; protect the
sperm from the acidic vulva and lubricates the sperm to ensure motility, mobility
and viability in his journey to the fallopian tube to meet the egg.
When a woman is fertile, the cervical mucus:
1. Nourishes the sperm,
2. Form channels to help the sperm swim to the egg faster,
3. Filters out abnormal sperms so they do not reach the egg.
When a woman is infertile, the mucus forms a plug to prevent any sperm from
meeting the egg.
The mucus and sensations a woman experience on the days when she is fertile is
different from the mucus and sensations on the days when she is infertile. A
woman can learn to tell the difference and use this information to plan or
prevent a pregnancy.
Observing t he Mucus
Mucus observation is outlined below in terms of who, what, where and how.
Who observes? The woman observes.
What does the woman observe? A woman observes: The sensation of wetness
or dryness, and the appearance of the mucus. Another way to say this is that
the woman should observe: What she feels, and What she sees.

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Where does the woman observe? Outside the vagina. At the vulva.
When does the woman observe? Throughout the day. A good time to observe is
before or after urinating. This observation starts on the first day of menstruation.
How does a woman observe? Asking "How do I feel/" Looking at the mucus in
the un-derwear and asking. "What do I see?"
Recording t he Mucus Observat ion in t he Chart
It is important to record all observations in a chart or use a color coded learning
tool as a guide for fertile and infertile days.
Sensation is very important. Throughout the day the presence or absence of
mucus will be recognized by the sensation at the vulva (the vaginal lips), the
way the beginning of a period is noticed. The sensation may be a distinct feeling
of dryness, dampness, stickiness or slipperiness, lubrication or wetness.
The appearance. Soft white toilet tissue should be used to blot or wipe the vulva.
There may be dampness only or moistness. This moistness soaks into the tissue
and any cervical mucus will appear raised as a blob on the tissue. Mucus is
often noticed on underclothing, where it will have dried slightly causing some
alteration in its characteristics.
Mucus should be observed throughout the day and the chart marked each
evening. This allows changes to become apparent during the day.
 Each day of a period or blood loss, including spotting, is marked with a "R"
 Each day when there is a dry sensation at the vulva, and no visible mucus is
marked with a "D"
 Each day of sticky white/creamy mucus is marked with an "M"
 Each day of highly fertile wet or slippery, transparent, stretchy mucus is
marked with an "X"
 Peak Day: last day of wetness should be marked X
A woman should describe the mucus in her own words.
 Sensation: e.g. moist, sticky, stretchy, wet, slippery.
 Appearance or color on soft, white toilet tissue: e.g. white, pasty, cloudy, or
transparent. Fer-tile-type mucus may be slightly blood-tinged.
 Consistency may be described as sticky, thready or stretchy.
In practice the characteristic of mucus changes may not be well defined. There
may be a combination of two types of mucus, e.g. cloudy, thready mucus with
some transparent stretchy mucus. The mucus possessing the more fertile
characteristics should be recorded.
To avoid pregnancy:
 After menses, any mucus observation following dry days signify the
beginning day of the fertile period. Abstain throughout the mucus days.
 Identify the Peak Day X the last day of wetness, slipperiness, stretchiness
seen or felt. Fertile days end two days after peak.
 Count 2 post peak days of sticky mucus, or dry days following the peak.
These days are not available for lovemaking.
 Apply Peak Day Rule. On the 3rd day after the peak until the day before
the next menstruation, all days are considered infertile. Couple can resume
lovemaking, and will not result in pregnancy.

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
To achieve pregnancy:
Time lovemaking on the peak day, the day before Peak Day, or the day after
Peak Day. When mucus appears for only a short time, or even for part of a day,
it is important to have lovemaking at this time. Precision and timing are
extremely important and this would be suf-ficient for conception to take place.
Changes in cervical mucus during the fertility cycle
Pre-ovulat ory infert ile phase
Following the menstrual period there may be several dry days. These days may
be absent in short cycles and numerous in long cycles. A feeling of dryness or a
positive sensation of nothingness at the vulva will be experienced. There will be
no visible mucus.
Ovulat ory phase
 As the estrogen levels rise, cervical mucus will be felt at the vulva. At first it
will give a sensation of moistness or stickiness and will appear in scant
amounts -white or flour-like pastry mucus.
 The mucus goes through a transitional phase where increasing amounts of
cloudy mucus secretion may be observed. It may be slight ly stretchy
producing a wet sensation at the vulva.
 As the estrogen levels continue to rise with approaching ovulation, the
mucus will be-come more profuse, and there may be up to a tenfold
increase in volume. It will give a sensation of lubrication or slipperiness at the
vulva. The appearance will be similar to that of raw egg white, thin, watery
and transparent.
 Fertile mucus maintains the life of sperm nourishes it and allows it to pass
freely through the cervix. In fertile mucus, the sperm may live for up to three
days, in rare circumstances; it may live up to five days or even longer.
 Peak day. Peak day denotes the LAST day on which this highly fertile-type
slippery, transparent stretchy mucus is either seen or felt.

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Post -ovulat ory complet ely infert ile phase
 During the post-ovulatory phases following peak day, the slippery sensation
is lost and there will be a relatively abrupt return to stickness or dryness
again.
 This subjective symptom reflects the presence of progesterone, which
thickens the mucus again forming a plug at the cervix acting as an
imperative barrier to sperm or protects the growing baby from any
bacteria.
 The amount and quality of mucus will vary from woman to woman and also
from one cycle to the next.
 Any mucus observed during the post-ovulatory infertile phase can be
disregarded for the mucus is related.
BASAL BODY TEMPERATURE (BBT)
- is the daily charting of a woman's body temperature at rest at the same time
each morning before she gets out of bed. The woman's temperature rises 0.2 to
0.5 degrees centigrade around the time of ovulation. The couple avoids
lovemaking from the first day of menstruation until the temperature has risen
above her regular temperature and stayed up for 3 full days. After this, the
couple can have lovemaking until next menstrual bleeding begins.
Recording and Chart ing t he Basal Body Temperat ure
 The temperature should be taken at the same time each morning
immediately on waking after at least three hours uninterrupted sleep,
before getting out of bed, drink-ing tea or any other activity.
 Begin on the first day of the cycle (first day of menses).
 Basal body temperature may be taken by the mouth, axillary or rectal for
five min-utes. Oral temperatures usually give satisfactory results if exact
instructions are fol-lowed.
 Daily readings should be taken through the same route for consistency and
better in-terpretation.
 Record the temperature on the BBT chart. The chart is marked with the
temperature reading by a dot in the center of the appropriate square. The
dots should be joined to form a continuous graph.
 Determine the coverline by identifying the first 10 temperature. Disregard
days one to five. Find the highest temperature from day six to ten. Draw
ahorizontal line on the highest of the temperatures from day six to ten. This is
the coverline.
 Continue taking the temperature until the thermal shift is identified. The
thermal shift is consecutive temperature recordings above the coverline.
This indicates that ovula-tion has taken place.
 Draw a vertical line between days 2 and 3 of the thermal shift. From day 3
until the next menstruation, all days are available for lovemaking without
fear of getting preg-nant. This is the infertile phase. From day 2 of the
thermal shift to the first day of the cycle is the fertile phase
 If one or more temperature reading are missed do not join non-consecutive
dots.
 Anything unusual should be noted on the chart, such as a cold, a late
night, drinking alcohol, or any stressful situation.

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Cover line and Thermal Shift
A horizontal line joining the highest temperature of the low temperatures from
cycle days six (6) to ten (10). Thermal shift is the three (3) consecutive elevations
of temperature above the cover line, one of which is 0.2 degrees centigrade
above the cover line. These three temperature elevations are numbered 1, 2, 3
respectively. A vertical line is drawn between 2 and 3. To the left of the vertical
line are the fertile days while to the right of the vertical line are the infertile days.
The infertile phase commences on the third undisturbed high temperature that
has been recorded.
SYMPTOTHERMAL METHOD (STM)
- is the combination of the observation of the cervical mucus changes, low and
high temperature changes and secondary signs and symptoms of fertility before
and after ovulation. The couple should avoid lovemaking until both the peak
day and thermal shift rules have been applied.
Symptothermal applies a multiple index fertility indicators to determine the
beginning and end of fertile an infertile days of the menstrual cycle. This is done
through the observation and interpretation of cervical mucus, basal body
temperature, cervical changes, secondary sign and symptoms of ovulation and
cycle length.
Mechanism of Act ion
The sympto-thermal method adopts the temperature and mucus observation to
indicate a woman's state of fertility. However, some women find that monitoring
changes directly at the cervix gives additional support and adequate
information. In special circumstances, such as stress, illness, breast -feeding and
the pre-menopause, it can give valuable early warning signs of approaching
fertility.
How t o est ablish fert ile and infert ile days (basal body t emperat ure)
1. Record your temperature reading by marking a dot inside the box at the chart.
2. Identify first 10 temperature readings of the cycle.
3. Disregard temperature on days 1-5.

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4. Find the highest temperature on days 6-10, disregard any temperature reading
that is abnormally high due to illness.
5. Draw a horizontal line along the highest temperature on days 6-10. This is the
coverline or baseline.
6. After coverline is established, identify the first three consecutive temperature
above the coverline and mark 1, 2, 3 respectively.
7. Draw a vertical line between day two and three from the top to the bottom of
the chart.
8. Fertile days are days to the left of the vertical line and infertile days are all days
to the right of the vertical line.
9. Post-ovulatory infertile phase starts on the 3rd day of consecutive rise of
tempera-ture above the coverline or the 3rd day after the peak whichever
come later.
How t o est ablish t he beginning and end of fert ile and infert ile day (cervical
mucus met hod)
 After menses, any change from dry sensation to wet sensation is the beginning
of fertile days and ends at 2 days after peak.
 Identify Basic Infertile Pattern Dry (BIP Dry) or Basic Infertile Pattern Mucus (BIP
Mucus) after menses. BIP are consecutive dry days or consecutive sticky mucus
days after menses.
 Identify your peak day. X
 Mark Post Peak Day with 1,2
 Continue observation and charting in the next 2 months/cycles. Apply Peak Day
Rule.
 Check husband's feeling and one's feeling on the "waiting time".
 Apply Early Days Rule (EDR) which is lovemaking only on alternative evening
during pre-ovulatory phase of the 3rd cycle.
Plan lovemaking on:
 - Evening of alternate dry days only after menses (BIP dry)
 - 3rd day after peak till the day before next menses
 - For short cycle women (less than 25 days avoid lovemaking beginning men-ses
until peak day + 1, 2.
For Symptothermal Method, combine BBT (Body Basal Temperature) rules and
OM/BOM (Ovulation Method/Billings Ovulation Method) rules which ever come
later is applied, to identify one's post-ovulatory infertile days.

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STANDARD DAYS METHOD (SDM)
- is a new method in which all users are counseled to abstain from sexual
intercourse on days 8-19 of any cycle to avoid pregnancy among women with
menstrual cycle between 26 and 32 days. The couple uses a device, the color
coded "Cycle Beads" to mark the fertile and infertile days of their menstrual
cycle.
Who can use t he met hod?
The SDM works well for women who usually have menstrual cycles between 26
and 32 days long.
Who cannot use t he met hod?
Women with cycles not within 26-32 days cannot use the method.
How t o use t he met hod?
Before using the SDM, the client should consult trained family planning workers
who will assess conditions that may prevent her from using the method. The
service provider can teach clients how to use the method.
 The cycle beads have 32 beads, which represent the menstrual cycle. It has
1 red bead which represents the first day of menstruation, followed by 6
brown beads which represents the days that a woman cannot get
pregnant, then 12 white beads which represent the days that a woman
can get pregnant, and 13 brown beads that also represent the days that a
woman cannot get pregnant.
 The user/client moves the rubber ring to the red bead on the first day of
menstruation. The date of the first day of menstruation should be recorded
in the SDM card. This can be used later to remember if the marker has been
moved or not.
 The client should move the marker to the next bead every morning. The
marker should always be moved in the same direction, from the narrow to
the wide end.
 Among the 13 brown beads is a dark brown bead. This marks the 26th day
of the cycle. If the next menstruation comes before this bead then the
client has a cycle less than 26 days.
 Between the last brown bead and the red bead is a small black bead. If
the next mentruation falls on or beyond this bead, this means that the cycle
is longer than 32 days.
 On the day the period starts again, she should move the marker to the red
bead. This means a new cycle has started.
2. Pills - contain hormones, in different proportion; comes in 21 or 28 pill packs
taken daily. The pill prevents ovulation and thickens the cervical mucus,
which prevents the sperm from entering the uterus
HEALTH BENEFITS AND ADVANTAGES
Birth control pills provide certain health benefits in addition to preventing
pregnancy.
 Highly effective reversible contraception. Birth control pills provide highly reliable
contraceptive protection, exceeding 99%. Even when imperfect use (skipping

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an occasional pill) is considered, the BCPs are still very effective in preventing
pregnancy.
 Menstrual cycle regulation. Birth control pills cause menstrual cycles to occur
regularly and predictably. This is especially helpful for women with periods that
come too often or too infrequently. Periods also tend to be lighter and shorter.
 Reduce menstrual cramps. Birth control pills can offer significant relief to women
with painful menstrual cramps (dysmenorrhea).
 Decreased risk of iron deficiency (anemia). Birth control pills reduce the amount
of blood flow during the period. Less blood loss is helpful in preventing anemia.
 Reduce the risk of ovarian cysts. The risk of developing ovarian cysts is greatly
reduced for birth control pills users because they help prevent ovulation. An
ovarian cyst is a fluid - filled growth that can develop in the ovary during
ovulation (the release of an egg from an ovary).
 Protection against pelvic inflammatory disease. Birth control pills provide some
protection against pelvic inflammatory disease (PID). Pelvic inflammatory
disease is a serious bacterial infection of the fallopian tubes and uterus that can
result in severe pain and potentially, infertility.
 Can improve acne. Birth control pills can improve acne. For moderate to severe
acne, which other medications can't cure, birth control pills may be prescribed.
The hormones in the birth control pill can help stop acne from forming.
 Reduces the risk of symptomatic endometriosis. Women who have
endometriosis tend to have less pelvic pain and fewer other symptoms when
they are on the Pill. Birth control pills won't cure endometriosis but it may stop the
disease from progressing. The pills are the first-choice treatment for controlling
endometriosis growth and pain. This is because birth control hormones are the
hormone therapy that is least likely to cause bad side effects.
 Improves fibrocystic breasts. 70 - 90% of patients see improvement in the
symptoms of fibrocystic breast conditions with use of oral contraceptives.
 Improved excess hair (hirsutism). Women with excessive facial or body hair may
notice an improvement while taking the Pill, because androgens and
testosterone are suppressed by oral contraceptives. High androgen levels can
cause darkening of facial and body hair, especially on the chin, chest, and
abdomen.
 Prevents ectopic pregnancy. Because birth control pills work primarily by
suppressing ovulation, they effectively prevent ectopic pregnancy as well as
normal pregnancy. This makes the pills an excellent contraceptive choice for
women who are at particular risk for ectopic pregnancy, a potentially life-
threatening condition.
 Helps prevent osteoporosis. Several studies show that by regulating hormones,
the pill can help prevent osteoporosis, a gradual weakening of the bones.
However, the results of different studies are conflicting (1-3).
 Does not affect future fertility. Using the pills will not affect a woman’s future
fertility, although it may take two to three months longer to get pregnant than if
a woman did not take pills.
 Easy to use. Does not interrupt foreplay or sexual intercourse.
 Safe for many women. Research for over 40 years has proven long term safety.
RISKS AND DISADVANTAGES
About 40% of women who take birth-control pills will have side effects of one
kind or another during the first three months of use. The vast majority of women
have only minor, transient undesired effects. Some side effects are uncommon
but may be dangerous.

15
 Heart attack. The chances of birth control pills contributing to a heart attack are
small unless you smoke. Studies have shown that smoking dramatically increases
the risk of heart attack in women age 35 years or older, which is why pills are
generally not prescribed to women in this age group who smoke.
 Blood pressure. Women taking birth control pills usually have a small increase in
both systolic and diastolic blood pressure, although readings usually remain
within the normal range. Blood pressure should be closely monitored for several
months after a women starts taking oral contraceptives, and followed yearly
thereafter.
 Migraines and stroke. Women who take oral contraceptive and have a history
of migraines have an increased risk of stroke compared to nonusers with a
history of migraine4.
 Blood clots (Venous thromboembolism). Women who use birth control pills are at
a slightly increased risk of having a blood clot in the legs or lungs. Studies
consistently show that the risk of venous thromboembolism (VTE) is two to six
times higher in oral contraceptive users than in nonusers. The risk of blood clots is
highest in women with clotting disorders or who have previously had a deep
venous thrombosis or pulmonary embolism. Other risk factors include obesity,
older age, having several family members who've had blood clots before old
age, air travel, and having to lie or sit for a prolonged period, as you might after
major surgery.
 Headaches. Headaches may start in women who have not previously had
headaches, or can get worse in those who do.
 Depression. Depression (sometimes severe) and other mood changes may
occur.
 Nausea and vomiting. This side effect usually goes away after the first few
months of use or can be prevented by taking the pill with a meal.
 Breast tenderness. Your breasts may become tender or may get larger. Breast
tenderness is relatively common during the first month of BCPs and uncommon
thereafter.
 Breakthrough bleeding or spotting. Spotting or bleeding between menstrual
periods is very common in the first cycle of pills or if pills are missed or taken late.
 Decreased enjoyment of sex. Some women experience a decreased interest in
sex or a decreased ability to have orgasms.
 Weight gain. Some women report slight weight gain. Weight gain is often
caused by fluid retention or estrogen-induced fat deposits in the thighs, hips,
and breasts. Weight gain may also be related to a reduction in physical activity
or increased intake of food. In some women the androgenic effects from the
progestin in their OCs can increase their appetite.
 Chloasma (spotty darkening of the skin on the face). Darkening of the skin on
the upper lip, under the eyes, or on the forehead (chloasma). This may slowly
fade after you stop taking the pills, but in most cases, it is permanent.
 Drug interactions. Birth control pills may not be as effective if you are taking
certain medications. Some antibiotics, antifungal, anticonvulsants, herbs like St.
John's Wort, can change the amount of the contraceptive hormones absorbed
by the stomach and the metabolism of these hormones.
 Not suitable for everyone. Some women should not take pills if they have
specific health conditions, including some types of diabetes, liver disease, and
cardiovascular disease. Women with risk factors for heart disease, such as those
with high blood pressure or who are obese are also at higher risk when on the
Pill.
 Sexually transmitted diseases. Birth control pill does not offer any protection
against sexually transmitted infections.

16
 Must be taken every day. You must remember to take the pills at the same time
every day. Pills must be taken every day, even if a woman does not have
intercourse that day. Must use a secondary form of birth control for the initial
seven days of use.
 Diarrhea or vomiting. Anything that makes the pill go through your system too
fast can make the pill not work as well because it was not absorbed or, worse, if
it is lost in the vomit.
 Glaucoma. Taking oral contraceptives for more than 3 years significantly
increases the risk of glaucoma7.
 Progestogen-only contraceptives may worsen the results of the glucose
tolerance test.
 Cost. The pill costs more than other methods of contraception.
LONG-TERM USE AND RISK OF DEATH
Latest 2014 study revealed that risk of death did not significantly differ between
women who had ever used birth control pills and those who had never used
them.
3. Intra-uterine device (IUD) - is a small device that is inserted into the uterus
through the vagina. The IUD prevents sperm from meeting the egg.
ADVANTAGES
•More than 99% effective in preventing pregnancy1
•Most cost-effective method of birth control over time
•Easy to use
•Does not require interruption of foreplay or intercourse
•Does not require cooperation of sexual partner
•Safe to use while breast-feeding
•Can be removed whenever you have problems or want to stop using it. Fertility
returns with the first ovulation cycle following IUD removal.
•Hormonal IUD can relieve heavy menstrual bleeding and cramping in most
women
•Copper IUD can be used for emergency contraception within 5 days of
unprotected intercourse
•Can be inserted after a normal vaginal delivery, a cesarean section, or a first -
trimester abortion
DISADVANTAGES
•Costs several hundred dollars for insertion. (This cost may be covered by your
health insurance. Some community clinics may offer insertion and removal at a
reduced rate or free to low-income clients.) If the IUD is expelled, it costs just as
much to get a new one. Having an IUD removed is also costly. However, if an
IUD is used for 5 years or longer, it is the most cost-effective form of birth control.
•Only a health professional can remove the IUD. Never attempt to remove the
IUD yourself or allow a partner to try to remove it.
•Does not provide protection against sexually transmitted diseases (STDs) or HIV.
(A condom is needed for STD protection.)

17
•When inserted, can spread a genital infection into the uterus, leading to pelvic
inflammatory disease (PID) in the first months after insertion. This is why you are
screened for STDs before getting an IUD.
4. Injectable - is injected in the arm or in the buttocks. It may be administered
every 3 months or monthly depending on the preparation. The injectable
thickens the cervical mucus which prevents sperm from entering the uterus,
stops ovulation and causes changes in the uterus and fallopian tubes,
which prevents fertilization.
HOW DOES THE CONTRACEPTIVE INJECTION WORK?
The progestogen is injected into a muscle and then is gradually released into
the bloodstream. It works mainly by stopping the release of the egg from the
ovary (ovulation). It also thickens the mucus made by the cervix which forms a
mucus plug. This stops sperm getting through to the womb to fertilise an egg. It
also makes the lining of the womb thinner. This makes it unlikely that a fertilised
egg will be able to implant in the womb.
HOW EFFECTIVE IS THE CONTRACEPTIVE INJECTION?
It is very effective. Between 2-60 women in every 1,000 using it will become
pregnant after two years. Compare this to when no contraception is used. More
than 800 in 1000 sexually active women who do not use contraception become
pregnant within one year.
WHAT ARE THE ADVANTAGES OF THE CONTRACEPTIVE INJECTION?
•You do not have to remember to take a pill every day. You only have to think
about contraception every 2-3 months.
•It does not interfere with sex.
•It can be used when breast-feeding.
•It may help some of the problems of periods, such as premenstrual tension,
heavy periods and pain.
•It can be used by some women who cannot take the combined pill.
•It may help to protect against pelvic infection. The mucus plug in the cervix
may stop bacteria travelling into the womb.
WHAT ARE THE DISADVANTAGES OF THE CONTRACEPTIVE INJECTION?
•The injection cannot be removed once given. Any side-effects will last for more
than 2-3 months, until the progesterone goes from your body.
•As the injection is long-acting, it takes some time after the last injection to
become fertile again. This time varies from woman to woman. Some women
may not ovulate for 6-8 months after the last injection. Rarely, it can take up to
two years before fertility returns. This delay is not related to the length of time you
use this method of contraception.
•Your periods are likely to change. During the first few months some women
have irregular bleeding which can be heavier and longer than normal.
However, it is unusual for heavy periods to persist. After the first few months it is

18
more common for the periods to become lighter than usual, although they may
be irregular. Many women have no periods at all. The longer it is used, the more
likely periods will stop. Periods stop for about 7 in 10 women after they have had
the injection for a year.
Some women find that having unpredictable or irregular periods can be a
nuisance. However, if you do develop irregular bleeding while receiving the
injection then you should inform your doctor. Irregular bleeding can sometimes
be due to another reason, such as an infection. This may need to be treated.
ARE THERE ANY SIDE-EFFECTS WITH THE CONTRACEPTIVE INJECTION?
Apart from changes to periods, side-effects are uncommon. If one or more
should occur, they often settle down over a couple of months or so. Examples of
possible side-effects include weight gain, fluid retention, increase in acne and
breast discomfort.
The most common reason for women to stop having the injections is because of
irregular bleeding.
The injection can lead to some thinning of the bones. This does not usually cause
any problems and the bones revert back to normal when the injections are
stopped. Using injectable contraception for many years would lead to more
bone thinning. It is therefore recommended that you have a review every two
years with your doctor or nurse. They will discuss if this method is still the best one
for you.
Very occasionally, the injection can cause some pain or swelling at the site
where the injection was given. You should see your doctor or nurse if you have
any signs or symptoms of infection at the site of injection (for example, redness
or swelling).
WHO CANNOT HAVE THE CONTRACEPTIVE INJECTION?
Most women can have the contraceptive injection. Your doctor or family
planning nurse will discuss any current and past illnesses. For example, you
should not have it if you have recently had breast cancer or have hepatitis.
If you have risk factors for osteoporosis (thinning of the bone) then it is normally
advisable to use another method of contraception. Examples of risk factors
include not having a period for six months or more (as a result of over-exercising,
extreme dieting or eating disorders), heavy drinking or a close family history of
osteoporosis.
HOW IS THE CONTRACEPTIVE INJECTION GIVEN?
The injection is given into a muscle, usually in the buttock. It should not be given
during pregnancy. It is therefore important to be sure you are not pregnant
when you have your first injection.
For this reason the first injection is usually given during the first 1-5 days of a
period. If you have the injection within five days of starting a period, you will be
protected immediately. Further injections are then given up to 12 weeks apart,
depending on the type used. If you are unable to make an appointment within
that 5 day window, you can have the injection anytime, as long as you are
reasonably sure you are not pregnant. Your practice nurse or doctor will advise

19
you to use extra contraception (such as a condom) for 7 days after the
injection. This what is called an 'off label use' and not all practices will allow it.
The doctor or nurse will tell you which type of injection you have and how long it
is until the next injection. It can be given up to two weeks early. This may be
convenient if, for example, you are due to be on a holiday when your next
injection is due.
5. Condom - is a rubber sheath worn over the penis during sexual intercourse
thus preventing the sperm from entering the vagina.
A male condom is a thin sheath that covers the penis during intercourse and is
made of one of the following materials:
 Rubber (latex)
 Plastic (polyurethane): the best alternative for people allergic to
latex
 Lambskin
Male condoms can vary greatly in color, size, and amount of lubrication and
spermicide.
The male condom protects against sexually transmitted infection
(STI) and pregnancy by covering the penis and preventing direct contact
between the penis and vagina, as well as collecting the semen and preventing
it from entering the vagina.
HOW IS IT USED?
The male condom is rolled over the erect or hardened penis and prevents
against direct contact between the penis and vagina. The condom must be
removed before the erection ends or the sperm can leak out. Use the condom
once only, then throw it in the garbage. Do not flush it down the toilet.
DOES IT PROTECT AGAINST STIS?
Yes. The latex condoms can protect against STIs includingHIV. Testing of the
plastic, polyurethane condoms suggests that they also protect against
infections; however, this is not definite. Lambskin condoms do not protect
against HIV and other STIs.
DOES IT PROTECT AGAINST PREGNANCY?
Yes and using spermicidal in addition to the condom improves pregnancy
prevention. For best protection, use the condom before any sperm – or pre-
ejaculate – comes in contact with the vagina.
The chances of getting pregnant while using a condom (latex) are:
 Typical use: 14 percent
 Perfect use: 3 percent
ADVANTAGES:

20
 The condom is the best method for reducing the risk of STIs for those
who choose to have intercourse. (As always, abstinence is the only
100 percent guarantee.)
 Allows men to share responsibility for pregnancy prevention and
protection against STDs.
 Can be easily obtained and does not require a prescription.
DISADVANTAGES:
 Some people are allergic to latex. Polyurethane condoms can be
used as an alternative.
 Some individuals argue that condoms reduce sensitivity and
pleasure during intercourse.
 Some people dislike interrupting sex to put it on.
 Condoms may break if they are put on incorrectly.
THINGS TO REMEMBER
 The male condom cannot be used in conjunction with the female
condom.
 Condoms should not be used with oil-based lubricants such as
petroleum jelly, Vaseline, or mineral and vegetable oil. Such
lubricants damage the condom or increase breakage.
 Condoms (particularly latex ones) should be protected from the
heat, which can weaken them or cause breakage.
 Some condoms do have a "shelf life" – after which they are too
weak to use.
PERMANENT METHODS
1. Bilateral Tubal Ligation (BTL) or female sterilization - a small incision is made
in the abdomen to gain access to the fallopian tubes, which are then cut
and tied; requires local anesthesia.
RISKS OF TUBAL LIGATION
As with any type of surgery, there are risks involved with having your tubes tied,
including infection and uterine perforation. Additionally, women who have had
their tubes tied and become pregnant are more likely to experience an ectopic
pregnancy. Other possible risks associated with having your tubes tied include
menstrual cycle disturbances and gynecological problems.
While a tubal ligation is an effective way of preventing pregnancy, it offers
absolutely no protection against sexually transmitted diseases). Therefore, it will
still be necessary to use condoms unless you are in a relationship with someone
that has tested negative for STDs.
ADVANTAGES
Tubal ligation is a permanent method of birth control offering immediate and
highly effective protection against unexpected pregnancy. Women, who are
sterilized, have the same sexual desire and function since the hormone levels
remain the same as before, and can enjoy more spontaneous sex life. This mean
of birth control has very few side effects. It is cost-effective in a long term and
requires no daily attention. Moreover, tubal ligation effectively protects women,
whose lives would be in danger if they were to conceive.

21
 Permanent birth control.
 Immediately effective.
 Allows sexual spontaneity.
 Requires no daily attention.
 Not messy.
 Cost-effective in the long run.
DISADVANTAGES
Tubal ligation is a surgical procedure and therefore has the risks associated with
surgical intervention and anesthesia. Unlike male sterilization, vasectomy , it is a
more complicated and risky procedure. It involves possible discomfort at the
surgical site.
Tubal ligation does not offer any protection against sexually transmitted
diseases (STD’s), therefore, a condom should be used.
Every woman should understand that female sterilization is a permanent method
of birth control , and therefore, it is very important to consider thoroughly before
deciding to go through the procedure. Although reversal is technically possible,
it is not always possible in practice, and when performed, only 60% to 80% of
women are able to conceive a baby. Hence, some women may have regrets
for what they have done.
 Does not protect against sexually transmitted infections, including
HIV/AIDS.
 Requires surgery.
 Has risks associated with surgery.
 More complicated than male sterilization.
 May not be reversible.
 Possible regret.
 Possibililty of Post Tubal Ligation Syndrome.
WILL THIS SURGERY AFFECT MY LIBIDO?
No. The procedure has no effect on your sex drive or your hormone production.
You’ll still ovulate each month, only the egg will never reach your uterus (it’s
reabsorbed by your body). You’ll also continue to have menstrual periods.
2. Vasectomy (Non-Scalpel Vasectomy or NSV) - where a small puncture is
made on the scrotum to expose the vas deferens which is then cut and
tied; requires local anesthesia.
A vasectomy is considered a permanent method of birth control. A vasectomy
prevents the release of sperm when a man ejaculates.
During a vasectomy, the vas deferens from each testicle is clamped, cut, or
otherwise sealed. This prevents sperm from mixing with the semen that is
ejaculated from the penis. An egg cannot be fertilized when there are no sperm
in the semen. The testicles continue to produce sperm, but the sperm are
reabsorbed by the body. (This also happens to sperm that are not ejaculated
after a while, regardless of whether you have had a vasectomy.) Because the
tubes are blocked before the seminal vesicles and prostate , you still
ejaculate about the same amount of fluid.
It usually takes several months after a vasectomy for all remaining sperm to be
ejaculated or reabsorbed. You must use another method of birth control until

22
you have a semen sample tested and it shows a zero sperm count. Otherwise,
you can still get your partner pregnant.
WHAT HAPPENS DURING A VASECTOMY?
 Your testicles and scrotum are cleaned with an antiseptic and possibly shaved.
 You may be given an oral or intravenous (IV) medicine to reduceanxiety and
make you sleepy. If you do take this medicine, you may not remember much
about the procedure.
 Each vas deferens is located by touch.
 A local anesthetic is injected into the area.
 Your doctor makes one or two small openings in your scrotum. Through an
opening, the two vas deferens tubes are cut. The two ends of the vas deferens
are tied, stitched, or sealed. Electrocautery may be used to seal the ends with
heat. Scar tissue from the surgery helps block the tubes.
 The vas deferens is then replaced inside the scrotum and the skin is closed
with stitches that dissolve and do not have to be removed.
The procedure takes about 20 to 30 minutes and can be done in an office or
clinic. It may be done by a family medicine doctor, a urologist, or a general
surgeon.
No-scalpel vasectomy is a technique that uses a small clamp with pointed ends.
Instead of using a scalpel to cut the skin, the clamp is poked through the skin of
the scrotum and then opened. The benefits of this procedure include less
bleeding, a smaller hole in the skin, and fewer complications. No-scalpel
vasectomy is as effective as traditional vasectomy.1
In the Vasclip implant procedure, the vas deferens is locked closed with a
device called a Vasclip. The vas deferens is not cut, sutured, or cauterized
(sealed by burning), which possibly reduces the potential for pain and
complications. Some studies show that clipping is not as effective as other
methods of sealing off the vas deferens.
WHAT TO EXPECT AFTER SURGERY
Your scrotum will be numb for 1 to 2 hours after a vasectomy. Apply cold packs
to the area and lie on your back as much as possible for the rest of the day.
Wearing snug underwear or a jockstrap will help ease discomfort and protect
the area.
You may have some swelling and minor pain in your scrotum for several days
after the surgery. Unless your work is strenuous, you will be able to return to work
in 1 or 2 days. Avoid heavy lifting for a week.
You can resume sexual intercourse as soon as you are comfortable, usually in
about a week. But you can still get your partner pregnant until your sperm count
is zero. You must use another method of birth control until you have a follow-up
sperm count test 2 months after the vasectomy (or after 10 to 20 ejaculations
over a shorter period of time). Once your sperm count is zero, no other birth
control method is necessary.
Most men go back to the doctor's office to have their sperm count checked.
But there is also a home test available.

23
A vasectomy will not interfere with your sex drive, ability to have erections,
sensation of orgasm, or ability to ejaculate. You may have occasional mild
aching in your testicles during sexual arousal for a few months after the surgery.
WHY IT IS DONE
A vasectomy is a permanent method of birth control. Only consider this method
when you are sure that you do not want to have a child in the future.
HOW WELL IT WORKS
Vasectomy is a very effective (99.85%) birth control method. Only 1 to 2 women
out of 1,000 will have an unplanned pregnancy in the first year after their
partners have had a vasectomy.2
RISK OF FAILURE
Pregnancy may occur after vasectomy because of:
 Failure to use another birth control method until the sperm count is confirmed to
be zero. It usually takes 10 to 20 ejaculations to completely clear sperm from the
semen.
 Spontaneous reconnection of a vas deferens or an opening in one end that
allows sperm to mix with the semen again. This is very rare.
RISKS
The risk of complications after a vasectomy is very low. Complications may
include:
 Bleeding under the skin, which may cause swelling or bruising.
 Infection at the site of the incision. In rare instances, an infection develops inside
the scrotum.
 Sperm leaking from a vas deferens into the tissue around it and forming a small
lump (sperm granuloma). This condition is usually not painful, and it can be
treated with rest and pain medication. Occasionally, surgery may be needed to
remove the granuloma.
 Inflammation of the tubes that move sperm from the testicles
(congestive epididymitis).
 In rare cases, the vas deferens growing back together (recanalization) so the
man becomes fertile again.
ADVANTAGES
Vasectomy is a permanent method of birth control. Once your semen does not
contain sperm, you do not need to worry about using other birth control
methods.
Vasectomy is a safer, cheaper procedure that causes fewer complications than
tubal ligation in women.1
Although vasectomy is expensive, it is a one-time cost and is often covered by
medical insurance. The cost of other methods, such as birth control
pills or condoms and spermicide, is likely to be greater over time.

24
DISADVANTAGES
A vasectomy does not protect against sexually transmitted infections (STIs),
including infection with the human immunodeficiency virus (HIV). Condoms are
the most effective method for preventing STIs. To protect yourself and your
partner from STIs, use a condom every time you have sex.
OTHER CONSIDERATIONS
If you are considering a vasectomy, be absolutely certain that you will never
want to father a child.
A vasectomy is not usually recommended for men who are consideringbanking
sperm in case they decide later to have children. Discuss other options with your
partner and your health professional.
Surgery to reconnect the vas deferens (vasectomy reversal) is available. But the
reversal procedure is difficult. Sometimes a doctor can remove sperm from the
testicle in men who have had a vasectomy or a reversal that didn't work. The
sperm can then be used for in vitro fertilization. Both vasectomy reversal and
sperm retrieval can be expensive, may not be covered by insurance, and may
not always work.
Some older studies showed a risk of prostate cancer in men who have had
vasectomies. But many years of research have found no clear evidence that
vasectomy is linked to prostate cancer.1
Some doctors or health insurance plans may require a waiting period from the
time you request a vasectomy and the time the procedure is done. This time
allows you to be certain about your decision.
Researchers are studying other male birth control methods, such as reversible
vasectomy or hormonal methods. Reversible vasectomy involves plugging the
vas deferens and then removing the plug when birth control is no longer
wanted. Hormonal methods include pills or injections that the man would use to
prevent sperm production. So far, no new method has been shown to be
effective enough, with low side effects, to be marketed for men.
-END-

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