Chapter 13: Reproductive Choices

Abstinence

• Avoidance of

copulation

• The only birth

control method that

is 100% effective!

Barrier Contraceptives

• Block the meeting of egg and sperm by

means of a physical or chemical barrier

Condoms • Male condom

- Pre-lubricated, spermicide treated are

best

- Check expiration dates

- If lubrication is used, it MUST BE water-

based

• Female condom

- External ring,

internal ring with

polyurethane

sheath in between

- May be more

effective than male

condom at

preventing

pregnancies &

infections

Male / Female Condoms

• 15-20% failure rate

(5% when used with

spermicide)

• No side effects

(except latex

allergies)

• Do protect against

STIs

Contraceptive Sponge

• Polyurethane foam

laced with

spermicide

• Covers entrance to

cervix

• Can be inserted up

to 24 hours before

sex

Vaginal Spermicide

• Designed to kill sperm and potential pathogens

• Foams, creams, jellies, suppositories

• Some meant to be used with other methods, some used alone

Vaginal Contraceptive Film (VCF)

• Thin, 2”-square film

laced with

spermicide

• Folded and

inserted, dissolves

into gel

Spermicides

• NEARLY 100%

effective when

paired with a

condom

• 20-50% failure rate

alone

• Prevent some

infections

Prescription Barrier Methods

• Diaphragm – rubber

“bowl” that covers

cervix and holds

spermicide

• Cervical cap – smaller

& thicker than

diaphragm

• FemCap – Non-latex

Prescription Barrier Methods

• Can be inserted

several hours before

sex

• Must be left in for 6

hours after

• No hormones or side

effects

• 6-16% failure rate

Hormonal Contraceptives

• Mimic hormones produced during pregnancy which can: - Block hormones that stimulate ovulation - Make cervix hostile to sperm - Prevent implantation of egg

• **DO NOT protect against STIs**

Oral Contraceptives

• “The pill”

• 28-day packs are most

common (21 with

hormones, 7 without)

• Combination (estrogen

+ progestin) or minipills

(progestin only)

• Must be taken at same

time each day

Oral Contraceptives

• Up to 99% effective

• Reduced risk of some cancers

• Side effects: nausea, weight gain, decreased sex drive

• Risks for smokers, those with high BP, diabetes, seizure disorders

Ortho Evra Patch

• Transdermal (through the skin)

• Continuous low dose of estrogen and progestin

• Looks like a band-aid, but waterproof

• Increased risk of heart attack and stroke

NuvaRing

• Ring made of flexible

plastic that is inserted

into vagina

• Slowly releases

estrogen and

progestin

• Stays in place for 3

weeks, removed for 1

Contraceptive Injection

• Ex: Depo-Provera

• Progestin only – prevents implantation

• Shot given every 3 months

• Cannot use for more than 2 years – bone mineral loss

• Increased risk of chlamydia and gonorrhea

Emergency Contraception

• Reactive (rather than proactive) hormonal contraception

• Ex: Plan B (“morning after pill”)

• Prevents ovulation or implantation

• Non-prescription if over 18

Intrauterine Device (IUD)

• Molded plastic that is

inserted into uterus

• Interferes with

implantation

• Old model associated

with serious

complications

• Last 1-10 years

• 99.2-99.9% effective

Mirena Intrauterine System

• IUD + continuous

low-dose of

progestin (so it’s

partly a hormonal

method)

• Effective for 5 years

• 99% effective

Fertility Awareness Method

• “Rhythm method”

• Woman tracks her

cycle for at least 8

months

• 20% failure rate

• Complies with

Roman Catholic

Church

Male Sterilization

(Vasectomy)

• Severing of vas

deferens

• Short, in-office

procedure to

block flow of

sperm

• Reversal is about

50% effective

Female Sterilization

(Tubal ligation or Tubal occlusion)

• Cutting, tying, or

blocking fallopian

tubes

• Outpatient surgery

using laproscopy

• Can sometimes be

reversed