CONTRACEPTIVE METHODS

1. CONTRACEPTIVE METHODS PART ONE

2. Howeffective are thevariousmethods? • Some contraceptive methods are more effective in preventing pregnancy than others, while only condoms offer any protection against sexually transmitted infections. The following figures will give you some idea of which kinds of contraception are the most efficient at protecting you against pregnancy.

3. Contraceptive method Effectiveness • Vasectomy Almost 100 per cent • Female sterilisation Almost 100 per cent • The Pill Almost 100 per cent • Contraceptive injection Almost 100 per cent • IUS (Mirena) 98 to 99 per cent • IUD (the coil) 97 to 98 per cent • The mini-Pill Around 98 per cent • Male condom 90 to 98 per cent • Female condom 90 to 98 per cent • Diaphragm with spermicide 90 to 96 per cent.

4. Non Hormonal methodsdiaphragm • It is a dome shaped latex or silicone cup that fits securely in the vagina and covers the cervix. It should always be used together with a spermicidal gel formulated for diaphragm use. • It works by blocking the opening to the uterus and holds spermicide that may slow destroy sperm cell membrane. • The diaphragm can be inserted into the vagina at the time of intercourse or up to 6 hours before intercourse. After intercourse, the diaphragm is left in place for at least 6 hours no longer than 24 hours.

5. Advantages • Contains no hormones • Immediately effective • Used only when needed Disadvantages • Spermicidal cream or jelly may cause irritation • Some individuals are allergic to latex or silicone • No protection from STIs • More bladder infections for some women • Less effective than other types of contraception

6. Malecondom Condoms work as a barrier by collecting semen before, during, and after a man ejaculates. This can prevent sperm from coming into contact with the inside of the vagina and from joining a female’s egg.

7. Advantages • Convenient and easy to obtain • Inexpensive • Do not require a prescription • Can be used with other methods • Are lightweight • Are disposable • Help in preventing pregnancy and sexually transmitted infections

8. Disadvantages • Some men and women feel that the condom dulls sensation. • A few men are unable to maintain an erection after putting on condoms. • Friction caused by condoms may reduce female stimulation which can make sex less enjoyable or even uncomfortable but using lubricated condoms may avoid this issue. • Condoms may break if they are put on incorrectly.

9. Femalecondom A female condom is a soft, loose fitting polyurethane pouch. It has two flexible rings. One smaller ring fits inside the vagina and covers the cervix. The other larger ring hangs outside the vagina and covers the vulva. The inside of the condom is lubricated.

10. Advantages • Female condoms give women more control over protecting themselves from pregnancy, STIs, and HIV. • Female condoms are polyurethane, so they may be better for people who have an allergy to latex. • You can use the condom with other methods of birth control to lower the risk of STI’s, HIV, and pregnancy, except with male condom.

11. Disadvantages • The female condom costs a lot compared to male condoms. • The outer ring hangs out of the vagina—this may make it hard for some women to enjoy foreplay. • The female condom twists easily. Sometimes the penis goes in next to the condom instead of inside the condom. • Some women find them hard to put in.

12. Contraceptivesponge Using this method correctly guarantees about 84 to 87% effective at preventing pregnancy. As it was mentioned, this contraception does not prevent the transmission of many sexually diseases, including herpes, HPV or HIV.

13. Advantages • Easy to use. • Small and inexpensive. • Can be obtained at most drugstores. • Do not require prescription. • Can be inserted up to an hour before sex, effective for 24 hours.

14. Disadvantages • No protection against STIs. • Some women cannot easily reach their cervix and can remove. • May increase the risk for urinary tract infection, toxic shock syndrome, vaginal infection or inflammation of the cervix. • The sponge is more effective for women who have never given birth. • If it breaks into pieces and you cannot remove all of the pieces, see a doctor to have the sponge removed.

15. Cervical cap The cervical cap works to prevent sperm from entering the uterus. Unlike the diaphragm, however, the cervical cap is much smaller and fits more tightly around the cervix when in place. Cervical covers are 84-91% effective at preventing pregnancy for women who have never given birth. They are 68-74% effective for women who have given birth.

16. advantages • Can be inserted many hours before sex play. • Easy to carry around, comfortable. • Does not alter the menstrual cycle. • Does not affect future fertility.

17. Disadvantages • Does not protect against HIV/AIDS. • Requires a fitting in a clinic. • Not able to fit with all women. • Can be difficult to insert or remove. • Can be dislodged during intercourse.

18. VAGINAL SPERMICIDES • Vaginal spermicides are products containing an ingredient (Nonoxynol-9) that kills sperm on contact. • Spermicide is inserted into the vagina before sex to help prevent pregnancy. • Spermicides are available as film, foam, suppositories, cream, and gel.

19. ADVANTAGES • Vaginal spermicides can be purchased at a pharmacy or grocery store without a prescription. • Vaginal spermicides provide extra lubrication. • Women who cannot use a hormonal birth control method have vaginal spermicide options.

20. DISADVANTAGES • You have to wait after inserting spermicide before having sex. • Vaginal spermicides can cause irritation (e.g., itchiness, redness or pain). If this happens you should stop using the spermicide and talk to your doctor. • Some women experience more frequent urinary tract infections when a spermicide and condom or spermicide and diaphragm are used together.

21. INTRAUTERINE DEVICE IUD is one of the most effective methods of birth control. It is placed in the uterine cavity of woman and having a thread hangs down into the upper part of vagina. Currently, there are two types of IUD. One is Copper IUD and other is progesterone hormone IUD.

22. ADVANTAGES • It is not expensive. • You can enjoy sexual intercourse without any interruption. • Do not require any daily attention. • Once it is fitted it can work for more than 5 years. • It does not change the hormone level of your body. • It is very easy to use. There is only one insertion and you will have to check the threads periodically. • If IUD is placed in a correct manner and properly maintained, you will get rapid return of fertility after removing IUD.

23. Disadvantages • IUD does not give you protection against STI’s. • You cannot insert or remove IUD by yourself. • You may have a longer, heavier and more painful period. • It may injure the uterus during fitting. • IUD may lead to infection in three weeks after insertion. • IUD may can cause infertility. • While using IUD if you got pregnant it may lead to a severe infection.

24. Fertilityawarness (FAM) is a collection of practices that help a woman know which days of the month she is most likely to get pregnant. • Write down the number of days in each of your last six menstrual cycles. • Count the days in each cycle starting with the first day of your period until the day before your next period starts. • Now pick out the longest of the six cycles and the shortest of the six cycles. • Try to decide which part of the month is your fertile time, subtract 18 from the shortest cycle and subtract 11 from the longest cycle. For example, if your shortest cycle is 26 days and your longest cycle is 34 days, you need to abstain from sexual relations from Day 8 (26-18=8) through Day 23 (34-11=23).

25. advantages • Do not require medication or supplies. • Can be used to plan a pregnancy. • They are permitted by some religions and cultures that do not permit other methods of contraception. • They have no side effects.

26. Disadvantages • Do not provide protection against HIV infection and other STI’s. • Take time to learn. • The couple must keep careful records.

27. Bodytemperature • Take your temperature every morning before you get out of bed and before you begin any kind of activity, including talking, eating, drinking, smoking, or sexual activity. You can use the thermometer either orally or rectally, but you must choose one site and use this same site every day. How to tell when you may be fertile: You can assume your fertile days are over when your BBT has risen has remained elevated for three full days.

28. Cervical mucus • You may be fertile when you feel a sensation of wetness at the opening to your vagina or when you can see mucus on your finger, underpants, or tissue paper. • You may not see mucus until a few days after menstrual bleeding has ended. When mucus begins to appear, it is sticky, pasty, or crumbly, and may range in color from yellow to white. As the fertile time approaches, the mucus increases in amount, becomes clearer in color, wetter, stretchy, and slippery.

29. considerations If you wish to prevent pregnancy: • Do not have sexual intercourse on any day that you feel or see mucus on your fingers, on tissue paper, or on your underpants. • Do not have sex until the fourth day after the "peak symptom day." The peak symptom day is the last day of the wettest mucus. • Do not have sex during your menstrual period, because the blood may hide the mucus.

30. withdrawal Withdrawal, also known as “coitus interruptus,” is the removal of the penis from a partner’s vagina before ejaculation. This is the most common method of birth control since it’s free and always available to prevent contact between egg and sperm, reducing the possibility of pregnancy. While withdrawal has been criticized as a non-method, it is 73-96% effective for birth control, depending on the male partner’s self-knowledge and self-control.

31. advantages • Free and alwaysavailable • No sideeffects. • Does not alter the menstrual cycle. • Does not affect future fertility. • May be a more acceptable form of birth control for people with religious concerns.

32. disadvantages • Does not protect against HIV/AIDS. • Nervousness and sexual interruption may lessen pleasure. • Less effective than other methods of birth control. • Less effective if under the influence of alcohol or drugs.

33. Hormonal methods Parttwo

34. Oral contraceptives There are many different brands of The Pill. Some come in packs of 21 or 28 pills. One pill is taken orally (swallowed) every day. The first 21 pills have a combination of synthetic estrogen and progesterone hormones that work to prevent fertilization. The last seven pills of a 28-day pack are hormone-free pills called spacers. The hormones stop ovulation (the process of the ovaries releasing eggs), as well as thicken cervical mucus to make it harder for sperm to enter the uterus. ThePillis 92 to 99.7% effective as birth control.

35. advantages • Can regulate periods or lighten them • Easyto use • Does not harm future fertility. • Doesnotinterrupt sex play • May protect against uterine and ovarian cancers • Can be used for Emergency Contraception

36. disadvantages • Does not protect against sexually transmitted infections, including HIV/AIDS • Must be taken every day • Less effective when taken with some medications • Raises risk of heart attack and stroke • Requires a prescription

37. Thepatch • Thebirth control patchis a thin, beige, plasticpatchthatstickstotheskin. Itisusedtopreventpregnancy. A new patchis placed ontheskin once a weekforthreeweeks in a row, followedby a patch-free week.

38. advantages • Highlyeffective • Predictable, regular menstrual cycles • Easyto use • Doesnotinterferewithhaving sex • Protectionfromovariancysts, cancer of theovaries, cancer of theuterus

39. disadvantages • Difficulttoconcealpatchordifficulttogetgoodskinadherence • Spottingbetweenperiods • Needtochangepatch once a week • Offers no protectionagainstsexuallytransmittedinfections • Lowereffectiveness in womenweighing 198 lbsor more.

40. Vaginal ring Vaginal Ring is a thin, transparent, flexible ring that you insert into the vagina yourself to provide contraception protection. Leaving the Vaginal Ring in for 3 weeks, it slowly releases estrogen and progestin hormones into the body. These hormones stop ovulation and thicken the cervical mucus, creating a barrier to prevent sperm from fertilizing an egg. Worn continuously for three weeks followed by a week off, each Vaginal Ring provides one month of birth control. The Vaginal Ring is 92-99.7% effective.

41. advantages • Easyto use. • Can be worn for three weeks. • Effects fertility one month at a time. • Does not interrupt sex play.

42. disadvantages • Does not protect against sexually transmitted infections, including HIV/AIDS. • Raised risk of heart attack and stroke. • Requires a prescription.

43. injectable The active ingredient of Depo-Provera (DMPA) is a synthetic form of progesterone called medroxyprogesterone acetate. Each injection provides contraception for 13 weeks. DMPA primarily works by preventing the ovaries from releasing an egg (ovulation) and by thickening the cervical mucus to prevent sperm from entering the uterus.

44. advantages • Highlyeffective • Doesnotinterferewith sex • Helpstopreventcancer of theuterus • Doesnotcontainestrogen • Oftendecreasesbleeding and crampingwithperiods • Effectivefor 12-13 weeks

45. disadvantages • Mustreceiveshotevery 12-13 weeks • May cause irregular bleeding, light bleeding, oreventually no bleeding • AfterdiscontinuingDepo-Provera, itmaytake up to 9-10 monthsto resume ovulation • Long termusers of Depo-Proveramaydeveloptemporary and usually reversible decreasedbonedensity. Calcium and vitamin D are recommendedwhileusingshots. • Mayhaveweightchanges • Mayworsendepression • No protectionfromSTI's

46. implanon Implanonis a progestin hormone containingrodthatisinsertedundertheskin of a woman’sarm. Itworksbyreleasing a constantlow hormone levelkeepingtheovariesfromreleasinganegg (ovulation), thickeningthe cervical mucus and changingthelining of theuterus.

47. advantages • Highlyeffective • Easyto use • Itprovidescontraceptionfor at least 3 years and can be removed at any time. • Contains no estrogen

48. disadvantages • Unscheduled and irregular bleeding (may decline after 3 months of use) • Needstobeinsertedby a healthcareprovider • Offers no protectionagainstsexuallytransmittedinfections

49. PREGNACY IN TEENAGERS CAUSES AND CONSEQUENCES

50. Why do teenagershaveunwantedpregnancies? • Lack of information • Excessive confidence • Surprise factor • Afraid of abandonment • Run away from home • Low self-stem