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Contraceptives

Contraceptives . Historical Background. A wide variety of effective contraceptive devices is a modern phenomena The US formerly prohibited both their use and the dissemination of relevant information – The Comstock Laws of 1870

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Contraceptives

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  1. Contraceptives

  2. Historical Background • A wide variety of effective contraceptive devices is a modern phenomena • The US formerly prohibited both their use and the dissemination of relevant information – The Comstock Laws of 1870 • Margaret Sanger led the charge to give women some control their own fertility • in 1960 the birth control pill debuted

  3. More Background • In 1965 the Supreme Court ruled in Griswold vs. Connecticut that married couples can use contraceptives • In 1968 use was extended to singles • Thus began the controversial Right to Privacy • Now the debate has shifted to parental notification

  4. Contemporary Issues • Contraceptives have contributed to women’s financial stability, health, and career advancement • Should health insurance plans cover? • Should we halt population growth? • Cultural gender-role expectations? • Religious objections? But 70% of US Catholics use banned methods.

  5. Ideally, a Mutual Decision • Today, contraception is much more effective if both partners participate • Also, • Discussion can enhance a relationship • Together women can learn how to obtain; men can learn how to request their use • Now both sexes are more likely to use, even the first time

  6. Choosing a Method • Many forms are available • None are perfect • Each has its advantages and disadvantages • They vary as to price, effectiveness, convenience and safety

  7. Effectiveness • The biggest peril? Errors by the user. • About half of unintended pregnancies occur among women using contraceptives. • Poor, unmarried women under 30 have the highest failure rate.

  8. Characteristics of those who try, but fail • They feel guilty about using it • They have a negative view of sex itself. • Some women feel that being prepared makes them appear too “eager”. • Taking this into account, each contraceptive has a failure rate – the number out of a 100 who become pregnant by the end of the first year of use

  9. Back-up • With so much human error in play, many couples use two methods to be sure. • When backups are necessary: during the pill’s first cycle if you missed a few pills if you are taking antibiotics with the pill during the first 3 months of IUD use while using a new method

  10. The Pill • Work by altering hormone levels • Used by 100 million worldwide • Top choice among American women • Four basic types Constant-dose Combination Triphasic Seasonale Progestin-only

  11. The Constant-dose Combination • Number 1 in US • Available since the early 60’s • Two hormones, synthetic estrogen & progestin are taken at a level daily dose • Very effective, if used properly, only .3 fail • Reduces cramps and flow • Some possible side-effects

  12. The Triphasic Pill • Varies proportions of estrogen and progesterone during the menstrual cycle • Reduces overall hormone dosage • Fewer side-effects • Also very effective

  13. Seasonale • The latest • Lower yet hormone doses • Reduces periods to just 4 per year • Progestin-only - just a constant dose of a very small level of progestin

  14. How they do it • The combination and triphasic pills and Seasonale primarily inhibit ovulation. • Their estrogen dose stops the hypothalamus from releasing hormones essential to ovulation. • Their progestin hampers the sperm’s passage into the uterus. • The progestin-only stops sperm in cervix.

  15. Taking the Pill • Must be taken every day • Should be taken at the same time each day • Many forget to take the pill each day • Objective measures showed that 50% missed up to 3 pills per cycle • If so, a backup is necessary

  16. Advantages • No effect on sexual spontaneity • Easily reversible • If taken as prescribed, very effective • Lessen menstrual discomfort • Also reduces risk of some cancers

  17. Disadvantages • Does not protect against Aids or other STDs • Some side effects from steady presence of hormones in blood stream • For women over 35 who smoke, the risks outweigh the benefits • Some medications weaken the pill’s effectiveness and vice versa

  18. ACHES • An acronym for serious problems possibly associated with the pill • Abdominal pain (severe) • Chest pain (severe) or shortness of breath • Headaches (severe) • Severe leg pain, calf or thigh • Many deal with blood clots/cardiovascular concerns

  19. Condoms • The most basic of the barrier methods • Work by preventing sperm from entering the vagina • Men’s only temporary form of birth control • Made of surgical latex or sheep membrane • Wide variety, long history • Mass production followed the vulcanization of rubber in the 1840s • 6 to 9 billion sold each year worldwide

  20. How to use • Must be used effectively • Must be put on before penetration • Cowper’s gland secretions can contain sperm • The end of a plain-end condom must be twisted • Lubrication helps prevent breakage • Avoid oil based lubricants

  21. Advantages of Condoms • The best protection against contracting and spreading STDs and preventing vaginal infections • Easily available • No harmful side effects • Can decrease sensitivity for greater endurance

  22. Disadvantages • Can interrupt spontaneity • Decreases penile sensitivity • Tiny leaks can ruin effectiveness • Should be put on properly

  23. The IUD • Intrauterine devices – small plastic objects inserted into the uterus • Various types halt conception in differing ways • Some prevent fertilization • Others disrupt normal ovulatory patterns

  24. Using the IUD • Inserted by a health care professional using sterile instruments • Careful screening is necessary • Woman should be over 25, in a monogamous relationship, with no history of STDs or PID • String should be checked each month after menstruation

  25. Advantages of the IUD • Tremendous effectiveness • Very little inconvenience • Can work for 10 years • Very inexpensive • Possible discomfort usually diminishes within a month or so

  26. Disadvantages • Insertion can be painful • Some expel the device • Serious problems – PAINS • Period disappears or is late • Abdominal pain • Increased temperature, fever, chills • Nasty discharge, foul smell • Spotting, bleeding, heavy periods

  27. Emergency Contraception (EC) • Taking hormone pills or inserting a Copper-T IUD (99% effective) can serve in an emergency • Could possibly eliminate over 2 million unintended pregnancies a year in the US alone • But only 49% are aware of this • Hormone pills can be taken up to 5 days after intercourse but the sooner the better

  28. ECII • Side effects such as nausea and vomiting are possible • Approved in 1996, but available only through prescription? • Unwise • Some states have changed this • Also access can be difficult • Catholic hospitals often refuse to provide

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