Contraceptives
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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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Historical background
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


More background
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


Contemporary issues
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.


Ideally a mutual decision
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


Choosing a method
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


Effectiveness
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.


Characteristics of those who try but fail
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


Back up
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


The pill
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


The constant dose combination
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


The triphasic pill
The Triphasic Pill

  • Varies proportions of estrogen and progesterone during the menstrual cycle

  • Reduces overall hormone dosage

  • Fewer side-effects

  • Also very effective


Seasonale
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


How they do it
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.


Taking the pill
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


Advantages
Advantages

  • No effect on sexual spontaneity

  • Easily reversible

  • If taken as prescribed, very effective

  • Lessen menstrual discomfort

  • Also reduces risk of some cancers


Disadvantages
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


Aches
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


Condoms
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


How to use
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


Advantages of condoms
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


Disadvantages1
Disadvantages

  • Can interrupt spontaneity

  • Decreases penile sensitivity

  • Tiny leaks can ruin effectiveness

  • Should be put on properly


The iud
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


Using the iud
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


Advantages of the iud
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


Disadvantages2
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


Emergency contraception ec
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


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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