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Contraception

Contraception. IUC ’ s, Sterilization. Intrauterine Contraceptives (IUC ’ s). IUC ’ s are made of flexible plastic, available only through prescription Two types ParaGard (copper) Mirena (hormone). IUC ’ s: ParaGard. ParaGard contains copper Copper prevents sperm from fertilizing an ovum

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Contraception

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  1. Contraception IUC’s, Sterilization

  2. Intrauterine Contraceptives (IUC’s) • IUC’s are made of flexible plastic, available only through prescription • Two types • ParaGard (copper) • Mirena (hormone)

  3. IUC’s: ParaGard • ParaGard contains copper • Copper prevents sperm from fertilizing an ovum • Copper also makes implantation of fertilized ovum difficult • Amount of copper released is less than needed in daily diet • Copper intolerance or insensitivity would preclude use of ParaGard

  4. IUC’s: Paragard • Requires insertion into uterus by healthcare provider • Takes only a few minutes • Insertion may cause cramping, dizziness • Once inserted, may remain in place for ten years • Patient should not feel IUD • Since no hormones present, monthly cycle should remain unchanged • Effectiveness: 99%+ against pregnancy • Requires monthly checking for IUD slippage

  5. IUC’s: ParaGard • Side effects: heavier and longer periods, cramping, spotting in between periods • May lessen after a few months on ParaGard • Complication risks: pelvic inflammatory disease shortly after insertion, perforation of uterus, expulsion • Copper may provide protective benefit against endometrial cancer • Cost: $450 (Contracept.org)

  6. IUC’s: Mirena • Hormonal method (pregestogen) • Intrauterine device • Lasts for five years • Mirena: • Prevents sperm from fertilizing ovum • Prevents release of egg • Changes uterine lining

  7. IUC’s: Mirena • Insertion: Similar to ParaGard • Effectiveness: 99%+ against pregnancy • Cost: $300-400 (Consumer Reports) • Side effects: Abdominal cramping (10% of users during first few months), acne, breast tenderness, headache, mood changes, back pain • May lessen after a few months • As use continues, less menstrual bleeding • Complication effects: ovarian cysts, pelvic inflammatory disease shortly after insertion, perforation of uterus, expulsion

  8. IUC’s • Internal Birth Control- IUD’s (3:18 via Youtube) • Insertion of IUC (1:43 via Medialvideos.us)

  9. IUCs: Advantages & Disadvantages • Effectiveness • Cost • Frequency of application • Safety & side effects • Religion • STI risk • Availability • Conspicuousness • Duration

  10. Sterilization

  11. Sterilization • Sterilization = permanent contraception • Women undergo tubal ligation • Men undergo vasectomy • The second most common contraceptive method used in the United States, behind the pill • No formalized data collection system exists • Data retrieved from surveys, questionnaires

  12. Female reproductive anatomy

  13. Male reproductive anatomy

  14. Sterilization: Tubal Ligation • Surgical technique • Close fallopian tubes, preventing egg from traveling to uterus, preventing sperm from reaching egg • Neither organs nor glands are removed • Effectiveness: 99%+ • Considered irreversible

  15. Sterilization: Tubal Ligation • Tubal sterilization: • Tubal coagulation/cauterization • Tubes can be tied and cut (Pomeroy &Parkland techniques) • Tubes can be clipped, clamped • These incision methods often performed after childbirth/abortion

  16. Sterilization: Tubal Ligation • Cost: $1000-3000 • Side effects: thought by many to be rare; hormonal imbalance may lead to increased menstrual bleeding, cramping; adhesions • Complications: infection, internal bleeding, ectopic pregnancy

  17. Sterilization: Implants • Non-incision method • No general anesthesia • Under an hour • Coils inserted into fallopian tubes • In following months, coils and tissue grow together, forming barrier to prevent sperm from reaching egg

  18. Sterilization: Implants • Side effects: expulsion of coil inserts, risk for ectopic pregnancy, cramping, menstrual changes, nausea/vomiting • Demo

  19. Sterilization: Vasectomy • Vasectomy blocks sperm from traveling through vas deferentia, preventing sperm from mixing into semen • No glands or organs are removed • Effectiveness: 99%+ • Considered irreversible

  20. Sterilization: Vasectomy • Vas deferens must be isolated • Similar to tubal ligation, the vas deferens can be cut and tied, clamped, cauterized; “no scalpel” technique • Another form of contraception must be used for a few months

  21. Sterilization: Vasectomy • Cost: $450-700 (vasectomymedical.com) • Side effects: bruising, sensitivity/pain, sperm leaking from tubes may lead to small lump (usually clears on its own), antibodies to sperm may develop, reducing chances of fertility in a reversal • Complications: rare, usually associated with infection (fever, pus/blood from incision site, swelling, pain); ends of tubes may grow back together (very rare); decreased sexual desire (4 out of 1000 cases per Planned Parenthood) - no apparent physical cause

  22. Sterilization: Vasectomy • Open-ended (no scalpel) vasectomy (medicalvideos.us) • Video (vasectomymedical.com)

  23. Sterilization: Advantages & Disadvantages • Effectiveness • Cost • Frequency of application • Safety & side effects • Religion • STI risk • Availability • Conspicuousness • Duration

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