Transcript Sexual Health

Sexual Health
Teens & Birth Control:
Excuses...Excuses...Excuses
O “It was unromantic and planned”
O “I Would feel guilty”
O “It is against my religion”
O “We used the withdrawal method”
O “Doctor will blab to my mom”
O “It won’t happen to me”
O “Condoms break and don’t work”
Teens & Pregnancy
O 1 million teens became pregnant in 2000
O 512,000 of these teens gave birth
O 6 of 10 U.S. pregnancies are unplanned
O Most teens do not plan to have sex the first
time forget to use a birth control method
Sexually Transmitted
Infections
Basic but commonly misunderstood
information
Sexually transmitted infections (STIs) are
infections that are spread primarily through
person-to-person sexual contact such as
vaginal intercourse, oral and anal sex. There
are more than 30 different sexually
transmissible bacteria, viruses and parasites.
The 4 Most Common STIs in
Canada Are:
1. Human papillomavirus (HPV)
2. Herpes Simplex Virus (HSV)
3 Chlamydia
4. Gonorrhea
How Common are STI in Canada?
O HPV: At least 50% of sexually active
males and females will have an HPV
infection at some point in their lives. Up
to 80% of women will have been infected
by HPV by age 50.
O HSV-2: About 25% of women and 13% of
men have an HSV-2 infection.
O Chlamydia: About 4% to 6% of women
aged 15-24 have an active Chlamydia
infection.
Most Cases of STI are Asymptomatic
(no visible signs or symptoms)
O HPV – 80%+
O HSV-2 – 60%
O Chlamydia – men 50%, women 70%+
Gonorrhoea
Sexually
transmissible
bacteria
Syphilis
Chlamydia
Chlamydia: Key Facts
O Females are disproportionately infected and
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affected
Asymptomatic carriers are the main reservoir of
transmission
It can affect the penis, cervix, fallopian tubes,
anus, throat and - in rare cases - the eyes.
Chlamydia can cause serious health problems
such as pelvic inflammatory disease and infertility
if it is not treated.
Consistent condom use significantly reduces
Chlamydia transmission
Chlamydia Statistics
O In 2004 there were 31,109 positive Chlamydia tests for
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females aged 15-24 reported to the Public Health
Agency of Canada.
Up to 50% of male and 70% of female cases are
asymptomatic
In 10% - 40% of cases in females, Chlamydia results in
Pelvic Inflammatory Disease (PID)
In 20% of cases, PID results in infertility
In 18% of cases, PID results in Chronic Pelvic Pain
PID is a leading cause of Ectopic pregnancy
SYMPTOMS:
Symptoms for women include:
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vaginal discharge
needing to urinate a lot
burning when you urinate
itchiness
bleeding and/or deep pain during sex
bleeding between periods
painful periods
high temperature
stomach pain
Men with chlamydia might notice:
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needing to urinate a lot
burning when you urinate
watery discharge from your penis
burning and itching around the hole of your penis
pain in your balls
swelling of your balls
How do you get it?
O Chlamydia can be passed on through unprotected
oral, vaginal or anal sex with an infected person.
O A pregnant woman can also pass it on to her baby
during childbirth.
Treatment
O Chlamydia can be easily treated with a course of
antibiotic pills.
O After you've had the antibiotics you will need to do a
follow-up test to check that the infection is really gone.
SYPHILIS
How do people get syphilis?
O Direct contact with a syphilis sore. Sores occur mainly
on the external genitals, vagina, anus, or in the rectum.
Sores also can occur on the lips and in the mouth.
O Transmission of the organism occurs during vaginal,
anal, or oral sex.
O Pregnant women with the disease can pass it to the
babies they are carrying.
O Syphilis cannot be spread through contact with toilet
seats, doorknobs, swimming pools, hot tubs, bathtubs,
shared clothing, or eating utensils.
Syphilis Signs and symptoms
Syphilis progresses in stages and can damage many
parts of the body.
Signs and symptoms
Primary Stage:
O The primary stage of syphilis is usually marked by
the appearance of a single sore (called a
chancre).
O The chancre is usually firm, round, small, and
painless. It appears at the spot where syphilis
entered the body.
O The chancre lasts 3 to 6 weeks, and it heals
without treatment. However, if adequate treatment
is not administered, the infection progresses to the
secondary stage.
Secondary stage:
O Skin rash and mucous membrane lesions characterize the
secondary stage.
O This stage typically starts with the development of a rash on one
or more areas of the body.
O The rash usually does not cause itching. Rashes associated with
secondary syphilis can appear as the chancre is healing or
several weeks after the chancre has healed.
In addition to rashes, symptoms of secondary syphilis may include:
O Headaches
O Fever
O weight loss
O sore throat
O muscle aches
O patchy hair loss
O fatigue.
The signs and symptoms of secondary syphilis will resolve with or
without treatment, but without treatment, the infection will
progress to the latent and possibly late stages of disease.
Late and Latent Stages
Without treatment, the infected person will continue
to have syphilis even though there are no signs or
symptoms; infection remains in the body.
O This latent stage can last for years.
O In the late stages of syphilis, the disease may
subsequently damage the internal organs,
including the brain, nerves, eyes, heart, blood
vessels, liver, bones, and joints.
O Signs and symptoms of the late stage of syphilis
include difficulty coordinating muscle movements,
paralysis, numbness, gradual blindness, and
dementia. This damage may be serious enough to
cause death.
How is syphilis diagnosed?
O Examining material from a chancre
(infectious sore) using a special microscope
called a dark-field microscope.
O A blood test is another way to determine
whether someone has syphilis.
What is the treatment for
syphilis?
O A single intramuscular injection of penicillin, an
antibiotic, will cure a person who has had syphilis for
less than a year.
O Additional doses are needed to treat someone who
has had syphilis for longer than a year.
O Persons who receive syphilis treatment must abstain
from sexual contact with new partners until the
syphilis sores are completely healed.
O Persons with syphilis must notify their sex partners so
that they also can be tested and receive treatment if
necessary.
GONORRHOEA
Gonorrhoea (also known as 'the clap') is a common
sexually transmitted bacterial infection. It can affect the
penis, cervix (inside the vagina), anus, throat or eyes.
O Gonorrhoea is transmitted through unprotected sex
(sex without a condom), this can be vaginal, anal or
oral sex.
O A pregnant woman with gonorrhoea can also pass it
onto her baby during birth.
Symptoms
If symptoms show, they appear within 2-7 days after contact, and can
include:
O an unusual discharge from your vagina (sometimes yellow or bloody)
O an itchy, swollen or red vagina
O pain in your stomach, when you urinate & during sex
O Men can have a discharge from the penis that is thick, white and yellow,
burning pain when they urinate, and swollen testicles.
Both men and women can get a gonorrhoeal infection in their anus, and
their symptoms might include:
O Discharge & bleeding
O Soreness & an itchy bum
O Gonorrhoea can infect your throat too, via oral sex.
It might give you a sore throat, but sometimes there are no
symptoms.
How does the treatment
work?
O Once you've started taking antibiotics, the infection will
clear up in about seven days
O About a month later you'll need a check-up to make sure
the infection is completely gone.
O All your partners over the last three months should also be
contacted and treated. This is called 'contact tracing'. The
doctor or nurse will give you a letter to give to all your
partners so they can go to a doctor for treatment.
O After your treatment is finished, if you have unprotected sex
with somebody that has the infection, you can catch
gonorrhoea again.
Herpes
Simplex
Virus (HSV)
Acquired
Immunodeficiency
(AIDS)
Sexually
Transmissible
Viruses
Human
Immunodificiency
Virus (HIV)
Human Papilloma
Virus
"Genital Warts"
HPV
Hepatitis A
Hepatitis B
HIV/AIDS in Canada (HIV/AIDS Epi
Update; Public Health Agency of Canada)
O As of the end of 2005, there were 58,000 people living
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with HIV in Canada.
Of these 58,000 HIV+ people, 15,800 (27%) were
unaware of their infection.
An estimated 2,300 to 4,500 new infections occurred
in 2005 compared to 2,100 to 4,000 in 2002.
Increasing proportions of HIV infections are among
women (27.8% in 2006) and this proportion is growing.
Aboriginal people, especially women, are overrepresented in the HIV epidemic in Canada.
How is HIV transmitted?
O Unprotected sexual contact or sharing drug injecting
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equipment are the most common causes of HIV
transmission.
In a some cases, HIV can be transmitted from
pregnant mother to child.
Healthcare workers and emergency personnel are at
low risk of acquiring HIV from workplace exposure to
HIV
Blood products have been screened for HIV in Canada
since 1985
There is no transmission of HIV through ordinary social
contact.
Stages of HIV infection
Seroconversion and primary illness
O People experience ‘Seroconversion’ illness between two
and six weeks after becoming infected.
O The symptoms of this illness include
- Tiredness
- Fever
- Diarrhoea
- Rash
- flu like symptoms
Treating HIV
O Drug treatment for HIV is known as combined antiretroviral
therapy (CAR)
O Drug treatment does not prevent transmission of the virus but
starting treatment early can lead to better outcomes for many HIVinfected people.
O New drug treatments
New drugs and types of drugs are being developed all the time.
Trials of these treatments are being conducted in specialist
HIV/AIDS treatment and research centres.
Alternative therapies include:
O Vitamin and mineral supplements
O Massage
O Meditation
O Herbal remedies
O Traditional Chinese Medicine
O Acupuncture.
HERPES SIMPLEX VIRUS
O Type 1 typically infects the mouth and face
producing cold sores.
O Type 2 typically infects the genital area
(genital herpes).
O However, due to oral sex, type 1 can infect
the genital area and type 2 can infect around
the mouth.
How is Herpes caught?
O The virus is spread through direct contact with blisters/
ulcers, mucus or vaginal secretions.
O This includes vaginal, oral, anal sex or other intimate
physical contact.
O NOTE: the virus can be passed on by an infected person
displaying NO symptoms of the infection i.e. no ulcers or
blisters at the time.
O Unfortunately, condoms only provides protection when
covering or separating body parts infected with ulcers and
blisters.
Short term effects of Herpes:
O Itching and tingling in the genital area can
cause discomfort.
O Cold sores around the mouth and on the
face can be annoying, inconvenient and
embarrassing.
O Typically clear up within 7 to 10 days.
How is Herpes treated?
O There is NO cure for Herpes
O Bathing the sores in warm salt water can aid the
healing process and reduce inflammation.
O Antiviral treatment is highly effective in decreasing
the symptoms and preventing lapses.
O The doctor may do a viral swab to confirm the
presence of the virus.
HPV GENITAL WARTS
O The human papilloma wart virus belongs to a large
family of viruses with 100 members.
O About 30 strains of these viruses tend to infect the
genital areas, and may infect the vagina, penis, anus,
cervix and the vulva.
O Some viruses never produce any symptoms at all and
only show up in routine pap smears.
How are Genital Warts caught?
O Usually HPV is passed on during sexual activity either by
direct skin – on – skin contact, or through the exchange of
body fluids from genital to genital (especially if there is any
broken skin).
O HPV is invisible
O Using a condom will provide SOME protection from HPV,
however a condom does not cover all the areas of the skin
that may be infected.
O NOTE: the virus can also be passed on by an infected
person displaying NO symptoms of the infection.
Symptoms of Genital Warts:
O Some people never have any symptoms at all.
O Usually don’t cause any discomfort, unless they rub
against tight clothing.
O Some people feel mild irritation and need to scratch, or
the warts may be in an inconvenient position and
interfere with sexual activity.
How are Genital Warts treated?
O Genital warts can be removed by a doctor.
O Can be frozen or treated with creams or
chemical paints.
O Regular and frequent pap smears for
women.
HEPATITIS B
O The term ‘hepatitis’ means inflammation of the liver.
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Hep B can be transmitted by:
Unprotected sex
Sharing needles and drug taking equipment
Non sterile piercing or tattooing.
A baby can become infected with the virus at birth
from an infected mother.
Never share personal items such as tooth brushes or
razors as they can harbour the virus in infected blood.
Symptoms of Hep B
O Many people infected with Hepatitis B show no
symptoms.
Some experience shortly after contracting the
infection:
Long term effects:
• Most people recover from
O Loss of appetite
Hepatitis B.
O Fever
• Some people become chronic
carriers (infectious for the rest
O Tiredness
of their lives).
O Jaundice
• Long term effect can be
O Painful joints
scarring of the liver , poor liver
function and even liver cancer.
How is Hep B treated?
O A vaccine is readily available which prevents
people from contracting the disease.
O Prevention is better than a cure.
O If you do not know if you have had the
vaccination, get a blood test at the doctors.
Hepatitis C
O Hep C is a viral disease that leads to swelling
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(inflammation) of the liver.
Hep C can be caught via:
-blood-to- blood contact
Sharing needles
Razor blades
Unsterile tattooing
Body piercing equipment
Rarely acquired through unprotected sex
SYMPTOMS of HEP C:
O Some people show no symptoms at first
O Others can experience flu-like symptoms
O Jaundice or a darkening of the urine
O Fatigue
Testing for Hep C involves a blood test.
A test can give a negative result for
several months after infection, so a
second follow up test needs to be done.
How is Hep C treated?
O Some Hep C strains are showing promising
results with the use of anti-viral therapy.
O As hepatitis affects the function of the liver,
alcohol should be avoided.
Trichomoniasis
Scabies
Phthiriasis
"Crabs"
"Pubic
Lice"
Sexually transmissible
parasites
Trichomoniasis
Trichomoniasis is a sexually transmitted
infection caused by the parasite Trichomonas
vaginalis – also referred as “trich”
Symptoms of Trich
Women:
O Discomfort during intercourse
O Itching of the inner thighs
O Vaginal discharge (thin, greenish-yellow, frothy or
foamy)
O Vaginal itching
O Vaginal odour (foul or strong smell)
Men:
O Burning after urination or ejaculation
O Itching of urethra
O Slight discharge from urethra
TREATMENT for TRICH:
O Antibiotics are taken to cure the infection.
O Avoid sexual intercourse until treatment has
been completed.
O Sexual partners should be treated at the
same time, even if they have no symptoms.
PUBIC LICE
O They are small, six-legged creatures that infect
the pubic hair area and lay eggs.
O These lice can also be found in armpit hair and
eyebrows.
O Causes:
O Usually spreads during sexual activity.
O Sometimes, pubic lice can spread through contact
with objects such as toilet seats, sheets, blankets,
or bathing suits at a store.
Symptoms & Treatments
O Symptoms:
O Itching in the area covered by pubic hair. This itching may start
soon after getting infected with lice, or it may not start for up to
2 to 4 weeks after contact.
O Skin reaction that is bluish-grey in colour. Sores (lesions) in the
genital area due to bites and scratching
O Treatment:
O Inform your sexual Partners
O Treatments for pubic lice are similar to those for head lice, and
can be purchased from any pharmacy without a prescription.
O Careful mechanical removal of eggs will be required, as the lice
apply cement like substances when gluing the eggs to the hair
and they are difficult to remove.
O The infected person’s underwear and bed linen should be
washed in hot water, followed by hot tumble drying to ensure
all lice have been killed.
SCABIES
O Scabies is an itchy, highly contagious skin condition caused
by an infestation by the itch mite Sarcoptes scabiei. Mites
are small eight-legged parasites.
O They are tiny, just 1/3 millimeter long, and burrow into the
skin to produce intense itching.
O Signs & Symptoms:
O Scabies produces a skin rash composed of small red bumps
and blisters and affects specific areas of the body.
O Textbook descriptions of scabies always mention "burrows" or
"tunnels."
O Scratching actually destroys burrows.
How can you get it?
O Direct skin-to-skin contact is the mode of
transmission.
O They can only live off of a host body for 24-36 hours
under most conditions.
O It is hard, if not impossible, to catch scabies by
shaking hands or sharing pyjamas with someone with
Scabies.
TREATING SCABIES:
O Scabies are treated with prescription scabicide drugs.
Types of Birth Control
O Hormonal
O Barrier
O IUD
O Methods based on
information
O Permanent sterilization
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Hormonal Methods
O Oral Contraceptives
(Birth Control Pill)
O Injections (Depo-Provera)
O Implants (Norplant I & II)
How does the pill work?
O Stops ovulation
O Thins uterine lining
O Thickens cervical mucus
Positive Benefits of Birth Control Pills
& Side Effects
 Prevents pregnancy
 Eases menstrual cramps
 Shortens period
 Regulates period
 Decreases incidence of
ovarian cysts
 Prevents ovarian and
uterine cancer
 Decreases acne
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Breast tenderness
Nausea
Increase in headaches
Moodiness
Weight change
Spotting
Taking the Pill
O Once a day at the same time everyday
O Use condoms for first month
O Use condoms when on antibiotics
O Use condoms for 1 week if you miss a
pill or take one late
O The pill offers no protection from
STD’s
Vaginal Ring (NuvaRing)
O 95-99% Effective A new ring is inserted into the
vagina each month
O Does not require a "fitting" by a health care provider,
does not require spermicide, can make periods more
regular and less painful, no pill to take daily, ability to
become pregnant returns quickly when use is
stopped.
NuvaRing is a flexible
plastic (ethylene-vinyl
acetate copolymer)
ring that releases a
low dose of a
progestin and an
estrogen over 3
weeks.
Depo-Provera
O Birth control shot given once every three months to prevent
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pregnancy
99.7% effective preventing pregnancy
No daily pills to remember
Stops ovulation
Stops menstrual cycles!!
Thickens cervical mucus
How Does The Patch Work?
• The same way as the Pill!
• Stops ovulation
• Thickens cervical mucus
Norplant Considerations
O Should be considered long term birth control
O Requires no upkeep 
O Extremely effective in pregnancy prevention >
99%
O Implants are placed in the body filled with
hormone that prevents pregnancy
O Physically inserted in simple 15 minute
outpatient procedure
O Plastic capsules the size of paper matchsticks
inserted under the skin in the arm
Norplant Implant
Emergency Contraception
E.C. – Morning After Pill – Plan B
O What? A pill or combination of pills you take
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after sex to prevent pregnancy
How? Contains a higher dosage of the same
hormones found in regular birth control
Notes: Won’t stop an existing pregnancy
Access: Available at pharmacy for girls 17+,
prescription is needed if less than 17
Effectiveness: Approx 95% if taken within
first 24 hours of unprotected sex
Emergency Contraception
E.C. – Morning After Pill – Plan B
O Floods the ovaries with high amount
of hormone and prevents ovulation
O Alters the environment of the uterus,
making it disruptive to the egg and
sperm
O Two sets of pills taken exactly 12
hours apart
BARRIER METHODS
O Spermicides
O Male Condom
O Female Condom
O Diaphragm
O Cervical Cap
• Barrier methods work by preventing
the egg and sperm from meeting
• These methods have higher failure
rates than hormonal methods due to
design and human error
How Effective are Condoms in Reducing
the Risk of STI Transmission?
O Studies suggest that consistent condom use
may reduce the risk of STI transmission by:
O 80% for HIV
O 60% for Chlamydia
O 90% for Gonorrhea
O 70% for HPV
O Increasing condom use = lower risk
for STI’s
Condom Use and Public
Health
O Promoting consistent condom use is the
single most important and powerful tool in
reducing the burden of STI infection on the
Canadian population
Male Condom
O What? A thin covering that you unroll over an erect
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penis. Made of latex, polyurethane, or animal
membrane (don’t protect against STIs).
How? Put on before any genital contact. At
withdrawal, hold the rim in place at the base of the
penis so it doesn’t slip off.
Notes: May decrease the sensation for men.
Lubrication makes condom less likely to break.
Access: Easy to buy in a store or online. Inexpensive.
Usually offered for free at a health clinic.
Effectiveness: 82-98%, higher effectiveness with
spermicides.
MALE CONDOM
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Most common and effective barrier method when used
properly
Latex and Polyurethane should be used in the prevention of
pregnancy and spread of STD’s (including HIV)
Female Condom
O What? A soft, loose pouch that is inserted in the
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vagina. Flexible rings at each end hold it in
place. Can be put in up to 8 hours before sex.
How? Insert the small ring in vagina, large ring
stays outside partially covering labia.
Notes: Can be used if you are allergic to latex
(made of nitrile). Men usually feel no reduction
in sensation.
Access: Available at many pharmacies, clinics,
and online
Effectiveness: 79%
Reality  : The Female Condom
DIAPRAGHM
O Typical Effectiveness Rate = 80%
O Latex barrier placed inside vagina
during intercourse
O Fitted by physician
O Spermicidal jelly before insertion
O Inserted up to 18 hours before
intercourse and can be left in for a
total of 24 hours
DIAPHRAGM
CERVICAL CAP
O Latex barrier inserted in vagina before
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intercourse
“Caps” around cervix with suction
Fill with spermicidal jelly prior to use
Can be left in body for up to a total of 48
hours
Must be left in place six hours after
sexual intercourse
Typical effectiveness rate = 80%
Cervical Cap
Sponge
The sponge is inserted by the woman into the vagina and covers the
cervix blocking sperm from entering the cervix. The sponge also
contains a spermicide that kills sperm. It is available without a
prescription
SPERMICIDES
O Chemicals kill sperm in the vagina
O Different forms:
-Jelly
-Film
-Foam
-Suppository
O Some work instantly, others require pre-insertion
O Only 76% effective (used alone), should be used in
combination with another method i.e., condoms
Long Term Pregnancy
Prevention
IUD’s: 3-10 years
Sterilization: Permanent
Intra Uterine Device (IUD)
O What? A small plastic or copper “T” with a string inserted
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into the uterus
How? Plastic IUD’s release synthetic progestin hormone
that changes cervical mucus, fallopian tubes and the
uterine lining. Stops or slows sperm and egg. Copper IUD’s
disturbs the lining of the uterus preventing implantation.
Time: Lasts 3-10 years depending on the type of IUD.
Notes: Insertion can cause a few minutes of intense pain,
but removal is fast and easy
Access: Clinic / doctor visit needed
for insertion & removal
Effectiveness: 99.8%
Controversies: Egg can be fertilized but never implanted
leading some groups to call this a form of abortion. Has a
slightly higher risk of entopic pregnancies.
Copper T vs. Homonial IUD
Both are implanted by a doctor.
0% effective for preventing STI’s
O 10 years
O 3-5 years
O 99.2 % effective in
O 99% effective in
preventing pregnancy
O Copper on IUD acts as
spermicide, IUD blocks
egg from implanting
O Small ends of string are
present at the base of
the cervix
preventing pregnancy
O T shaped plastic that
releases hormones over a
one year time frame
O Thickens mucus, blocking
egg
O Small ends of string are
present at the base of the
cervix
STERILIZATION
O Procedure performed on a man or a woman
permanently sterilizes
O Female = Tubal Ligation
O Male = Vasectomy
TUBAL LIGATION
O Surgical procedure performed on a woman
O Fallopian tubes are cut, tied, cauterized, prevents eggs from reaching
sperm
O Failure rates vary by procedure, from 0.8%-3.7%
O May experience heavier periods
O Recovery usually takes 4-6 days
Tubal ligation is
considered
permanent, but
surgical
reversal can be
performed in
some cases.
LAPAROSCOPY-’BAND-AID’
STERILIZATION
VASECTOMY
O Male sterilization procedure
O Ligation of Vas Deferens tube
O No-scalpel technique available
O Faster and easier recovery than a tubal
ligation
O Failure rate = 0.1%, more effective than
female sterilization
During a vasectomy (“cutting the vas”) a urologist cuts and
ligates (ties off) the ductus deferens. Sperm are still
produced but cannot exit the body. Sperm eventually
deteriorate and are phagocytized. A man is sterile, but
because testosterone is still produced he retains his sex
drive and secondary sex characteristics. A male will still
ejaculate, but there won’t be any sperm present
METHODS BASED ON
INFORMATION
O Withdrawal
O Natural Family Planning
O Fertility Awareness Method
O Abstinence
Natural Family Planning (NFP)
& Fertility Awareness Method (FAM)
O Women take a class on the menstrual cycle to
calculate more fertile times
O Requires special equipment and cannot be selftaught
O NFP abstains from sex during the calculated
fertile time
O FAM uses barrier methods during fertile time
O Perfect effectiveness rate = 91%
O Typical effectiveness rate = 75%
O No 100% safe day-irregular periods
Behavioral Methods
O Predicting fertility: Basal Body
Temperature & Calendar method
O Withdrawal/Pullout
O Abstinence**
O The only 100% effective way to
prevent pregnancy, STIs & pregnancy
Basal Body Temp
O What? lowest temp of
the body at rest
O How? Ovulation raises
body temp ½ - 1 degree
F, and temp will drop if
fertilization does not
occur
Calendar
O What? Predicting fertility
based on menstrual
cycles
O How? Women chart
previous menstrual
cycles to predict the days
they are fertile and
infertile
Withdrawal/Pullout
O What? The man takes his penis out
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of the vagina before he ejaculates
How? Male needs to ejaculate away from female;
sperm on legs and labia can still travel into vagina
Notes: Depends on a male’s self knowledge and self
control
Access: Free, available to anyone
Effectiveness: 78-96%
WITHDRAWAL
O Removal of penis from the vagina before ejaculation occurs
O NOT a sufficient method of birth control by itself
O Effectiveness rate is 80% (very unpredictable in teens, wide variation)
O 1 of 5 women practicing withdrawal become pregnant
O Very difficult for a male to ‘control’
SOMETHING TO THINK
ABOUT…
Couples who use no birth control have a 85%
chance of a pregnancy within the first year.
Will you be one of the 512,000 of the teens
that gave birth in 2000?