Transcript Contraceptives Historical Background     A wide variety of effective contraceptive devices is a modern phenomena The US formerly prohibited both their use and the dissemination.

Contraceptives
Historical Background
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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
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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
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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
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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
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Many forms are available
None are perfect
Each has its advantages and
disadvantages
They vary as to price, effectiveness,
convenience and safety
Effectiveness
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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
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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
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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
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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
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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
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Varies proportions of estrogen and
progesterone during the menstrual
cycle
Reduces overall hormone dosage
Fewer side-effects
Also very effective
Seasonale
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The latest
Lower yet hormone doses
Reduces periods to just 4 per year
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Progestin-only - just a constant
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dose of a very small level of
progestin
How they do it
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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
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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
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No effect on sexual spontaneity
Easily reversible
If taken as prescribed, very effective
Lessen menstrual discomfort
Also reduces risk of some cancers
Disadvantages
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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
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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
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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
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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
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The best protection against contracting
and spreading STDs and preventing
vaginal infections
Easily available
No harmful side effects
Can decrease sensitivity for greater
endurance
Disadvantages
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Can interrupt spontaneity
Decreases penile sensitivity
Tiny leaks can ruin effectiveness
Should be put on properly
The IUD
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Intrauterine devices – small plastic
objects inserted into the uterus
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Various types halt conception in
differing ways
Some prevent fertilization
Others disrupt normal ovulatory
patterns
Using the IUD
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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
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Tremendous effectiveness
Very little inconvenience
Can work for 10 years
Very inexpensive
Possible discomfort usually diminishes
within a month or so
Disadvantages
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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)
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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
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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