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Birth Control_Hutchinson

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					Contraception Choices




  Adolescent Clinic NNMC
            Objective
 Discussthe different options
 Important counseling points
 Review by playing a game
                                Method        Typical Use   Perfect Use
                                Implant          0.09          0.09


       Options
                            Injection-combo       0.1           0.1
                               Injection-         0.3           0.3
                               progestin
   Abstinence                    IUD           0.1-2.0       0.1-1.5

    Timing schemes
                             OCP-combo          2.5-6.0         0.1

                            OCP-progestin      3.0-10.0         0.5
   Barrier methods              Patch             -            0.1
                              Vaginal ring         -           0.65
   Hormonal preparations    Male condom         12.0           3.0
                            Diaphragm/Cerv     16.0-18.0        6.0
                                  cap
                              Withdrawal         19.0           4.0
                               Periodic            -          2.0-9.0
                              abstinence
                            Female condom      21.0-26.0        5.0
                             Spermicides         40.0           6.0
                              No method          85.0          85.0
        Abstinence/Timing
   While some groups encourage “The rhythm
    method” as a form of birth control we do not
    recommend it
   Temperature, cervical mucus and record
    keeping are needed to do it right.
             Barrier
 2nd most popular
 STD protection
 Inexpensive
 Failure rate: 3-18%
 Proper wear important
              Hormonal
   Combination OCPs
    – Monophasic
    – Biphasic
    – Triphasic
    – Failure rate 0.1% (2-6%)
   Progestin only
    – Failure rate 0.5% (3-10%)
    Depo-Provera, DMPA
   Depo medroxyprogesterone acetate
    – Prevents egg release
    – Failure rate: 0.3%
    – Shot every 3 months
            The Patch
   Ortho Evra




   Combination preparation
   20% bleeding in first cycle
   Change patch once per week
   May not be as effective if >90kg
          Vaginal Ring
   NuvaRing




   Combination preparation
   Worn for 3 weeks at a time
   Low breakthrough bleeding rate
          Vaginal Ring
   NuvaRing
    – Low failure rate
    – Can wear during menses
    – Can wear during intercourse
    – Can remove for intercourse
    – Does not have to be fitted
    – Vaginal position does not matter
    – No increased risk of infection
  Choosing a Method
What myths have you heard?

What side effects have you
 heard about?
     Common Myths
 2/3 women believe OCPs unsafe
 Causes cancer
 Causes heart disease
 Leads to infertility
 Body needs break from OCPs



 ALL   FALSE
          Advantages
 Less dysmenorrhea
 Shorter, lighter menses
 Less Mittelschmerz
 Acne & hirsutism improved
 Prevents ovarian & endometrial cancer
 Reduction in PID
Possible side effects
      ESTROGEN          PROGESTERONE
   Nausea/vomiting       Androgenic

   Edema/leg cramps         –   Oily skin
                             –   Hirsutism
   Bloating                 –   Acne
   Vascular headaches       –   Increased appetite
   Clear vaginal d/c       Mastalgia
   Cystic breast changes   Inreased breast size
   Chloasma                Bloating
                            Depression
            Do not use if:
   You have had a      You have high blood
    blood clot           pressure

   You have had        You are on seizure
    cancer               medicine

   You have liver      You have bad
    disease              migraines
   If you miss a pill
 Missed   pills
    2 per day until caught up
    Condoms if miss >2 pills per

     month
            Headaches
 Contactus if you get frequent
 headaches or headaches
 during the reminder pills
Some things that can Interact
  Seizure medicine
  St. John’s Wort
  Rifampin, griseofulvin
  Vitamin C
     – Irregular bleeding
Time to Play……
                    $100             1,000,000
                                     500,000

Which is not sexual                  250,000

activity                             100,000
                                      50,000
                                      25,000
 A.   Oral Sex       C.   Adultery    10,000
 B.   Intercourse    D.   Coveting    5,000
                                      1,000
                                       500
                                       100
                    $100             1,000,000
                                     500,000

Which is not sexual                  250,000

activity                             100,000
                                      50,000
                                      25,000
 A.   Oral Sex       C.   Adultery    10,000
 B.   Intercourse    D.   Coveting    5,000
                                      1,000
                                       500
                                       100
                   $500                 1,000,000
                                        500,000

What is the best way                    250,000

to prevent pregnancy                    100,000
                                         50,000
                                         25,000
 A.   Monogamy     C.   Withdrawal       10,000
 B.   Abstinence   D.   Rhythm Method    5,000
                                         1,000
                                          500
                                          100
                   $500                 1,000,000
                                        500,000

What is the best way                    250,000

to prevent pregnancy                    100,000
                                         50,000
                                         25,000
 A.   Monogamy     C.   Withdrawal       10,000
 B.   Abstinence   D.   Rhythm Method    5,000
                                         1,000
                                          500
                                          100
                 $1,000          1,000,000
                                 500,000

Most OCP side effects            250,000

resolve by                       100,000
                                  50,000
                                  25,000
 A.   1 month      C.   1 year    10,000
                                  5,000
                                  1,000
 B.   3 months     D.   Never
                                   500
                                   100
                 $1,000          1,000,000
                                 500,000

Most OCP side effect             250,000

resolve by                       100,000
                                  50,000
                                  25,000
 A.   1 month      C.   1 year    10,000
                                  5,000
                                  1,000
 B.   3 months     D.   Never
                                   500
                                   100
                $5000                 1,000,000
                                      500,000

Depo causes this side                 250,000

effect, and thus a 2 year             100,000

use recommendation                     50,000
                                       25,000
 A.   Weight gain   C.   Thin bones    10,000
 B.   No period     D.   Acne          5,000
                                       1,000
                                        500
                                        100
                $5000                 1,000,000
                                      500,000

Depo causes this side                 250,000

effect, and thus a 2 year             100,000

use recommendation                     50,000
                                       25,000
 A.   Weight gain   C.   Thin bones    10,000
 B.   No period     D.   Acne          5,000
                                       1,000
                                        500
                                        100
                 $10,000           1,000,000
                                   500,000

     The easiest method of         250,000

     birth control to keep         100,000

     private                        50,000
                                    25,000
A.   The Pill      C.   The Shot    10,000
B.   The Patch     D.   The Ring    5,000
                                    1,000
                                     500
                                     100
                 $10,000           1,000,000
                                   500,000

     The easiest method of         250,000

     birth control to keep         100,000

     private                        50,000
                                    25,000
A.   The Pill      C.   The Shot    10,000
B.   The Patch     D.   The Ring    5,000
                                    1,000
                                     500
                                     100
             $25,000             1,000,000
                                 500,000

How often does a                 250,000

patient need Depo                100,000

Provera                           50,000
                                  25,000
 A.   Monthly    C.   3 months    10,000

 B.   6 months   D.   Annually    5,000
                                  1,000
                                   500
                                   100
             $25,000             1,000,000
                                 500,000

How often does a                 250,000

patient need Depo                100,000

Provera                           50,000
                                  25,000
 A.   Monthly    C.   3 months    10,000

 B.   6 months   D.   Annually    5,000
                                  1,000
                                   500
                                   100
                   $50,000               1,000,000
                                         500,000
     What side effect of the             250,000

     Patch is in the news                100,000
                                          50,000
                                          25,000
A.   Rashes           C.   Pregnancies
                                          10,000
B.   Falling off      D.   Clots          5,000
                                          1,000
                                           500
                                           100
                   $50,000               1,000,000
                                         500,000
     What side effect of the             250,000

     Patch is in the news                100,000
                                          50,000
                                          25,000
A.   Rashes           C.   Pregnancies
                                          10,000
B.   Falling off      D.   Clots          5,000
                                          1,000
                                           500
                                           100
              $100,000       1,000,000
                             500,000

     What percent of teens   250,000

     15-19 get pregnant      100,000

     each year                50,000
                              25,000
A.   1%         C.   5%       10,000
B.   10%        D.   25%      5,000
                              1,000
                               500
                               100
              $100,000       1,000,000
                             500,000

     What percent of teens   250,000

     15-19 get pregnant      100,000

     each year                50,000
                              25,000
A.   1%         C.   5%       10,000
B.   10%        D.   25%      5,000
                              1,000
                               500
                               100
                 $250,000               1,000,000
                                        500,000
                                        250,000

 Which item does not
                                        100,000
                                         50,000
 decrease STIs?                          25,000

A.   Condom        C.   Dental dam       10,000
                                         5,000
B.   Diaphragm     D.   Female condom
                                         1,000
                                          500
                                          100
                 $250,000              1,000,000
                                       500,000
                                       250,000

 Which item does not
                                       100,000
                                        50,000
 decrease STIs?                         25,000

A.   Condom       C.   Dental dam       10,000
                                        5,000
B.   Diaphragm    D.   Female condom
                                        1,000
                                         500
                                         100
                $500,000          1,000,000
                                  500,000

     What percent of teens not    250,000

     using birth control become   100,000

     pregnant in a year            50,000
                                   25,000
A.   15%            C.   50%       10,000
B.   85%            D.   99%       5,000
                                   1,000
                                    500
                                    100
                $500,000          1,000,000
                                  500,000

     What percent of teens not    250,000

     using birth control become   100,000

     pregnant in a year            50,000
                                   25,000
A.   15%            C.   50%       10,000
B.   85%            D.   99%       5,000
                                   1,000
                                    500
                                    100
          $1,000,000    1,000,000
                        500,000

What percentage of      250,000

10th grade girls have   100,000

had sex                  50,000
                         25,000
A.   20       C.   35    10,000

B.   50       D.   67    5,000
                         1,000
                          500
                          100
          $1,000,000    1,000,000
                        500,000

What percentage of      250,000

10th grade girls have   100,000

had sex                  50,000
                         25,000
A.   20       C.   35    10,000

B.   50       D.   67    5,000
                         1,000
                          500
                          100
         Conclusion
 We  are here to help you in any way
  we can
 Please feel free to contact us with
  any questions or concerns you
  have
Questions?