Contraception sponge by benbenzhou

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									                                  Contraception

The decision to become sexually active is related to your ability to make
responsible sexual health choices. The following information is an effort to help
you make the right decision according to your values and beliefs.

Why is contraception important?

             Prevents unintended pregnancy
             Some methods can lower risk of contracting or transmitting a
              sexually transmitted infection (condoms provide the best but not
              absolute protection against sexually transmitted infections)
             Depending on which method of contraception you choose, there
              are other potential health benefits such as reducing menstrual
              cramps and improving acne.

Contraception (any method) should be a SHARED RESPONSIBILITY, one you
are able to discuss with your partner.

Your decision should be based upon many factors and deciding which method is
best for you and your partner is not an easy decision, but you can make an
informed choice with the information provided below.

The best method of protection is the one that is most consistent with your
beliefs, lifestyle, goals, and medical history.

AND REMEMBER…Two METHODS are better than one! So you prevent
sexually transmitted infections AND unintentional pregnancies.

How do contraceptive methods work to prevent unintentional
pregnancy?

          1. Suppresses ovulation ( The pituitary tells the ovary not to release
             egg)
          2. Creates thick cervical mucous (acts as a barrier and interferes with
             sperm movement)
          3. Thins uterine lining (does not support implantation of fertilized
             egg)

When choosing the contraceptive that’s best for you, it helps to look at all your
available options and to talk with your provider – they can answer any questions
you may have.
 Call 882-7481 to make an appointment with a health care provider at the
  Student Health Center to talk about your options.


To help you decide which method is best for you. Take the following interactive
quiz:

http://www.arhp.org/patienteducation/interactivetools/choosing/index.cfm?I
D=275

When deciding which method is best for you, you should ask yourself the
following questions:

http://www.smartersex.org/quizzes/contraceptive_matchmaker/question_1.as
p

          1. Are you ready to engage in sexual activity?



          2. How effective is this method in preventing pregnancy AND
             sexually transmitted diseases?

             Remember: Most birth control methods do not protect you from
             sexually transmitted infections. Barrier methods are the best for
             preventing sexually transmitted infections.

          3. How cost effective is this method?

             We know cost is an important issue for most college students; that
             is why it is important to shop around. Call your insurance agency
             to check to see if your preferred method is covered.

          4. Have you spoken with your partner about all your contraceptive
             choices?



          5. Do you know your medical history? Will it influence your choice?
                a. Does anyone in your family (or you) have a history of high
                   blood pressure (hypertension)?
                b. Do you smoke?
                c. What are the health risks, potential side-effects, and
                   advantages associated with this method?
                 d. Do you have a history of blood clots?
                 e. Have you recently had an abortion?



          6. Is there a particular method that best fits with your religious
             beliefs?



          7. How likely am I to use the method accurately and consistently?

The easiest way to investigate all your birth control and STD prevention options
is to categorize them in the following way:

   1. Behavioral
             Abstinence
                 i. Only perfect method of contraception and STD prevention;
                    continuous total abstinence means no genital contact or
                    penetration.

             Fertility-Awareness-Based
              Methods (sometimes known as
              the “Calendar Method”)
                  i. Method of family
                      planning that identifies
                      the “window of fertility”
                      when a woman is most
                      likely to become
                      pregnant; involves
                      intricate training and dedication for success


             Withdrawal (Coitus Interruptus)
                 i. Prior to ejaculation, the penis is removed from the vagina;
                    relies on male’s sensations when ejaculation will occur; does
                    not prevent sexually transmitted infections and only reduces
                    the likelihood of pregnancy; there is sperm in the pre-
                    ejaculatory fluid
2. Hormonal
       Depo Provera
           i. Injectable contraceptive given intramuscularly
              (either arm or hip) every 3 months. It does not
              protect against STDs but may be a more
              culturally acceptable method to some women as
              it is not coitally dependent. It’s the only
              contraceptive method on the FDA “Black
              Box” list, meaning that prolonged use (>2
              years) may lead to decreases in bone
              mineralization

       The Combined Pill
           i. Most extensively studied and widely used
              method for reproductive health and family
              planning, contains estrogen and
              progesterone taken once daily orally.

       Progestin-only Pill
           i. These pills contain only progesterone and no estrogen so it is
              easier to take (no pill-free week), prescribed for women who
              cannot take estrogen supplements; effectiveness and side
              effects same as combined pill

       The Patch
           i. A patch that releases estrogen and
              progesterone and is worn on the skin;
              use similarly to the pill but instead of
              switching every day you only need to
              replace patch once per week on the
              same day for three weeks, remove for
              the last week. The FDA recently
              approved the addition of label
              warnings indicating that the Ortho Evra Contraceptive
              Patch contains higher levels of estrogen than many BC pill
              and may place women at an increased risk for blood clots.
              Women must speak with their healthcare provider to
              balance the potential risks related to increased estrogen
              exposure against the risk of pregnancy.
        Nuva Ring
           i. A collapsible ring that is inserted into
              the vagina and delivers low doses of
              estrogen and progesterone; keep the
              ring inserted for three weeks and
              remove for one week during which you
              have your period; easy to insert and
              effectiveness expected to be similar to
              the patch or the pill

        Emergency Contraceptive Pills
           i. Prevents pregnancy within a few hours or a
              few days (up to 5 days) after having
              unprotected intercourse; contains high doses
              of hormones-combined or progestin-only


3. Barrier
        Male Condom
            i. Condoms made of latex or
               polyurethane are the most
               effective. DO NOT use animal
               skins as they are too porous
               and allow some infections
               through; prevents against STD
               transmission AND pregnancy;
               be sure to use water-based
               lubricant so as not to
               deteriorate the integrity of the
               condom

        Female Condom
            i. Larger and wider polyurethane barrier for use in vaginal,
               anal, and oral sex, flexible ring-shaped opening, covers
               larger surface area and subsequently protects against STDs;
               newest version (September 2005) made of nitrile to control
               expense for consumers; requires use of lubricant to keep in
               place and reduce friction




        Diaphragm
             i. Flexible latex or silicone barrier used with spermicidal cream
                or jelly; blocks and kills sperm, must be fitted by a
                healthcare provider to cover the cervix; must be left in for 6-
                8 hours after intercourse

         Dental Dam (Oral Dam)
             i. A rectangular sheet of latex or silicone used to cover the
                vulva or the anus to protect an individual against bodily
                fluid transmission during oral or anal sex.


         Cervical Cap
             i. Soft, deep rubber cup with a firm round rim;
                the cap should fit snuggly around the base of
                the cervix, spermicide is used to hold in place




         Spermicide
             i. Chemicals designed to kill
                sperm; may be in the form
                of foams, suppositories,
                sponge, films, jellies,
                creams; also recommended
                for use with other barrier
                methods to reduce friction and improve effectiveness

         Intra uterine device (IUD)
              i. Small device inserted into the uterus by a
                 healthcare provider, contains copper and
                 hormones that prevent fertilization by
                 thickening cervical mucus; plastic strings
                 hang outside through cervix into the vagina

4. Sterilization
         Female-
             i. Termed “tubal ligation”, fallopian tubes are either tied or cut
                to block sperm from egg (laproscopic surgery); menstrual
                cycle continues, usually done as an outpatient basis; is
                reversible but costly
         Male
         i. Termed vasectomy, not effective until all sperm in the
             reproductive tract is ejaculated, vas deferens are tied, cut or
             sewn shut; done as an outpatient surgery, is reversible but
             complicated
           http://www.tubal-reversal.net/tubal_ligation_Pomeroy.htm




               Summary of Contraceptive Methods
Method   How does it work?  Effectiveness Rate Cost          Additional Information
Abstinence                    No vaginal-penile, oral    ~100%                   No cost        Endorsed by many religious
No prescription necessary     or anal intercourse; no                                            groups
                              side effects               This is a very                         No risk of STI transmission as
There are many reasons                                   effective method as                     long as there is no genital
why people choose to not                                 long as there is no                     contact;
engage in intercourse, and                               genital contact and                    Staying sober (from alcohol
there are equally as many                                both partner’s                          and drugs) will help you
ways to display affection                                mutually agree.                         maintain abstinence
without engaging in sex.                                                                        Can be by choice or
If no method of                                                                                  circumstance
contraception is available,
you can always say “no”
and abstain from
intercourse.
Fertility-Awareness           Factors that indicate      Failure rate: 5-30%*;   Depends        Not recommended for
Based Method                  fertility include          (70-95% effective)      on              women with irregular
No prescription necessary     monitoring change in         No STI protection     materials       menstrual cycles
                              position and feel of                               and            Fertility indicators can be
Method of family              cervix, basal body         Observations must       supplies;       affected by illness, level of
planning that uses one or     temperature,               be consistent,          low cost        activity, stress, drugs, alcohol
more indicators to            observation of cervical    regular and                             and hormones
identify the window of        mucous, and charting       accurate.                              Requires accurate and
fertility in a woman’s        menstrual cycles.                                                  consistent record keeping
menstrual cycle; Requires                                                                       Can be an effective method to
proficient knowledge of                                  *depending upon                         achieve pregnancy
cycle and the body,                                      techniques used
training
Withdrawal (coitus            Withdrawal before any      Failure rate: 4-19%     No cost        Requires no devices and
interruptus)                  ejaculate is released to   (81-96% effective)                      available in any situation
No prescription required      prevent fertilization                                             Pre-ejaculate may contain
                              between egg and sperm        No STI protection                     sperm and viruses including
Male partner interrupts                                                                          HIV
intercourse and                                                                                 Requires control
withdraws his penis from
partner’s vagina before
ejaculating.
Outercourse                   Hold hands, hug, kiss,     Requires good           No cost        Emotional closeness
No prescription required      mutual masturbation,       partner                                Fun
                              petting, touching          communication and                      Minimizes risk of infection
Sexual intimacy that does                                dedication
not involve penis entering
vagina or anus




Methods                       How does it work?          Effectiveness           Cost        Additional Information
Nuva Ring®                    Insert the ring into       Failure rate: 1-2%      $30/mon     Similar risks as oral
Prescription required      your vagina and          (98-99% effective)     th         contraceptives
                           leave it there for                                         Possible side effects include
Flexible transparent       three weeks; remove       No STI protection                vaginal irritation/discharge,
ring that provides         for one week, ring-                                        headache, weight gain
month-long                 free to allow for        Must reinsert
contraceptive              menstruation             within 3 hours if
protection; after                                   falls out or is
insertion releases a                                removed
continuous low dose of
estrogen and
progesterone
Ortho Evra®                Patch worn on skin       Failure rate: <1%      $30/mon    Patch must be replace if falls
Prescription required      for one week and         (92-99% effective)     th         off
                           replaced with                                              Can wear in shower,
Birth control patch that   another patch on the      No STI protection                exercising and swimming
releases a continuous      same day for three                                         Clinician will evaluate with
low dose of hormones;      weeks                                                      family medical history
                           Fourth week=patch
                           free; FDA
                           BLACK BOX
                           WARNING! May
                           contain high levels of
                           estrogen, consult
                           doctor
Combination Pill           Preventing ovulation     0.5-3%*                $15-       Does not interfere with sex
Most popular method        and thickens the         (97-99% effective)     30/mont    Can reduce cramps
Prescription required      cervical mucous                                 h
                           sperm cannot
Pill that contains         penetration/effects      *depends on type
synthetic estrogen and     motility                 of pill and
progesterone; Many                                  consistency of use
brands with varying
Mini Pill                  Thickens cervical        Same as above          Same as
Prescription Required      mucus, thins                                    above
                           endometrial lining
Contains progesterone
only



Method                     How does it work?        Effectiveness Rate     Cost       Additional Information
Depo Provera®              Inhibits ovulation,      Failure rate: 0.3% ;   $280-      Must have injection every 12
Prescription required      altering the uterine     meaning 3 in 1000      480/year   weeks (given by a practitioner)
                           lining and thickening    women become                      No way to reverse medicine if
**FDA “Black Box” list.    the cervical mucous      pregnant in the                   unhappy with the side effects
An injectable form of      so sperm cannot          first year of use                 Associated weight gain, hair
progesterone only          penetrate                (99.7% effective)                 loss
given every three                                                                     Many women quit having
months in arm or hip                                 No STI protection                periods altogether
                                                                                      May take up to 9-18 mons. to
                                                                                      conceive
Emergency                   It delays ovulation      Failure rate: 25%      $8-200       Used in cases of method
Contraception (EC);         and may cause            (*75% effective                     failure, when no contraceptive
“morning after pill”        disruption of            with combined                       is used, or in rape situations
No prescription needed      hormone production,      pills and 89%                       Treatment is more effective
for individuals 18 and      which renders the        effective with                      within the first 12-24 hours,
older                       uterine lining           progesterone only)                  but can be used up to 120
                            unsuitable for             No STI protection                 hours after intercourse
High oral doses of          implantation; may                                            May cause nausea and
hormones (combined or       interfere with                                               vomiting
progesterone only) that     fertilization                                                Take two pills at once, and
must be taken within                                                                     then two more 12 hours later
120 hours of                                                                             Some birth control pills can be
unprotected                                           *If taken within 72                used as EC
intercourse.                                                 hours                       For more information about
                                                                                         Emergency Contraception
                                                                                         click here: Not-2-late.com at
                                                                                         http://ec.princeton.edu/

Extended Hormonal           Inhibits ovulation,      Same as pill           $100 for 3   Offers choice of when menses-
Contraception               thickens cervical                               months       free
                            mucous                                                       No medical contraindications
Continuous                                                                               Familiar names: Yasmin,
monophasic or                                                                            Seasonale, Cyclessa
triphasic hormones                                                                       Can use the Patch and the
used daily without                                                                       Vaginal ring same way
interruption for period
Implanon®                   Inhibits ovulation,      Failure rate: (first                    FDA approved on July 17,
                            increases cervical       year) 0.05%                             2006.
Single rod injectable       mucous viscosity          No STI protection                      Requires removal after three
inserted into the upper     inhibiting sperm                                                 years
arm, low dose               penetration                                                      Minimizes menstrual side
progestin-only released                                                                      effects
3 yr                                                                                         6.4% of women report weight
                                                                                             gain
     **should not be on Depo for more than a total of two years; decreases bone mineralization
Method                    How does it work?        Effectiveness Rate   Cost        Additional Information
Male Condom               Blocks sperm from        98% effectiveness    Free at     Always use water-based
                          entering the uterus      if used correctly    health      lubricants to prevent
A latex or polyurethane   Kills sperm if           and consistently     offices     deterioration and reduce
barrier used to prevent   spermicide present                            across      friction
pregnancy and provide                                                   campuse
some protection against                                                 s
some sexually
transmitted infections;
do not use animal skins
Female Condom             Physical barrier that    95% against          Currentl    Stronger than latex and more
                          blocks sperm and         pregnancy            y free at   heat resistant; does not
A polyurethane (or        other bodily fluids                           the         degrade as easily; can use oil-
silicone) device          from entering or                              Student     based or water-based
with two rings, one       transmitting; prevent                         Health      lubricants
used as an anchor         bodily fluid exchange                         Center;
and the other as an       during oral, anal, or                         $2.50 at
opening for               vaginal sex                                   some
insertion; the                                                          pharmaci
external portion                                                        es
provides some
protection to the
labia and the base
of the penis
Dental Dam                Extremely easy to        When used            Free at     ONLY use one side of the
                          use. Rinse off any       correctly and        the         dam. Don't flip and do not re-
A rectangular sheet of    powder on the dam        consistently they    Student     use a dam on another body
latex designed to cover   and check the dam to     offer some           Health      part (e.g. from anus to vulva
the vagina or anus        make sure there are      protection against   Center      or vice-versa) because you can
during oral sex           no holes or              many STIs            and         transfer germs from one body
                          perforations. The        (herpes, HPV, and    LGBT        area to another. Do not re-use
                          partner performing       HIV) that can be     Resource    a dam for another act of oral
                          oral sex will hold the   transmitted via      Center      sex later on either. Dams are
                          dam against the          oral sex                         for one-time use only.
                          vulva or anus of the
                          receiving partner.
                          You can opt to apply
                          a water-based
                          lubricant on the
                          vulva or anus before
                          using the dam.
Method                     How does it work?        Effectiveness Rate    Cost        Additional Information
Spermicide, Vaginal        Serves to immobilize     If a couple uses      Free at
Contraceptive Film         and kill sperm,          spermicides alone     the
(VCF)                      according to the 2002    (not using            Student
                           Centers for Disease      condoms or            Health
Chemicals designed to      Control STI              another method)       Center;
kill sperm;                Treatment                correctly every       available
recommended to be          Guidelines, N-9          time they have        at all
used in conjunction        contraceptives do not    intercourse, about    pharmaci
with many barrier          protect against these    6% of them will       es
methods; typically         infections and may       become pregnant.
made of nonoxynol-9        increase STI             However, not all
or octoxynol to            exposure risk            couples use
prevent pregnancy          because it can cause     spermicides every
                           genital irritation.      time and they
                                                    don't always use
                                                    the spermicide
                                                    correctly, so the
                                                    average
                                                    pregnancy rate is
                                                    about 21%.
Intra Uterine Device       It affects the way the   The IUD is one of     Intially    Must be fit by a medical
(IUD)                      sperm or egg moves.      the most effective    expensiv    provider
                           Substances released      methods of            e ($175-    Paragard can leave in for 5
IUDs are small, "T-        by the IUD               contraception         400)        years; Progestasert must
shaped" contraceptive      immobilize sperm, It     available. The rate               change annually
devices made of flexible   moves the egg            of pregnancy for                  Does not prevent STDs
plastic and are            through the fallopian    women using the
surgically implanted       tube too fast to be      ParaGard is 0.8%
into a women's uterus.     fertilized., Paragard    and for women
Two IUDs available on      copper-T; copper         using the
the US market, the         affects the uterine      Progestasert the
Progestasert and the       lining not allowing      rate is 2%.
Paragard copper-T. The     egg to implant,          However, IUDs do
IUD remains a              Progestasert disrupts    not offer any
medically safe method      the uterine lining but   protection against
for many women and is      also releases            sexually
the reversible             progestin, which         transmitted
contraceptive method       thickens the cervical    infections (STIs).
used by more women         mucous (barrier)
across the globe.
Methods                         How does it work?       Effectiveness         Cost   Additional
                                                        Rate                         Information
Cervical Cap, Fem Cap,          Each method acts as     Typical                      Can insert up to 6 hours
Lea’s Shield                    a physical and a        pregnancy rate               prior to intercourse,
                                chemical barrier,       for cervical cap is          Must leave in for 6-8
Cervical cap is a rigid,        similar to the          16% per year; the            hours post coitus
thimble-shaped cup              diaphragm, to           perfect use rate             No hormonal side
made of latex rubber            prevent sperm from      is 9% per year.              effects
that fits over the cervix       entering the uterus     Pregnancy rates
and is held in place by         and fertilizing an      for women who
suction.. The Fem Cap is        egg. They must be       have given birth
a silicone cup shaped           used with               are 32% for
like a sailor's hat that fits   spermicidal cream or    typical use and
securely in the vagina to       jelly which helps       26% perfect use.
cover the cervix. Lea's         inactivate sperm.       Difference due to
Shield is also a silicone                               change in cervix
cup with an air valve                                   size post
that fits snugly over the                               childbirth. For
cervix and has a loop to                                Fem Caps,
help remove it. It is                                   typical use the
necessary to use a small                                rate is 14%. For
amount of spermicidal                                   Lea's Shields,
cream or gel with each                                  typical use the
method. Must be fit by a                                rate is 15%.
practitioner.
                                                        Offers no
                                                        protection
                                                        against STIs
Diaphragm                       Stops the sperm from    Does not protect             Check for placement by
                                entering the cervix;    against STIs                 feeling for the cervix
Dome-shaped rubber cup          apply a spermicide in                                under the cup, should
with a flexible rim,            the middle of the cup   84-94% effective             feel like the tip of a
obtained with a                 and around the rim,                                  nose; leave in place for
prescription only and fit       pinch the sides and                                  6-8 hours after sex
by a practitioner; fits over    push into the vaginal
the cervix                      canal, tuck front of
                                the rim behind the
                                pubic bone

     References:
     Brown University, visit
     http://www.brown.edu/Student_Services/Health_Services/Health_Education/sexual
     _health/home.htm
     Hatcher, R.A. et al. (2004). Contraceptive Technology (18th ed.). New York: NY: Ardent
     Media, Inc.



     Current Events:

          1. Norplant removed from the market!
         A form of birth control that consisted of six small silicone capsules,
         each filled with 36 mg levonorgesterel (a progestin used in many birth
         control pills) implanted in the skin of the upper arm, effective for five
         years, was removed from distribution in 2002.

         Lawsuits were filed against the company because the plantiffs felt they
         had not been adequately warned about the possible side effects of
         Norplant such as irregular menstrual bleeding, headaches, nausea, and
         depression.

         Shipments were suspended because quality assurance monitoring
         revealed lower end of product specifications, including shelf life. Due
         to limitations in product component supplies, the company would not
         resume marketing Norplant (six capsules) in the United States.

         Jadelle, (Norplant II, consisting of two small capsules containing 75 mg
         of levongesterol) was FDA approved November 22, 2002 as being
         effective for a period of five years. Jadelle has not been marketed in the
         United States.

   2. Lunelle is no longer available in the United States!

      Lunelle was a combination hormonal method given monthly as an
      injection in the arm, thigh, or buttocks. This method works to prevent the
      release of egg and thickens the cervical mucous; does not require
      physician visits and must be used only certain days during the menstrual
      cycle.

      Lunelle was pulled from the market because the company was not doing
      well fiscally.

   3. Student-designed condoms (Condom One)

One Condom’s is a line of condoms and other items where the consumer creates
the design and is owned by the Global Protection Corporation, the industry's
fastest growing condom manufacturer and distributor, featured in Inc. magazine
on The Inner City 100 List for 2002, 2003 and 2004 as one of America's fastest
growing inner city companies. As a recognized leader in condom marketing and
manufacturing, Global Protection Corp.'s mission is to make condoms as socially
acceptable as toothpaste and safer sex as second nature as wearing a seatbelt.

Davin Wedel, Founder and President of Global Protection Corp., has
campaigned to make condoms a socially accepted, proverbial norm since 1988 by
combining condoms with popular culture. Some of Global’s innovations include:
the first glow-in-the-dark-condoms, the first condoms in fun or customized
packaging, and the first stores to sell nothing but condoms. Today, Global
Protection Corp. products are not only known as successful educational tools,
but are also considered a critical part of the fight against HIV and AIDS.


Then and now, Global Protection Corp. pledges ultimate commitment to quality
and protection. In fact, every condom manufactured by Global Protection Corp.
is subject to stringent testing and manufactured to the world’s highest standards.
The result is a premium quality product line that reflects consistent excellence.

If you are an artist (or just play one on TV), check out this site to enter a drawing
for condom designs: http://www.onecondoms.com/design.php

4. Lybrel-a new period free contraceptive! Check it out!

   http://www.fda.gov/bbs/topics/NEWS/2007/NEW01637.html

5. The Contraceptive Sponge is back by popular demand!

   The sponge is a small, pillow-shaped polyurethane sponge containing
   nonoxynol-9 spermicide. Click here for warnings about N-9 use.
   http://www.who.int/mediacentre/news/notes/release55/en/print.html

   The sponge can be purchased over the counter. It should be moistened with
   tap water prior to use and inserted deep into the vagina. The sponge will
   offer protection for up to 24 hours, no matter how many times you engage in
   intercourse. Following intercourse, the sponge should be left in place for at
   least 6 hours before removing and discarding. The sponge is 72% to 84%
   effective at preventing pregnancy, depending on whether you have had
   children or not.

   Male contraceptives
   The development of contraceptive methods for men poses a different
   challenge because men are continuously producing sperm and therefore are
   continuously fertile, unlike women who have a limited number of fertile days
   each month. The current research is focused on developing contraceptive
   injections, implants, or vaccines that will reduce a male's sperm count low
   enough to levels unlikely to cause pregnancy, but without damaging lifetime
   sperm production. Tests are currently being conducted overseas and the
   information in this field will continue to be expanded


Test your knowledge!!!
http://www.surveymonkey.com/s.aspx?sm=PdOjqpbtnhUwHbQnxmu_2buA_
3d_3d

								
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