Teens and Methods of Birth Control An Overview

							   Teens and
  Methods of
 Birth Control:
     An Overview

Lisa Wehr, Program Coordinator
Family Planning Plus of SUN & MJ Counties
lisa@familyplanning.cnchost.com
       Teen Sexual Trends
      and Birth Control Use

• For the first time in 15 years, the teen
  birth rate increased.
• Between 2005 and 2007, the percent-
  age of teens who have ever had sex
  increased while contraceptive use
  decreased.
          (Source: 2007 Youth Risk Behavior Survey)
 Teens and Birth Control                                      cont.


• More than one-quarter of teen girls and almost
  one in five teen boys did not use a method of
  contraception the first time they had sex.
• Teen girls have similar or better patterns of
  contraceptive use compared to older women.
• Teen girls report that the primary reason why
  they stopped using contraception is because of
  “side effects.”
            (Source: 2002 National Survey of Family Growth)
It’s important for teens to know…
• Except for abstinence, no birth control
  method is 100% effective.
• If you do choose to have sex, correct and
  consistent use of some form of birth
  control is essential.
• Expect side effects –
  report them to your
  medical care provider
  and learn how to
  manage them.
It’s important for teens to know…
             • Partners should decide
               together which method
               to use.
             • Most birth control
               methods do not protect
               you against STDs – use
               additional protection.
             • Don’t try to make sexual
               decisions under the
               influence of drugs and
               alcohol.
        Pregnancy
     Prevention Myths
What doesn’t work…
          • Drinking Mountain Dew before sex.
          • Having sex standing up or in other
            non-traditional positions.
          • Urinating after sex.
          • Douching after sex.
          • Having sex in water
            (pool, tub, river).
          • Jumping up and down after sex.
     Pregnancy
  Prevention Myths
Don’t depend on…

          • Having sex during your
            period.
          • Having sex before she’s had
            her first menstrual period.
          • Withdrawal (pulling out).
Hormonal
Methods
Hormonal methods in general…
• Produce changes in hormone levels to trick
  the body into thinking it’s pregnant.
• They work by…
  – Preventing ovulation.
  – Altering tubal transport of sperm and/or egg,
    thereby preventing fertilization.
  – Altering the endometrium which may inhibit
    implantation.
• Are highly effective, but must be used
  correctly and consistently for maximum
  protection.
Hormonal methods in general…
• Have more minor side effects during the first
  few months of use.
• May have serious side effects, including…
  – Blood clots        - Heart Disease
  – Stroke             - Liver problems
        Smoking increases these risks.
• Do not provide protection against STDs.
• Are available by prescription only, with the
  exception of…
Emergency Contraceptive Pills
              • Can be used up to 120
                hours after unprotected
                sex, contraceptive failure,
                or sexual assault to prevent
                pregnancy.
• Prevents pregnancy, does not terminate
  pregnancy.
• Works mainly by delaying ovulation – the
  same way as the pill.
• Extremely safe to use.
Emergency Contraceptive Pills
• Reduces the risk of pregnancy
  by 75-89%.
• Should be considered
  emergency contraception.
• Consists of 2 pills taken in
  one or two doses.
• Available over the counter to women 18
  and older - around $45.
• Most common side effects are nausea
  and menstrual changes
               Oral Contraceptives
                  • AKA, the “pill,” OCs come in
                    many variations, brands, and
                    types.
•   Must be taken at same time everyday.
•   >99% effective when used perfectly, but are
    typically 92% effective.
•   Certain medicines and supplements make
    the pill less effective
•   Have other medical benefits.
OrthoEvra® Contraceptive Patch
• A thin, beige, plastic patch containing time-
  released hormones absorbed through the skin.
• Placed on the skin once a week for 3 weeks in
  a row, followed by a patch-free week.
• Same effectiveness and medical benefits as the
  pill.
• Less effective for women weighing > 198 lbs.
• Like the pill, some medicines and supplements
  make the patch less effective.
• Slightly greater risk for blot clots.
  NuvaRing® Contraceptive Ring
            • A small, flexible ring inserted into
               the vagina containing time-released
               hormones.
            • The ring is left in place for 3 weeks,
               followed by a ring-free week.
            • Same effectiveness and medical
               benefits as the pill.
• Like the pill, some medicines and
  supplements make the patch less
  effective.
• Greater risk of vaginal irritation and
  infection.
• May be removed prior to sex.
    Depo-Provera® Injections
                      •  AKA “the shot.”
                      •  Given every 10-13 weeks.
                      •  Progestin-only method.
                      •  Less risk of serious side
                         effects.
•   >99% effective when used perfectly, but
    typically 97% effective.
•   Most common side effect is irregular
    bleeding.
•   Breastfeeding women can use it.
•   Decrease in bone density.
•   Slower return to fertility.
                           Implanon®
                 • A thin, flexible, plastic, match-
                   stick-sized rod inserted under
                   the skin of the upper arm.
• Provides continuous pregnancy protection for up to
  three years.
• Progestin-only method, so less risk of serious side
  effects.
• Breastfeeding women can use it.
• Most common side effect is irregular bleeding.
• Some medications and supplements
  may make it less effective.
• Requires minor surgery for removal.
• Initial high cost but relatively cost
  effective.
    Hormonal Intrauterine Systems
                      • Mirena® is an intrauterine
                        system that contains time-
                        released progestin.
                      • Provides continuous
                        protection up to five years.
                      • Over 99% effective.
•   Is a progestin-only method, so less risk of
    serious side effects
•   Breastfeeding women can use it.
•   Reduces menstrual flow.
•   If pregnancy does occur, there is a
    higher risk of ectopic pregnancy.
•   Initial high cost, but cost effective.
Barrier
Methods
    Barrier methods in general…
                • Prevent pregnancy by forming a
                  barrier between the sperm and
                  egg.
                • Are generally less effective
                  than hormonal methods.
•   Have fewer side effects.
•   Can be used safely by women
    who are breastfeeding.
•   Are less expensive than
    hormonal methods.
•   Must be inserted prior to
    intercourse which could affect
    sexual spontaneity.
                        Spermicides
                • Chemicals that cover the cervix and
                  prevent sperm from moving.
                • Available in foams, creams, gels,
                  films, suppositories.
                • Must be reapplied with each sex act.
                • Available without a prescription.

     The Today® Sponge
• A plastic foam device that contains
  spermicide; it covers the cervix to trap
  and immobilize sperm.
• Can be used continuously for 24 hours.
• Less effective for women who have
  had children.
• Available without a prescription
                                 Condoms
                      • Latex or plastic sheaths worn
                         on the penis or inside the
                         vagina to catch semen.
                      • Reduce the risk of STDs.
•   Male condoms come in many varieties.
•   Must be used correctly for maximum
    effectiveness.
•   Inexpensive and easy to get.
•   Can be used in addition to other
    methods to increase effectiveness of
    pregnancy prevention.
•   Male & female condoms should never
    be worn together.
    Diaphragms and Cervical Caps
                      • Silicone or latex cups that cover
                        the cervix to prevent pregnancy.
                      • Must be used with spermicide.
                      • Can be re-used for up to 2 years.
                      • Must be fitted by a practitioner.
•   Must be left in place at least 6 hours after
    intercourse, but no longer than 24-48 hours.
•   Cervical caps are less effective in women who have
    had children.
•   More spermicide is needed for
    repeated acts of intercourse.
•   May cause more vaginal or urinary
    tract infections.
                  Paragard® IUD
              • A small T-shaped device containing
                 copper that is placed inside the
                 uterus.
              • Effective for 12 years.
•   Must be inserted and removed through the
    cervix by a medical professional.
•   Extremely low failure rate.
•   Increases menstrual flow and cramping.
•   High initial cost, but extremely cost-
    effective.
        Natural Methods

              • Sexual Abstinence
              • Breastfeeding or LAM
• Natural Family Planning
  - CM/BBT
 - Calendar
      Permanent Methods

                 • Vasectomy – pieces of
                    the vas deferens are removed
                    and the ends sealed shut.




• Tubal Ligation – pieces of
  the fallopian tubes are removed
  and the ends sealed shut.
  Remember to Emphasize
• Only abstinence provides 100% protection against
  pregnancy.
• Be sure to talk with your partner about how you will
  prevent pregnancy. If you choose a method other than
  abstinence, be sure to make a plan if pregnancy should
  occur.
• There are many different methods of birth control. Be sure
  to choose one that suits your personality and lifestyle.
  Consider advantages and disadvantages of each method.
• Contraception works best when used correctly and
  consistently.
• Don’t mix alcohol/drugs and sex.
• If STDs are a concern, remember that most contraceptives
  will not provide any protection against STDs. Either abstain
  or use a condom in addition to your regular birth control
  method.