Supplemental Topics

1. Supplemental Topics Chapter 1: Family Planning And Birth Control

2. What you should get out of this • The 2 most effective methods of birth control • Disadvantage of condom use • Is spermicide effective when using a single method • Different types of birth control methods and their advantages and disadvantages

3. Take a moment to answer this… • What do you know about birth control? • What are some methods?

4. Continuous Abstinence Periodic Abstinence The Rhythm Method Fertility Awareness-Based Methods (FAMS) The Pill The IUD Spermicide The Sponge Depo-Provera The Male Condom The Female Condom The Diaphragm Sterilization Common Methods…

5. Name 2 common methods of birth control? Only 1 person shall answer this question… a person who’s favorite color is blue…yellow…pink… For one treat…

6. Continuous Abstinence • NOT having intercourse at all • This is an option you can choose or not choose • The only 100% effective method

7. Advantages 100% effective You are in control No possibility of disease No fear No Chemicals No side effects Costs nothing No clinic Visits Disadvantages Restricting Requires will power Continuous Abstinence…

8. How does abstinence work • If two people don't have sex, then sperm can't fertilize an egg and there's no possibility of a pregnancy. Some forms of birth control depend on barriers that prevent the sperm from reaching the egg (such as condoms or diaphragms). Others interfere with the menstrual cycle (as birth control pills do). With abstinence, no barriers or pills are necessary because the person is not having sex. • You don't have to be a virgin to practice abstinence. Sometimes people who have been having sex decide not to continue having sex. Even if a person has been having sex, he or she can still choose abstinence to prevent pregnancy and sexually transmitted diseases (STDs).

9. How well does it work? • Abstinence is 100% effective in preventing pregnancy. Although many birth control methods can have high rates of success if used properly, they can fail occasionally. Practicing abstinence ensures that a girl will not become pregnant because there is no opportunity for sperm to fertilize an egg.

10. Abstinence protects people against STDs. Some STDs spread through oral-genital sex, anal sex, or even intimate skin-to-skin contact without actual penetration (genital warts and herpes can be spread this way). So only avoiding all types of intimate genital contact can prevent STDs. Avoiding all types of intimate genital contact — including anal and oral sex — is complete abstinence. Only complete and consistent abstinence can totally prevent pregnancy and protect against STDs. Because a person does not have any type of intimate sexual contact when he or she practices complete abstinence, there is no risk of passing on a sexually transmitted infection. Consistent abstinence means that someone practices abstinence all the time. Having sex even once means that the person risks getting an infection. Abstinence does not prevent AIDS and hepatitis B infections that come from nonsexual activities like using contaminated needles for doing drugs, tattooing, or taking steroids. Protection against STD’s

11. Periodic Abstinence orFertility Awareness-Based Methods • Occurs when partners abstain during the woman’s most fertile time of the month 70-80% effective

12. Advantages Accepted by all No chemicals No side effects No cost No clinic visits Disadvantages Restricting Relies on the regularity of menstrual cycles Requires will power Need accuracy I prediction for “best days” Risky Periodic Abstinence or FAMs

13. How does it work? • By avoiding intercourse on days when the woman is most fertile, a couple may reduce the chances of pregnancy. Finding the “unsafe” days, when the woman is her most fertile and the chances of pregnancy are higher, is very tricky and NOT very reliable

14. For one treat… What is one difference that you learned between continuous abstinence and periodic abstinence?

15. The Pill • Taken orally by women to prevent pregnancy • The pill is 92-99.7% effective

16. Advantages Convenient Regulates menstrual flow and associated discomforts A variety available Available at clinics at a low cost Long term safety Strengthens your bones by regulating hormones Can provide relief from acne and unwanted facial hair Disadvantages Some experience minor side effects Does not protect against STDs The Pill

17. irregular menstrual bleeding Nausea Weight gain Swelling Retention of fluids Upset stomach Headaches Dizziness Breast tenderness Mood changes Blood clots (rare in women under 35 who do not smoke) Some of these side effects improve over the first 3 months on the Pill. When a girl has side effects, a doctor will sometimes prescribe a different brand of the Pill. The Pill also has some side effects that most girls are happy about. It usually makes periods much lighter, reduces cramps, and is often prescribed for women who have menstrual problems. Taking the Pill often improves acne, and some doctors prescribe it for this purpose. Birth control pills have also been found to protect against some forms of breast disease, anemia, ovarian cysts, and ovarian and endometrial cancers. Possible Side Effects

18. The pill creates a condition in the female similar to pregnancy Hormones are released which stop the ovaries from releasing eggs When the female stops taking the pill, the ovaries can once again release eggs Must be prescribed by a physician Must be taken VERY regularly or it won’t be effective in preventing pregnancy How does it work?

19. Oral Contraceptives--combined pill • FDA Approval Date: First in 1960; most recent in 2003Description: A pill that suppresses ovulation by the combined actions of the hormones estrogen and progestin. A chewable form was approved in November 2003.Failure Rate (number of pregnancies expected per 100 women per year): 1-2 Some Risks: Dizziness; nausea; changes in menstruation, mood, and weight; rarely, cardiovascular disease, including high blood pressure, blood clots, heart attack, and strokesProtection from Sexually Transmitted Diseases (STDs): None Convenience: Must be taken on daily schedule, regardless of frequency of intercourse. Women using the chewable tablet must drink 8 oz. of liquid immediately after taking.Availability: Prescription

20. Oral Contraceptives--91-day regimen (Seasonale) • FDA Approval Date: 2003Description: A pill containing estrogen and progestin, taken in 3-month cycles of 12 weeks of active pills followed by one week of inactive pills. Menstrual periods occur during the 13th week of the cycle.Failure Rate (number of pregnancies expected per 100 women per year): 1-2Some Risks: Similar to oral contraceptives--combined pillProtection from Sexually Transmitted Diseases (STDs): NoneConvenience: Must be taken on daily schedule, regardless of frequency of intercourse. Since users will have fewer periods, they should consider the possibility that they might be pregnant if they miss scheduled periods. May have more unplanned bleeding and spotting between periods than with 28-day oral contraceptives.Availability: Prescription

21. Oral Contraceptives--progestin-only minipill • FDA Approval Date: 1973Description: A pill containing only the hormone progestin that reduces and thickens cervical mucus to prevent the sperm from reaching the egg.Failure Rate (number of pregnancies expected per 100 women per year): 2Some Risks: Irregular bleeding, weight gain, breast tenderness, less protection against ectopic pregnancyProtection from Sexually Transmitted Diseases (STDs): NoneConvenience: Must be taken on daily schedule, regardless of frequency of intercourse.Availability: Prescription

22. How much does it cost? • The Pill usually costs between $20 and $50 a month, depending on the type. Many health and family planning clinics (such as Planned Parenthood) sell birth control pills for less. In addition, birth control pills and doctor visits are covered by many health insurance plans.

23. For one treat (each question) • Name 3 possible side effects • Will the side effects ever go away? • Some girls like the side effects because…

24. The IUD The Intra-Uterine Device Small device that is inserted into a woman’s cervix to prevent pregnancy.

25. Advantages Once in place, there is nothing to remember A variety available One time cost to buy IUD Disadvantages Can become dislodged Requires medical insertion and medical follow-up Temporary side effects (cramps, heavy menstrual flow, spotting, infection) Does not protect against STD’s The IUD

26. The copper-coated IUD primarily prevents pregnancy by not allowing the sperm to fertilize the egg. When an IUD is coated with progesterone, it works in a similar way, but may also prevent ovulation (the release of an egg during a girl's monthly cycle) and thicken the cervical mucus, which prevents sperm from entering the uterus Most experts think that the IUD works in a combination of ways: Interferes with implantation of the egg Causes a chemical reaction that destroys the sperm or egg Hinders the progress of the sperms How does it work?

27. Possible side effects • The most common side effects of the IUD include: • spotting in between periods • heavier periods with more cramps with the copper IUD • irregular or loss of periods with use of the hormonal IUD • expulsion, or loss of the IUD. For some IUD users — particularly teens — the IUD can fall out or become displaced and not work properly. • perforation of the uterus. There is a very minimal risk of the IUD perforating the uterine wall when it is being inserted. • acne, breast tenderness, headaches, and nausea with the hormonal IUD

28. How much does it cost • An IUD costs about $250 plus the cost of having a doctor insert and remove it. Many health insurance plans cover these costs, and family planning clinics (such as Planned Parenthood) may charge much less.

29. Name one advantage and one disadvantage • How much does it cost?

30. A chemical preparation placed in a woman’s vagina just before intercourse to prevent pregnancy 74-94% effective Spermicide

31. Spermicides immobilize and kill the sperm before they are able to swim into the uterus. To be effective, the spermicide must be placed deep in the vagina, close to the cervix. Creams, gels, and foams are squirted into the vagina using an applicator. Other types of spermicides include vaginal contraceptive film (VCF), a thin sheet placed in the back of vagina by hand, and vaginal suppositories. Spermicides must be placed in the vagina before sexual intercourse. Some offer protection right away. But most must be placed in the vagina at least 15 minutes before sex so they have enough time to dissolve and spread. All forms of spermicides are only effective for 1 hour after they are inserted. If more than 1 hour goes by before having sex, or if you have sex again, another application of spermicide is needed. When using spermicides, girls should not douche for at How does it work?

32. How does it work… according to text • The spermicide is placed deep in the vagina • The chemicals in the spermicide destroy male sperm upon contact • This method is not terribly effective when used alone • Best used in combination with another birth control method such as the diaphragm or condom

33. Advantages Variety of brands Easy to use Inexpensive Available No clinic visit required No side effects Good back-up method Disadvantages Not reliable when used alone Messy Must wait for spermicide to take action before having intercourse which can take away from spontaneity Spermicides

34. Spermicides alone are not effective against sexually transmitted diseases (STDs). For those having sex, condoms must always be used with spermicide to protect against STDs. Abstinence (not having sex) is the only method that always prevents pregnancy and STDs. Spermicides may irritate the vagina and surrounding skin. Another possible side effect is recurrent urinary tract infections because the spermicide can disrupt the normal balance of bacteria in a girl's body. Depending on the type of spermicide you choose (film is more expensive than gel), spermicide costs only about $0.50 to $1.50 per use Protection against STDs andPossible Side Effects and Cost

35. Pop _Quiz • What is percent (%) effective for spermicide? • According to our manual, it is best (most effective) when __________ • A) Used alone • B) Not Used at All • C) Used in Combination with another birth control method • D) None of the above

36. The Sponge 68-91% effective • Is this the right sponge? Which sponge do you think is right?

37. Advantages No prescriptions needed Easy to use Can be worn for up to 30 hours after insertion Does not have an effect on women’s natural hormones Disadvantages May be difficult for some to insert or remove Possible vaginal irritation Messy The Sponge

38. How does it work? • The sponge is first moistened with water then inserted into the vagina before intercourse • It covers the cervix and blocks sperm from entering the uterus • It also continuously releases a spermicide that prevents the sperm from joining the egg

39. Depo-Provera A drug very similar to progesterone, a hormone normally produced by the ovaries every month as part of the menstrual cycle. Depo-Provera is an injectable form of this medicine that prevents pregnancy for up to 3 months with each injection.

40. Advantages Safe and long-lasting protection Stops monthly periods or causes light periods Contains no estrogen Decreases menstrual cramps and pain Disadvantages Shots may be uncomfortable Must be given every three months Costly Requires doctor visits May cause irregular monthly periods or spotting May cause bloating, weight gain, headaches, depression, hair loss Does not protect against STDs Depo Provera97-99.7% effective

41. How does it work? • The hormone progesterone in the birth control shot primarily works by preventing ovulation (the release of an egg during the monthly cycle). If a girl doesn't ovulate, she cannot get pregnant because there is no egg to be fertilized. • Depo Provera prevents pregnancy by stoppin ovulation. Depo Provera is given as 1 shot in the buttock or upper arm. The first shot should be given within 5 days after the beginning of a normal menstrual period, and shots should be repeated every 3 months.

42. Possible Side Effects • Many young women who receive the birth control shot will notice a change in their periods. Other possible side effects include: • irregular or no menstrual periods • weight gain, headaches, and breast tenderness • depression • The U.S. Food and Drug Administration (FDA) has issued a safety warning with regard to the use of the long-acting progesterone shot. Studies link this shot to a loss of bone density in women, although bone density may recover when a woman is no longer getting the shot

43. How much does it cost? • Each injection (3 months' worth of birth control) costs about $60. Many health insurance plans cover the cost of birth control shots, as well as the cost of the doctor's visit. Family planning clinics (such as Planned Parenthood) may charge less.

44. Treat Time • What is one advantage to using the sponge? • Which has the better % effective rate? • A) The sponge • B) Depo-Provera • Depo-Provera is a ________ • A) Shot • B) Pill • C) Jelly

45. Condoms: Male and Female

46. The Male Condom • Made of a thin material, often rubber, and when extended it resembles a thin-walled tube. It fits over the penis during sexual relations and is discarded after use • 80-98% effective when used alone

47. The Male Condom

48. The Female Condom • The female condom is a plastic sheath with an inner ring that can be inserted into the vagina up to eight hours before sexual intercourse • The female condom is 79-95% effective

49. Advantages Easy to use, small, easy to carry Inexpensive No clinic visit necessary No advance preparation required Available in most stores, many choices No side effects Provides protection against sexually transmitted diseases Disadvantages Can dull sensation during intercourse May interfere with spontaneity Can leak or break Can only be used once The Male Condom

50. Advantages Easy to obtain Inexpensive No side effects No need for special medical procedures or exams Protects against STDs Disadvantages More expensive than male condoms Insertion can be difficult for some women Most plan ahead – may interfere with spontaneity Single use The Female Condom