Teens and Methods of Birth Control: An Overview

1. Teens and Methods of Birth Control:An Overview Lisa Wehr, Program Coordinator Family Planning Plus of SUN & MJ Counties lisa@familyplanning.cnchost.com

2. 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)

3. Teens and Birth Controlcont. • 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)

4. 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.

5. 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.

6. 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.

7. 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).

8. Hormonal Methods

9. 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.

10. 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…

11. 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.

12. 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

13. 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.

14. 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.

15. 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.

16. 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.

17. 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.

18. 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.

19. Barrier Methods

20. 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.

21. 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

22. 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.

23. 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.

24. 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.

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

26. 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.

27. 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.