w w w . s e x u a l i t y a n d u . c a

1. w w w . s e x u a l i t ya n du. c a Choosing a contraception that’s right for u

2. s e x u a l i t y a n d u . c a Unintended Pregnancies Unintended pregnancies with various contraceptive methods Numbers given are pregnancies for every 1000 women during first year of use Adapted from Trussell et al, 2004.

3. s e x u a l i t y a n d u . c a F e m a l e r ep r o d u c t i v e s y s t e m Fallopian tube Ovaries Uterus Cervix Vagina

4. s e x u a l i t y a n d u . c a F e m a l e r ep r o d u c t i v e s y s t e m Fallopian tube Ovary Uterus Bladder Clitoris Cervix Urethra Vagina Rectum

5. s e x u a l i t y a n d u . c a F e m a l e menstrual c y c l e

6. s e x u a l i t y a n d u . c a O r a l c o n t r a c e p t i v e s What are they? • Prescription tablets taken once a day • There are two main types: 1. Combination pill which contains two female hormones similar to the body’s own estrogen and progesterone 2. Progestin-only pill (or mini-pill) which does not contain estrogen • Available under a variety of brand names with various strengths and formulations How do they work? • Stop the release of a mature egg • Thicken the cervical mucus making it difficult for sperm to get to the egg • Change the lining of the uterus making implantation difficult Failure rate: 80 per 1000 women per year

7. s e x u a l i t y a n d u . c a O r a l c o n t r a c e p t i v e s What are the advantages? 1. One of the most effective reversible birth control methods when taken consistently and reliably 2. Simple and easy to use 3. Regulates menstrual cycle and reduces cramps 4. Does not interfere with intercourse 5. Decreases acne 6. Reduces the risks of endometrial and ovarian cancer 7. May reduce perimenopausal symptoms

8. s e x u a l i t y a n d u . c a O r a l c o n t r a c e p t i v e s What are the disadvantages? 1. Must be taken every day. The progestin-only pill must be taken at the same time every day 2. May cause irregular bleeding or spotting 3. Effectiveness may be reduced by other medications 4. Should not be used by women over the age of 35 who smoke 5. May increase the risk of blood clots, particularly in women who have certain blood disorders or a family history of blood clots 6. Does not protect against STIs 7. May increase the number of headaches 8. May not be suitable for breastfeeding women

9. s e x u a l i t y a n d u . c a Side-Effects of Hormonal Contraception Sideeffects that may occur during the first few months on hormonal contraception include : • irregular bleeding, spotting • nausea • mood swings • bloating • breast tenderness • headaches

10. s e x u a l i t y a n d u . c a Side-Effects of Hormonal Contraception Reason: • Your body is getting used to birth control • Fluctuating hormone levels when you start When will it stop? • Most symptoms are normal and will decrease or stop in the first 2-3 months. If they bother you or don’t get better: • Talk to your healthcare provider • There might be a method that’s better suited for you.

11. s e x u a l i t y a n d u . c a Myths and Misconceptions about Hormonal Contraception Common myths and misconceptions • Causes weight gain • Causes acne • Causes infertility • Causes birth defects • Should take a break from time to time • Smokers should not be taking it • Women over age 35 should not take the Pill • No need for condoms if you’re on the Pill

12. s e x u a l i t y a n d u . c a M a l e r ep r o d u c t i v e s y s t e m Seminal vesicles Vas deferens Prostate gland Penis Epididymis Testicle

13. M a l e b a r r i e r m e t h o d s s e x u a l i t y a n d u . c a Male Condom What is it? • A soft disposable sheath • Available in various shapes, sizes, thicknesses, colours and flavours • Most are latex, but non-latex condoms are also available in polyurethane, silicone, and lambskin How does it work? • Fits over the erect penis • Acts as a physical barrier preventing direct genital contact and the exchange of genital fluids, so the sperm does not enter the uterus and fertilize the egg • A new condom is used for each repeated act of intercourse Failure rate: 150 per 1000 women per year

14. M a l e b a r r i e r m e t h o d s s e x u a l i t y a n d u . c a What are the advantages? 1. Available widely without a prescription 2. Inexpensive 3. Latex condoms protect against STIs 4. Allows the male partner to assume some responsibility for birth control 5. Both partners can participate in their use 6. May help the wearer avoid premature ejaculation

15. M a l e b a r r i e r m e t h o d s s e x u a l i t y a n d u . c a What are the disadvantages? 1. Must be available at time of intercourse 2. May slip or break during intercourse 3. Must be stored and handled properly 4. People with latex allergies cannot use latex condoms, but may be able to use non-latex condoms 5. May reduce sensitivity for either partner 6. May interfere with the maintenance of an erection 7. May reduce spontaneity 8. Lambskin condoms do not protect against STIs

16. S T I p r e v e n t i o n s e x u a l i t y a n d u . c a Dental dams and gloves A dental dam is a small piece of latex similar to the material used for latex condoms. • It can be used during oral sex. The dental dam is stretched across a woman’s vagina to prevent the exchange of bodily fluids. • It can also be used in other activities where a barrier is desired. • Latex surgical gloves can also be used in activities where a barrier is desired. General tips • When using latex dental dams, gloves, or condoms, apply only water- based lubricants. They are available at drugstores. • Use new dental dams, gloves, or condoms for each partner. • Do not re-use latex barriers or turn them over and use the other side.

17. S T I p r e v e n t i o n s e x u a l i t y a n d u . c a 1 Cutting a condom to make a dental dam • When a dental dam is not available, a latex condom can be cut to create a latex barrier. 1. Unroll a new condom. 2. Using scissors, cut off both ends of the condom, removing the closed tip and the round loop at the base. 3. Cut the condom lengthwise so that it opens up into a rectangle. • If you are going to use the barrier for oral sex, you may wish to select a condom without spermicide or lubrication. A flavoured condom may be a good choice. 2 3

18. S T I p r e v e n t i o n s e x u a l i t y a n d u . c a * Remember that no method of protection from STIs is perfect. Some STIs can be passed through skin-to-skin contact.

19. s e x u a l i t y a n d u . c a What To Ask Your Healthcare Provider Following are some questions you might want to ask regarding your sexual health. A good idea is to make a list before you visit. Birth control related: • How do I know what birth control method is best for me? • How to take your method • How to deal with missed pills, patches, rings, or injections • What are the side-effects? Which are normal and how can I cope with them. General women’s health • Should I get a mammogram? How do I know if I'm doing my breast self-exam correctly? • How often do I need a Pap smear or gynecological check-up? • How do I know if my period is normal? • Should I be tested for AIDS or other STIs?

20. s e x u a l i t y a n d u . c a What Your Healthcare Provider May Ask You Be prepared to answer questions about: • Medical history (surgeries, vaccines, menstrual cycle, etc) • Medications you are taking • Allergies • Family history (medical conditions like diabetes, heart problems) • Lifestyle • Sexual practices Don't be embarrassed to tell the truth or ask a question. They are professionals and the information is required to give you the best care possible.