Contraception/Birth Control Choices

1. Contraception/Birth Control Choices

3. Abstinence is the only safe sex! • Abstinence is the only 100% sure way to prevent pregnancy and sexually transmitted infections. • What does abstinence mean to you? • Abstinence= Freedom & Independence How can you explain the above phrase?

4. Before choosing a method, you should consider: • How well will it fit into your lifestyle? • How effective will it be? • Will it help protect against sexually transmitted infections? • How safe will it be? • How affordable will it be? • How reversible will it be?

5. Formula for Pregnancy Ovulation + Fertilization + Implantation = Pregnancy *Barrier methods- prevent fertilization ex: condoms, diaphragm, cervical cap, spermicides *Hormonal methods- prevent ovulation or thicken cervical mucous ex: birth control pill, cervical ring, patch, Depo & Lunelle shots, Norplant *Permanent/surgical- prevents fertilization ex: tubal ligation, vasectomy *Intrauterine Device- prevents implantation ex: IUD *Emergency contraception- prevents ovulation ex: Plan B, Preven

7. Not Recommended Fertility Awareness Methods/Rhythm- attempts to predict ovulation and combine periodic abstinence. Uses basal temperature, cervical mucous, and calendar tracking Withdrawal- pulling out penis before ejaculation These methods do NOT protect you from sexually transmitted infections! Requires self-control High rates of pregnancy

8. Barrier Methods to Prevent Fertilization

9. Male Condom • Effectiveness Rate: 70-90% due to breakage, slippage, not using entire time • Disadvantages: Some may be irritated or have allergy to latex Some decrease in sensation • STI Protection: YES (not as much for herpes, warts, syphilis) Avoid “nonoxynol-9” lubricants • How to use: Pinch tip, roll to base, grasp rim before removal *Never reuse *Do not use two at one time *Only use water based lubricants (NOT Vaseline or oils) *Store in cool place (NOT wallet or glove compartment) • Cost: 25 cents to $2.50 each No prescription or age restriction for purchase

10. How to Use Condoms

11. How do you choose condoms? • Look for lubricated • Look for latex condoms • Receptacle tip *Avoid nonoxynol-9 spermicidal lubricant *Avoid lambskin condoms

12. Controversial Issue:Taking a Stance ForAgainst

13. Female Condom • Effectiveness Rate: 74-79% • Disadvantages: Possible irritation or allergic reaction • STI Protection: Yes (not as good as male condom) • How to use: Fits in vagina and hangs outside body Use once • Cost: $2.50 each No prescription needed

14. Diaphragm & Cervical Cap • Effectiveness Rate: 82-94% • Disadvantages: irritation/allergic reaction, difficulty removing, TSS • STI Protection: NONE • How to use: Insert before sex with spermicide Leave in 6-8 hours after sex • Cost: $13-25 $50-125 for dr. exam & fitting $8 for spermicide jelly

15. Hormones to Prevent Ovulation

16. Birth Control Pills • Effectiveness Rate: 97-99% Antibiotics, vomiting, diarrhea may reduce effectiveness- use back up! • Disadvantages: Must be taken daily, (rare but serious- blood clots, heart attacks, stroke), depression, spotting, water retention, mood changes, nausea, not for smokers especially over 35 yrs. old • STI Protection: NONE • How to use: Taken every day at the same time regardless of how often you have sex Takes at least 1 week to become effective If you forget to take one, take 2 the next day- use back up for rest of month! • Cost: $15-25 monthly pill-pack $35-125 dr. exam, clinics less Need prescription Can reduce cramping, acne May protect against ovarian & endometrial cancers, PID

17. Other hormonal methods... • Ortho Evra Patch *New patch applied on skin on the same day of week for three consecutive weeks. *The fourth week is patch free. • Nuva Ring (Vaginal Ring) *Insert ring in vagina and leave in place for 3 weeks *The fourth week is ring free.

18. More hormones • Depo-Provera Injection *99.7% effective *NO STI protection *A shot given every 12 weeks *$30-75 injection $35-125 dr. exam • Implanon Capsule Implant *99.9% effective *NO STI protection *1 capsule put under skin within arm *Can be left in for 3 years *$500-600: exam, implants, insertion

19. Intrauterine Device to Prevent Implantation

20. IUD *97-99% effective *Small plastic device inserted into the uterus *Contains copper or hormones that keep sperm from joining egg & prevent fertilized egg from implanting in uterus Not recommended for women who have not had children. (uterus may be too small) Pelvic inflammatory disease (PID) can occur if infection is present PID can cause infertility

21. Tubal Ligation 99% effective $1000-2500 operation Vasectomy 99% effective $250-500 surgical procedure Surgical Sterilization

22. Emergency Contraception • Morning After Pills • Ex. Plan B or Preven • Series of hormonal pills taken as back-up method for condom failure or sexual assault • First dose within 72 hours and second dose taken 12 hours later • Can reduce risk of pregnancy from 75-89% • Does not work if woman is already pregnant

24. Is it his? Or hers? So who's responsibility is birth control anyway?

25. Essential Questions • Whose responsibility is BC/DC? • Which methods: • Provide BC • Provide DC • Require Doctor Visits • Why is withdrawal ineffective? • Why don’t teens use BC? • Difference between: • THEORETICAL VS. REAL-LIFE USER

26. The Final Word… • Know what you want. • Communicate openly with your partner about your commitment and expectations. • Set your limits and respect them. • Choose partners who respect you. • Believe in yourself.