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Sexuality: Contraceptive Methods

Sexuality: Contraceptive Methods. Perry pp. 138-156. Contraceptive Methods . Sterilization. Tubal ligation, Essure (micro-coil tubal obstr), vasectomy Considered permanent altho is only 99.5% effective; reversal more likely with vasectomy

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Sexuality: Contraceptive Methods

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  1. Sexuality: Contraceptive Methods Perry pp. 138-156

  2. Contraceptive Methods

  3. Sterilization • Tubal ligation, Essure (micro-coil tubal obstr), vasectomy • Considered permanent altho is only 99.5% effective; reversal more likely with vasectomy • Tubals are done by laparoscopy and require outpatient surgery with general anesthesia • Essure done in doctor’s office by hysteroscopic placement in tubes; requires contrast • Vasectomies are done in doctor’s office with local anesthesia and small incision

  4. Hormone Therapy • Comes in oral (BCP), transdermal (patch), injection (Depo), implant (Implanon), vaginal ring • Most are some combination of estrogen and progestin • All prevent ovulation if working properly • Advantages are convenience, effectiveness, spontaneity in sex, changes in menstrual cycle

  5. Hormone Therapy cont’d • Disadvantages are having to remember pills qd, weight gain, changes in menstrual cycle, no STD protection, need Rx, serious side effects (DVT, stroke, MI; see ACHES on p. 351). • Interacts with anticonvulsants and antimicrobials • Absolute contraindications: clots, e-dependent tumors, liver disease, pregnancy, undx uterine bleeding, smokers over 35.

  6. Mechanical Method • Intrauterine device—Mirena (levonorgestrel), Paragard Cu • Foreign object inserted into uterus by physician. Can stay in 5-10 years, barring any serious side effects (expulsion, pregnancy complications). • Advantages include convenience, not having to remember to take pills, spontaneity, effectiveness

  7. Mechanical cont’d • Disadvantages include having to examining self for strings, cramps, increased bleeding, no STD protection, need Rx, PID risk, uterine perforation • Absolute contraindications: acute cervicitis, PID

  8. Barrier Methods • Types include condoms, diaphragm, cervical cap, spermicides • Advantages include protection against most STDs (not HPV and natural condoms do not protect against HIV), virtually no side effects except for allergic reactions, some need no Rx, effectiveness with spermicides

  9. Barrier cont’d • Disadvantages—have to plan for sex, need to use spermicide, messy, decreased sensation, allergy to latex or deodorants, diaphragms have to be fitted by trained clinician and left in for 6-8h, can also increase UTIs and staph infections.

  10. Coitus Interruptus • A.K.A. “pulling out”. Man withdraws penis just before ejaculation. • Advantages—hmmm…this is a hard one….no Rx needed, no prep beforehand, better than no method, cheap (unless you get pregnant!) • Disadvantages—difficult for man, messy, large room for error

  11. Rhythm Method • Assessing time of ovulation using basal body temperature readings and using those results to avoid times to have intercourse. • Advantages: no drugs, no artificial barriers, nothing invasive, more natural, religious beliefs • Disadvantages—requires a lot of discipline, room for error without dedication, a least 7-10 days of abstinence each month. Eggs live 24h, sperm 5d.

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