Download - Birth Control Methods/Forms
Birth Control Methods/Forms
Mrs. FarverHealth
Key Turning Points in History
• 1937: America Medical Association ends the 25 year opposition to contraception; recognized that birth control needs to be taught in medical school.
• 1960: BIRTH CONTROL PILL becomes available in the in the U.S.
• 1966: Griswold Decision: Supreme Court declares laws prohibiting sale and use of contraceptive are unconstitutional.
Hormonal Birth Control
• Requires a Prescription from a Doctor– Exception is morning after pill if you are 18 or older
• Suppresses ovulation– Uses doses of estrogen and progestin to
regulate cycle an assure no release of the egg from the ovary
• Thickens cervical mucus• Thins endometrium• Slows tubal motility
Hormonal – The Pill (oral contraception)
• 21 day, 28 day, or seasonal packs• 1 pill is taken daily• Time sensitive, the pill is to be taken at the
same time every dayEffectiveness:• Perfect Use Failure Rate in First Year: 0.1% (of
every 1,000 women who take pills for one year 1 will become pregnant in the first year)
• Typical Use Failure Rate in First Year: 5 % (of every 1,000 women who take pills for one year 5 will become pregnant in the first year)
The Pill (cont.)
ADVANTAGES Regulates menses Decreases blood loss/
menstrual cramps No disruption at time
of intercourse Decrease risk of
ovarian/endometrial cancer
Treatment for acne
DISADVANTAGES Mood Changes,
depression, anxiety Daily pill taking may be
stressful No Protection against
STI (Sexually Transmitted Infections), including HIV
Nausea, breast tenderness, especially in the first few cycles
Weight gain
Hormonal – Ortho Evra (The Patch)
• 1 Patch a week, for 3 weeks• 4th week patch free, Menstruation• Usually worn lower abdomen or buttocksEffectiveness:• Perfect Use Failure Rate in First Year: 1
women of every 1,000 women will become pregnant in the first year
• Overall Failure Rate: ?
Ortho Evra Cont.
Advantages: Menstrual (Similar
to the Pills) Nothing to do on a
daily basis No disruption at
time of intercourse
Disadvantages: Mood Changes,
depression, anxiety No Protection against
STI (Sexually Transmitted Infections), including HIV
Nausea, breast tenderness, especially in the first few cycles
Weight gain Cannot use if
breastfeeding
Ortho Evra – The PatchSpecial Considerations:• Avoid placing the patch on exactly the same site
two consecutive weeks• NEVER PLACE PATCH ON THE BREAST!!!• Location of patch should not be altered mid-
week• No band aide, tattoos or decals on top of patch
as it may alter absorption of hormones• It is unknown if tanning beds interfere
with efficacy• Avoid placing lotion/creams/powders
on site
Hormonal – Nuva Ring• Thin flexible transparent ring• Left in place in the vagina for three weeks
and removed for a week to allow a menstrual period the fourth week.
• Maintains a steady low release rate while in place.
Effectiveness:• Overall pregnancy rate:
1.2 per 100 women
Nuva RingAdvantages: Only TWO TASKS:
Insertion/Removal 1x month
Steady even hormonal levels in blood are achieved
Privacy/No visible patch or pill packages
95% of women say they cannot feel device
Disadvantages: Some women
dislike placing/removing objects into/out of their vagina
Adverse side effects similar to the pill
Could Fall Out
Hormonal - Depo Provera “The Shot”
• Injected intra-muscularly into the deltoid or gluteus-maximums every 11 to 13 weeks.
• Progestin only• Four times a yearEffectiveness:• Perfect use failure rate in first year:
0.3% • Typical use failure rate in first year: 3%
DEPO Continued
Advantages: Less menstrual blood
loss and anemia After one year 50% of
users will develop amenorrhea
80% will develop amenorrhea in 5 years
Only need to remember 1x every three months
Disadvantages: Irregular menses during first
several months Unpredictable spotting and
bleeding Possible weight gain:
Progressive-Significant (5.4 1st year, after 5 years 16.5)
Patient fear of pregnancy or build up of menses in uterus if not explained well
Decreased libido Fear of needles Return to fertility is long
average 10 months from last injection
Hormonal and Non-Hormonal – Intrauterine Device (IUD)
Paraguard or Mirena
• T-shaped device with two flexible arms that bend down for insertion but open into the uterus.
• Two straw-colored strings protrude through the cervix into the vaginal canal
IUD – Mirena (Hormonal)
Mechanism: Mirena• Progestin Only• Causes cervical mucus to become
thicker then by preventing sperm from moving up the reproductive track
• Prevents implantation• Cumulative 5 year failure
rate: .7%
IUD - MirenaAdvantages: After 3-4 months it
decreases menstrual blood loss more than 70%
Amenorrhea: 20% by 1 year, 60% by 5 years
Reduced risk PID, ectopic pregnancy by 60%
As effective, or more effective than female sterilization
Long lasting method, up to 5 years
Immediate return to fertility
Disadvantages: Possible expulsion Acne, Headaches,
discomfort after insertion or removal
Risk of PID increased
Ovarian cysts, most regress spontaneously
IUD – Paraguard (Non-Hormonal)
Mechanism: Paragard• Works by preventing fertilization• Works primarily as a
spermicide,Copper ions inhibit sperm motility so they rarely reach the tube
• Cumulative 10 year failure rate:2.1-2.8%
IUD - ParaguardAdvantages: Effective long term (10
years) contraception from a single decision.
Requires no action at time of intercourse
Cost effective Rapid return to fertility Good option for women
who cannot use hormones 95% user satisfaction, the
highest of any other contraceptive currently begin used by women.
Disadvantages: Blood loss during
menstruation increased by 35% and increase cramping
Must check strings monthly after menstruation
Requires office procedure for insertion and removal, can be uncomfortable
• Increase risk of infection PID• Uterine perforation• May be expelled
Hormonal - Implanon
• Progestin only• Thin, flexible, plastic implant about the size
of a matchstick. • Inserted under the skin by the bicep muscle.• Implanted in the arm for
3 years.• Constantly releases progestin into the
bloodstream• Suppresses ovulation
ImplanonAdvantages:• Insertion only takes a few
minutes• Protection against
pregnancy is immediate if you get the implant during the 1st five days of your period
• Ability to get pregnant is immediate after removal
• Gives continuous long-lasting birth control without sterilization
• No medicine to take every day
Disadvantages:• Irregular bleeding is the
most common side effect• Periods become lighter
and may stop altogether or periods may become heavier and last longer
• Some women will have longer heavier periods
• Acne, change in appetite, or sex drive
• Pain at the site of insertion
Emergency Hormonal Contraception – Plan B (Morning After Pill)
Description: Progestin Only (More effective less side effects than
combine EC) ASAP, but can be used up to 120 hours, sooner is
better Pills must be taken 12 hours apart Over-the-counter for women ages 18 and over FDA recently passed a ruling allowing EC to be OTC
for women beginning at 17 yearsof age, but it has not gone effect as of yet
• There is no limit to the number times in a year a woman can use EC, but it is not to be used in place of birth control (it is also expensive).
Plan B – Morning After PillAdvantages Opportunity to
prevent pregnancy after, rape, mistake or method failure
Reduces anxiety Process attaining
EC may initiate women to use ongoing
Disadvantages Time limitation Next menses may be
early Notable changes in flow
for next menses Not as effective as
other forms of birth control
Can be more expensive 23% experience nausea
few experience vomiting
Non-Hormonal Birth Control
• Cervical Cap/Diaphragm – Need a doctor to size for you
• Male Condom• Female Condom• Spermicide• Withdrawal Method• Natural Family Planning• Abstinence – the only 100% effective birth control