Contraceptionn methods

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BENEMÉRITA UNIVERSIDAD AUTÓNOMA DE PUEBLA FACULTAD DE LENGUAS CENTRO DE AUTO-ACCESO Y TECNOLOGIA – CU

CONTRACEPTION OBJECTIVE: To skim general information about contraception methods, and to scan for specific information.

Level: 203-204 Choosing the right method of contraception involves many factors, including lifestyle, frequency of intercourse, and number of partners. Finding the right method or methods of birth control to use on a long-term basis might mean experimenting with several first.

There are some side effects from all methods of contraception- for more detailed information about these options, speak to a nurse or physician or consult pamphlets available at health institutions.

PRE-ACTIVITY: Read about contraception and write the methods in the appropriate heading: 1. barrier

2. abstinence

3. sterilization

4. emergency contraception

5. lactational

6. hormonal methods

7. coitus interruptus

8. ormeloxifene (centchroman)

9. fertility awareness

10. statical methods

11. avoiding vaginal intercourse

12. induced abortion

13. intrauterine methods

Behavioural methods Abstinence is defined as not having any type of intercourse or sex play with a partner. It is the only birth control method that is 100% effective in preventing pregnancy __________________________ __________________________ __________________________

as well as sexually transmitted diseases.

Physical methods These types of contraceptives do not contain hormones or toxic products, except for mixed contraceptives, which has a double action, physical and chemical. ________________________ ________________________ ________________________

BARRIER METHODS 1.Condoms

Effectiveness: The effectiveness of condoms, as of most forms of contraception, can be assessed in two ways. Perfect use or method effectiveness rates only include people who use condoms properly and consistently. Actual use, or typical use effectiveness rates are of all condom users, including those who use condoms improperly, inconsistently, or both.

Condoms are widely recommended for the prevention of sexually transmitted diseases (STDs). They have been shown to be effective in reducing infection rates in both men and women. While not perfect, the condom is effective at reducing the transmission of HIV (Human immunodeficiency virus), genital herpes, genital warts, syphilis, chlamydia, gonorrhea, and other diseases.

According to a 2000 report by the National Institutes of Health, correct and consistent use of latex condoms reduces the risk of HIV/AIDS transmission by approximately 85% relative to risk when unprotected.

The same review also found condom use significantly reduces the risk of gonorrhea for men.

Failure Rate: The perfect use pregnancy rate of condoms is 2% per year.

How it works: The most popular barrier method is the male condom, a latex or polyurethane sheath placed over the penis. The condom is also available in a female version, which is made of polyurethane. The female condom has a flexible ring at each end — one secures behind the pubic bone to hold the condom in place, while the other ring stays outside the vagina.

Getting and using it: See post activity*

Advantages: According to a 2000 report by the National Institutes of Health, correct and consistent use of latex condoms reduces the risk of HIV/AIDS transmission by approximately 85% relative to risk when unprotected. The same review also found condom use significantly reduces the risk of gonorrhea for men.

A 2006 study reports that proper condom use decreases the risk of transmission for human papilloma virus by approximately 70%.

Another study in the same year found consistent condom use was effective at reducing transmission of herpes simplex virus-2 also known as genital herpes, in both men and women.

Although a condom is effective in limiting exposure, some disease transmission may occur even with a condom. Areas of the genitals hosting an infection may not be covered by a condom, and as a result, some diseases can be transmitted by direct contact. The primary effectiveness issue with using condoms to prevent STDs, however, is inconsistent use.

Concerns include: Condom users may experience slipping off the penis after ejaculation, breakage due to faulty methods of application or physical damage (such as tears caused when opening the package), or breakage or slippage due to latex degradation (typically from being past the expiration date or being stored improperly). Even if no breakage or slippage is observed, 1-2% of women will test positive for semen residue after intercourse with a condom.

Use condoms for all penetration and close genital contact, not only for ejaculation. Do Not use oil-based lubricants like Vaseline, baby oil.

They weaken condoms! Adding extra lube, even on pre-lubricated condoms, decreases the chance of breakage.

Always check the expiry date. Store condoms in a cool, dry place- not in a wallet, light pocket. For oral sex use condoms without lube and without spermicide.

ACTIVITY I 1. What mistakes can be made when wearing a condom? _______________________________________________ 2. Condoms can protect you from diseases like: _______________________________________________

2. Diaphragm and Jelly:

Effectiveness: Highly effective. Good fitting and proper instruction in use are very important, since misuse accounts for about half of all failures.

Failure Rate: Average Users: 10% Reliable users 2% How it works: A rubber dome is worn inside the vagina, and prevents sperm from entering the cervix.

Spermicidal jelly kills sperm before it can enter the uterus.

Getting and using it: A diaphragm must be fitted by a health professional. It must be inserted no more than 2 hours before intercourse. The woman must check that it propely covers the cervix, and that it is well placed behind the pubic bone. The diaphragm must be left in for at least 6 hours after intercourse (never more than 24 hours!) Jelly should be reiserted with an applicator if you have sex more than once (do not take diaphragm out for this!).

Advantages: Few health risks. May protect against cervical cancer.

Concerns include: Messiness, interruption of sexual spontaneity, allergy to rubber or jelly, vulvar itching and burning, slight risk of toxic shock syndrome, discomfort due to improper fitting, cystitis.

3. Spermicidal creams, Jellies or foams: these do not offer much protection alone but enhance the effectiveness of condoms and diaphragms. Available without a prescription.

4. Sponge: Effectiveness: Very effective, if used properly.

Failure rates: average user, 14% reliable.

How it works: Spermicide kills sperm before reaching the uterus and the sponge itself blocks the entrance to the cervix and absorbs sperm.

Getting and Using it: Available at pharmacy without a prescription. Although the Today sponge has been taken off the market,a new sponge called the Protectaid sponge has recently been introduced. This sponge does not have to be wet water before use.

Three different types of spermicide are incorporated in this sponge and the manufacture claims that this combination may reduce the chances of contracting certain sexual transmission diseases. It is inserted in the vagina before intercourse, can be used for several acts of intercourse, but must be left in for six to twelve hours after the last ejaculation.

Unlike the today sponge which had string for removal, the protectaid sponge has handles made of the same material as the rest of the sponge.

Concern include: Breakage of the sponge, difficulty removing it, irritation from and allergic reaction to the spermicide, small possibility of toxic shock syndrome.

5. IUD: Intrauterine Device (A birth control device, such as a plastic or metallic loop, ring, or spiral, that is inserted into the uterus to prevent implantation; intrauterine device): Effectiveness: highly effective.

Failure rates: Average users, 4% Reliable users.

How it works: The exact way in which it works is still unclear. It may affect sperm, ova, fertilization, implantation, or the endometrium to prevent pregnancy.

Getting and using it: A device is inserted into the uterus by a doctor. Depending on the type, it may be kept in for a maximun of 2.5 to 5 years.

Advantages: Very convenient, unexpensive, no interruption of lovemaking, no daily action necessary, not usually felt or noticed.

Concerns include: Heavy and more painful menstruation, expulsion, pregnancy with IUD in place, uterine perforation, pelvic inflammatory disease. Serious complications have been associated with the IUD; these include sterility, ectopic (tubal or ovarian) pregnancy and rarely, death from infection.

The IUD is not recommended for women under 25. Ask your doctor about other conditions that may prevent you from being a candidate.

6. Cervical Cap: Effectiveness: Highly effective.

Failure rates: Similar to diaphragm.

How it works: A rubber thimble-shaped device fits over the cervix and blocks the entry of sperm.

Getting and Using it: The cap, which must be fitted by a health professional. The cap is inserted at least one hour before intercourse, and left in place from 6 to 48 hours after intercourse. It can be used for more than one act of intercourse.

Advantages: Few health risks.

Concerns include: Allergy to the rubber or jelly, possibility of toxic shock syndrome, unpleasant sensation for male partner if he feels the cap during intercourse. Some women notice an unplesant odour if the cap is left in for too long. Also, some studies have raised concerns about precancerous changes of the cervix.

HORMONAL METHODS 7. The Pill: Effectiveness: Highly effective.

Effectiveness: is decreased with certain medications,illness which causes vomiting or diarrhea, and not taking the pill at the same time every day or missing pills. If you are taking the pill, make sure you inform health professionals when they are prescribing other medication.

Failure Rates: average users; 2-2% How it works: Hormones (estrogen and progesterone) are taken daily in the form of small pills, preventing ovulation (release of the egg) and changing the mucus of the cervix so sperm has more difficulty getting through.

Getting it: The pill requires a prescription from a doctor.

Advantages: Extremly effective, easy to use, no interruption of lovemaking, lighter, more regular menstrual periods with fewer cramps, lower risk of pelvic inflammatory disease, ovarian cysts, certain cancers, ectopic pregnancy (maybe), and fibrocystic breast disease (maybe).

Concerns include: Side-effects such as intermenstrual bleeding, breast tenderness, and itching (these can often be counteracted by switching to a different type of pill). Possible serious side effects include increased risk of stroke, blood clots, and heart attack. Some conditions will prevent you from being a candidate. Consult your doctor about the effects of the pill on your health and have an examination three months after starting the pill.

8. Norplant: Effectiveness: Highly effective. Norplant can interact with other medicationbe sure to mention that is implanted with other medication is being prescribed. However, effectiveness, decreases slightly toward the end of the five year period.

Failure rate: .01 %

How it works: Hormones that prevent pregnancy are relaeased directly into the bloodstream.

Getting and using it: Small capsules are surgically inserted under the skin of the arm, which usually last for five years. They are surgically removed after this time.

Concerns include: Although the implants can be removed at any time, the removal process can be bothersome. Manyminor side effects can also occur. Currently, the implants are also very expensive. Many professionals have serious reservations about this product. Essentially, it has not been around for long enough to prove its safety, and its testing using questionable methods in third-world countries.

9. The morning after pill: This is an emergency method of birth control to be used only when your regular method fails.

Effectiveness: The morning after pill must be taken within 72 hours (3 days) after having unprotected intercourse. It is most effective within the first 12-24 hours.

How it works: the morning after pill affects the uterine lining so that the egg, if fertilized, cannot implant itself. Because there is still a change of pregnancy, and the high levels of hormones could damage the fetus, use of the morning after pill is recommended only if an abortion is planned in the event of pregnancy.

Getting and use it: It is taken in two doses- two pills immediately and two exactly twelve hours later. It should be taken as soon as is reasonably possible- usually the next day.

Concerns include: mild to severe nausea and repeated vomiting are side effects- they can be alleviated by taking Gravol (Dramamine®; Vomisin®; Dimenhydrinate[Antihistamínico]) before each dose of the pill. Women with conditions which preclude them from taking the pill should not use the morning after Pill.

10. Unplanned Pregnancy: If you don’t want to be pregnant, but think you might be, wait until you are sure before you stop using contraception. Urine pregnancy tests are available in pharmacies for use at home.

Pregnancy can be an incredible experience, but it can also be emotionally and physically stressful, especially if it is unwanted or unplanned. As a university student, you may feel overwhelmed and unprepared to take on the responsibilities of parenthood. You may also

be dealing with various personal, emotional, and ethical issues that make your decision about continuing the pregnancy more difficult. You may not be sure whether you want to go on with the pregnancy and keep the child, give it up for adoption or terminate the pregnancy by having an abortion. It’s important to get support from friends, and to talk to a health professional and consider all available options.

ACTIVITY II According to the previous methods complete the following questions: 1. STD’S means: ____________________ 2. Why oil-based lubricants are not recommended? __________________________________ 3. This method protects you from STD’s and pregnancy, too: ___________ 4. The diaphragm must be fitted by: __________ 5. The ___________ it is taken in two doses- two pills immediately and two pills exactly twelve hours later.

6. IUD is: _______________________.

7. The ________ is a hormonal method. 8. It prevents _______________.

9. The ________________ can cause side effects like nausea.

POSTACTIVITY: How to Use a Condom: Put the following steps in order to the drawings: a)

1- Place the rolled up condom on the tip of the erect penis.

b)

2- Roll it all the way down to the base of the penis.

c)

3- Carefully open the package at the edge to ensure the condom doesn’t tear.

d)

4- Hold the receptacle end to squeeze out the air as ou put it on, leaving space for the semen. Be careful not to damage the condom with fingernails, jewellery, or other objects.

e)

5-After ejaculating, pull out while the penis is still erect. Hold onto the condom at the base of the penis, being sure not to spill any semen.

f)

6- The penis must be erected

*-Throw the condom in the garbage. *-Never reuse a condom.

Preactivity: Behavioural: 2,5,7,9,10,11.

Physical:1,3,4,6,8,12,13.

Activity I: 1. Wearing a condom with expired date, breaking it when opening, wearing oil-based lubricants, keeping it in a wallet.

2. HIV/AIDS, gonorrhea, human papilloma virus, herpes simplex virus-2, also known as genital herpes, warts, syphilis and chlamydia.

Activity II: 1: sexually transmitted diseases, 2: They weaken condoms, 3. condom, 4: a health professional, 5: morning after pill, 6: Intrauterine device, 7: pill, 8: pregnancy, 9: morning after pill.

Postactivity: a)-3. b)-6. c)-1. d)-2. e)-4 . f)-5.

REFERENCES http://en.wikipedia.org/wiki/Birth_control www.urbandictionary.com Student’s Handbook. Mc Gill University.

Canada.

IMAGES

http://en.wikipedia.org/wiki/Image:MalePregnancy_poster.jpg Poster released in the 1970s by the Family Planning Association of Victoria, Australia

Adapted by Raúl García Báez raulgb1@yahoo.com.mx