ContraceptionContraception

© Robert J. Atkins, Ph.D.

What are my chances of What are my chances of getting pregnant without getting pregnant without

contraceptives?contraceptives?

No method = 85% chance of No method = 85% chance of pregnancy over a yearpregnancy over a year

Should I use oral Should I use oral contraceptives?contraceptives?

AdvantagesAdvantages Very effective (99%+)Very effective (99%+)

DisadvantagesDisadvantages Decrease sexual Decrease sexual

motivationmotivation Water weight gainWater weight gain Problems with blood Problems with blood

clots (in some users)clots (in some users)

What types of pills are What types of pills are there?there?

Constant dose Constant dose combination pillcombination pill Most commonMost common

Multiphasic pillMultiphasic pill Both types prevent Both types prevent

conception by inhibiting conception by inhibiting ovulationovulation

Mini pillMini pill Progestin onlyProgestin only

What medications can What medications can reduce the effectiveness of reduce the effectiveness of

the pill?the pill? St.John’s WortSt.John’s Wort AmpicillinAmpicillin TetracyclineTetracycline

What if I only want a What if I only want a period every three period every three

months?months?

Seasonale & SeasoniqueSeasonale & Seasonique

One period every 3 months (4 per year)One period every 3 months (4 per year) SeasonaleSeasonale

7 placebo pills every 84 pills7 placebo pills every 84 pills Seasonique Seasonique

7 estrogen pills every 84 pills7 estrogen pills every 84 pills

More stable hormone levelsMore stable hormone levels

What if I want no periods What if I want no periods at all?at all?

LybrelLybrel No periods at allNo periods at all Estrogen & progestinEstrogen & progestin Designed to be taken Designed to be taken

continuallycontinually Not all women will be Not all women will be

“period free”.“period free”.

What if I have What if I have unprotected sex?unprotected sex?

What is emergency What is emergency contraception Plan contraception Plan

“B”?“B”? Not for routine useNot for routine use Take up to 72 hrs. (3days) after sexTake up to 72 hrs. (3days) after sex Progesterone only (no estrogen)Progesterone only (no estrogen) Reduces chances of pregnancy by Reduces chances of pregnancy by

89% (7 out of 8 women who would 89% (7 out of 8 women who would have gotten pregnant will not.)have gotten pregnant will not.)

Plan “B” cont.Plan “B” cont.

It works better the earlier you take itIt works better the earlier you take it In WA. State you can get it from a In WA. State you can get it from a

pharmacy without a prescription.pharmacy without a prescription. American College of Obstetricians and American College of Obstetricians and

Gynecologists you get it Gynecologists you get it beforebefore sex sex “just in case”. The “Ask me” program.“just in case”. The “Ask me” program.

Dosage:Dosage: 2 tablets, 1-ASAP 2 tablets, 1-ASAP

and 1 – 12 hrs later. and 1 – 12 hrs later.

Do you remember?Do you remember?

What are the advantages and What are the advantages and disadvantages of oral disadvantages of oral contraceptives?contraceptives?

What medications can reduce the What medications can reduce the effectiveness of the pill?effectiveness of the pill?

What if I only want a period every What if I only want a period every three months?three months?

What can I do after unprotected sex?What can I do after unprotected sex?

What is the transdermal What is the transdermal patch?patch?

Ortho EvraOrtho Evra Slow release of hormones Estrogen Slow release of hormones Estrogen

and progestinand progestin 1 patch a week for 3 weeks on & 1 1 patch a week for 3 weeks on & 1

week offweek off 99% effective (similar to pill)99% effective (similar to pill) Prevent ovulation Increase cervical Prevent ovulation Increase cervical

mucusmucus

What is the shot?What is the shot?

Depo-ProveraDepo-Provera Progestin onlyProgestin only InjectionInjection

Once every 12 weeks (3months)Once every 12 weeks (3months)

What is the Mirena IUD?What is the Mirena IUD?

Releases hormone progestinUterine irritation

Why do IUDs work?Why do IUDs work?

Copper Copper (Paragard)(Paragard)

ProgesteroneProgesterone MirenaMirena

Irritation in uterusIrritation in uterus Makes implantation Makes implantation

unlikelyunlikely

What is Implanon?What is Implanon?

Only implantable contraceptive sold Only implantable contraceptive sold in USAin USA

99% effective99% effective Good for 3 yearsGood for 3 years Progestin only (Avoids blood clots)Progestin only (Avoids blood clots) Irregular menstrual bleedingIrregular menstrual bleeding

What is NuvaRing?What is NuvaRing?

Vaginal ringVaginal ring Slowly releases hormone (Estrogen) into Slowly releases hormone (Estrogen) into

bloodstreambloodstream Insert in vaginaInsert in vagina Worn 3 out of 4 weeksWorn 3 out of 4 weeks Position not criticalPosition not critical Low dose hormone = low side effectsLow dose hormone = low side effects

What is the cervical cap?What is the cervical cap?

What are the female What are the female condoms?condoms?

Do you remember?Do you remember?

What is the transdermal patch?What is the transdermal patch? What is the shot?What is the shot? Why do IUDs work?Why do IUDs work? What does the vaginal ring do?What does the vaginal ring do?

What is one of the least What is one of the least effective methods?effective methods?

Diaphragm and spermicideDiaphragm and spermicide One of the least effective methodsOne of the least effective methods

Can I use spermicide by Can I use spermicide by itself?itself?

What IUD uses copper What IUD uses copper and has no hormones?and has no hormones?

ParagardParagard Can be used by Can be used by

women as young women as young as 16 who have as 16 who have never had a babynever had a baby

Women with a Women with a history of STD’s or history of STD’s or PID can use it.PID can use it.

Good for 10 yearsGood for 10 years

Paragard IUD in uterusParagard IUD in uterus

What is the Essure What is the Essure Intra-fallopian insert? Intra-fallopian insert?

What should I look out What should I look out for if I have an an IUD?for if I have an an IUD?

Danger signs = Danger signs = PAINSPAINS PPeriod late or no perioderiod late or no period AAbdominal painbdominal pain IIncreased temperature, fever, chillsncreased temperature, fever, chills NNasty dischargeasty discharge

Foul smellingFoul smelling SSpotting, bleeding, heavy periods, clotspotting, bleeding, heavy periods, clots

What about male What about male Condoms?Condoms?

Advantages:Advantages: Additional protection Additional protection

against STD’sagainst STD’s Also during fellatioAlso during fellatio

Diminished Diminished sensation and delay sensation and delay ejaculationejaculation

DisadvantagesDisadvantages Some people are Some people are

allergic to latex allergic to latex condomscondoms

What about male What about male sterilization? sterilization? (Vasectomy)(Vasectomy)

What about the Pro-Vas What about the Pro-Vas clip?clip?

NewNew A plastic and metal clip closes the A plastic and metal clip closes the

vasvas Effectiveness compared to Effectiveness compared to

vasectomy is unknown.vasectomy is unknown.

What about female What about female sterilization sterilization

(Tubal ligation)(Tubal ligation)

What about the rhythm What about the rhythm method? (Basal Body method? (Basal Body

Temp.) Temp.)

When should I use a backup When should I use a backup method of birth control?method of birth control?

During the first cycle of the pillDuring the first cycle of the pill When taking antibioticsWhen taking antibiotics When first learning to use a new When first learning to use a new

method of birth controlmethod of birth control

Do you remember?Do you remember?

What is one of the least effective What is one of the least effective methods?methods?

What pains should I watch for with What pains should I watch for with an IUD?an IUD?

What are the advantages and What are the advantages and disadvantages of male condoms?disadvantages of male condoms?

When should I use a backup method When should I use a backup method of birth control?of birth control?