Contraceptives

Historical Background A wide variety of effective contraceptive

devices is a modern phenomena The US formerly prohibited both their

use and the dissemination of relevant information – The Comstock Laws of 1870

Margaret Sanger led the charge to give women some control their own fertility

in 1960 the birth control pill debuted

More Background In 1965 the Supreme Court ruled in

Griswold vs. Connecticut that married couples can use contraceptives

In 1968 use was extended to singles Thus began the controversial Right to

Privacy Now the debate has shifted to

parental notification

Contemporary Issues Contraceptives have contributed to

women’s financial stability, health, and career advancement

Should health insurance plans cover? Should we halt population growth? Cultural gender-role expectations? Religious objections? But 70% of US

Catholics use banned methods.

Ideally, a Mutual Decision Today, contraception is much more

effective if both partners participate Also, Discussion can enhance a relationship Together women can learn how to

obtain; men can learn how to request their use

Now both sexes are more likely to use, even the first time

Choosing a Method

Many forms are available None are perfect Each has its advantages and

disadvantages They vary as to price,

effectiveness, convenience and safety

Effectiveness The biggest peril? Errors by the

user.

About half of unintended pregnancies occur among women using contraceptives.

Poor, unmarried women under 30 have the highest failure rate.

Characteristics of those who try, but fail They feel guilty about using it They have a negative view of sex itself. Some women feel that being prepared

makes them appear too “eager”.

Taking this into account, each contraceptive has a failure rate – the number out of a 100 who become pregnant by the end of the first year of use

Back-up With so much human error in play, many

couples use two methods to be sure. When backups are necessary: during the pill’s first cycle if you missed a few pills if you are taking antibiotics with the pill during the first 3 months of IUD use while using a new method

The Pill Work by altering hormone levels Used by 100 million worldwide Top choice among American women Four basic types Constant-dose Combination Triphasic Seasonale Progestin-only

The Constant-dose Combination Number 1 in US Available since the early 60’s Two hormones, synthetic estrogen &

progestin are taken at a level daily dose

Very effective, if used properly, only .3 fail

Reduces cramps and flow Some possible side-effects

The Triphasic Pill

Varies proportions of estrogen and progesterone during the menstrual cycle

Reduces overall hormone dosage Fewer side-effects Also very effective

Seasonale

The latest Lower yet hormone doses Reduces periods to just 4 per

year

Progestin-only - just a constant dose of a very small level of progestin

How they do it The combination and triphasic pills and

Seasonale primarily inhibit ovulation. Their estrogen dose stops the

hypothalamus from releasing hormones essential to ovulation.

Their progestin hampers the sperm’s passage into the uterus.

The progestin-only stops sperm in cervix.

Taking the Pill

Must be taken every day Should be taken at the same time

each day Many forget to take the pill each

day Objective measures showed that

50% missed up to 3 pills per cycle If so, a backup is necessary

Advantages

No effect on sexual spontaneity Easily reversible If taken as prescribed, very

effective Lessen menstrual discomfort Also reduces risk of some cancers

Disadvantages Does not protect against Aids or

other STDs Some side effects from steady

presence of hormones in blood stream

For women over 35 who smoke, the risks outweigh the benefits

Some medications weaken the pill’s effectiveness and vice versa

ACHES An acronym for serious problems possibly

associated with the pill Abdominal pain (severe) Chest pain (severe) or shortness of

breath Headaches (severe) Severe leg pain, calf or thigh Many deal with blood clots/cardiovascular

concerns

Condoms The most basic of the barrier methods Work by preventing sperm from entering

the vagina Men’s only temporary form of birth control Made of surgical latex or sheep membrane Wide variety, long history Mass production followed the

vulcanization of rubber in the 1840s 6 to 9 billion sold each year worldwide

How to use Must be used effectively Must be put on before penetration Cowper’s gland secretions can

contain sperm The end of a plain-end condom

must be twisted Lubrication helps prevent breakage Avoid oil based lubricants

Advantages of Condoms

The best protection against contracting and spreading STDs and preventing vaginal infections

Easily available No harmful side effects Can decrease sensitivity for

greater endurance

Disadvantages

Can interrupt spontaneity Decreases penile sensitivity Tiny leaks can ruin effectiveness Should be put on properly

The IUD

Intrauterine devices – small plastic objects inserted into the uterus

Various types halt conception in differing ways

Some prevent fertilization Others disrupt normal ovulatory

patterns

Using the IUD Inserted by a health care

professional using sterile instruments

Careful screening is necessary Woman should be over 25, in a

monogamous relationship, with no history of STDs or PID

String should be checked each month after menstruation

Advantages of the IUD

Tremendous effectiveness Very little inconvenience Can work for 10 years Very inexpensive Possible discomfort usually

diminishes within a month or so

Disadvantages Insertion can be painful Some expel the device Serious problems – PAINS Period disappears or is late Abdominal pain Increased temperature, fever, chills Nasty discharge, foul smell Spotting, bleeding, heavy periods

Emergency Contraception (EC) Taking hormone pills or inserting a

Copper-T IUD (99% effective) can serve in an emergency

Could possibly eliminate over 2 million unintended pregnancies a year in the US alone

But only 49% are aware of this Hormone pills can be taken up to 5 days

after intercourse but the sooner the better

ECII Side effects such as nausea and vomiting

are possible Approved in 1996, but available only

through prescription? Unwise Some states have changed this Also access can be difficult Catholic hospitals often refuse to provide