Contraceptives 12 13 2012 A Why is there a gap between intention and behavior a The Fog Zone How misperceptions magical thinking and ambivalence put young adults at risk for unplanned pregnancy b Birth control pill 96 97 effective i When people are asked how effective they thought 50 effective ii People fear it may cause weight gain iii People fear it will cause infertility iv 18 29 year olds think they are infertile v Ambivalence yeah I want to be a parent at some point but haven t really given it any thought want to finish school first vi Some people are suspicious of the birth control enterprise vii Belief that side effects are much worse than they actually are viii Not knowing that you can switch methods c What steps can be taken to close the gap i Education ii Communicating with young adults iii Health care system iv Social environment B Contraceptives a Hormonal Birth Control works in 3 ways i Ovulation is suppressed synthetic hormones produces as artificial cycle to replace it ii Thickens cervical mucus iii Prevents the uterine lining from thickening b Barrier i Prevent sperm and egg from meeting ii Ex tubes tied c Birth control pills combination i Estrogen progestin combo d Birth control pills progestin only i Known as the mini pill do not contain estrogen ii Release a small amount of progestin everyday of the month and don t give you a period during a set week e Typical use vs perfect use i Perfect 1 Use we see in a lab 2 Something doing everything right 3 What is on the pamphlet instructions ii Typical 1 Real world 1 IUD or implant f NuvaRing iii The method that would make these two closest together would be i Small bendable ring that you insert into vagina ii Leave in it place for three weeks at a time then take it out for the fourth week iii Sits inside the vagina and continuously releases hormones iv Put a new one in every four weeks don t have to think about it every day v A doctor does not have to put it in vi More expensive vii Perfect use greater than 99 and Typical use 91 g Withdrawal i The more significant finding however was that most pre ejaculate samples did not contain any sperm and those that did had only small slumps of a very small amount of sperm which seemed to be immobile ii Using it perfectly can be 96 but typical use is 78 h IUD inta uterine devise i Sits inside the uterus ii This and the shot are the only methods that you have to go back to health care providers other than to just get a prescriptions iii For most people it costs no more than 50 dollars to get it iv Implant and IUD are seen as long acting reversible contraceptive 1 Paraguard a Made of plastic and a small amount of natural safe cooper b 100 hormone free c Doesn t alter periods d It can stay inside up to 12 years e Women is still ovulating f Fertility returns immediately 2 Mirena i Choice project Plastic IUD releases a small amount of synthetic hormone progestin to help your body keep sperm from reaching your Lasts up to 7 years and may give you lighter periods Fertility returns usually within 3 months cervix 2 Implant a Effective for up to 3 years b Placed in upper arm c Return to fertility within 2 months 1 Washington University in St Louis 2 Enrolled over 9 000 women and provided free contraceptives 3 Monitored their use satisfaction and pregnancy 4 Many people are not aware of the newer options 5 Repeat abortion rates have gone down 6 Choice Project Results a Women using LARC and DEPO had the lowest unintended pregnancy rates at 1 2 and 3 years of follow up Pill ring and patch users had much higher unintended pregnancy rates more than 16 times higher than LARC users in 1 year b all pregnancies in the US are unintended j Why LARC Long acting Reversible contraceptives 1 Benefits a Overtime less expensive b Use is independent from user motivation user appearance no human error sex c Invisible discrete d Effective typical and perfect use are the same e Saving time and money because don t need to go back to provider pharmacy f Reversible 2 Negatives a No STD protection k Emergency Contraception s i How does it prevent pregnancy 1 Emergency contraceptive prevent pregnancy primarily or perhaps exclusively by delaying or inhibiting ovulation and inhibiting fertilization 2 We can t always completely explain how contraceptives work and it is possible that any of these methods may at times inhibit implantation of a fertilized egg in the endometrium 3 But the best evidence that we have suggested is that leconorgestrel EC does not interfere with post fertilization events 1 Prescription only effective for up to five days after unprotected ii Ella sex iii Plan B Next Choice 2 Available over the counter without a prescription if you are over age 17 effective up to 5 days after unprotected sex but effectiveness decreases each day 3 The instructions for Plan B and Next Choice say to take it within 72 hours after sex iv Paraguard IUD v Yuzpe method a specific order 4 The most effective EC a doctor inserts it within 5 days of a missteo and lower your pregnancy by 99 9 5 Woman uses everyday birth control pills as EC By combining pills in 6 The estrogen and progestin in those pills work to prevent an unplanned pregnancy before it starts 7 Most effective when used within 72 hours 8 You take your birth control pills in two doses 12 hours apart It only works with certain brands vi Emergency contraceptive pill prevents pregnancy If you re already pregnant EC will not work vii What are the side effects of EC The side effects of EC when any are present are similar to strong PMS symptoms Women with an established pregnancy heart conditions blood clots or certain cancers may not be able to use emergency contraception viii Does use of EC cause birth defects Accidental use of EC during pregnancy will not cause birth defects Numerous studies for risk of birth defects during regular use of oral contraceptives found no increased risk ix What about repeat use of EC Emergency contraceptives are not appropriate for regular use as an ongoing contraceptive method because of higher possibility of failure compared to modern contraceptives Frequency use of emergency contraception would result in more side effects such as menstrual irregularities Repeated use poses no known health risks Pregnancy Options Parenting adoption abortion C Options Counseling and Adoption a Effective options counseling i Reduce anxiety to make decisions ii Safe environment to discuss future iii Know knowledge and facts about the various options