HLTH377 Winter Term 1 8 January 2014 Contraception I During the 1960 s oral contraception became widely available but today there are still some heated debates on contraception Sawyer Study College students reasons for nonuse Number 1 Reason Risky but still took a chance Other Reasons Unexpected sex not very sexually active 3 7 times during an academic year Maryland women went on and off the pill o The reason was because the relationship ended Research Findings Under the influence Men assume women are safe Men do not want to use the condom Forms of Contraception Implanon Nexplanon Intrauterine Device IUD Depo Provera Oral contraception Patch Nuvaring Condom Foam Diaphragm Gel or Cream o Represents forms of contraception that are ineffective The most common global effective form of contraception is sterilization o Reversible Yes Efficacy of reversible 50 less effective College Students Reasons for Non use Knew it was risky but took a chance Didn t expect sex to happen Not really very sexually active I we were too drunk to think about it Sawyer s Study It was found that the highest rate of pregnancy by year while in school was Seniors Study conducted at the University of Maryland Effectiveness Rates Theoretical versus Actual Effectiveness o Theoretical is the highest rate compared to the actual o How to Calculate Actual Effectiveness Have 100 couples promising to use one method of contraception and look to see how many people became pregnant by the end of the year Methods versus User Failure o Did the method work o Did the user use the contraception incorrectly o Between the two its typically user failure Oral Contraception First marketed in the 1960s o Although it has been around since the 50s How does the pill work o Estrogen helps to prevent ovulation cannot get pregnant o Progesterone helps to prevent ovulation and also thickens cervical HLTH377 Winter Term Borja 2 mucous physical barrier and lack of ovulation Medical Contraindications Most people who want to use the pill are fine but 25 of people cannot use the pill due to a personal or family medical history Oral contraception increases the risk of yeast infections Hormonal Methods Very effective for preventing pregnancy Side Effects can vary in degrees Types of Oral Contraception 21 Active pills and 7 placebo pills Sequential Combination o When the pill was first developed the hormones were not mixed together o This was less effective than the combination of hormones o Current pill today and has both hormones progesterone and estrogen o Model Pill today 1 mg of progesterone and 30 35 micrograms of estrogen o Past dosages were 3 and 180 The person could forget about the pill 4 days and still not get pregnant Patent for combination pill was running out Triphasic o Modern pill because patent for combination pill was running out o Artificially controls hormone flow o It is a pill marketed to mimic women s hormonal flow by manipulating the combination pill Seasonale o Based on the premise that a woman does not have to menstruate every month o 84 days of active pills 7 placebos and have a total of 4 periods per year o No periods per year o No endometrium lining Lybrel present Mini pill o The mini Pill is different from the combined Pill because it contains only one hormone instead of two That hormone is one of the group called progestogens These are synthetic compounds which are similar to the natural female hormone called progesterone Examples of Contraindications About 10 of women who would like to take oral contraception may have to rule it out History of cancer o Personal Rule out the o Family A little more History of heart problems o Personal Rule out the o Family A little more pill leeway pill leeway HLTH377 Winter Term 3 Mechanism prevent ovulation slow the transport of the egg to the fallopian tubes This is not a form of birth control More intense side effects intense nausea Some refer to it as the abortion pill political debate History of strokes o Personal Definitely rule out the pill o Family Most likely rule out Migraines o Personal Rule out the pill o Family Some leeway Possible Side Effects Non life threatening o Weight gain o Tender breasts o Increased breast size o Mood swings verging on depression o Overemotional o Nausea o Diarrhea o Loss of libido o Increased chance of yeast infection o Affects acne o Spotting o Treat dysmenorrhea painful periods o Increase chance of stroke blood clots and heart attacks o Breast cancer Life threatening Risk of Uterine cancer decreases with oral contraception Emergency Contraception Plan B progestin only most effective if taken within 72 hours OTC over the counter 17 years and older Ella active ingredient is ulipristal effective if taken within 120 hours prescription only FDA found its safer than aspirin 8 January 2014 Contraception II HLTH377 Winter Term Borja 4 Contraceptive Patch combined hormones Progestin and estrogen Hormones get into the blood stream through the skin Change patch every 7 days After 3 patches 7 days without Resume new patch on day 29 or day 1 in new cycle Contraindications and side effects similar to the pill Most of the time its user failure o Forgetting to take the pill o For the patch the chances of forgetting are reduced Nuvaring combined hormones Progestin and estrogen Placed into the back of the vagina Situated around the cervix Left in place for 21 days Removed on day 22 new ring on day 29 or day 1 in new cycle Contraindications and side effects similar to the pill FDA reported increased risk of blood clots cause stroke and the nuvaring now has a warning label Implanon Nexplanon Plastic capsule containing progestin only Implanted under the skin Effective against pregnancy for up to 3 years Contraindications and side effects similar to the pill Most effective reversible sterilization Intrauterine Devices IUD It is believed that a foreign body placed inside the uterus where a fertilized egg attempts to implant is somehow stopped Unclear how IUDS work Device placed in uterus by practitioner Can be left in for several years Most common type used Mirena Copper T 380A Progestasert DepoProvera Condoms Injectable Progestin only Effective up to 12 weeks Might delay fertility Amenorrhea in some No user failure May delay fertility May lose period May stop menstruation 6 months to a year after stopping DepoProvera Latex lambskin polyurethane Should really be used with spermicide Failure rate usually user failure Move to create different sizes Latex synthetic