Birth Control

There are many different types of Birth Control that are on the market today.  Throughout the world birth control is widely used. Depending on the situation of the woman, society and other factors, different types are used in different places.  The key to understanding the importance of birth control is in the education of not only woman but also men.  It is important for everyone to understand the different kinds of birth control and understand how each one works.  Abstinence is of course the only 100% safe method of being protected from pregnancy as well as STDS. Some believe that this should be only the only information given out to teens while others believe that options should be available and that sex education should be taught to teens.  In this website and following presentation I hope to establish the different options and alternatives.

Condoms

Condoms are over-the-counter, barrier methods of reversible birth control. They are sheaths of thin latex or plastic worn on the penis during intercourse. They are available dry or lubricated. Condoms collect semen before, during, and after ejaculation and can keep sperm from entering the vagina.

Out of 100 women whose partners use condoms, about 15 will become pregnant during the first year of typical use. Only two women will become pregnant with perfect use. More protection against pregnancy is possible if condoms are used with a spermicide foam, cream, jelly, suppository, or film.

Latex condoms offer very good protection against HIV. They also reduce the risk of other sexually transmitted infections, including gonorrhea, syphilis, Chlamydia, HPV, and herpes. (1)

Female Condom-The female condom is a reversible barrier method of birth control. It is a polyurethane (plastic) pouch with flexible rings at each end. It is inserted deep into the vagina like a diaphragm. The ring at the closed end holds the pouch in the vagina. The ring at the open end stays outside the vaginal opening. The female condom collects semen before, during, and after ejaculation and keeps sperm from entering the vagina. Of 100 women who use female condoms, 21 will become pregnant during the first year of typical use. Five will become pregnant with perfect use. The female condom reduces the risk of many sexually transmitted infections, including HIV. Advantages of the female condom include the fact that they can be purchased easily at drugstores and supermarkets just like male condoms. Also no prescriptions or fittings are needed and insertion is easy. (1)

The Pill

The birth control pill is a daily pill that contains the hormones estrogen and progestin that prevent pregnancy. Most birth control pills contain the combination of the hormones estrogen and progesterone to prevent ovulation (the release of an egg during the monthly cycle). If a woman doesn't ovulate she cannot get pregnant because there is no egg to be fertilized. The combination pill comes in either a 21-day pack or a 28-day pack. One hormone pill is taken each day at about the same time for 21 days. Depending on the pack, the woman will stop taking pills for 7 days or shewill take a reminder pill (that contains no hormones) for 7 days. When a woman stops taking her hormones she has her period. Some women prefer the 28-day pack because it helps them stay in the habit of taking a pill every day.(2)

Over the course of one year about five out of 100 typical couples who rely on the Pill to prevent pregnancy will have an accidental pregnancy. Of course, this is an average figure and the chance of getting pregnant depends on whether you take your birth control pills every day. The Pill is an effective form of birth control, but even missing 1 day increases the chance of getting pregnant.

In general, how well each type of birth control method works depends on a lot of things. These include whether a person has any health conditions or is taking any medications that might interfere with its use. It also depends on whether the method chosen is convenient - and whether the person remembers to use it correctly all the time. (2)

The birth control pill does not prevent Sexually Transmitted Diseases.

Disadvantages of Birth Control include-irregular menstrual bleeding, nausea, weight gain, headaches, dizziness, breast tenderness, mood changes, blood clots (rare in women under 35 who do not smoke).

Cervical Cap

A cervical cap is a latex, thimble-shaped device that is inserted into the vagina and fits snugly over the cervix. Suction keeps the cap in place. A cervical cap provides a barrier to block sperm from entering the uterus and prevents fertilization. After intercourse, it should be left in place for 8 hours. A cervical cap is used with spermicidal jellies or creams that kill sperm. As birth control, cervical caps are 80-91% effective for women who have never given birth. They are 60-74% effective for women who have given birth. Cervical caps come in different sizes to fit different women. A fitting is done in a clinic. (3) Some advantages to using the cervical cap include the fact that it can be left in for up to 48 hours, uses less spermicide than the diaphragm and its smaller and less noticeable.  Some disadvantages include the fact that it is not appropriate for all types of cervix. It can sometimes be more difficult to insert than a diaphragm and it can become dislodged from the cervix during intercourse.  Also an odor can occur with use over two days.

IUD

The intrauterine device (IUD) is a small, plastic, T-shaped device that is inserted inside a woman's uterus.  A plastic string tied to the end of the IUD sticks down through the opening of the uterus into the vagina.  The woman checks that the IUD is in place by feeling for the string.  The string is also used by a health professional to remove the IUD.

The IUD prevents fertilization of the egg by producing a sterile inflammatory response that kills sperm.  Some IUDs release progesterone, which prevents fertilization by affecting how the sperm or egg move. The hormone also make the mucus in the cervix thick and sticky, so sperm can not get through to the uterus.  Progesterone IUDs may also prevent implantation.  The copper in the most common used IUD, the Copper T 380-a, seems to increase the number of white blood cells in the uterus and cause other changes that kill sperm. (4)

IUD's have been used in one form or another since 1909.  It wasn't until the 1970's that  they got such a horrid reputation.  The  reason that IUD's have such a bad reputation in the UNITED STATES is as a result of an IUD called the Dalkon Shield.  The Dalkon Shield was associated with12 deaths due to miscarriage related infections.  The device came in two sizes and it was only the large size that had any problems, even though at the time the string was believed to be the cause of the infections.  The Dalkon Shield had a multi-filament string which was twisted and this was thought to be a way bacteria entered the uterus.  However, this was never shown in the smaller version or in any testing that was done.  40% of IUD users had the Dalkon Shield during this time.  This form of the IUD was taken off the market in 1975 and then doctors charged that all IUD's caused Pelvic Inflammatory Disease.  (This has SINCE been proven untrue) It received such bad publicity that manufacturers stopped making the IUD because of potential lawsuits in the US and the number of women using the device dropped to almost nothing.  In the rest of the world the Dalkon Shield is still used.  The news coverage of the problems with the Shield did not travel to all corners of the world and in fact the IUD is the MOST widely used form of Birth control throughout the world. (5)

Contraceptive Patch

The patch releases two hormones, estrogen and progesterone into the bloodstream through the skin. Like the combined pill it stops the ovaries from releasing an egg for fertilization every month. It also thickens the mucus around the cervix, which makes it difficult for sperm to get into the womb.

Patches can be worn discreetly on most areas of the body, including the upper arm, shoulder or hip, but should not be applied to the breasts or to broken or irritated skin.

The patch provides protection from pregnancy straight away only if started on the first day of your period and worn continuously for seven days. On the eighth day it should be changed. The patch should be changed every week for three weeks.

After three weeks the patch should not be worn for seven days. During the patch-free week the woman may bleed as in a normal period. After seven patch-free days a new one is applied and the four week cycle of three weeks with a patch, one week without starts again.

One big advantage to the patch is that the woman does not have to remember to take the pill every day.

Some disadvantages include the fact that it does not protect against STDs, can cause headaches and skin irritations, and in a small number of women it can cause blood clots and breast cancer.

The patch is 99% effective when it is used properly.That means one in every 100 women on the patch will become pregnant. (6)

The "Shot"

The "Shot" is known as Depo-Provera®. The injection contains a synthetic hormone called progestin. This chemical is similar to the natural hormone progesterone that is produced by the ovaries during the second half of the menstrual cycle. Depo-Provera is injected into the muscle of your buttock. The injection will prevent pregnancy for three months and the birth control effects begin as soon as you have your first shot. The injection should be repeated every three months (12 weeks) as long as birth control protection is wanted. If an injection is late or missed, pregnancy can occur.  Depo-Provera is highly effective. (97%)  It is more effective than the birth control pill because it is not dependent upon correct daily usage. (7)

The most common side effect is a change in the menstrual cycle especially during the first 6 months of using Depo-Provera. Bleeding may be heavier than usual, spotting between periods may occur or women may have no periods. After about one year most women will stop having periods. The lack of periods does not mean that you are pregnant if you have received injections regularly every three months (12 weeks). Depo-Provera is not a good choice if the woman wants to become pregnant in the next year or two. Why? Because it typically takes 9 to 10 months to become pregnant after the woman stops taking Depo-Provera as a contraceptive. It could even take up to 24 months after discontinuing use of Depo-Provera for the woman to become pregnant. The length of time the woman uses Depo-Provera has no effect on how long it takes the woman to become pregnant. If the woman does not wish to become pregnant after stopping Depo-Provera, then she should start another form of birth control immediately. (7)

There are multiple side effects associated with the "Shot".  These include weight gain, headache, nervousness, cramps, dizziness, fatigue and decreased sex drive. Most of these decrease over time.  The "shot" does not protect against STDs and can increase risk of pelvic inflammatory disease.

Depo-Provera should not be used if the woman thinks she might be pregnant, if she has vaginal bleeding for no reason, if she had cancer of the breast or reproductive organs, if she had a stroke, if she has or had blood clots in the legs, or if she had problems with her liver.

Diaphragm

The diaphragm is a small, dome-shaped rubber shield that sits over the cervix and rests on the pubic bone. The diaphragm works by keeping sperm from entering the cervix and going into the uterus. It does this with the help of spermicidal jelly or cream. It MUST be used with a spermicidal jelly or cream! Think of it as a spermicide holder.

Spermicide is put inside the bowl of the of the diaphragm and around the edges. A good tablespoon size is what is recommended.  The diaphragm is folded in half and inserted into the vagina, high enough so that it covers the cervix.  The diaphragm should always be checked to make sure that the latex of the diaphragm is covering the cervix. When the diaphragm is inserted properly the woman should feel no discomfort. The diaphragm must be put in place before sex and must be left in place for 6-8 hours afterward.  The diaphragm must washed, rinsed and dried and then stored in its case after use.  It should never be touched by petroleum jelly or baby oil since these substances can cause the rubber to break down. (8)

Advantages of the diaphragm include the fact that it is a very effective method when used correctly. It can be inserted up to 2 hours before intercourse, so it doesn't interrupt sex as much as other barrier methods. and it is less expensive per month than the pill. Some disadvantages include the fact that the woman has to be fitted and she needs a prescription in order to have one and it must be replaced every two years. (8)

Side effects include the fact that the spermicides may irritate or cause an allergic reaction in the vagina. Any irritation should go away after you stop using it.  The woman must also make sure that if her weight fluctuates she must be refitted.

Morning After Pill-Emergency Contraception

Emergency contraceptives are methods of preventing pregnancy after unprotected sexual intercourse. They do not protect against sexually transmitted infections. Emergency contraception can be used when a condom breaks, after a sexual assault, or any time unprotected sexual intercourse occurs. Emergency contraceptives should not be used as the only protection against pregnancy if the woman is sexually active or planning to be, because they are not as effective as any ongoing contraceptive method.

There are two types of emergency contraceptive pills. One type uses hormones that are the same type and dose as hormones used in some kinds of ordinary birth control pills. These hormones are called estrogen and progestin . In many countries (but not the United States), these pills are especially packaged and labeled for emergency use. But several other brands packaged for ongoing contraception can be used as well. About 50% of women who use this type get nauseated and 20% vomit. Use of this pill cuts the chance of pregnancy by 75%. This statement does not mean that 25% of women using them will become pregnant. Rather, if 100 women had unprotected intercourse once during the second or third week of their cycle, about 8 would become pregnant; following treatment with this pill, only 2 would become pregnant: a 75% reduction. (9)

The other type of emergency contraceptive pill contains only the hormone called progestin. In many countries this type is specially packaged and labeled for use for emergency contraception; the brand name in the United States is Plan B. It is more effective than the first type, and the risk of nausea and vomiting is also lower. If the same 100 women used Plan B, only 1 would get pregnant: an 89% reduction. (9)

Some people call emergency contraceptive pills "morning after pills." But you do not have to wait until the morning after. You can start the pills right away or up to five days after you have had unprotected sex - that is, sex during which you did not use birth control or your birth control may have failed. Therapy is more effective the earlier it is initiated within the 120 hour window.

There is controversy surrounding the Morning After Pill.  Many believe that using the pill is a form of abortion. For more information Click HERE!!

Contraceptive Ring

The vaginal contraceptive ring (also called "the ring") is a flexible, transparent, colorless vaginal ring measuring two inches in diameter that releases a continuous low dose of estrogen and progestin. The ring is inserted into the vagina for three weeks and is then removed for one week while the woman has her period. A new ring is used with each cycle. It is inserted and removed by pressing the sides of the ring together between the thumb and index finger and gently pushing it in or pulling it out of the vagina. Use begins on or before the fifth day of a woman's period.

Advantage of using the contraceptive ring includes a dosage schedule that  is easy to follow, as the ring only needs to be changed once a month (compared to birth control pills, which must be taken every day). It is also easily inserted and removed. As the doses of hormones are low and steady, little spotting or irregular bleeding occurs, and ovulation returns quickly after a woman stops using the ring.

Disadvantages of using the ring include the fact that it does not provide protection against STDs. Some reported side effects include vaginal infections and irritation, discharge, headache, weight gain, and nausea, some of which are similar to those of birth control pills. Women who use the ring are strongly advised not to smoke, as doing so can increase the risk of severe cardiovascular side effects. It is not suggested for women who are or may be pregnant, or have blood clots, severe high blood pressure, certain cancers or a history of heart attacks and strokes. (10)
 

Religion-Catholic View-Natural Family Planning

Two methods of natural family planning are currently taught. The first is the ovulation method. In this method, the days just before and just after ovulation are determined by checking the woman's cervical mucus. When a woman is most likely to become pregnant, the cervical mucus is stretchy, clear and slick. Some people say that the cervical mucus during this time looks and feels much like an uncooked egg white.

The second method is called the symptothermal method. With this method, the woman takes her temperature each day with a special thermometer and writes it down on a chart. At the time of ovulation, a woman's temperature will rise slightly. The woman also checks the consistency of her cervical mucus. She may also notice other changes, such as pain in the area of the ovaries, bloating, low backache and breast tenderness.

In both methods, couples use a special chart to keep track of the changes in the woman's body.

These methods can help a couple avoid pregnancy if the couple receives training from a specialized instructor and if they carefully follow all of the instructions provided. Both methods can be 90% to 98% effective (2 to 10 pregnancies per 100 couples) when they are practiced correctly. However, if a couple doesn't follow the instructions completely, these methods will be much less effective. In practice, these methods may not be as reliable as other forms of birth control.

Advantages of natural family planning include First, natural family planning does not involve the use of medicines, mechanical devices or chemicals. Side effects or risks that may occur with the use of such medicines or devices will not occur with natural family planning methods. Second, natural family planning methods are inexpensive. A fee is usually charged for instructional training and supplies, but there are no ongoing costs.(11)

Rhythm Method-The rhythm method is based on calendar calculations of previous menstrual cycles. This method doesn't allow for normal changes in the menstrual cycle, which are common. The rhythm method isn't as reliable as the ovulation method or the symptothermal method and is generally not recommended. Women who have no variation in the length of their menstrual cycles can use the rhythm method to know when they are ovulating (14 days before the start of their period). (11)

For more information on birth control in general visit www.plannedparenthood.org.

Bibliography

1. Facts about Birth Control, March 2004. http://www.plannedparenthood.org/bc/bcfacts1.html. Accessed on November 7, 2004.

2. Birth Control Pill, 2003. http://www.kidshealth.org/teen/sexual_health/contraception/contraception_birth.html. Accessed on November 4, 2004.

3. Cervical Cap, April 2004.http://www.fwhc.org/birth-control/capinfo.htm.  Accessed on November 4, 2004.

4. IUD for Birth Control, February 26, 2004. http://mywebmd.com/hw/healthy_women/hw7384.asp. Accessed on November 7, 2004.

5. IUDS. http://www.mjbovo.com/Contracept/IUD.htm.Accessed on November 7, 2004.

6. Contraceptive Patch. http://www.brook.org.uk/content/M2_1_9_patch.asp.  Accessed on November 8, 2004.

7. Depo-Provera. http://www.indiana.edu/~health/depo.html. Accessed on November 8, 2004.

8. Diaphragm, 2004. http://www.coolnurse.com/diaphragm.htm.  Accessed on November 4, 2004.

9. The Emergency Contraception Website, 10/2004. http://ec.princeton.edu/.  Accessed on November 7, 2004.

10. Vaginal Contraception Ring, 5/22/2003. http://www.ivillagehealth.com/features/birthcontrolaz/pages/0,,166931_438022,00.html?arrivalSA=1&cobrandRef=0&arrival_freqCap=2.  Accessed on November 4, 2004.

11. Natural Family Planning, September 2004. http://familydoctor.org/x1740.xml. Accessed on November 4, 2004.