Contraceptives

Announcement - New Warning on Contraceptive Patch:   The FDA, on November 10, 2005, updated the label on the Ortho Evra Contraceptive Patch. The new label warns patients and health care providers about the high level of estrogen the patch contains. The estrogen level in the Ortho Evra Patch is about 60 percent more than the estrogen level in a typical birth control pill. If you are currently using Ortho Evra as your contraceptive measure, or if you are thinking about using Ortho Evra, be sure to speak with your health care provider about specific health concerns pertaining to the increased estrogen level.

(1) BEHAVIORAL CONTRACEPTIVE METHODS

• When used to prevent pregnancy, no vaginal intercourse. Abstinence has many different definitions; from a ‘safer sex’ perspective, it should include no contact with bodily fluids whatsoever, i.e. no anal sex, no oral sex, etc.

Pros:

• Does not affect future fertility
• No side effects
• Free

Cons:

• Difficult to maintain
• Range of definitions
• Still can be exposed to sexually transmitted infections (STI), unless no contact with other bodily fluids

(2) HORMONAL METHODS

Oral Contraceptive (Pill) - 92-99.7% effective

How it works:

• Oral pill taken everyday
• Blocks egg production
• Thickens cervical membrane
• Prevents egg implantation

Pros:

• Regular periods
• May protect against uterine and ovarian cancers
• Easy to use
• Does not interrupt sex
• No harm to future pregnancy
• May reduce acne
• Decreased menstrual cramps and pain
• Decreased risk of Pelvic Inflammatory Disease (PID)
• Effective six days after first pill is taken

Cons:

• No sexually transmitted infection (STI) protection
• Can interact with antibiotics and other drugs
• Must be taken daily
• Some side effects may occur during the first month
• Requires a prescription
• Increased risk for blood clots in legs

Precautions:

• Pill must be taken at the same time every day
• Avoid smoking
• Pill may be less effective when taken with other medications, be sure to let every provider you see know you are taking a birth control pill
• Do not take while breast feeding or if you think you may be pregnant

Birth Control Patch - 92-99% effective

How it works:
• Topical patch placed on skins surface which releases hormones to be absorbed through the skin
• Patch in place for one week
• Same as pill – blocks egg production, thickens cervical membrane, prevents egg implantation

Pros:

• Effective for next menstrual cycle
• Regular periods
• Does not interrupt sex
• Easy to use
• Does not have to be taken daily
• Waterproof
• May reduce acne

Cons:

• Must be changed every week
• Can leave sticky residue
• Prescription required
• No STI protection
• Increased risk for blood clots in legs

Precautions:

• Avoid smoking
• Do not use if breast feeding or if you think you may be pregnant
• May be less effective in women who weigh more than 198 lbs.
• Place patch in a different spot on skin each time to avoid skin irritation
• May fall off
• Do not use creams, oils, powder, or make-up to area where patch is
• Effects can be compromised when taking other medications, be sure to tell all other medical providers that you are on the patch

Depo Provera - 97-99.7% effective

How it works:
• Hormonal shot given every 12 weeks
• Blocks egg production
• Thickens cervical mucus
• Prevents egg implantation

Pros:

• Effective 24 hours after first injection
• No daily pill
• Can be used when breast feeding
• Can be used by some women who cannot use the pill
• Effective for 13 weeks
• Does not interrupt sex
• Decreases risk for ovarian and endometrial cancers
• Prevention of endometriosis (disease of uterine lining)

Cons:

• May cause a 6-18 month delay in future pregnancy
• Causes loss of bone density which may lead to osteoporosis
• Irregular bleeding, possible cessation of periods
• Weight gain
• No immediate discontinuation
• Depression
• No STI protection
• Requires a clinic visit every 11-13 weeks

Precautions:

• Using this method for long term protection (>5 years) may result in significant bone density loss, only use this method if other options are inadequate
• Must take calcium supplements to lessen effects to bone density
• Avoid smoking
• Do not take if you think you may be pregnant
  
  

Emergency Contraception - 69-85% effective
(not available at Student Health Services)

How it works:

• Pills taken within 72 hours of sexual act
• Prevents ovulation
• Disrupts fertilization of egg
• Inhibits implantation

Pros:

• Can be used if regular form of birth control fails
• Does not prevent future pregnancy
• Regular birth control pills can be used when taken in different dosages (contact docto

Cons:

• Nausea
• No STI protection
• Not intended for long term, ongoing pregnancy prevention
• May fail if pregnancy has already occurred
• Side effects including; breast tenderness, irregular bleeding, dizziness, and headaches

Precautions:

• First dose must be taken within 72 hours and second dose 12 hours after that
• Do not take if you think you may be pregnant or are breast feeding
• Schedule a three week follow-up
• May need to take an anti-nausea medicine
• Next menstrual cycle may be different (heavier, different time, etc.)
• Not as effective as consistent forms of birth control
• Frequent use may cause irregular periods

 

(3) INTRAUTERINE DEVICE

IUD (intrauterine device) - 99.2-99.9% effective

How it works:
• Small plastic device inserted in uterus; some methods also release the hormone progestin
• Prevents sperm from fertilizing the egg
• Prevents egg implantation

Pros:

• Effective immediately after insertion
• Does not interrupt sex
• May reduce menstrual cramping
• Good for up to 10 years
• Requires no daily attention
• Neither partner should feel the device during intercourse

Cons:

• Possible risk to future fertility
• Spotting
• Heavier, longer periods
• May lead to infections
• No STI protection
• May increase chance of getting pelvic inflammatory disease (PID)
• Insertion and removal must be done by a physician

Precautions:

• Must check the device regularly to ensure the device is in place
• Avoid smoking
• Be sure to do monthly breast checks for lumps
• Do not take if you may be pregnant
• Can be expelled

 

(4) BARRIER METHODS

Cervical Cap - 84-91% effective

Diaphragm - 86-91% effective

How they work:

• Placed in vagina covering the cervix
• Barrier

Pros:

• May be inserted up to 2 hours before intercourse
• No serious side effects
• Some STI protection
• Does not interfere with future pregnancy
• Generally cannot be felt by either partner during intercourse

Cons:

• Can be dislodged during intercourse
• Must be professionally fitted, fit must be checked every 1-2 years
• Requires a prescription
• Can be messy
• Allergic reactions
• Cannot use during menstruation or infection
• No sexually transmitted infection protection
• Anatomical variations make use difficult or impossible
• Increased risk for urinary tract infections

Precautions:

• Must be left in for 8 hours after intercourse
• Use with a spermicide cream or jelly
• A new diaphragm is needed every 2 years
• Do not douche or use oil based lubricants
• Wash device thoroughly after each use
• If multiple sex acts occur in 6 to 8 hours, re-apply lubricant

Note: the cervical cap has recently lost its US manufacturer and may be difficult to obtain


Sponge - 91-98% effective

How it works:
• Soft polyurethane foam shaped like a cervical cap
• Spermicide infused which is activated by dampening sponge
• Kills sperm on contact
• Barrier

Pros:

• No prescription needed
• Can be inserted in advance, no interruption to intercourse
• One size fits all
• Can stay in for 24 hours
• No need to change or add spermicide in between multiple sex acts

Cons:

• No STI protection
• May shift during intercourse
• May aggravate urinary tract
• Increased risk of yeast infections and toxic shock syndrome
• May cause irritation due to the spermicide

Precautions:

• Sponge must remain in place for six hours after intercourse
• Do not use while menstruating
• Do not re-use a sponge

Female Condom - 79-95% effective

How it works:
• Worn inside vagina, bottom ring on outside of body
• Barrier

Pros:

• No prescription needed
• Does not effect future fertility
• Can be used by those with latex sensitivity (it’s plastic)
• Stronger than latex
• Can be used during oral sex for STI protection – placement is different
• Can be inserted up to 8 hours before intercourse

Cons:

• Noticeable during sex
• May be difficult to insert
• Can break or leak if precautions are not taken
• Expensive
• Not as readily available as the male condom

Precautions:

• Do not use male and female condom at the same time
• Use a water based lubricant
• May want to use spermicide
• Do not re-use a female condom
• Store condoms at room temperature in a place where they will not become punctured (you may want to avoid your purse if you keep pens, safety pins, or other sharp objects in it)

Male Condoms - 85-98% effective

How it works:
• Fits over penis
• Keeps sperm from entering vagina
• Barrier

Pros:

• No prescription needed
• Easy to carry
• Readily available
• STI protection
• Does not affect future pregnancy
• Only reversible birth control method for men
• May decrease woman’s risk of developing pre-cancerous cells on her cervix
• Can and should be used for anal sex
• Can be helpful for premature ejaculation

Cons:

• Reduced sensitivity
• Can break or leak if precautions are not taken
• Allergic reaction
• Interruption to intercourse

Precautions:

• Do not use a male condom and a female condom at the same time
• Use a water based lubricant
• May want to use a spermicide
• Store at room temperature, avoid heat and sunlight
• Keep in a place where package will not become punctured
• Do not re-use a male condom