Who s s The Daddy? What You Should Know About OTC Contraception

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1 Who s s The Daddy? What You Should Know About OTC Contraception By: Vona Broughton, BS Public Health & Kevin McCarthy, RPH This program has been brought to you by PharmCon PharmCon is accredited by the accreditation counsel for Pharmacy Education as a provider of continuing pharmacy education

2 Who s s The Daddy? Speaker: Vona Broughton received her BS degree in Health Promotion from Coastal Carolina University in Conway, SC. She then joined PharmCon as the Assistant Director of Continuing Education, where she coordinates CE programs on location nationwide, as well as moderates CE webinar programs. Her primary interests include women's health (contraception, breast cancer as well as other cancers, menstruation), eating disorders, nutrition, as well as an array of international health issues. Speaker Disclosure: Miss Broughton has no actual or potential conflicts of interest in relation to this program. This program has been brought to you by PharmCon PharmCon is accredited by the accreditation counsel for Pharmacy Education as a provider of continuing pharmacy education Legal Disclaimer: The material presented here does not necessarily reflect the views of Pharmaceutical Education Consultants (PharmCon) or the companies that support educational programming. A qualified healthcare professional should always be consulted before using any therapeutic product discussed. Participants should verify all information and data before treating patients or employing any therapies described in this educational activity.

3 Who s s The Daddy? Accreditation: Pharmacists L04-P Pharmacy Technicians L04-T Target Audience: Pharmacists & Technicians CE Credits: 1.0 Credit hour or 0.1 CEU for pharmacists/technicians Expiration Date: 8/15/2011 Program Overview: Counseling the patient who seeks advice on over the counter contraception can often result in an awkward encounter, especially if the pharmacist is not fully knowledgeable in the latest products on the market. In addition, advice and counseling on this topic must be done professionally and with sensitivity to avoid embarrassment to either party. Objectives: 1. Identify several available birth control methods, specifically over the counter options. 2. Provide an update on the birth control method options including mechanisms of action, efficacy, safety, and tolerability. 3. Describe the role pharmacists can have in identifying, educating and counseling patients seeking contraceptives. This program has been brought to you by PharmCon

4 Program Overview: WARNING! GRAPHIC PHOTOS AND SEXUALLY EXPLICIT LANGUAGE. This program contains sexually explicit images and audio content which may be considered offensive to some audiences. If such material offends you, please do not continue your participation in this presentation. If you sign off now, you will be refunded your registration fee. Exercise mature judgment if your viewing area may be seen by children or coworker s who may find the content offensive Who s s The Daddy?

5 Objectives: Identify several available birth control methods, specifically over the counter options. Provide an update on the birth control method options including mechanisms of action, efficacy, safety, and tolerability. Describe the role pharmacists can have in identifying, educating and counseling patients seeking contraceptives.

6 What Are Contraceptives? Definition: A substance or device capable of preventing pregnancy.

7 Note: Birth control methods are NOT substitutes for prevention methods against sexually transmitted diseases or infections. PREVENTION IS MUCH EASIER THAN A CURE!!!

8 Fast Facts: Some birth control methods are more effective than others. No method, other than abstinence, is 100% effective. Many factors influence effectiveness of any method available. Best method is individual choice and should be discussed with healthcare provider.

9 Choosing a Birth Control Method: Choose contraception like you choose a partner carefully. It is a choice know your options.

10 Choosing Birth Control Method Become informed about STDs and risk of pregnancy. Partners should choose together.

11 How Does Conception Occur?

12 Journey of the Sperm

13 Busting Birth Control Myths A female can t get pregnant the first time Sex education: Talking to your teen about sex

14 Busting Birth Control Myths Douching, showering, or bathing can prevent pregnancy

15 Busting Birth Control Myths A female cannot get pregnant if male pulls out Suggestion: Get a signed contract by the guy beforehand!

16 More Myths Busted A female can t get pregnant if she has sex during her period

17 More Myths Busted Birth control pills cause cancer Breast cancer inconclusive Protective effect against ovarian cancer

18 More Myths Busted Use saran wrap or a balloon if a condom is unavailable

19 Myths continued Pregnancy is prevented by jumping up and down or placing seeds in the vagina

20 Myths continued Having sex standing up works as contraceptive

21 More Myths Busted Not having an orgasm can be a great method of birth control

22 More Myths Busted The tighter the condom, the more protection

23 What to Consider: Frequency of sexual relations Number of partners Communication with partner Availability of contraceptive options Overall health and family history

24 A Few More Items to Consider Health risks & side effects Does it fit your lifestyle? What are your intentions? Your comfort level

25 What Are My Choices? Tubal Ligation Tubal Microinserts Male Sterilization (Vasectomy) Diaphragm Cervical Cap Vaginal Sponge Male Condom Female Condom Spermicides Withdrawal Outercourse

26 Failure Rates for Birth Control Methods When Used Correctly (Number of pregnancies per 100 women per year) Male condom alone 11 Female condom alone 21 Diaphragm with spermicide 17 Cervical cap with spermicide 17 to 23 Sponge with spermicide 14 to 28 Spermicide alone 20 to 50 Oral contraceptives 1 to 2 Contraceptive patch* 1 to 2 Vaginal contraceptive ring 1 to 2 Hormone shots less than 1 IUD less than 1 Periodic abstinence 20 *Contraceptive patch is less effective in women weighing more than 198 pounds. Information from U.S. Food and Drug Administration. Birth Control Guide.

27 OTC Options: Male Condom Female Condom Spermicides Vaginal Sponge Emergency contraception

28 Male Condom Made of a thin sheath of latex or natural animal membrane and place over penis. Prevents pregnancy and STIs. Available readily in stores and clinics.

29 Advantages of Male Condom 85%- 98% effective No adverse health effects Available OTC/ low cost Easy to use Protects against diseases and pregnancies Easily reversible

30 Disadvantages of Male Condom Lower efficacy than other non-barrier methods Lack of spontaneity Depends on cooperation of male partner

31 Counseling Message Counseling on condom use should be tailored to each patient s individuals needs, risk factors, and lifestyle.

32 Female Condom FDA approved First woman-controlled birth control method that protects against STIs. Lubricated inside and out 79%- 92% effectiveness One time use only Do not use with male condom

33 Risks and Side Effects Female Condom Safe to use (better for latex allergies) Made of polyurethane Sensitivity to spermicides

34 Advantages of Female Condom Protects against STIs and pregnancy Available OTC Less interruption Less allergies Easily reversible

35 Disadvantages of Female Condom Less discreet Uncomfortable insertion Noisy Somewhat lower effectiveness than other non-hormonal methods

36 Counseling Message Just like any birth control method, counseling on condom use should also be tailored to each patient s individual needs, risk factors, and lifestyle.

37 Vaginal Sponge Covers the cervix One time use only Effective about 24 hours Risk of TSS 60%-91% effective

38 Risks and Side Effects of Vaginal Sponge Sensitivity to spermicide TSS if left inserted too long Yeast infection may occur Vaginal dryness

39 Advantages and Disadvantages of Vaginal Available OTC Relatively discreet Easily reversible Sponge Disadvantages Not for parous women Risk of TSS and yeast infection

40 Counseling Message This method is best for nulliparous women. Women should be aware of risk of TSS and should be counseled on protecting themselves against STIs.

41 Gas, foam, cream, or suppositories that kill sperm Purchased in grocery store or drug store About 70%- 75% effective used alone Often combined with other methods Spermicide

42 Risks and Side Effects Not effective against STDs when used alone May irritate vagina and surrounding skin Recurrent UTIs for females

43 Advantages and Disadvantages of Disadvantages Does not protect against STDs Messy Allergies/ irritations Spermicides Advantages Can be obtained easily Relatively discreet Easily reversible

44 Counseling Message Can be used alone for pregnancy prevention. Are easy to use & are available without prescription. Do not protect against STIs & can increase the risk of vulvovaginal irritation and vaginal infection.

45 Emergency Contraception For emergency situation only Rape, unplanned sex, contraception malfunction Definition Morning after pill Prevents pregnancy Reduces pregnancy risk by 75-95%

46 2 3 1 Adapted from

47 EC: Regimens Progestin-only (Plan B two doses of 0.75 mg levonorgestrel taken 12 hrs apart) Combined estrogen-progestin (Yuzpe regimen - two doses of 100 mcg ethinyl estradiol plus 0.5 mg levonorgestrel taken 12 hrs apart) Alesse Nordette Levlen Levlite 5 pink pills 100 mcg EE 0.50 mg LNG 4 light-orange pills 120 mcg EE 0.60 mg LNG 4 light-orange pills 120 mcg EE 0.60 mg LNG 5 pink pills 100 mcg EE 0.50 mg LNG

48 Emergency Contraception Plan B Only Emergency Contraceptive pill in U.S. Sold to women over age 18 without prescription Alternative Yuzpe regimen EC Sold in pharmacies and clinics without a prescription if over age 18. Emotional duress of patient No restrictions on quantities Wont terminate pregnancies

49 Risks and Side Effects of EC No long term effects Nausea/ Vomiting Abdominal pain Fatigue Headache Tender breasts Break through bleeding, Menstrual cycle changes SE greater with Yuzpe Vomiting meclizine

50 Advantages of EC Back up plan Available OTC any time Prevents abortion/ costs less 75% -95% effective Not abortifacients

51 Disadvantages of EC Does not prevent STDs Under 18 needs prescription Costly $45 - $65 Side effects such as nausea, vomiting, and fatigue, etc.

52 Counseling Message Counseling Message Patient is under stress Supportive attitude and respect for patient Need to convey that EC is for emergency use only and should not be used on a regular basis. After counseling, may be obvious that referral to family planning, social services, law enforcement. STD concerns EPT after 3 weeks Pharmacist - Last resort

53 Conclusion Choose contraception wisely Understand the facts Counseling should be tailored to individual Seek info from healthcare provider

54 Life is tough enough without having someone kick you from the inside. ~Rita Rudner

55 Who s s The Daddy? What You Should Know About OTC Contraception

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