Birth Control - Contraception

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1 Birth Control - Contraception Introduction Birth control is designed to prevent pregnancy. It is also known as contraception. There are many different birth control methods. Each method has its advantages and disadvantages. Some methods may be more effective than others in general. Talk to your health care provider about what method best suits your personal health and preferences. This reference summary explains birth control. It discusses the different birth control options that are available. Information about the effectiveness of certain birth control methods is also covered. Pregnancy It is important to understand how natural pregnancy happens in order to understand different birth control methods and how they work. The female reproductive organs are located in the pelvis, between the urinary bladder and the rectum. They include: The ovaries. The Fallopian tubes. The uterus. The cervix. The vagina. The ovaries are two small glands with 2 main functions: 1. The production of specialized hormones, such as estrogen and progesterone. 2. Ovulation, which is the release of eggs needed for reproduction. Ovulation is controlled by many hormones. 1

2 About once a month, an egg matures in a fluid-filled ovarian cyst called the follicle. The egg is released by one of the ovaries into the Fallopian tube. Healthy sperm travel up the female reproductive tract to the Fallopian tube to fertilize the egg. The fertilized egg then divides and becomes an embryo. The embryo travels down the Fallopian tube into the uterus. The embryo implants in the uterine lining. The uterine lining is called the endometrium. The endometrial lining that develops to prepare the uterus for pregnancy is shed if the egg is not fertilized. This is known as the menstrual period. Contraception Birth control, also known as contraception, is designed to prevent pregnancy. This reference summary focuses on birth control methods. Birth control is designed to prevent pregnancy for people who choose to have an active sex life. People who choose not to have sex practice abstinence. Abstinence means not having sex. Abstinence is 100% effective at preventing pregnancy. Permanent birth control methods are not reversible. They should be considered if you do not want any more children. Many different types of temporary birth control are available if you may want to have a child in the future. The type of temporary birth control you choose depends on your needs and preferences. Some temporary methods of birth control do more than prevent pregnancy. Some also protect you from sexually transmitted infections, or STIs. You may choose latex condoms instead of other methods if you are worried about getting or passing on STIs. STIs are diseases that you can get from having sex with someone who has the infection. Bacteria, parasites and viruses cause STIs. Some people may also have allergies that prevent them from using certain methods of birth control. For example, people who are allergic to latex should not use latex condoms. Spermicide is another form of birth control that may cause an allergic reaction in some people. 2

3 Age and whether or not you smoke can also affect birth control choice. For example, if you are 35 years old or older and you smoke tobacco products, your risk of side effects from using certain forms of birth control, such as the pill, increases. You should also not use some methods of birth control if you have certain medical conditions. For example, birth control methods that use estrogen are not safe if you have high blood pressure or heart problems. How often you want to take or use birth control can also determine which method you choose. Certain birth control methods must be put on or in place before you have sex. These include: Condoms. Diaphragms. Cervical caps. Sponges. Spermicide. Certain methods of birth control, such as the pill, are taken daily. Others may be taken weekly or monthly. Some birth control methods can last for several years. No matter which birth control method you choose, using your birth control properly is the only way you can prevent pregnancy. Before choosing a birth control method, you should also consider: How easy it is to use. Whether you need a prescription. Its effectiveness. The cost of the method. Choosing the method of birth control that is right for you can be hard. Talk to your health care provider about which method will work best for you and how to use it properly. Implantable devices are inserted into a woman s body by her health care provider. They can prevent pregnancy and be left in place for a few years. Some devices use hormones while others use copper to prevent pregnancy. 3

4 Hormonal birth control uses hormones to prevent a woman s ovaries from releasing eggs that could be fertilized. The birth control pill is an example of this method. Spermicide uses chemicals to kill sperm after they are ejaculated into the vagina. Barrier methods block sperm from reaching the eggs. The condom is an example. Implantable Devices Implantable devices are a form of birth control that are inserted into a woman s body. They can be left in place for a few years. Implantable Rod The implantable rod is one kind of implantable device. It is a matchstick-size, flexible rod that is put under the skin of the upper arm. The implantable rod releases a hormone that helps prevent a woman from becoming pregnant. The rod is effective for up to 3 years. Its failure rate is less than 1%. Intrauterine devices, or IUDs, are another kind of implantable device. An IUD is a small device that is shaped like a T. It is placed in a woman s uterus. Its failure rate is less than 1%. There are 2 types of IUDs: copper and hormonal. A copper IUD releases a small amount of copper into the uterus. This prevents the sperm from reaching and fertilizing the egg. If fertilization does happen, the IUD keeps the fertilized egg from implanting in the lining of the uterus. IUD A hormonal IUD is another form of IUD. It is sometimes called an intrauterine system, or IUS. The hormonal IUD releases a hormone into the uterus to prevent pregnancy. Health care providers place IUDs into their patient s bodies. A copper IUD can stay in your uterus for 5 to 10 years. A hormonal IUD can stay in your uterus for up to 5 years. Talk to your health care provider about the success rates and side effects associated with each type of implantable device. 4

5 Hormonal Methods and the Pill Certain hormones can be used to prevent pregnancy. Hormones like progesterone and estrogen can prevent pregnancy by interfering with ovulation. They can also cause changes in cervical mucus and the lining of the uterus to keep the sperm from joining the egg. The birth control pill is a popular form of birth control that uses hormones to prevent pregnancy. Women who use the pill often take it daily. In order for the pill to be effective, it must be taken as directed. The pill only fails about 1% of the time when it is used correctly. But if it is used incorrectly the failure rate may be as high as 8%. For many women, the pill has benefits other than preventing pregnancy. These include: Fewer menstrual cramps. More regular and lighter periods. Women who take the birth control pill have a lower risk of developing: Ovarian cancer. Endometrial cancers. Pelvic inflammatory disease. Noncancerous ovarian cysts. Iron deficiency anemia. The birth control pill may cause side effects. Some women may not notice side effects. For many women, the side effects usually go away after taking the pill for a few months. Common side effects include: Changes in mood. Changes in menstrual periods. Dizziness. Upset stomach. Weight gain. 5

6 The birth control pill may not be right for you if you: Are older than 35. Have a history of blood clots, breast cancer or uterine cancer. Smoke tobacco products. Talk with your health care provider to see if the pill is right for you. Antibiotics may reduce how well the pill works in some women. Talk to your health care provider about a backup method of birth control if you need to take antibiotics. Another type of hormonal method is the patch. The patch delivers hormones through the skin. It can be worn on your: Buttocks. Lower abdomen. Outer arm. Upper body. The patch can be as effective as the pill. A new patch is put on your skin once a week for 3 weeks. During the 4th week, no patch is placed. You will get your regular period during this week. A shot, or injection, can also be used to deliver hormones that can prevent pregnancy. A hormone injection is given in the buttocks or arm every 3 months. The shot is as effective as the pill and the patch. But it is more likely to be used correctly. For instance, some women may forget to take the pill daily, making it less effective than the shot. The birth control shot should not be used for more than 2 years in a row. It can cause a temporary decrease in bone density. Bone starts to regrow after this method is stopped. But the risk of fracture and osteoporosis increases if the shot is used for a long time. Osteoporosis is a disease that makes your bones weak and more likely to break. The vaginal ring is another way to deliver hormones that prevent pregnancy. It is a thin, flexible ring that is placed inside the vagina. The ring is as effective as the pill and the patch. 6

7 The vaginal ring should be kept in place for 3 weeks. You will then take it out for a week and have your regular period. After your period, a new vaginal ring should be inserted. Different hormonal methods have different side effects. Talk to your health care provider about the success rates and side effects associated with each type of hormonal birth control method. Barrier Methods Barrier methods involve putting up a block, or barrier, to keep sperm from reaching the egg. There are several forms of barrier methods. The male condom is a popular barrier method that is worn by men during sex. Male condoms are a thin, close-fitting cover that is placed over an erect penis. It keeps sperm from entering a woman's body. Condoms can be made of latex, polyurethane or natural lambskin. The natural kind do not protect against STIs. The failure rate of a male condom is 2% if it used correctly. But the overall failure rate of condoms is 15% due to incorrect use. Male condoms work best when used with spermicide. Condoms should only be used once. A new condom is needed for each sex act. Condoms are either: Lubricated, which can make sexual intercourse more comfortable. Non-lubricated. These condoms can be used for oral sex as well as vaginal or anal sex. It is best to add lubrication to non-lubricated condoms if you use them for vaginal or anal sex. When adding lubricant to a condom, use a water-based lubricant, such as K-Y jelly. You can buy lubricants at a drug store. Oil-based lubricants like massage oils, baby oil, lotions or petroleum jelly will weaken the condom. This could cause it to tear or break. 7

8 Keep condoms in a cool, dry place. Condoms can break down if you keep them in a hot place like a wallet or glove compartment. This could cause the condom to tear or break. The female condom is another type of barrier method. It can be placed in a woman s vagina to prevent sperm from entering her body. Its failure rate is 21%, but can be as low as 5% if used correctly. The female condom is made of thin, flexible rubber and is packaged with a lubricant. It can be inserted up to 8 hours before having sex. It must be thrown away after it is used. Do not use a female condom and a male condom at the same time. They may tear or break. The contraceptive sponge is another type of barrier method used by women. It is a soft, disk-shaped device made out of polyurethane foam. It contains the spermicide nonoxynol-9. It is effective for more than one act of sex for up to 24 hours. The sponge s failure rate varies depending on whether a woman has given birth before. The failure rate for women who have had a previous birth ranges from 20% to 32%. A woman who has not had a previous birth has a lower failure rate of 9% to 16%. The contraceptive sponge needs to be left in place for at least 6 hours after you have sex to prevent pregnancy. It must then be taken out within 30 hours after it is inserted into the vagina. Women who are sensitive to the spermicide nonoxynol-9 should not use the sponge. The diaphragm, cervical cap and cervical shield are other barrier methods. They block sperm from entering the cervix and reaching the egg. They are placed inside the vagina to cover the cervix. The diaphragm is a shallow latex cup. The cervical cap is a thimble-shaped latex cup. The cervical shield is a silicone cup that fits against the cervix. 8

9 Diaphragms, cervical caps and cervical shields have a failure rate of 26% to 32% for women who have given birth before and 9% to 16% for women who have never given birth. The diaphragm and cervical cap come in different sizes. You will need a health care provider to help you find the right fit. The cervical shield only comes in one size so a fitting is not needed. Adding spermicide to a barrier device to block or kill sperm can help prevent pregnancy. Spermicide gel or foam can be bought over the counter without a prescription. Different barrier methods have different side effects. Side effects may include: Allergic reactions. Irritation. Toxic shock if left in for too long. Urinary tract infection. Talk to your health care provider about the benefits as well as the side effects of each type of barrier method. Spermicide Spermicide is another form of contraception. Spermicide works by killing sperm. Spermicide has a failure rate of 18% when used correctly. But the failure rate may be as high as 29% when it is not used properly. Spermicide comes in many forms, including: Cream. Film. Foam. Gel. Suppository. Tablet. Spermicide is put in the vagina no more than 1 hour before having sex. If you use a film, suppository or tablet, wait at least 15 minutes before having sex so the spermicide can dissolve. 9

10 Do not douche or rinse out your vagina for at least 6 to 8 hours after having sex when you use spermicide to prevent pregnancy. You will need to use more spermicide each time you have sex. Spermicide is much more effective if it is used along with a barrier method, such as a condom, diaphragm or cervical cap. Some spermicide is made just for use with the diaphragm and cervical cap. Spermicide contains sperm-killing chemicals. Some contain nonoxynol-9. This can irritate the tissue in the vagina and anus. This irritation can make it easier for the virus that causes HIV to enter the body. It may increase the risk of getting HIV if your partner has the virus. Some women are sensitive to nonoxynol-9 and need to use spermicide without it. Medications for vaginal yeast infections may lower the effectiveness of spermicide. Spermicide does not protect against sexually transmitted infections. It may increase the risk of urinary tract infections. A urinary tract infection, or UTI, is an infection in the body s drainage system for removing wastes and extra water. The urinary tract includes 2 kidneys, 2 ureters, the bladder and the urethra. Sterilization Permanent birth control methods are for people who are sure they do not want more children. These methods are barrier methods. They work by preventing the eggs and sperm from meeting. For women, the Fallopian tubes can be surgically cut or scarred to prevent eggs from traveling to the uterus. For men, sperm can be surgically prevented from reaching the seminal vesicles in the male s reproductive system. This makes his ejaculate or semen free of sperm. 10

11 Sperm can still be found in the ejaculate for about 3 months after a vasectomy. During that time, use a backup form of birth control to prevent pregnancy. A simple analysis of the semen is usually done to check if all the sperm are gone. Like any form of surgery, surgery to prevent pregnancy in women and men has risks and possible side effects. If these permanent forms of birth control are recommended for you, ask your health care provider about their risks. Essure is a non-surgical method that can permanently prevent pregnancy in women. A thin tube is used to thread a tiny spring-like device through the vagina and uterus into each Fallopian tube. The spring-like device causes scar tissue to form around the coil. This blocks the Fallopian tubes and stops an egg and sperm from joining. It can take about 3 months for the scar tissue to grow. It's important to use another form of birth control during this time. You will need to meet with your health care provider for a test to see if scar tissue has fully blocked your tubes. Summary Birth control is designed to prevent pregnancy. It is also known as contraception. There are many different birth control methods. Each method has its advantages and disadvantages. Talk to your health care provider about what method best suits your personal health and preferences. Many different types of temporary birth control are available if you may want to have a child in the future. The type of temporary birth control you choose depends on your needs and preferences. Some temporary methods of birth control also protect you from sexually transmitted infections, or STIs. Implantable devices are a form of birth control that are inserted into a woman s body. They can be left in place for a few years. The implantable rod is one kind of implantable device. Intrauterine devices, or IUDs, are another kind of implantable device. 11

12 Certain hormones can be used to prevent pregnancy. The birth control pill is a popular form of birth control that uses hormones to prevent pregnancy. Women who use the pill often take it daily. In order for the pill to be effective, it must be taken as directed. Barrier methods involve putting up a block, or barrier, to keep sperm from reaching the egg. There are several forms of barrier methods. The male condom is a popular barrier method that is worn by men during sex. Male condoms are a thin, close-fitting cover that is placed over an erect penis. It keeps sperm from entering a woman's body. Spermicide is another form of contraception. Spermicide works by killing sperm. Spermicide has a failure rate of 18% when used correctly. But the failure rate may be as high as 29% when it is not used properly. Permanent birth control methods are for people who are sure they do not want more children. These methods are barrier methods. They work by preventing the eggs and sperm from meeting. For women, the Fallopian tubes can be surgically cut or scarred to prevent eggs from traveling to the uterus. For men, sperm can be surgically prevented from reaching the seminal vesicles in the male s reproductive system. This makes his ejaculate or semen free of sperm. 12

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