Age Class
15-44 15-19 20-24 25-29 30-34 35-39 40-44
Percent distribution
Using contraception (contraceptors) 64.2 29.8 63.4 69.3 72.7 72.9 71.5
Female sterilization 17.8 0.1 2.5 11.8 21.4 29.8 35.6
Male sterilization 7.0 - 0.7 3.1 7.6 13.6 14.5
Pill 17.3 13.0 33.1 27.0 20.7 8.1 4.2
Implant 0.9 0.8 2.4 1.4 0.5 0.2 0.1
Injectable 1.9 2.9 3.9 2.9 1.3 0.8 0.2
Intrauterine device (IUD) 0.5 - 0.2 0.5 0.6 0.7 0.9
Diaphragm 1.2 0.0 0.4 0.6 1.7 2.2 1.9
Condom 13.1 10.9 16.7 16.8 13.4 12.3 8.8
Female condom 0.0 - 0.1 - - - -
Periodic abstinence 1.5 0.4 0.6 1.2 2.3 2.1 1.8
Natural family planning 0.2 - 0.1 0.2 0.3 0.4 0.2
Withdrawal 2.0 1.2 2.1 2.6 2.1 2.3 1.4
Other methods1 1.0 0.3 0.9 1.2 1.3 0.9 1.8
II. Birth Control MethodsEffectiveness Effectiveness =
Theoretical effectiveness –
Use-effectiveness –
III. Contraception Methods
A. Fertility awareness methods
B. Hormonal methods
C. Barrier methods
D. Permanent methods
E. Other forms
A. Fertility Awareness Method Calendar Method, Natural Family Planning
An understanding of the female menstrual cycle is essential as a foundation for using this method Advantage: no side effects, can be used by anyone Disadvantages:
Effectiveness = ~ 15 - 20 pregnancies occur over 1 year out of 100 women using this method (for women who are properly trained)
B. Hormonal Methods1) Oral Contraceptives (birth control pills) Most common used non-surgical method (17%
of women) Suppresses natural ovarian cycle and
endometrial cycle Creates an artificial cycle via synthetic estrogen
and progestin
Effectiveness -
Risks of Birth Control Pills Oral antibiotics may decrease the effectiveness of birth
control pills. Therefore, a backup method of contraception should be used while taking antibiotics and until the next menstrual period after completion of the antibiotic
Positive Side effects – less painful periods, decreased symptoms of PMS, increased bone density, potential protection from PID, ovarian cancer & endometrial cancer, increased cardiovascular protection
Lack of protection against STDs
Types of Birth Control Pills 30 different brands available
monophasic –
biphasic - These have a fixed amount of estrogen, but there are two different strengths of progestogen in the dispenser. The first seven to 10 days are one strength (and one color). The next 11 to 14 tablets are another strength (and another color).
Triphasic –
Patch –
2) Hormonal Implantsa) Norplant – contains no estrogen,
consists of six 1-2 inch flexible rods filled with synthetic progesterone
Effectiveness = Less than 1 pregnancy occurs over 1 year out of 100 women
Norplant is no longer available in the US due to insertion and removal complications…
b) Now we have Implanon - single, thin, polymer rod, no bigger than a matchstick, that is inserted under the skin of a woman's upper arm
removal of the rod takes slightly longer than the insertion — about two minutes — but with the use of local anesthetic, most women describe "mild discomfort."
c) Depo-Provera – Effectiveness - Less than 1 pregnancy
occurs over 1 year in 100 women
Lack of protection against STDs
C. Barrier Methods
1) Spermicidal – cream, foam, film, suppository or gel
Work as a mechanical barrier in that they are spread over the surface of the cervix & block access to cervical opening
Effectiveness - ~ 26 pregnancies occur over 1 year out of 100 women
Spermicides should be inserted deep into the vagina, and the product should be left in place for at least 6 hours post intercourse
2) Diaphragm – Dome shaped latex cup, coated with spermicidal agent before being inserted into the vagina
Requires proper fitting by clinician
3) Cervical Cap – works like a small, deep diaphragm, fits snugly over the cervix
4) Condom Thin sheath (preferably latex to also protect from
transmission of disease-causing organisms) placed on the penis or, in the case of the female condom, within the vagina prior to intercourse
Male Condom – permits the male partner to take an active role in birth control
Condoms are The only methods effective at preventing STDs
Lubrication may help reduce risk of irritation and increase pleasure
Effectiveness - About 14 pregnancies occur over 1 year out of 100 couples using male condoms, and about 21 pregnancies occur over 1 year out of 100 couples using female condoms
http://www.ripnroll.com/femalecondoms.htm
http://www.ripnroll.com/condoms.htm
5) Contraceptive sponge - Soft synthetic sponge, saturated with a spermicide, which is moistened and inserted into the vagina, over the cervix, before intercourse
Effectiveness - ~18 to 28 pregnancies occur over 1 year out of 100 women
This method was removed from the market due to contamination problems at the manufacturing facility a few years ago,
D. Permanent Methods
Female sterilization Tubal ligation
Male Sterilization Vasectomy
Lack of protection against STDs
E. Other forms of contraception1) Abstinence –
2) Coitus interruptus
This is an unreliable method. Lack of protection against STDs
3) Intrauterine Devices (IUD) A small plastic or copper device, placed inside the
woman's uterus by her health care provider, which changes the uterine environment to prevent pregnancy
Effectiveness = 1 to 3 pregnancies occur per year out of 100 women
Risks – Lack of protection against STDs
4) Emergency Birth Control “morning-after pill” may prevent pregnancy by temporarily
blocking
The morning-after pill is reserved for emergency situations and not as a regular method of birth control.
Emergencies include
Plan B (levonorgestrel)
RU-486 (mifepristone) –Blocks progesterone, binds to progesterone receptors in the endometrium
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