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Posts Tagged ‘contraception’

Contraception – Hormonal Methods

Hormonal methods of contraception work in similar ways. They suppress ovulation (the monthly release of an egg from the ovaries) by the combined actions of the hormones estrogen and progestin. It also thickens the mucus from your cervix (this makes it difficult for sperm to move through it and reach an egg) as well as makes the lining of the womb thinner so it is less likely to accept a fertilized egg (which also can lessen menstrual cramps and flow). Hormonal methods are only available after consultation with a doctor who will give you a prescription fill out at the pharmacy.

These methods include the Pill, the patch, and the Ring. Rare but serious health risks are associated with women who are on hormonal methods who smoke and/or are over the age of 35.

Oral Contraceptive Pill (The Pill) – With proper use, the Pill is 99.9% effective, making it the most reliable contraception available. However, there is a 3% user failure rate. It does not protect against Sexually Transmitted Infections.

Besides preventing pregnancy, the Pill offers additional benefits. As stated in the labelling, the pill can make periods more regular. It also has a protective effect against pelvic inflammatory disease, an infection of the fallopian tubes or uterus that is a major cause of infertility in women, and against ovarian and endometrial cancers. The Pill’s effectiveness may be reduced if the woman is taking certain medications, including some antibiotics.
Side effects may include irregular bleeding, weight gain or loss, breast tenderness, nausea (rarely, vomiting), and changes in mood. Rare but serious health risks include blood clots, heart attack, stroke, and liver tumours — the chance of developing some of these problems increases with age. Smokers, women over the age of 35, and especially women over the age of 35 who do smoke should not use hormonal methods such as the Pill. Smokers must either give up smoking or use another form of contraception.

Contraceptive Patch – It is a 4 x 4 cm beige patch that sticks to a woman’s skin and continuously releases estrogen and a progestin (female hormones) into the bloodstream.

Like the Pill, the patch is also more than 99% effective at preventing pregnancy when used perfectly, with about a 3% failure rate for typical users. For women who have trouble remembering to take a pill every day, the patch may work better than the Pill. It may be a bit less effective in women who weigh more than 90 kg (198 pounds). It does not protect against Sexually Transmitted Infections.

A new patch is worn each week for 3 weeks. The patch should be changed on the same day each week (called the “Patch Change Day”). The fourth week is patch-free, and during this week your period will occur. The patch should never be off for more than seven days. Following the seven patch-free days, a new cycle is started when you apply a new patch on your Patch Change Day.

The patch can be worn on the buttocks, stomach, back or upper arms, but not on the breasts. It may help to change the location a bit each week. The patch should be applied to clean, dry skin. You should not use any creams or lotions near a patch you’re already wearing, or where you’ll be applying a new one. The patch is very “sticky”. You can exercise, shower, swim or go in a sauna or hot tub and it still sticks 98% of the time.

Vaginal Ring (Nuva Ring) – It is a soft, flexible, clear plastic ring measures 54mm in diameter and is inserted into a woman’s vagina where it slowly releases two female hormones (estrogen and a progestin) for three weeks. The ring’s method of action is very similar to the combined oral contraceptive pill. The ring does not provide a physical barrier to sperm and it does not prevent sexually transmitted infections. The ring is at least as effective as the birth control pill, and it may be more effective if a woman has trouble remembering to take her pill every day.

The ring comes in only one size, and does not need to be in a particular position in the vagina to be effective. It is held in place by the walls of the vagina and a woman usually cannot feel the ring once it is in. The woman inserts and removes the ring herself and most women find this easy to do. Remember, the vagina is a closed space and there is no way for the ring to get “lost” or go anywhere else.

The ring is worn inside the vagina for three weeks, followed by a one-week (seven day) ring-free interval. When the ring is removed, a woman usually has a period within a few days. At the end of the ring-free week, the woman inserts another ring to begin a new cycle. The ring should be left in place during sex. Most men and women don’t notice it during intercourse, and even for those who do, it is usually not bothersome.

Injection (Depo-Provera) – This method is a bit different from other hormonal forms of birth control. It is a hormonal birth control method that contains a progestin. It does not contain estrogen. It is administered by a needle in the muscle of the arm or buttocks every 12-13 weeks. It is 99.7% effective in preventing pregnancy, but causes loss of bone density. Because of this, Depo-Provera™ is usually only recommended for people who are unable to take other contraceptive methods.

Fifty percent of women will stop having periods all together (amenorrhea) within the first year of starting Depo-Provera. This is not unhealthy and, for women who have heavy or painful periods, this may be a positive side effect. Depo-Provera™ can be used by breastfeeding mothers. It has no effect on breast milk production. t also decreases the risk of endometrial cancer.

Mainly because of growing concerns about its effect on bone density, Depo-Provera™ is typically only recommended when other birth control methods are not options. Depo-Provera™ may also be linked to osteoporosis. The most common side-effects are irregular bleeding and weight gain, although they do not happen to every user. Some hormonal side-effects have been reported, but only occur in a small number of users.

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Contraception – Timing Methods

Preventing pregnancy is a concern for most sexually active adults. Most of the methods of contraception available today fall under the control of women, but that does not mean that men should not be interested and knowledgeable about such things. In fact, I think it is in everyone’s best interest that they know what options are available, how they function, and what their failure rate is so they and their partner can make the best decision for themselves.

In this installment I will review methods whereby timing and control are significant issues.

Withdrawl – In this contraceptive method, the man withdraws his penis from a woman’s vagina before ejaculation. Both partners must be in agreement on this method, and must be prepared to deal with an unplanned pregnancy. It provides no protection against sexually transmitted infections.

Effectiveness – Pregnancy occurs in 1 out 5 users.

Issues – This method isn’t very effective because there may be sperm in the pre-ejaculate, which can lead to pregnancy. It also requires a lot of self-control and practice. However, it is better than nothing. Unless you are prepared to deal with the possibility of pregnancy, it is highly recommended that you put off intercourse until some other form of contraception can be obtained.

Fertility Awareness – A woman can keep track of her monthly cycle by taking her temperature, by checking the thickness of her vaginal mucus, or by tracking the time of her periods on a calendar. Once she has determined the pattern of her cycle, she can predict when she’s most likely to be fertile. During this fertile period, she stays away from sex, or uses another form of contraception.

Effectiveness – 20% of women become pregnant within the first year of using this method.

Issues – This method helps women understand their bodies and cycles, and can eventually be used to plan a pregnancy. Fertility awareness is not a very effective form of contraception, especially in teens and premenopausal women who have an irregular cycle, and it offers no protection against sexually transmitted infections (STIs). Women need to make sure that their partner will cooperate with them.

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