birth control

Question 1

attitudes towards birth control

5

Answer 1

• Roman Catholic Church only approves of abstinence
  it is appropriate to
• prevent illness
• avoid deformities
• prevent unwanted pregnancy
• limit population growth

Question 2

law for birth control and abortion

5

Answer 2

• BC used to restrict docs from prescribing birth control or abortion for kids under 16 without parents
• not against the law now in canada
• in 2021 = 87,595
• health care = provincial
• non hospital = agency that would provide abortion outside the hospital with things like birth control

Question 3

The pill (mechanism)

3

Answer 3

• estrogen and progestin (synthetic progesterone)
• inhibiting releasing factors (RFs) (interrupts FSH and LH)
• prevents ovulation (no eggs found in W getting hysterectomies while on the pill)(direct influence on ovarian follicle)(true contraception = no egg to be fertilized)

Question 4

the pill (non human research)

3

Answer 4

• estrogen and progestin impact motility of egg (interferes with muscle contractions of fallopian tubes and mucous secretion)
• endometrium less developed (less hospitable to “visitor”)
• cervical plug thicker and more acidic (less accessible to entering uterus)(hostile to sperm)

Question 5

the pill (starting out)

Answer 5

• take at start of menstruation
• withdrawal bleeding 3-4 days after last active pill (21 active)
• lighter than without the pill
• last 7 pills are inactive
• start new sequence of 28 pills whether or not bleeding occurs

Question 6

the pill (after starting it)

4

Answer 6

• protection starts after 1 week of taking the pill
• can control timing of withdrawal bleeding (bleeding for 3-4 days after last active pill) (need to take at least 14 active pills)(take 14 active pills and stop = move up 7 days)(take 20 active pills and stop = moves up by 1 day)
• skip dummy pills and start next set immediately to avoid bleeding until end of 2nd package
• regularity of when taken (same time each day is preferred)

Question 7

the pill (missed and -‘ve effects)

Answer 7

• missed 1 pill = double up
• missed 2 pills = double for next 2 days
• vomiting within 4 hrs of taking active pill (take another since not digested)
• severe diarrhea for 2 days or more (double, finsih cycle, and use another method)
• spot bleeding within cycle is normal

Question 8

the pill (drug and alcohol)

Answer 8

• drug interactions can diminish effectiveness of pill, especially if low in estrogen (barbiturates (sleeping pills), butazolidin (joint injuries), miltown and equanil (minor tranquillizers), dilantin (epilepsy), rifampin (TB), antibiotics)
• alcohol metabolism slowed down, so you stay drunk longer

Question 9

the pill (effectiveness)

Answer 9

• effective 99.9% of the time, 6% user failure
• age 15-19 = 66.6%
• age 20-29 = 58.3%
• age 30-39 = 31.5%
• aged 40+ = 17.1%

Question 10

the pill (ad)

8

Answer 10

• responsibility
• ease and convenience (pill mentality, +’ve for some, drawback of method for others)
• no break in the flow of sex viz. condom, diaphragm (without spontaneity, sex act is cheapened)
• regulates menstrual cycle
• relief from dysmenorrhea, acne, PMS, decreased flow
• decreased facial hair
• increased breast size
• reduces risk of some illnesses (67% for endometrial cancer after 8 yrs)(54% for ovarian cancer)(fallopian tube infection and pelvic inflammation)(fewer benign ovarian cysts and breast diseases)

Question 11

the combination pill (uses estrogen and progesterone, is a true contraceptive, must be taken each day without failure to be effective)

Answer 11

• is a true contraceptive

Question 12

the pill (dis)

STD, access, selection)

Answer 12

• no protection against STDs
• access: costly (but free in BC), fear of parents being told (but they don’t have to anymore)
• selection is important cause it can cause disadvantages (low estrogen can tolerate higher dosages of estrogen)(switch to different dosages to avoid -‘ves)

Question 13

the pill (dis)

thrombophlebitis, heart, smoker

Answer 13

• thrombophlebitis (blood clots in veins) is estrogen related (not a high rate of dying)
• risk of fatal heart attacks for 40-44 yr olds (higher risk for someone who smokes and on the pill)
• the pill does not increase the risk of cardiovascular disease in non smokers cause of the low dose of estrogen
• avoid if certian risks factors (especially if >40 and smoker): history phlebitis, previous embolism, painful varicose veins, cardiac problems, blood type A

Question 14

the pill (dis)

blood pressure and sugar

Answer 14

• increase hypertension (blood pressure): push those at borderline over (5-7% of population), increase for almost all women
• elevated blood sugar levels: can lead to diabetes if borderline, so no pill (none issue if taking insulin)

Question 15

the pill (dis)

cancer

Answer 15

• breast cancer contra-indicator: 40-50% of breast concers worsen under estrogen secretion
• cervical/uterine cancer correlation most likely related to # of sexual partners, not pill itself: more likely to have sex without a condom

Question 16

the pill (dis)

pregnancy, yeast infections

Answer 16

• women who thing they are pregnant should stop taking the pill
• greastest risk of fetal birth defects at 15-16th day of embryo development
• more susceptible to vaginal yeast infections (but helps protect against inflammation in fallopian tubes)

Question 17

the pill (dis)

sexual desire

Answer 17

• dampens sexual desire and functioning: HC-W rate selves as less passionate and romantic, tend to initiate sex less frequently, and have lower libido viz. naturally cycling W, quicker to lose interest in sexual imagery, reates to keeping estrogen levels low and stable (HC cayses steep decline in levels of testosterone)
• evidence suggest an impact on human mating

Question 18

the combination pill (is causally linked to breast cancer, should not be used by individuals with insulin-controlled diabetes, increases the likelihood of a heart-attack in heavy smokers, provides protection against sexually transmitted infections)

Answer 18

• increases the likelihood of a heart-attack in heavy smokers

Question 19

other hormone-beased contraceptions

7

Answer 19

• progestin only pill (mincor): take daily, high level of bleeding irregularities
• injectable (depro-provera): 10-13 weeks, can not get pregnant until the end of the cycle
• under the skin implant (norplant): 5 yrs, easily removed, increased appetites leads to weight gain
• all use progestin only, no estrogen
• emergency oral contraception (EC): morning after pill
• progestin only EC
• IUD

Question 20

the morning after pill

7

Answer 20

• plan B, backup one step, contingency one
• no prescription necessary
• within 5 days of unprotected intercourse, but sooner is better
• all prescription contaceptives free in BC (including morning after pill)
• progestin only: prevent 57-93% births, up to 5 days after unprotected intercourse, high body weight may decrease effectiveness (BMI>25)
• can get EC in advance in case of emergency
• copper/hormonal infauterine device: up to 7 days post coitus (need professional), most effective form (99%) but it needs an appointment

Question 21

hormonal IUDs

5

Answer 21

• very effective (99.9%)
• hostile to sperm by thickening mucus plug and can stop release of ovum
• thin endometrium lining (lighter to no flow)
• benefits: convenient and last for 8-12 yrs, less costly than the pill, no human error, removed easily, can act as emergency contraception within 7 days
• dis: spot bleeding, no protection agaisnt STD, needs professional to insert

Question 22

depression

5

Answer 22

• danish study (2016) found that there was a +’ve link to the use of hormonal birth conrol and use of anti-depressants
• 40% risk of increased depression after 6 months
• combination pill: 1.2 -fold increase in rate of subsequently taking antidepressants during study period
• minipill: 1.3-fold increase in rate of subsequently taking antidepressants during study period
• no causation

Question 23

the pill (risk/benefits)

5

Answer 23

• many W, side-effects are mininal or non-existent
• safe relative to problems associated with pregnancy/child birth b/c it works
• pill risk of death increases if W is older than 40
• canada/norway: safer to give birth
• USA/china: even for pill v. birth

Question 24

condoms

what is, popularity

Answer 24

• increased pop. cause of STI
• thin sheath as physical barrier
• rubber is better than skins cause of the limited protection

Question 25

condom (application)

4

Answer 25

• unrolled on erect penis before intercourse
• plain end, leave space at tip
• no air channel down side (sperm can travel from the sides to inside the vagina)
• hold when withdrawing from vagina (when penis is still somewhat erect)

Question 26

condoms

barrier, spermicide, failure rate, allergy

Answer 26

• mechanical barrier that catches sperm
• spermicide enhances effectiveness (put on outside of condom to catch and kill sperm)
• failure rate of 12% assoicated with improper or inconsistent use: manufacturing defects relatively low, fragile
• some have allergy to latex: polyurethane alternative, not as good cause the latex isn’t as strechy

Question 27

condoms (ad)

8

Answer 27

• prevents most STI (not herpes or warts)
• relatively inexpensive
• easy to get and to use
• one sizr fits “all”
• only male option that is easily reversed
• 43% M did not use condom for 1st intercourse
• 37% had mixed feelings or not wanting sex
• M < 15 yr or 2+ yr younger partner most likely to not use

Question 28

condoms (dis)

Answer 28

• interrupts spontaneity
• forethought and motivation (have it and willing to use it)
• sensation reduced (may interfere with erection)
• unpleasant taste
• water-based lubes only (oil has an adverse effect)
• male responsiblility, must be cooperate
• can expire and disinagrate with heat

Question 29

condoms (female)

5

Answer 29

• some protection v. STIs
• not as good as males
• can put it on before intercourse beings
• does not disrupt the flow or interfere with spontaneity
• polyurethane is used

Question 30

if you wanted to avoid two of the possible -‘ve consequences of engaing in penile-vaginal intercourse you would (use a condom, use the pill, use both, no real -‘ve consequences)

Answer 30

• use both (condom and pill)