Chapter 11: Contraception and Abortion Flashcards
condom
Sheath made of latex, polyurethane / polyisoprene or animal skin (lambskin) that covers the penis and serves as a barrier to sperm following ejaculation
-Failure rate of 12% associated with improper or inconsistent use
When all age groups were combined, __% used condoms and ___% used oral contraceptives
54.3
43.7
Making these two ways the most common
artificial contraception
Method of contraception that applies human-made device
oral contraceptive
commonly referred to as a birth-control pill, or simply “the pill.”
-Consists of sex hormones
Birth-control pills fall into two major categories:
combination pills and minipills
Combination pills
contain a combination of synthetic forms of the hormones estrogen and progesterone. (The synthetic form of progesterone is called progestin.)
-Inhibit releasing factors, interrupt FSH and LH
-Prevent ovulation
-Direct influence on ovarian follicle
-Estrogen and progestin impact mobility of egg
-Endometrium less developed
-Cervical mucus thickens and is more acidic
(TRUE CONTRACEPTION - no egg to be fertilized)
Minipill
contains only synthetic progesterone (progestin).
-No estrogen
Disadvantage: High level of bleeding irregularities
contains only synthetic progesterone (progestin).
(1) It prevents the ovary from releasing an egg;
(2) it thickens the cervical mucus, making it difficult for the sperm to reach the egg; and
(3) it changes the lining of the uterine wall, making it inhospitable for implantation.
The combination pill is taken for ___ days of the typical 28-day cycle, for seven days, the woman takes no pill, or she takes an inert placebo pill, to maintain the habit of taking a pill a day
21
Seasonale Pill
which is taken for 84 days
-Advantages can include decreased incidence of headaches, bloating, and breast tenderness; improved control of endometriosis symptoms and polycystic ovarian syndrome; and greater convenience because of fewer withdrawal bleeding periods per year
- Disadvantages may include possible delay in recognizing pregnancy, unscheduled bleeding and spotting, and higher costs (though costs are balanced by savings through fewer purchases of tampons, pads, or other sanitary supplies)
Minipills act in two ways
1) They thicken the cervical mucus, to impede the passage of sperm through the cervix
2) they render the inner lining of the uterus less receptive to a fertilized egg.
When it’s used consistently and correctly, the failure rate of the birth-control pill is very low—____% or less, depending on the type of pill
0.5
Under typical use, the failure rate increases to ___%
3
Failures can occur
when women forget to take the pill for two days or more, don’t use backup methods when they first go on the pill, or switch from one brand to another
A woman may temporarily experience reduced fertility after discontinuing oral contraceptives, but their use is not associated with _____
permanent infertility.
-Nearly all women begin ovulating regularly within three months of suspending use
Advantages of oral contraceptives
- nearly 100% effective when it’s used properly
- doesn’t interfere with sexual spontaneity or diminish sexual sensation.
- reduce the risk of pelvic inflammatory disease (PID), benign ovarian cysts, and fibrocystic (benign) breast growths
- regularizes menstrual cycles and reduces menstrual cramping and premenstrual discomfort
Disadvantages of oral contraceptives
- no protection against STIs
- reduce the effectiveness of antibiotics used to treat STIs
- woman must plan to begin using the pill at least several weeks before becoming sexually active or before discontinuing the use of other contraceptives.
- Hormone withdrawal when they dont take an active pill; These include headaches, pelvic pain, bloating, and breast tenderness.
Disadvantages of minipills
- produce vaginal dryness causes decreasing sexual sensation and making sex painful
- Irregular bleeding between menstrual periods, or so-called breakthrough bleeding
- psychological effects. Some users report depression and irritability
Breast cancer and the pill
No likely connection
Woman should avoid the pill if
they’ve had circulatory problems, blood clots, coronary disease, heart attacks, strokes, breast or uterine cancers, undiagnosed genital bleeding, liver tumours, or sickle-cell anemia (because of associated blood-clotting problems)
Emergency Contraception (EC) (AKA morning after, or Plan B)
is taken after unprotected sexual intercourse or when contraception fails, such as when a condom breaks.
- most effective when taken within 24 hours, although it is indicated for use up to 72 hours after unprotected sex
- nausea is a common side effect
Two types of Emergency Contraception
The most popular is two 0.75-milligram tablets of levonorgestrel (progestin only), known as Plan B.
The other, known as the Yuzpe regimen (combined estrogen and progestin), combines multiple birth-control pills.
Plan B
has fewer side effects and is more effective than the Yuzpe regimen.
- Plan B isn’t generally considered an abortion pill, because it can’t end an established pregnancy.
- Plan B works by temporarily stopping the release of an egg from the ovary, preventing fertilization, and preventing a fertilized egg from attaching to the uterine wall.
The Contraceptive Patch
-The patch is thin and measures about 5 centimetres. It looks like a square bandage or a nicotine patch
The patch contains a week’s worth of hormones, which it gradually releases into the bloodstream. The patch is worn weekly for three weeks, then the fourth week is patch-free, to allow menstrual bleeding
The Vaginal Ring
The NuvaRing is a flexible vaginal ring that delivers hormones (a combination of estrogen and progestin) through the skin
- The ring is worn for three consecutive weeks, followed by a ring-free week, to allow menstruation. At the end of the ring-free week, the woman inserts another ring, beginning a new cycle.
- some studies have found an increase in sexual desire, fantasy, and satisfaction among users
- Not use if over 35 or smoke
Injectable Contraception
- Depo-Provera is an injectable hormone solution that’s available by prescription.
- Containing just progestin, it prevents ovulation and is 99.7% effective in preventing pregnancy.
- It’s administered by a needle in the muscle of the arm or buttocks every 12 weeks, preventing pregnancy for three months.
- Prolonged use—two years or more—has been associated with a decrease in bone-mineral density.
Lasts 10-13 weeks
Intrauterine Devices (IUDs) (aka intrauterine systems or IUS)
Small object inserted into the uterus and left in place to prevent conception
- considered the most effective reversible contraceptive methods and have the highest continuation rates
- available in canada: copper IUDs and levonorgestrel-releasing IUD systems
- excessive menstrual cramping, irregular bleeding (spotting) between periods, and heavier-than-usual menstrual bleeding
The Male Condom
- the most common barrier method of contraception
- Latex condoms are effective in preventing pregnancy and reducing the risk of STIs, especially HIV
- One disadvantage of the condom is that it may make sex less spontaneous.
The Female Condom
- The female condom consists of a polyurethane (plastic) sheath that’s used to line the vagina during intercourse
- brand name Reality
- During test trials, the pregnancy rate was estimated to range between 21% and 26%, though it’s estimated to be as low as 5% among cautious users
The Diaphragm
Shallow rubber cup or dome that is filled to the contours of a womens vagina. used with spermicide and it inserted before coitus
- left in place at least six hours after intercourse
- The major disadvantage of the diaphragm is the high pregnancy rate associated with typical use. Nearly one in five typical users (18%) of the diaphragm combined with spermicidal cream or jelly become pregnant during the first year of use
The Cervical Cap
- dome-shaped rubber cup. It comes in different sizes and must be fitted by a health care professional
- smaller than the diaphragm—about the size of a thimble—and is meant to fit snugly over the cervical opening
- spermicide applied inside it
- left in place for at least eight hours after intercourse
Disadvantages: Some women find the cap uncomfortable. Side effects include urinary tract infections and allergic reactions or sensitivities to the rubber or spermicide.
Spermicides
- coat the cervical opening, blocking the passage of sperm and killing sperm by chemical action
- Failure rates vary from 18% with perfect use to 28% with typical use.
- Spermicides should be left in place in the vagina (no douching) for several hours after intercourse
- Spermicides occasionally cause vaginal or penile irritation, and some partners find the taste unpleasant.
The Contraceptive Sponge
- soft, disposable device. Like the diaphragm, it provides a barrier that holds a spermicide, but the spermicide is built in. Unlike the diaphragm, the sponge doesn’t need to be fitted
- The failure rate is about 12% for women who have not had children, and about 24% among women who have.
Fertility-awareness methods, or rhythm methods
- rely on awareness of the fertile segments of a woman’s menstrual cycle. Terms such as “natural birth control” and “natural family planning” also refer to these methods
- rhythm methods seek to predict ovulation so the couple can abstain from intercourse when the woman is fertile.
- for religious or other reasons, prefer not to use artificial means
- No devices or chemicals are used, so there are no side effects.
The Calendar Method
assumes that ovulation occurs 14 days before menstruation. The couple abstains from intercourse during the period that begins three days before day 13 (because sperm are unlikely to survive for more than 72 hours in the female reproductive tract) and ends two days after day 15 (because an unfertilized ovum is unlikely to remain receptive to fertilization for longer than 48 hours). The period of abstention thus covers days 10 to 17 of the woman’s cycle
The Basal-Body-Temperature (BBT) Method
A fertility-awareness method of contraception that relies on predicting ovulation by tracking the women’s temperature during the course of menstrual cycle
-A woman’s basal body temperature sometimes dips slightly just before ovulation, then tends to rise between 0.2°C and 0.4°C just before, during, and after ovulation
The Cervical-Mucus (Ovulation) Method
A fertility-awareness method of contraception that relies on predicting ovulation by tracking the viscosity of cervical mucus
- One problem with the mucus method is that some women have difficulty detecting changes in the mucus discharge
- Such changes may also result from infections, certain medications, and contraceptive creams, jellies, and foams. Sexual arousal may also induce changes in viscosity.
Viscosity
Stickiness, consistency
