Contraceptives Lecture Flashcards
What can unprotected sexual activity result in:
Unintended pregnancy
STI (lifetime costs)
Teens sexually activity?
40% of teens are sexually active
1/5 engage in unprotected activity
How are STIs acquired contact with?
Genital tissues, mucous membranes, body fluids
Women more adversely affected: long-term complications, easier to transmit infections to
Group 1 STIs?
Genital Warts
Hepatitis B
Group 2 STIs?
Chlamydia Gonorrhea Nongonococcal urethritis Syphilis Trichomoniasis
Group 3 STIs?
AIDS
Herpes
Hep C
Group 4 STIs?
Bacterial vaginosis
VVC
Prevention strategies for STIs?
Abstain Avoid multiple partners New condom each time Examine partner for genital lesions Avoid sex if signs of STI Vaccinations
Perfect vs typical use?
Perfect use: theoretical, accidental pregnancy rate in first year, method-related failure, assumes accurate and consistent use every time
Typical use: realistics, accidental pregnancy rate in the first year, use-related failure
Define male condoms
Important method of barrier contraception
Only non-prescriptive method more effective is abstinence
Available in: latex, polyurethane, lamb cecum
What are latex condoms?
Various sizes, thickness, shapes
ARE degraded by oil-based lubes
Can be luned, reservoir tips, ribs or studs
PROTECT AGAINST STI AND PREGNANCY
What are polyurethane condoms?
Conduct heat well Come prelubed Not degraded by oil-based lubes Not as stretchy as latex PROTECT AGAINST STI AND PREGNANCY (higher pregnancy rates than latex and higher breakage rates than latex)
What are lamb cecum condoms?
Conduct heat well
Very strong
Porous and allow passage of viral organisms
Not degraded by oil-based lubes
PROTECTIVE AGAINST PREGNANCY AND SOME STIs
What leads to condom breakage?
22% of the time Manufacture defects Incorrect placement Oil-based lubes Reuse Increased duration, intensity or frequency Jewelry or nails --- if it breaks consider spermicide or EC
Guidelines for use of male condoms?
Only if: no previously opened, not stored in wallet, within expiration date, discard if brittle, sticky, discolored
Do not test for leaks prior, only check after
Discard if put on backwards
Remove immediately after ejaculation
Pinch 1/2 inch space at tip
What if a condom tears?
Insert spermcidal foam or jelly with high concentration of spermicide into vagina
Complaints of male condoms?
Contact dermatitis Decreased sensation (thin or ridged condoms, nonlatex synthetic condoms, natural skin condom
Female condoms?
Polyurethane FC: prelubed, not degraded, scant availability
Nitrile: synthetic latex (thinner than male condoms) and has an outer ring (vaginal mucosa) and inner ring (cervix)
Counseling points for female condoms
Initial application difficult
Single use only
Lower breakage rates but higher slippage rates
Inserted up to 8 hours prior
Complaints about female condoms?
Vaginal irritation Squeaky Decreased sensation Discomfort during intercourse Cumbersome and unattractive
What are vaginal spermicides?
Use surface-active agents to immobilize (kill) sperm
Certain dosage forms also act as a physical barrier
Dosage forms: gel, foam, suppository, film, sponge
PROTECTIVE AGAINST PREGNANCY BUT NOT STIs
Gel Spermicides?
Provide additional lubes Safe to use with condoms Higher concentration if alone Insert 1 hour prior Last for 1 hour Reapply for each encounter
Foam Spermicides?
Distribute and adhere better than jelly Difficult to know when canister empty Insert 1 hour prior Last for 1 hour Reapply for each encounter
Suppository Spermicides?
Solid/semisolid dosage forms Activated by moisture in vaginal tract Unpleasant grittiness if not completely dissolved Insert 15 minutes prior to intercourse Last 1 hour Reinsert for each encounter
Film spermicides
Paper-thin sheets Activated by vaginal secretions Most difficult to use but less "messy" Insert 15 minutes before intercourse Last 1-3 hrs Reapply for each encounter
Counseling points for vaginal spermicides?
Low efficacy if used alone
High efficacy if used with barrier method
Inactivate STI pathogens
Frequent use may lead to genital lesions (increases risk of STI, FDA warning)
Sponge Spermicide?
Small, circular, mechanical barrier Provides a spermicide Absorbs semen Made of polyurethane permeated with spermicide High risk of pregnancy if poorly fitted Placement is vital Risk of cervical infections
Complaints about the sponge?
Vaginal dryness Associated TSS Insert 24 hours prior to intercourse Duration of benefit 6 hours Not during periods
What is the fertility awareness-based methods?
Do not use a chemical or physical barrier
Do not protect against STI
Require fertile day determination
Require periods of abstinence or secondary contraception
Monogamous relationships
25% pregnancy rate
Examples of fertility awareness methods?
Basal Body temperature Method Calendar Rhthym Method Bilings Ovulation Method (cervical mucous method Lactational Amenorrhea Method Standard Days method Withdrawal
What are disadvantages of the fertility awareness methods?
Require 6-12 months of cycle history Do not experience temperature fluctuation during ovulation Some require strict interpretation Require normal cycle lengths Some require breast feeding Some require extreme self-control
What is emergency contraceptions?
Involves the use of pills or IUD after intercourse but within 72 hours after intercourse, method failure, or sexual assault
Mechanisms: suppresses ovulation and interferes with transport of egg (thickens cervical mucous)
Examples and availability?
Plan B One Step
Next Choice One Dose
My Way
OTC FOR EVERYONE (no age point of sale restrictions
Adverse effects of emergency contraceptions?
Nausea, vomiting
Heavier or light period or irregularities
Severe ab pain –> etopic pregnancy
Counseling on emergency contraception?
Take one tablet one hour immediately after unprotected sex or ASAP
If vomiting occurs, repeat
89% effective
