Thinking about birth control

If you think about birth control you must think about intercourse. Some people choose to engage only in sexual behaviors other than intercourse - some because they prefer other forms of intimacy; some because they're not ready for sexual connection; and some because they don't want to become pregnant.

It is difficult to accept a medecines. Among effectiveness, benefits, and possible side-effects of the methods you're considering, you need to think about what you feel comfortable using. For yourself, it's important to know what methods are corresponding to your personality and lifestyle.

What Do Effectiveness Rates Mean?
A border of efficacy is listed for each method of birth control in this handout. "Typical effectiveness", is the lower rating which takes into account incorrect or inconsistent use. “Theoretical effectiveness” is the higher rating, which describes the method's effectiveness when used correctly every time a couple has coitus. It is difficult to evaluate the effectiveness because it depends on the design of the research study. The method with the highest effectiveness rating may or may not be the "best" method for you. The best method for you is the one which you are informed about, comfortable with, and will use compatibly.

Birth Control and Sexually Transmitted Diseases (STDs)
Principally, you may be interested with averting pregnancy when you choose a method of birth control, but in case you or your partner has ever had sexual contact with anyone else, you may be at risk for contracting a Sexually Transmitted Disease (STD). The best way for protection - condoms. Other methods of birth control (noted in this handout) may also provide some protection. During sex many women and men use condoms and spermicide, it helps to protect themselves and their partners from STDs.

What If Your Method Fails?
No method is perfect, but correct and consistent use of your birth control method makes it less likely to fail. If you have protected coitus, the risk of pregnancy may be decrease, but if you have unprotected intercourse, the risk of pregnancy may be increase and you must immediately insert two applications of spermicide into the vagina. Also, call the Gynecology Clinic or Dial-A-Nurse about the availability of the morning-after pill.

METHOD Birth Contro l
Pill EFFECTIVENESS 97-99.9% HOW TO OBTAIN. It is necessary to do gynecological exam and visit the Birth Control Education Class. Call Gynecology for appointment and class schedule. STD PROTECTION No OTHER CONSIDERATIONS Provides continuous protection. Must be taken at the same time every day. Regulates menstrual cycle, decreases spasms and flow. May cause breakthrough haemorrhage, breast tenderness, sickness, weight gain/loss during the first few months. Some women are not suitable candidates because of medical history.

METHOD Norplant . (Hormonal Implants)
EFFECTIVENESS 99.9% HOW TO OBTAIN. Not useful at McKinley -- call Gynecology for detailed information. Recently available in 1991. Cost about $400-$600. STD PROTECTION No OTHER CONSIDERATIONS In necessary to do minor outpatient surgical procedure for insertion and removal. Guarantees continuous protection for five years (may be removed sooner, if wished). May cause weight gain. Often causes irregular haemorrhage during the first year of use.

METHOD Depo-Provera Hormonal Injection
EFFECTIVENESS 99.9% HOW TO OBTAIN. Not useful at McKinley, call Gynecology for detailed information. Confirmed for contraception use in 1992. Cost about $25 - $45 per injection. STD PROTECTION No OTHER CONSIDERATIONS One injection every 12 weeks provides continuous protection. Doesn’t contain estrogen. May cause irregular haemorrhage and eruption, heavier or lighter periods. May cause breast tenderness, sickness, during first few months. Also may cause weight gain.

METHOD IUD (Intrauterine Device)
EFFECTIVENESS 97-99.2% HOW TO OBTAIN. It is necessary to do gynecological exam and insertion. STD PROTECTION No OTHER CONSIDERATIONS Provides continuous protection. May cause heavier menstruation and more severe spasms. Some women are not good candidates for it.

METHOD Diaphragm & Cervical Cap
EFFECTIVENESS 82-94% HOW TO OBTAIN. It is necessary to do gynecological exam. May require multiple appointments for fitting STD PROTECTION Some OTHER CONSIDERATIONS Most effective if interject before any genital contact. Doesn’t wound menstrual cycle. Some women are not suitable candidates. Minimal side actions. Some women suppose it difficult to use.

METHOD Condom
EFFECTIVENESS 88-98% HOW TO OBTAIN. You can be find it at Health Resource Centers (locations on back of handout) and at drugstores STD PROTECTION Yes, most effective OTHER CONSIDERATIONS Most effective if get on before any genital contact. Recommended to be used with additional spermicide. May reduce feeling.

METHOD Spermicides (Jelly, foam, cream)
EFFECTIVENESS 79-97% HOW TO OBTAIN Spermicidal jelly. You can find it at Health Resource Centers (locations on back of handout). Other spermicides you can find at drugstores. STD PROTECTION Some OTHER CONSIDERATIONS Most effective if interject before any genital contact. Some women suppose messy to use. Recommended to be used with a condom. Provides additional lubrication. May cause skin irritation.

METHOD Sponge
EFFECTIVENESS 82-94% HOW TO OBTAIN. Not useful at McKinley -- you can find it at drug stores. Cost about $1 - $2 each. STD PROTECTION Some OTHER CONSIDERATIONS Most effective if interject before any genital contact. Effective 24 hours. Recommended to be used with a condom. Some women suppose it messy or difficult to use. May cause skin irritation. Some women are not good candidates for it.

METHOD Fertility Awareness
EFFECTIVENESS 80-98% HOW TO OBTAIN. It is necessary to get individual instruction about this method. Is available at Planned Parenthood -- call 359-8022 to schedule an appointment. STD PROTECTION No OTHER CONSIDERATIONS Requires some instruction, high motivation, and diligent record-keeping of fertility indicators. Increases awareness of changes in menstrual cycle. Requires use of back-up method or temperance from coitus during fertile part of cycle. Can be an all natural method. Stress, illness, or vaginal infection can wound fertility indicators

A NOTE ABOUT WITHDRAWAL, RHYTHM, AND DOUCHING
Sometimes couples use withdrawal method. It can fail due to the presence of sperm in pre-ejaculatory fluid, or the couple misjudging when the man should withdraw. Of course, this method demand of a high level of trust and interaction, and in many cases couples may find it unsatisfying to use. But remember, withdrawing before ejaculation is better than using no method at all. Couples who use the rhythm ("safe time") method refrain from coitus (or use another form of birth control) during the fertile time in the woman's menstrual cycle. This method can miscarry because it is possible for a woman to ovulate at any time during her cycle, including while she is menstruating. The Fertility Awareness Method (described in brief in this handout) combines tabulation of a woman's menstrual cycle with other fertility indicators to provide more complete information about when ovulation occurs.