8 Aralık 2010 Çarşamba

Possible Side Effects

The Pill is a safe and effective method of birth control. Most young women who take the Pill have none to very few side effects.
Smoking cigarettes and using the Pill can increase a girl's risk of certain side effects, which is why health professionals advise girls who use the Pill not to smoke. Side effects that some women have while on the Pill include:
  • irregular menstrual bleeding
  • nausea, headaches, dizziness, and breast tenderness
  • mood changes
  • blood clots (rare in women under 35 who do not smoke)
Some of these side effects improve over the first 3 months on the Pill. When a girl has side effects, a doctor will sometimes prescribe a different brand of the Pill.
The Pill also has some side effects that many young women enjoy. It usually makes periods lighter, reduces cramps, and is often prescribed for women who have menstrual problems. Taking the Pill can improve acne, and some doctors prescribe it for this purpose. Birth control pills have also been found to protect against some forms of breast disease, anemia, ovarian cysts, and ovarian and endometrial cancers.

How Does the Birth Control Pill Work?

Question: How Does the Birth Control Pill Work?
 
Answer: Birth control pills, or oral contraceptives, contain hormones that suppress ovulation. During ovulation an egg is released from the ovaries, without ovulation there is no egg to be fertilized and pregnancy cannot occur. There are 2 types of birth control pills -- the combined pill and the Minipill. The combined pill contains both estrogen and progestin, while the Minipill contains only progestin.The progestin in the Minipill may prevent ovulation; however it may not do this reliably each month. The Minipill works further by thickening the mucous around the cervix and preventing sperm from entering the uterus. The lining of the uterus is also affected in a way that prevents fertilized eggs from implanting into the wall of the uterus. The Minipill is taken every day. You may not have a period while taking the Minipill, if you do have periods that means you are still ovulating and your risk for pregnancy occuring is greater.
Combination birth control pills come in either 21 or 28-day packs. You take one pill each day at the same time for 21 days. If you have a 21-day pack, you stop taking birth control pills for 7 days at the end of the pack. If you are taking a 28-day pack, you continue taking pills every day, the last 7 non-hormonal pills serve as a reminder to help you remember to take your pill at the same time every day. Your period will occur during the week you take the 7 reminder pills.

Birth Control Pills Affect Women's Taste in Men

This year 2.25 million Americans will get married—and a million will get divorced. Could birth control be to blame for some of these breakups? Recent research suggests that the contraceptive pill—which prevents women from ovulating by fooling their body into believing it is pregnant—could affect which types of men women desire. Going on or off the pill during a relationship, therefore, may tempt a woman away from her man.
It’s all about scent. Hidden in a man’s smell are clues about his major histocompatibility complex (MHC) genes, which play an important role in immune system surveillance. Studies suggest that females prefer the scent of males whose MHC genes differ from their own, a preference that has probably evolved because it helps offspring survive: couples with different MHC genes are less likely to be related to each other than couples with similar genes are, and their children are born with more varied MHC profiles and thus more robust immune systems.
A study published in August in the Proceedings of the Royal Society B, however, suggests that women on the pill undergo a shift in preference toward men who share similar MHC genes. The female subjects were more likely to rate these genetically similar men’s scents (via a T-shirt the men had worn for two nights) as pleasant and desirable after they went on the pill as compared with before. Although no one knows why the pill affects attraction, some scientists believe that pregnancy—or in this case, the hormonal changes that mimic pregnancy—draws women toward nurturing relatives.
Women who start or stop taking the pill, then, may be in for some relationship problems. A study published last year in Psychological Science found that women paired with MHC-similar men are less sexually satisfied and more likely to cheat on their partners than women paired with MHC-dissimilar men. So a woman on the pill, for example, might be more likely to start dating a MHC-similar man, but he could ultimately leave her less sexually satisfied. Then if she goes off the pill during the relationship, the accompanying hormonal changes will draw her even more strongly toward more MHC-dissimilar men. These immune genes may have a “powerful effect in terms of how well relationships are cemented,” says University of Liverpool psychologist Craig Roberts, co-author of the August paper.
Note: This article was originally published with the title, "A Tough Pill to Swallow".

Can you have a pill withdrawal period and be pregnant?

I know that when you're on the pill, the bleeding you have during your placebo week is in fact withdrawal bleeding and not a "true" period, of course, the blood is real, but there is some difference.

Since this is true, is it also correct that if one became pregnant while on the pill, they would not have withdrawal bleeding at all during their placebo week, or it would be very spotty/light? (assuming that no pills were missed). I have heard that this withdrawal bleeding each month, when it is on time, normal, etc. is "proof" that the woman is not pregnant and the pills are working correctly--is this correct?

If you were to become pregnant on birth control pills, a normal withdrawal period would not occur because progesterone production from the corpus luteum gland on the ovary overrides the drop in progesterone from finishing the active pills. Occasionally a woman could have some spotting while pregnant but usually it isn't a full period.

Switching pills and switching back - Will they work the same?

I am switching from Loestrin 1.5/30® to Levlen® to try and lessen the amount of bleeding on the first day of my period, and also, to help some with the cramps. I will be starting these new pills this week. I am still a little leery about switching pills thinking I may end up worse off than I am now, but I am willing to give it a shot. My main concern is that if I take these new pills and I am not happy with the results the first month for some reason, will I be able to go back to taking the LoEstrin® and have it work exactly like it was working before I made the switch, or will it be like starting a whole new pill in that there may be breakthrough bleeding, spotting, and I may not get it on the exact same day as I used to (it was always 3 days after my last hormone pill). I am just asking this as I know that with other meds I've taken (like anti-depressants...I suffer from panic/anxiety disorder and depression) that you may take them once and have no side effects and they may work fairly well, but then if you stop that med for whatever reason and try and re- start it maybe a month or several months later, your body chemicals have now changed and the med either no longer works on you or you experience side effects this time around.

What do you think the chances are of me being able to re-start the LoEstrin® after being off of it for one month and having it work exactly like it used to?

80-90% - pure guess

I am sure there is always a risk that it will not work the same, but how large is that risk?? I have taken LoEstrin® for about 2 years. Does the risk increase the longer I am off of it?

Not over the course of less than a year, but after that I would think the chance is more that there might be change. Again pure guess -- no scientific studies I know of.

Pill potency to decrease flow on pills even more

Two and a half years ago, I started using Desogen®. I used the Sunday start method and tho I would not spot or have any breakthrough bleeding during the month, when I did get my period during the week of taking the "reminder" pills, it would start anywhere from a Tuesday one month, to a Saturday the next or anywhere in between. My periods had always been irregular so this was one of the reasons I decided to try the pill. Also, I knew they usually lessened the bleeding which was fairly heavy and also helped with cramps. Besides not getting my period on at least approximately the same day each month, they kept getting heavier and heavier each month, and the PMS also increased from one week in advance to having it the entire month. The pill did nothing to help with the cramps, either. I told my gyn and she switched me to LoEstrin 1.5/30® the following year. I also switched the pills to a Friday start so I would get my periods on Sundays.

At first, this pill worked great as far as the bleeding. It lessened it and also shortened the length of time it lasted. I also got it the exact same day (Sunday) each month, which I found very convenient. Unfortunately, it did nothing to help with the cramps and I usually had to take about 24 Advil® within a 24 hour time period for a day or two. Eventually, the Advil® wasn't helping and I switched to using Ultram® which helped much more. But, I noticed a few months after switching pain killers, that the first day of my period became quite heavy---heavier than it even was before I took any BC Pills---and also contained many more clots. For about 12-18 hours on the first day I will bleed very heavily, then it will lessen to average and then go to barely nothing for the next 2-3 days and end. I have since read that using Ibuprofen can lessen the flow and I think that's what happened with me---I stopped taking the Advil® and that's when the periods became heavier. I have become fed up with how heavy it is the first day and have recently asked my doctor what to do.

She suggested using Levlen® instead because it is a stronger pill than both Desogen® and LoEstrin 1.5/30® were. I am just wondering if you think this will help lessen the bleeding or make things worse like the Desogen® did because my understanding is that Desogen® is a stronger pill than LoEstrin®, yet it caused heavier bleeding. From what my pharmacist said, according to her chart, LoEstrin® is considered a "lower level" pill and Desogen® is an "intermediate level" pill. So, I'm thinking that because Desogen® caused me to bleed heavier and it was a higher level pill than the LoEstrin® (which lessened the bleeding in comparison to the two), then is Levlen® (which is a higher level than both of them) what I need or will it, too, cause heavier bleeding as the Desogen® did? Should I be going to a pill that's even lower than LoEstrin®? I guess I don't understand how you figure which way to switch someone's pills. My gyn said that you can't really compare two pills like Desogen® and LoEstrin 1.5/30® because the types of progestin in the two are completely different. I've read that if you have heavy periods that you want to increase the progestin level, but it seems like going from Desogen® to LoEstrin® was a decrease (at least according to the pharmacist's chart), but it did work in lessening the amount of bleeding compared to what I had on the Desogen®. So, now I'm completely confused whether to try this pill or not. I'm not as concerned with the cramps as I am with the bleeding and I'm hoping that my doctor is basing her choice of new pills on the bleeding factor more than the pain factor, which I tried to stress to her. She said she thinks this will help more with both, but I am still leery because, well, I have to worry about everything!!

Is there more progestin in Levlen® than the other two pills, and do you think it sounds like the right choice---or at least a choice that shouldn't make things worse even if it doesn't make things better?? I believe that the levels of progestin in each are:Desogen®---desogestrel 0.15mg LoEstrin®----1.5mg Norethindrone Acetate Levlen®-----0.15mg Levonorgestrel Is it true that you should increase the progestin level for heavy bleeding?? And, according to you, which is the weakest and strongest of all these pills? They all have the same dose of 30mcg of estrogen (the estradiol kind). I've heard that you can use two tampons at once---do you place them next to each other?? Does this really work?? Sorry this letter is so long, but I'm starting college in June and my period is, of course, due that week and I guess I'm looking for some reassurance that I won't be hemorrhaging at the time like with the Desogen®!! Should I give this pill a try--do you agree with her choice and that a stronger pill is what I need in spite of the bleeding, etc. that the Desogen® caused? Also, will I notice any change the first month or will it take a few? If the bleeding gets heavier on this pill in the first month, then I would think that it's not the right choice and change back or try another new one. If it doesn't get less, but stays the same, then I should try it for a few months, anyway. Does this sound correct? I am hoping that this pill will work like the others in that I will get my period the same day each month---do most pills work like that? Besides my Desogen® experience!! Again, sorry that this letter is so long, but for some reason, this is a big issue with me---what I'd really like is a hysterectomy so I won't have to deal with it anymore, but....

Keep in mind that what follows about pill potency is controversial. Some very prominent experts in the field feel that since there is so much individual variability in how any woman's specific tissue reacts to any specific hormone, you can't assign biologic potencies accurately enough to clinically prescribe different formulations according to different symptoms. That being said, pills are assigned biologic potencies as a combination of both the estrogen and the progestin. Since almost all pills have the same estrogen (ethinyl estradiol), the estrogen potency only varies from a few pills at the 20 ug level (Loestrin 1/20® and Allesse®) to the majority at 30 and 35 ug. In this respect Loestrin 1/20® would be considered -low- but actually Loestrin 1.5/30® I wouldn't consider low. The other component is the progestin. Progestin potency has in the past been measured by a "delay of menses" index, i.e., how well a hormone keeps the endometrium from sloughing. The higher the progestin potency (and it doesn't go mg per mg across different formulations) the more likely to stop heavy bleeding. For example Levlen® (levonorgestrel) mg for mg is more potent than many other progestins such as the one in Desogen® which is actually a very mild progestin. Higher progestin potency also tends to decrease cramps more. To complicate matters more, sometimes a higher estrogen potency (dose) is needed to "stabilize" the endometrium if if the progestin makes the endometrium too atrophic. You went from Desogen®, a low potency progestin, to Loestrin®, an intermediate potency progestin and your doctor has now suggested a higher potency progestin in Levlen. It seems like it would be worth a try. Another slightly higher progestin potency pill would be Demulen® 1/35. You may also need to get a thyroid check and a bleeding time check to rule out other causes of heavy bleeding.

How do I take birth control pills?

The most common pill packs come with 21 active hormone pills and seven placebo pills, but some packs have 23, 24, or even 28 active pills. The example shown below is for a 28–day pill pack in which you take 21 active hormone pills, and then seven placebo pills that contain no active hormones. These last seven pills are just "reminder" pills in most pill brands. They are taken during the fourth week, including during your period. With packages that have 24 active pills, the last 4 are "reminder" pills. There are also pill packages that have 84 active pills for continuous hormones and 7 "reminder" pills. Your health care provider will tell you whether you will be taking the active pills continuously or in cycles as illustrated below.


  1. To take the Pill, follow the instructions on the package. Your health care provider will explain how to use your pill pack. You will be told to start taking the oral contraceptive pill on a Sunday, on the first day of your menstrual period, or the day you are seen by your health care provider.
  2. You should take one Pill each day, at the same time of day until you finish the pack. Take the Pill at the same time as something that you do regularly so you don't forget. For example, you could keep them near your toothbrush, or set your cell phone alarm as a reminder. The best time is ½ an hour after a complete meal such as dinner or at bedtime. You may have slight nausea the first month, but this usually goes away with time. Some young women who take the Pill first thing in the morning find that they are more likely to have nausea, especially if they skip breakfast, so taking the pill at dinnertime may cure this symptom.
  3. After completing a 28–day pack, you should immediately start a new packet of pills the next day. During your fourth week on the pill cycle, you should get your menstrual period. Your menstrual period should stop once you begin the new packet of pills.

Birth Control Pills

Birth control pills (also called oral contraceptive pills) are a type of female hormonal birth control method, and are very effective at preventing pregnancy.

Out of 100 women using combination birth control pills
Typical use: 5 women become pregnant icon representing 5 pregnant women
Perfect use: 1 or fewer women become pregnant icon representing less than one pregnant woman

Out of 100 women using progestin-only birth control pills
Typical Use: 5 women become pregnant icon representing 5 pregnant women
Perfect Use: 2 women become pregnant icon representing 3 pregnant women

Birth Control Methods: How Well Do They Work?

Some Methods Work Better Than Others

Some birth control methods work better than others. The chart on the following page compares how well different birth control methods work.
The most effective way to prevent pregnancy is abstinence. However, within the first year of committing to abstinence, many couples become pregnant because they have sex anyway but don't use protection. So it's a good idea even for people who don't plan to have sex to be informed about birth control.
Couples who do have sex need to use birth control properly and every time to prevent pregnancy. For example, the chart below shows that the birth control pill can be effective in preventing pregnancy. But if a girl forgets to take her birth control pills, then this is not an effective method for her. Condoms can be an effective way to prevent pregnancy, too. But if a guy forgets to use a condom or doesn't use it correctly, then it's not an effective way for him to prevent pregnancy.
For every 100 couples using each type of birth control, the chart shows how many of these couples will get pregnant within a year. The information shown is for all couples, not just teenage couples. Some birth control methods may be less effective for teen users. For example, teenage girls who use fertility awareness (also called the rhythm method) may have an even greater chance of getting pregnant than adult women because their bodies have not yet settled into a regular menstrual cycle.
We list the effectiveness of different birth control methods based on their typical use rates. Typical use refers to how the average person uses that method of birth control (compared to "perfect" use, which means no mistakes are made in using that method).
For us to consider a birth control method completely effective, no couples will become pregnant while using that method. Very effective means that between 1 and 2 out of 100 couples become pregnant while using that method. Effective means that 2 to 12 out of 100 couples become pregnant while using that method. Moderately effective means that 13 to 20 out of 100 couples become pregnant while using that method. Less effective means that 21 to 40 out of 100 couples become pregnant while using that method. And not effective means that more than 40 out of 100 couples become pregnant while using that method.
In addition to preventing pregnancy, abstinence and condoms provide some protection against sexually transmitted diseases (STDs). However, most other birth control methods do not provide much protection against STDs, so condoms should also be used.

Dirty Places: Your Computer Keyboard

If you eat at your computer, sneeze on your keyboard, or sit down to surf the Internet without first washing your hands, your computer keyboard could be a health hazard. In a recent study by a British consumer group, researchers swabbed keyboards for germs and found a host of potentially harmful bacteria, including E. coli and staph. Four of 33 sampled keyboards had enough germs to be considered health hazards. One had levels of germs five times higher than that found on a toilet seat.
Quick fix to banish bacteria:
Wash your hands before and after using your computer. If you must eat at your desk, don't drop crumbs into your keyboard. To clean your keyboard, gently shake out the crumbs or vacuum it. Abruzzo recommends wiping the keys with alcohol or bleach wipes, but “nothing too wet,” she says. “And don’t forget to wipe the mouse.”

Breakthrough Birth Control Procedure

Birth control is a very personal choice with lots of options. On Tuesday, February 17, The Doctors cameras follow Dove, a mother of two who is done having children, while she undergoes a breakthrough permanent birth control procedure called Essure. For more, visit video links >>>>  Breakthrough Birth Control Procedure


http://www.youtube.com/watch?v=1aP5Aia6acY

6 Surprisingly Dirty Places in Your Home

If you dropped a piece of fruit in your kitchen sink while rinsing it, would you think twice about popping it in your mouth? What if you dropped it in the toilet?
Germs like cold viruses and bacteria can live in some unexpected spots. Here are six surprisingly dirty places in your home -- like your kitchen sink -- and what you can do to protect yourself.

Dirty Places: The Kitchen Sink

Although the mere thought of retrieving anything from your toilet bowl may be enough to make you sick, your toilet may be cleaner than your kitchen sink, says Eileen Abruzzo, director of infection control at Long Island College Hospital of Brooklyn, New York. Food particles from plates left to soak or rinsed from dishes on their way to the dishwasher can serve as a breeding ground for illness-causing bacteria, including E. coli and salmonella. They can get on your hands or spread to foods.
Although most people take steps to disinfect their toilet bowls, few give their kitchen sink the same consideration, Abruzzo tells WebMD. “They rinse their sinks with water and assume they are clean -- but they’re not.”
Quick fix to banish bacteria:
To sanitize your sink and prevent the spread of bacteria, Abruzzo recommends washing it with a solution of bleach and water once a day and then letting the solution run down the drain. Remember to remove the drain plug and clean it, too, she says. Then wash your hands.

Dirty Places: Your Toothbrush

You put it in your mouth twice a day, but do you ever think of all the germs lurking on it? “You rinse it off after using it and put it away damp,” says Abruzzo. “Bacteria like the moist area and grow on it.”
If the germs from your own mouth weren’t enough to contaminate your toothbrush, the germs from your toilet certainly are. Research in the 1970s by Charles P. Gerba, PhD, of the University of Arizona Department of Soil, Water and Environmental Science, found that flushing the toilet sends a spray of bacteria- and virus-contaminated water droplets into air. These germs, he found, can float around in the bathroom for at least two hours after each flush before landing on surfaces -- including your toothbrush.
Quick fix to banish bacteria:
 Abruzzo recommends placing your toothbrush where it can air out and dry between uses -- but not too close to the toilet. Also, replace your toothbrush often, particularly after you’ve been sick, and close your toilet lid before flushing.

Genital Herpes At A Glance

  • There is no "safe" sex.
  • Condoms do not necessarily prevent sexually transmitted diseases.
  • Genital herpes is a viral infection that can cause painful genital sores and causes recurrent outbreaks.

  • Many people are infected with herpes virus and are now aware of the infection.

  • The herpes virus is spread by direct person-to-person contact.

  • An infected person may transmit the virus to others even if no symptoms are present.

  • There is no cure for genital herpes, but viral shedding and outbreaks can be reduced with antiviral medications.

How are genital herpes diagnosed?

Genital herpes is suspected when multiple painful blisters occur in a sexually exposed area. During the initial outbreak, fluid from the blisters may be sent to the laboratory to try and culture the virus, but cultures only return a positive result in about 50% of those infected In other words, a negative test result from a blister is not as helpful as a positive test result, because the test may be a false-negative test. However, if a sample of a fluid-filled blister (in the early stage before it dries up and crusts) tests positive for herpes, the test result is very reliable. Cultures taken during an initial outbreak of the condition are more likely to be positive for the presence of HSV than cultures from subsequent outbreaks.
There are also blood tests that can detect antibodies to the herpes viruses that can be useful in some situations. These tests are specific for HSV-1 or HSV-2 and are able to demonstrate that a person has been infected at some point in time with the virus, and they may be useful in identifying infection that does not produce characteristic symptoms. However, because false-positive results can occur and because the test results are not always clear-cut, they are not recommended for routine use in screening low-risk populations for HSV infection.
Other diagnostic tests such as polymerase chain reaction (PCR) to identify the genetic material of the virus and rapid fluorescent antibody screening tests are used to identify HSV in some laboratories.

What are the symptoms of genital herpes?

Once exposed to the virus, there is an incubation period that generally lasts 3 to 7 days before a lesion develops. During this time, there are no symptoms and the virus cannot be transmitted to others. An outbreak usually begins within two weeks of initial infection and manifests as an itching or tingling sensation followed by redness of the skin. Finally, a blister forms. The blisters and subsequent ulcers that form when the blisters break, are usually very painful to touch and may last from 7 days to 2 weeks. The infection is definitely contagious from the time of itching to the time of complete healing of the ulcer, usually within 2-4 weeks. However, as noted above, infected individuals can also transmit the virus to their sex partners in the absence of a recognized outbreak.

What is genital herpes?

Genital herpes, also commonly called "herpes," is a viral infection by the herpes simplex virus (HSV) that is transmitted through intimate contact with the mucous-covered linings of the mouth or the vagina or the genital skin. The virus enters the linings or skin through microscopic tears. Once inside, the virus travels to the nerve roots near the spinal cord and settles there permanently.
When an infected person has a herpes outbreak, the virus travels down the nerve fibers to the site of the original infection. When it reaches the skin, the typical redness and blisters occur. After the initial outbreak, subsequent outbreaks tend to be sporadic. They may occur weekly or even years apart.
Two types of herpes viruses are associated with genital lesions: herpes simplex virus-1 (HSV-1) and herpes simplex virus-2 (HSV-2). HSV-1 more often causes blisters of the mouth area while HSV-2 more often causes genital sores or lesions in the area around the anus. The outbreak of herpes is closely related to the functioning of the immune system. Women who have suppressed immune systems, because of stress, infection, or medications, have more frequent and longer-lasting outbreaks.
It is estimated that as many as 50 million persons in the United States are infected with genital HSV. Genital herpes is spread only by direct person-to-person contact. It is believed that 60% of sexually active adults carry the herpes virus. Part of the reason for the continued high infection rate is that most women infected with the herpes virus do not know that they are infected because they have few or no symptoms. In many women, there are "atypical" outbreaks where the only symptom may be mild itching or minimal discomfort. Moreover, the longer the woman has had the virus, the fewer the symptoms they have with their outbreaks. Finally, the virus can shed from the cervix into the vagina in women who are not experiencing any symptoms.

Cervical cap

The cervical cap is a small (1-1/2 inches or about 3 cm.), thimble-shaped dome made of latex or silicone rubber (it is much smaller than a diaphragm) and it fits right over the cervix. The cervical cap is used along with a spermicide. One small application of spermicide is placed inside the cap at the time of insertion. The cap plus spermicide prevent sperm from going through the cervix and entering the uterus.
A woman pushes the cervical cap up her vagina and into position over her cervix. It can remain in place for up to 48 hours. Unlike the diaphragm, fresh spermicidal jelly or foam does not need to be added each time intercourse is repeated as long as the cervical cap is correctly positioned over the cervix.
As with the diaphragm, a cervical cap requires a prescription. A woman must see a health care practitioner to determine the correct size and to ensure that she understands the proper insertion technique.
There are no known related health risks associated with using the cervical cap and spermicide method of birth control. Some women may find spermicides to be irritating, but changing brands may help. The cervical cap can be difficult to insert, but is handy for women who cannot use a diaphragm because of poor muscle tone. Women who suffer from recurring urinary tract infections related to diaphragm use may want to try using the cervical cap.
It is important to remember that using a cervical cap does not protect from sexually transmitted infections, although spermicides may give some protection against chlamydia and gonorrhea.
When the cervical cap and spermicide are used correctly, they are more than 80% effective for birth control, essentially the same reliability as the diaphragm.

Diaphragm

The diaphragm is a soft flexible rubber cup shaped like a dome that is inserted into the vagina. The diaphragm blocks access to the cervix so that sperm cannot pass from the vagina into the uterus. The diaphragm must be covered on both sides and especially around its rim with spermicidal jelly, cream, or foam in order to form a tight seal around the diaphragm.
A woman inserts the diaphragm into her vagina no more than 4 hours prior to intercourse. After intercourse, she should check to be sure that the diaphragm has not been dislodged and is still in the correct position. The diaphragm must be left in place for at least 6-8 hours after intercourse; after this time it should be removed. Fresh spermicide jelly or foam must be inserted into the vagina each time intercourse is repeated.
Since diaphragms are only available with a prescription, a woman must see a health care practitioner to have a diaphragm properly fitted (they come in a range of sizes), and to learn proper insertion techniques. There are no known long-term health risks associated with using the diaphragm and spermicide method of birth control. Some women may find spermicides to be irritating, but changing brands of spermicides may help. There is also an increased risk of urinary tract infections with diaphragm use. One possible reason is that the diaphragm puts increased pressure on the urethra or the spermicide may contribute to irritation leading to infection. (The cervical cap is not associated with increases in urinary tract infections.)
The diaphragm may be appealing to women because it offers a safe temporary (not permanent) birth control that is under her control.
When the diaphragm and spermicide are used correctly, they are thought to have over an 82% success rate (18 pregnancies/100 women per year). To ensure protection, it is important that the diaphragm be checked after every use for rips or holes (this is best done by holding the diaphragm up to the light). Also, the fit of the diaphragm should be checked annually, after every pregnancy, and after significant weight loss.
Using a diaphragm does not protect a woman from sexually transmitted infections, although the spermicide does give partial protection against gonorrhea and chlamydia. It can, however, be used with condoms to offer some protection against sexually transmitted infections.

Contraceptive sponge

The contraceptive sponge is a doughnut shaped sponge. It is made of polyurethane foam and is impregnated with the spermicide Nonoxynol-9. This spermicide is essential to the contraceptive ability of the sponge.
Before intercourse, a woman pushes the sponge up into her vagina (as she would insert a tampon). The spermicidal sponge should then act as a barrier in order to prevent sperm from reaching the cervix. Once in place, the sponge provides protection for up to 24 hours without the need for additional spermicide.
The sponge must remain in the vagina for at least 6 hours after intercourse. However, the same sponge should never remain in the vagina for more than a total of 30 hours because of the risk of toxic shock syndrome. (Toxic shock syndrome is an uncommon and potentially very serious illness that is caused by a type of bacteria. This illness occurs when certain types of products, such as tampons, are left in place for excessive periods of time. This is why package instructions of these products are careful to specify how long they may be safely kept in place.) Each sponge is used only once and then thrown away.
The sponge is generally an effective birth control method. Some users of the contraceptive sponge may experience irritation and allergic reactions. The sponge can also be difficult to remove from the vagina. Removal has been made easier by the addition of a woven polyester loop.
The estimated effectiveness of the sponge as a contraceptive is 64% to 82%. As for protection from sexually transmitted infections, the spermicide may provide some protection against chlamydia and gonorrhea, but otherwise, the degree of protection is unknown.

Female condom

The female condom is not well known in the United States. It is essentially a vaginal pouch made of soft polyurethane (a type of plastic) with two rings at either end. One end of the pouch is open. The other end is closed. A woman inserts the closed end high up in her vagina over her cervix. The open end remains on the outside of her vagina. The vagina is now lined with the condom. When a woman has intercourse, the man inserts his penis into the open end of the woman's condom. Once intercourse is over and the man withdraws his penis, the condom containing the ejaculated sperm can now be removed and thrown away.
The female condom can be put in up to 8 hours before intercourse. A woman may need some practice before she can easily insert and position the condom within her vagina. The sides of the internal ring can be folded together and inserted into the vagina much like a diaphragm. The female condom is thinner than the male condom and is resistant to degradation by oil-based lubricants.
A female condom should never be used when the man is also wearing a condom. The two condoms can stick together and tear, resulting in no protection at all.
The female condom was approved by the U.S. Food and Drug Administration (FDA) in 1993. Its estimated effectiveness is 79% (21 pregnancies/100 women per year) as compared to 87%-90% for the male condom.
Objections that have been made to the female condom include irritation and allergic reactions to the polyurethane. Other concerns are that the female condom is cumbersome, difficult to insert, may not remain in place, and is unattractive. It may also produce unpleasant noises if there is not enough lubrication. For this reason, most female condoms are now generously pre-lubricated with silicone and packets of additional lubrication are included.
The female condom can be purchased over-the counter (OTC) without a prescription, but it may cost more than a male condom. Package instructions currently advise single use but studies are underway to determine if the female condom can be safely washed and reused up to five times.
The main disadvantage of the female condom is that it is not as effective as the male latex condom in preventing pregnancy.

Barrier Methods of Birth Control

Introduction to birth control

If a woman is sexually active and she is fertile and physically able to become pregnant, she needs to ask herself, "Do I want to become pregnant now?" If her answer is "No," she must use some method of birth control (contraception).
Terminology used to describe birth control methods include contraception, pregnancy prevention, fertility control, and family planning. But no matter what the process is called, sexually active people can choose from a plethora of methods to reduce the possibility of their becoming pregnant. Nevertheless, no method of birth control available today offers perfect protection against sexually transmitted infections (sexually transmitted diseases, or STDs), except abstinence.
In simple terms, all methods of birth control are based on either preventing a man's sperm from reaching and entering a woman's egg (fertilization) or preventing the fertilized egg from implanting in the woman's uterus (her womb) and starting to grow. New methods of birth control are being developed and tested all the time. And what is appropriate for a couple at one point may change with time and circumstances.
Unfortunately, no birth control method, except abstinence, is considered to be 100% effective.

Birth Control

Birth control, also known as contraception, is designed to prevent pregnancy. Birth control methods may work in a number of different ways. These include
  • Preventing sperm from getting to the eggs - condoms, diaphragms and intrauterine devices (IUDs) work this way
  • Keeping the woman's ovaries from releasing eggs that could be fertilized - birth control pills work this way
  • Sterilization, which permanently prevents a woman from getting pregnant or a man from being able to get a woman pregnant
Your choice of birth control should depend on several factors. These include your health, frequency of sexual activity, number of sexual partners and desire to have children in the future. Your health care provider can help you select the best form of birth control for you.
NIH: National Institute of Child Health and Human Development

Failure rates for birth control methods when used correctly

(Number of pregnancies per 100 women per year)
Male condom alone 11
Female condom alone 21
Diaphragm with spermicide 17
Cervical cap with spermicide 17 to 23
Sponge with spermicide 14 to 28
Spermicide alone 20 to 50
Oral contraceptives 1 to 2
Contraceptive patch* 1 to 2
Vaginal contraceptive ring 1 to 2
Hormone shots less than 1
IUD less than 1
Periodic abstinence 20
Surgical sterilization (female) less than 1
Surgical sterilization (male) less than 1
Contraceptive patch is less effective in women who weigh more than 198 pounds.

How well do these birth control methods work?

The box below shows the failure rates (number of pregnancies per 100 women per year) for different types of birth control. These numbers are for couples who use the methods the correct way every time they have sex. The failure rates are higher if you don't use birth control the correct way every time.

Is withdrawal effective?

No. When a man tries to pull out before ejaculating ("coming"), he usually leaves behind a small amount of fluid that leaks from the penis during sex. This fluid has enough sperm in it to cause pregnancy.

Natural family planning

Natural family planning requires a couple to learn when in the woman's cycle she can get pregnant (usually 4 days before and 2 days after ovulation). To prevent pregnancy, the couple must use a barrier method of birth control or not have intercourse during those days. There are a number of ways to keep track of a woman's ovulation. All of them require a lot of planning and commitment.

Sterilization

Sterilization is when a man or woman has a surgical operation to permanently prevent pregnancy. If you're sure that you don't want to have children or you don't want more children, sterilization may be the right choice for you.

Tubal ligation (also called "getting your tubes tied") involves closing off a woman's fallopian tubes so eggs can't travel through them to reach the uterus. Your doctor can also close off your fallopian tubes by inserting a metal coil into each tube.

Men are sterilized with a vasectomy. During this procedure, the doctor closes off the man's vas deferens (sperm ducts) so sperm can't get through.

What about an IUD?

"IUD" stands for "intrauterine device." An IUD is a small, T-shaped device put in a woman's uterus by her doctor. Two kinds of IUDs are available. One contains copper and the other releases a small amount of the hormone progestin. The copper IUD has been in use for a longer period of time. It lasts for up to 12 years. The hormonal IUD is similar in size and shape to the copper-containing IUD, but it is safer and has fewer side effects. It lasts for 5 years.

To have an IUD inserted, you go to the doctor for a pelvic exam within a week after you start your period. After cleaning your vagina and cervix, the doctor slides a thin plastic tube containing the device into your uterus. Your doctor removes the plastic tube and makes sure that the IUD is in the right place. The IUD has strings that the doctor cuts to the right length. You have to check these threads each month to make sure that the IUD is in place. Some women find that their uterus pushes out the IUD. There is a risk of ectopic pregnancy (when a fertilized egg grows outside the uterus). There is also a risk of pelvic inflammatory disease, but the risk is lower than for traditional IUDs.

Some IUDs used in the past were related to serious health problems. Today IUDs are safer, but they still have some risks. Most doctors prefer to use IUDs only in women who have already had a baby. Side effects of all IUDs include cramping or pain when the IUD is first inserted and spotting between periods for the first 3 to 6 months. Side effects of copper IUDs include heavier bleeding and stronger cramps during periods. Side effects of the hormonal IUD include irregular periods in the first 3 to 6 months. Some women stop having periods entirely.

What about hormone shots and implants?

The hormone shot is an injection (typically in your arm). You have to visit your doctor for each shot. One shot prevents pregnancy for 3 months. Women who have the shots may have some side effects, such as headaches and changes in their periods, moods and weight.

The hormone implant is a thin, flexible piece of plastic that is about the size of a matchstick. Your doctor inserts the implant under the skin of your upper arm. One implant prevents pregnancy for up to 3 years, but your doctor can remove the implant at any time. Side effects of the implant include irregular bleeding or spotting, or periods that are lighter or heavier than normal. Some women stop having periods entirely.

What is the vaginal contraceptive ring?

The vaginal contraceptive ring is a thin, circular, flexible ring that you insert into your vagina. After you insert the ring, you leave it in your vagina for 3 weeks and then take it out. It doesn't have to be in a specific position in your vagina. During the week the ring is out, your period starts. After a week without the ring, you put in a new one.

If the ring is out of your vagina for more than 3 hours, it may not work effectively when you put it back in. To protect against pregnancy, you will need to use another form of birth control until the ring has been in all the time for 7 days in a row. Some women stop using the ring because of concerns such as feeling the ring in their vagina, problems with sex and the vagina pushing out the ring. Women who use the vaginal ring should not smoke. Smoking increases the risk of serious side effects, such as blood clots.

What about the patch?

The contraceptive patch is a thin, flexible patch that you put on your upper arm, buttocks, stomach or chest (but not on your breasts). You put on a patch once a week for 3 weeks. On the 4th week, you don't wear a patch and your period starts.

The side effects are similar to those of birth control pills. Breast discomfort is more common in the first two months using the patch. The area of skin where the patch was placed can become irritated. Women who use the patch should not smoke. Smoking increases the risk of serious side effects, such as blood clots.

What about the pill?

The birth control pill is an oral contraceptive, meaning you take it by mouth. For the pill to work, you have to take it every day. Most women who take the pill have a period every 4 weeks (1 a month). One type of birth control pill reduces the number of periods from 1 period a month to about 1 period every 3 months.

Some common side effects of birth control pills are nausea, headaches, acne, increased blood pressure, breast tenderness, bloating, weight gain and depression. However, not every woman who takes the pill will have side effects. You may have to try several types of birth control pills before you find the type that is best for you. The pill may reduce cramping and shorten the number of days of bleeding during the menstrual period. The pill may also help premenstrual syndrome (PMS). Women who take the pill should not smoke. Smoking increases the risk of serious side effects, such as blood clots.

Hormonal methods of birth control

Hormonal methods of birth control prevent pregnancy mainly by preventing ovulation (the release of an egg by the ovaries). They do this by releasing the hormones estrogen and progestin (or progestin alone) into your body. Hormonal methods of birth control are prescribed by your doctor and include the birth control pill, the patch, the vaginal ring, hormone shots and implants and a type of intrauterine device.

Are condoms a good choice?

Yes. Condoms aren't expensive and are widely available. Condoms can be combined with other methods of birth control. Condoms are an especially good choice if you or your partner are also having sex with other people or if either of you have had sex with other people in the past.

Of all the barrier method options, condoms offer the most protection against STIs. Using a spermicide with condoms can offer better protection against pregnancy, but it may not increase your protection against STIs. Spermicides containing nonoxynol-9 can cause genital irritation and may actually increase your risk of catching an STI.

Female condoms aren't as effective as male condoms, but they may be a good choice if a man won't use a male condom.

Barrier methods of birth control

Barrier methods prevent pregnancy by blocking sperm from getting into the uterus. They include the diaphragm, the cervical cap, contraceptive sponges and condoms. Barrier methods must be used every time you have sex.
A woman must visit her doctor to be fitted for a diaphragm or a cervical cap. Using a diaphragm, cervical cap or contraceptive sponge may increase the risk of urinary tract infections in some women. Some women have allergic reactions with these methods.
 
 

Birth Control Options

What is contraception?

Contraception means preventing pregnancy, also called birth control. Most people know about options such as birth control pills and condoms. However, there are also other options. If you're thinking about birth control, talk with your family doctor. Your choice will depend on your health, your desire for protection against disease and your personal beliefs and preferences. As always, when looking at birth control, keep in mind that any method only works if you use it consistently and correctly.

What is the best method of birth control or contraception?

There is no “best” method of birth control. Each method has its pros and cons.
All women and men can have control over when, and if, they become parents. Making choices about birth control, or contraception, isn’t easy. There are many things to think about. To get started, learn about birth control methods you or your partner can use to prevent pregnancy. You can also talk with your doctor about the choices.

Before choosing a birth control method, think about:
  • Your overall health
  • How often you have sex
  • The number of sex partners you have
  • If you want to have children someday
  • How well each method works to prevent pregnancy
  • Possible side effects
  • Your comfort level with using the method
Keep in mind, even the most effective birth control methods can fail. But your chances of getting pregnant are lowest if the method you choose always is used correctly and every time you have sex.