Choosing a Method of Birth Control When choosing a method of birth control you need to consider the following eight questions: 1. How safe will this method be for me? 2. How effective will it be for me? 3. How convenient will it be for me? 4. Does it fit my needs if I plan to have children? 5. Will I be able to commit to the use of the method I want? 6. How much will it cost? 7. How does my partner feel about my choice? Will it provide any protection against sexually transmitted diseases? Abstinence is the most effective protection against pregnancy and sexually transmitted diseases (STDs). If you are sexually active, a latex condom with nonoxynol 9 is your best protection against STDs. Every individual reacts differently to different birth control methods. Some methods may not be right for you. It is recommended that you discuss your birth control options with your health care provider to determine which method is best for you. You should always inform any health care provider you see of your current method of birth control. _________________________________________________________________ Birth Control Methods Planned Parenthood On-Line ---------- The Diaphragm A Diaphragm is a bowl-shaped rubber cup with a flexible rim. When put in place, it covers the cervix and is used to prevent pregnancy. How the Diaphragm Works The diaphragm is used with spermicidal cream or jelly. Pregnancy is prevented in two ways. The diaphragm is inserted into the vagina so that it covers the cervix. It stops most sperm from entering the uterus and cannot travel to join an egg in the fallopian tubes. The diaphragm does not stop all the sperm. For this reason, spermicidal cream or jelly is used. The spermicidal cream or jelly stops or kills sperm that get past the diaphragm. Effectiveness * 82% - 94% effective in preventing pregnancy * May provide some protection against sexually transmitted diseases How the Diaphragm is Used Your health care provider will take your medical history, give you a physical exam and fitting to determine the correct size of diaphragm. The diaphragm is used with spermicidal cream or jelly and is inserted into the vagina up to six hours before intercourse and may be left in place for 24 hours. After intercourse, the diaphragm must be left in place for at least six hours. If sexual intercourse is repeated during these six hours, more jelly must be inserted into the vagina without removing the diaphragm. Check-Ups You need to receive a complete gynecological exam every year. It is recommended that your diaphragm fitting is checked also, especially if you have had a change in weight or a recent pregnancy. If you have any of the following problems, contact your health care provider: + Any discomfort when diaphragm is in place + If diaphragm does not stay in place + Irritation or itching + Frequent bladder infections + Unusual vaginal discharge Who Should Not Use the Diaphragm Due to the variety of types and size of diaphragms, just about anyone can use a diaphragm. You should not use a diaphragm it you: * Have a history of toxic shock syndrome * Have an abnormal pap smear Benefits of Using the Diaphragm * Diaphragm is an inexpensive, reusable method of birth control * Only need to use the diaphragm when sexually active * No change in menstruation (periods) * Almost no side effects * Provides some protection against abnormal changes in the cervix Possible Problems * Must plan in advance every time to use * It may take some practice to learn insertion and removal * Must be comfortable with inserting a diaphragm into vagina * May have allergies to spermicidal cream or jelly or rubber products in diaphragm * May increase chance of urinary tract infection Where You Can Get The Diaphragm You can visit your health care provider, go to a family planning agency or to a Planned Parenthood Health Center. Planing A Pregnancy Once use of the diaphragm is discontinued, you have the same chance of getting pregnant as before use. Warning Signs Women who use the diaphragm should be aware of the warning signals of toxic shock syndrome. If you experience any of the following, contact your health care provider: * Vomiting * High fever * Diarrhea * Sunburn-type rash * Itching or irritation in genital area * Unpleasant odor or discharge _________________________________________________________________ Birth Control Methods Planned Parenthood On-Line ---------- Foam and Condoms The Condom is made from thin rubber or animal tissue. The condom covers the penis and stops sperm from entering the vagina. Condoms are available with or without spermicide and lubricants. Foam and Vaginal Inserts are placed into the vagina before intercourse and stop or kill sperm. How the Condom and Foam, Vaginal Inserts Work Condoms prevent sperm from entering the vagina so fertilization cannot occur. Some condoms have spermicide which also kills the sperm. Foam and vaginal inserts have a chemical in them that stops the movement of most sperm. These methods kill most sperm and are intended to block any remaining sperm from swimming into the uterus. Effectiveness * Condoms alone: + 88-92% effective in preventing pregnancy * Foam Alone + 72-97% effective in preventing pregnancy * Condoms used with Foam or Vaginal Insert: + 98-99% effective in preventing pregnancy. + Provides some protection against sexually transmitted diseases How the Condom Is Used A condom is put on the erect penis before it goes in or near the vagina. Some space must be left at the tip to catch the sperm. The condom must be held against the penis when withdrawing from the vagina. A new condom is needed for each act of intercourse. How Foam and Vaginal Inserts Are Used There are many varieties of this method: foam, which looks like shaving cream and is inserted with an applicator; the sponge, which is moistened and inserted by hand; and suppositories and vaginal films, which are placed in the vagina a few minutes before intercourse. Check-Ups It is not necessary to have an exam before starting to use condoms, foam or vaginal inserts. However, it is recommended that all women who are sexually active or over the age of 18 receive complete gynecological exams every year. Who Can Use Condoms, Foam or Vaginal Inserts Just about anyone can use a condom, including people who: * want a form of birth control that offers some protection against sexually transmitted diseases * want inexpensive birth control * do not want to take a pill daily * do not want to use a hormonal method of birth control * do not want a change in menstruation Benefits of Using Condoms, Foam or Vaginal Inserts * Latex condoms provide some protection against sexually transmitted diseases (STDs) * Available at many stores and anyone of any age may buy condoms, foam or vaginal inserts * Inexpensive and a prescription is not needed * Only need to be used during sexual intercourse * No change in menstruation * There are many varieties * Almost no side effects Possible Problems * Must be used every time you have sexual intercourse (a new condom must be used every time you have sexual intercourse) * Must be comfortable inserting foam, sponge, suppository or vaginal film into your vagina * Some men feel certain kinds of condoms dull sensation * It takes some practice to use a condom correctly and easily every time * May have allergies to spermicide Where You Can Get Condoms, Foam or Vaginal Inserts You can go to a drugstore, visit your health care provider, go to a family planning agency or to a Planned Parenthood Health Center. Planning A Pregnancy Once use of condoms, foam or vaginal inserts is discontinued, you have the same chance of getting pregnant as before. Warning Signs * A man should withdraw immediately if it feels like a condom is breaking or not in place. * Women who use the sponge should be aware of the warning signals of toxic shock syndrome. If you experience any of the following, contact your health care provider: + Vomiting + High fever + Diarrhea + Sunburn-type rash + Itching or irritation in genital area + Unpleasant odor or discharge _________________________________________________________________ Birth Control Methods Planned Parenthood On-Line ---------- Norplant Norplant is a long-term method of birth control. Six soft capsules the size of matchsticks are surgically inserted under the skin of the inside of the upper arm and release a synthetic hormone called Progestin. How Norplant Works The Norplant capsules slowly release a synthetic hormone, Progestin, into the body over a five-year period. Progestin is a synthetic hormone similar to one of a woman's natural hormones. The hormone prevents the ovaries from releasing eggs. It also thickens the cervical mucus. This keeps sperm from joining with an egg if ovulation occurs. Effectiveness * 99.9% effective in preventing pregnancy * Does not provide protection against sexually transmitted diseases How Norplant Is Used Your health care provider will take your medical history, give you a physical exam and perform any necessary lab work. After this is done, he/she will numb a small area of your upper arm with a local anesthetic. A small incision (cut) will be made, and the six Norplant capsules will be inserted. This procedure takes about ten minutes. Norplant must be inserted within the first seven days of the beginning of a normal menstrual cycle. Protection against pregnancy begins within 24 hours. Check-Ups You need to have a follow up visit within the first two to three months of use. In addition, you also need to receive a complete gynecological exam every year. If you have any problems, see your health care provider. Norplant must be removed after five years of use. It can also be removed at any point before five years. Again, your health care provider will numb a small area of your upper arm with a local anesthetic, make a small incision and remove the six Norplant capsules. Removal usually takes 15 to 20 minutes. Removal may take longer with some individuals. If you want to continue using Norplant, new capsules can be inserted when old capsules are removed. Who Should Not Use Norplant You should not use Norplant if you: * are pregnant * have unexplained vaginal bleeding * are breastfeeding in the first six weeks after delivery * have ever had: + blood clots + liver disease + cancer of the breast or uterus + tumors or heart disease * develop keloids (thick and recurring scar tissue) Benefits of Using Norplant * Long-term birth control--prevents pregnancy for five years * Nothing to be taken daily or used before sexual intercourse * Does not contain estrogen so women who cannot use birth control pills may be able to use Norplant * Can be removed at any time * Is not usually visible (in some cases an outline of capsules may be visible) * Capsules will not break or burst * May offer some health benefits such as protection against endometrial cancer Possible Problems Side effects may include: * Irregular menstruation (periods) * Spotting or bleeding between menstruation (periods) * Weight gain or loss * Change in appetite * Acne * Headaches * Small incision scar * Discoloration of skin * Gain/loss of facial hair * Depression or nervousness * Ovarian cysts * Menstruation (periods) may stop completely and may not return immediately after this method is discontinued. * It is not yet known if smoking while using Norplant increases the risks of blood clots, heart attack, and stroke in women who are more than 35 years old or smoke more than 15 cigarettes per day. All women using Norplant are advised to stop smoking. Where Can You Get Norplant You can visit your health care provider, go to a family planning agency or to a Planned Parenthood Health Center. Planning A Pregnancy It is suggested that after you stop using Norplant, you use another method of birth control until you have had three normal periods. Studies indicate that your chances of getting pregnant are the same as before use of Norplant. Warning Signs The following problems may be warnings of a serious problem. Do not ignore these signals or wait to see if they will go away. Contact your health care provider immediately if you experience: * Vaginal bleeding lasts longer and is heavier than your normal period * Pain, bleeding or yellow discharge occurs near the area where Norplant capsules were inserted * Norplant capsule seems to be coming out * Your menstruation (period) is late after a long period of regular cycles * Severe depression * Breast lumps * Yellowing of skin or eyes * Severe headaches * Severe pain in stomach or abdomen _________________________________________________________________ Birth Control Methods Planned Parenthood On-Line ---------- Depo Provera Depo-Provera is a long-lasting method of birth control. It is an injection (a shot) of a synthetic hormone called Progestin and is given every three months. How Depo-Provera Works Depo-Provera is a synthetic hormone, Progestin, which is similar to one of a woman's natural hormones. Progestin prevents pregnancy in several ways. Progestin prevents a woman's ovaries from releasing an egg. It also thickens the cervical mucus making it more difficult for sperm to enter, while thinning the lining of the uterus. This makes implantation less likely to occur if an egg is fertilized. Effectiveness * 99.6% effective in preventing pregnancy * Does not provide protection against sexually transmitted diseases How Depo-Provera Is Used Your health care provider will take your medical history and give you a physical exam. Lab work is needed. After this is done, a Depo-Provera injection will be given in the muscle of your upper-arm or buttock. The injection must be given within the first five days of your normal menstrual period. Protection against pregnancy begins within 24 hours. You must return every 12 weeks (three months) to receive the next injection (shot). Check-Ups You must receive a Depo-Provera injection every 12 weeks (three months) for protection against pregnancy. In addition, you also need to receive a complete gynecological exam every year. If you have any problems, contact your health care provider. Who Should Not Use Depo-Provera You should not use Depo-Provera if you: * are pregnant * have unexplained vaginal bleeding * are breastfeeding in the first six weeks after delivery * have ever had: + blood clots + liver disease + cancer of the breast or uterus + tumors or heart disease * use a medication for Cushing Syndrome Benefits of Using Depo-Provera * Long-lasting birth control--prevents pregnancy for 12 weeks (three months) * Nothing to take daily or put in place before sexual intercourse * Menstruation (periods) slow down and often stop after six months of use * Does not contain estrogen so women who cannot use birth control pills may be able to use Depo-Provera * May offer some health benefits such as protection against endometrial cancer Possible Problems Side effects may include: * Headaches * Weight gain * Irregular bleeding * Depression or nervousness * Symptoms of pregnancy * Dark spotting of the skin * Change in hair growth * Change in sex drive * Side effects cannot be reversed until medication wears off (up to 12 weeks or longer). * Menstruation (periods) may stop completely and may not return immediately after this method is discontinued. 50% of women who use this method for one year report menstruation (periods) stopping. * It is not yet known if smoking while using Depo-Provera increases the risks of blood clots, heart attacks, and strokes in women who are more than 35 years old or women of any age who smoke more than 15 cigarettes per day. All women using Depo-Provera are advised to stop smoking. Where You Can Get Depo-Provera You can visit your health care provider, go to a family planning agency or to a Planned Parenthood Health Center. Planning A Pregnancy Because Depo-Provera wears off over time, it will take longer for you to get pregnant after stopping Depo-Provera than it would with other methods of birth control. Studies indicate that women may become pregnant 9 to 10 months after the last injection (shot) of Depo-Provera. 70% of the women become pregnant within the first 12 months. Over 90% became pregnant by 24 months. Warning Signs The following problems may be a warning of a serious problem. Do not ignore these signals or wait to see if they will go away. Contact your health care provider immediately if you experience: * Severe chest pains, coughing of blood or shortness of breath * Severe headaches, blurred vision, vomiting, dizziness, or fainting * Severe pain or swelling in legs or arms * Heavy or unusual vaginal bleeding * Severe pain or tenderness in abdominal area * Yellowing of skin or eyes _________________________________________________________________ Birth Control Methods Planned Parenthood On-Line ---------- The Oral Contraceptive Pill The Oral Contraceptive Pill (The Pill) is a reversible, hormonal method of birth control. The Pill consists of two synthetic hormones similar to the hormones in your body which regulate your period (estrogen and progestin). How the Pill Works Most types of birth control Pills stop a woman's ovaries from releasing eggs (prevents ovulation). Without an egg for the sperm to fertilize, a woman cannot get pregnant. Effectiveness: * 97-99% effective in preventing pregnancy (when used correctly) * Does not provide protection against sexually transmitted diseases How the Pill is Used: One Pill must be swallowed every day at the same time. It is not any single Pill, but the day-by-day process of taking the Pill which provides protection against pregnancy. Check-Ups: You need to have a follow up visit within the first six months of use. In addition, you also need to receive a complete gynecological exam every year. If you have any problems, see your health care provider. Who should not use the pill? * You should not use the Pill if you: + are over the age of 35 years + smoke more than 15 cigarettes per day + are not reliable at taking a pill every day at the same time * You should not use the Pill if you have ever had: + unexplained vaginal bleeding + blood clots + liver disease + cancer of the breast or uterus + tumors + heart disease Benefits of Using the Pill: + Very effective in preventing pregnancy + Easy to use + Nothing to put in place before intercourse + Periods usually become shorter and lighter + Less premenstrual tension, acne, iron deficiency, anemia and rheumatoid arthritis + Provides some protection against ovarian and endometrial cancers, pelvic inflammatory disease (PID), non-cancerous breast tumors and ovarian cysts + Fewer ectopic pregnancies Possible Problems: + Must remember to take every day at the same time + Antibiotics and certain medications may decrease the effectiveness of the Pill. Whenever you are going to take another medication while you are on the Pill, ask a health care provider whether the additional medication will have this effect. If so, us a second method of birth control until you finish your current cycle of Birth Control Pills. + Cannot be used when breast feeding + Side effects may include: o temporary irregular bleeding o possible weight gain o mood changes o mild headaches o nausea o breast tenderness + These side effects often clear up after two or three months of use. Rare but serious health risks include: blood clots, heart attack and stroke Women over 35 years of age or women of any age who smoke more than 15 cigarettes per day are at greater risk. Where You Can Get The Pill: You can visit your health care provider, go to a family planning agency or to a Planned Parenthood Health Center. Planning A Pregnancy: It is suggested that you stop taking the Pill at the end of a cycle and use another method of birth control until you have had three normal periods. Warning Signs: The following problems may be a warning of a serious problem. Do not ignore these signals or wait to see if they will go away. Contact your health care provider immediately if you experience: * Severe abdominal pain * Severe chest pain or shortness of breath * Severe headaches or dizziness * Eye problems such as blurred vision, flashing lights or blindness * Severe leg pain or swelling * Yellowing of skin or eyes * Severe depression _________________________________________________________________ Birth Control Methods Planned Parenthood On-Line ---------- The Intra-Uterine Device (IUD) IUD is a small plastic object that is usually t-shaped. It is inserted into a woman's uterus to prevent pregnancy. How the IUD Works The IUD contains copper or a hormone (Progesterone) that prevent sperm from joining an egg and prevent a fertilized egg from implanting in the uterus. Effectiveness * 97% - 99.2% effective in preventing pregnancy * Does not provide protection against sexually transmitted diseases How the IUD is Used Your health care provider will take your medical history, give you a physical exam, and complete any necessary lab work. After this is done, the IUD is inserted in your uterus usually during or after menstruation (a period). It may stay in place from one to eight years depending on the type of IUD used. The IUD has a string that extends into the vagina. This string should be checked by the woman monthly after menstruation to make sure the IUD is in place. Check-Ups You need to receive a complete gynecological exam every year. If you have any problems, contact your health care provider. Who Should Not Use the IUD You should not use the IUD if you: * are pregnant * have unexplained vaginal bleeding * have a history of pelvic infection * have a history of tubal pregnancy * had a recent abnormal pap smear Benefits of Using the IUD * Prevents pregnancy for up to eight years depending on the IUD used * Nothing to take daily or put in place before sexual intercourse * Easy to use - just check the string regularly * Can be removed by a health care provider at any time Possible Problems * Side effects may include: * Spotting between menstruation (periods) * Heavier and longer menstruation (periods) * Menstrual cramps may increase * Immediate medical care must be received if there are any signs of infection * There is a small chance that the IUD can fall out - you may not notice this and pregnancy may occur * A small percent of IUD users have ectopic (tubal) pregnancy Where You Can Get the IUD You can visit your health care provider, go to a family planning agency or to a Planned Parenthood Health Center. Planning A Pregnancy Once use of the IUD is discontinued, you have the same chance of getting pregnant as before use. Warning Signs The following problems may be a warning of a serious problem. Do not ignore these signals or wait to see if they will go away. Contact your health care provider immediately if you experience: * A missed, late or light period * Severe cramping or pain in lower abdomen * Pain or bleeding during sexual intercourse * Unexplained fever or chills * Unusual vaginal discharge * String is missing, shorter or longer * Exposed to sexually transmitted infections (STI) _________________________________________________________________ Birth Control Methods Planned Parenthood On-Lin