Barrier Method THE MALE CONDOM

1.

The Male Condom A condom is made of latex, plastic, or animal tissue and is a sheath that fits over the penis. Many words are used to describe a condom, including a rubber or a safe. A condom works by preventing sperm from ejaculate from entering a woman's vagina. The male condom not only provides a method of birth control, but also protects against sexually transmitted diseases. When used properly, male condoms are considered 98% effective in preventing pregnancy. Often, condoms are used with contraceptive creams, foams or jellies. This allows for protection from pregnancy if the condom breaks during intercourse. The usefulness of condoms for the prevention of sexually transmitted diseases, including HIV, cannot be overstated. Condoms offer the best possible protection, aside from abstinence, from STDs by blocking any exchange of body fluids that may carry infection. Condoms come in a variety of different sizes, colors and types. They can be rippled, studded, dry or lubricated. Lubricated condoms often cost slightly more than non-lubricated condoms. It is important to handle condoms gently and to ensure that they are stored properly. An expiration date can be found on the wrapper of all condoms and these dates should be strictly adhered to, as condoms do deteriorate over time. Using a lubricant with condoms (even those that are pre lubricated) can help to prevent tearing and ripping of the condom. As well, lubricants can enhance sensitivity. It is essential to use the correct lubricants with different types of condoms. Only use water based lubricants with latex condoms, as oil based lubricants, such as many creams and petroleum jelly, will damage the latex

THE FEMALE CONDOM

The Female Condom The female condom is made of polyurethane and is worn by a women during intercourse. It completely lines the vagina and partly covers the perineum, helping both to prevent pregnancy and provide protection against sexually transmitted diseases. One ring lies inside the vagina, while the other ring, on the open edge, remains outside the vagina and covers the perineum, allowing protection for the labia and base of the penis during intercourse. The female condom doesn't contain spermicide and should not be used at the same time as a male latex condom. There is lubricant on the inside of the female condom, and additional silicone based lubricant is often used with the female condom. The rates of effectiveness of the female condom vary according to how long a period a person has used it and whether it's used every time a woman has intercourse. Generally, it is considered effective just over 80% of the time, when used properly. The female condom is not difficult to use, but it takes some practice to become used to it. It is advised that women practice inserting the female condom and removing it before they use it during sexual activity. As with male condoms, the female condom should be used only once. Also important when using the female condom is that the penis enters the vagina correctly. It is often helpful to guide the penis as it enters the vagina to ensure that the penis hits the center of the female condom, instead of between the vaginal wall and outer side of the condom. If the penis does not enter correctly, the penis should be drawn out of the vagina and guided in correctly. The female condom has added another birth control method to the many pregnancy prevention options available. Although the effectiveness rates are not as high as the male condom, it offers women protection that they themselves can control and can be inserted hours prior to sexual activity.

Diaphragm

The Diaphragm

A diaphragm is a soft rubber dome that has a covered flexible spring at the outer edge. Diaphragms are used in conjunction with spermicidal gels or spermicidal creams. The diaphragm keeps the contraceptive cream or gel close to the cervix. This prevents sperm from entering the uterus, thereby reducing the chances of pregnancy. With correct use of the diaphragm and contraceptive gel, this method of birth control is considered approximately 94% effective in pregnancy prevention. The effectiveness decreases when the diaphragm and spermicide are not used properly. A diaphragm can last for 2-3 years, but it should be observed for any rips or holes prior to each use. This can be done by stretching the diaphragm while holding it up against light. A doctor will examine you and size a diaphragm for your body. The diaphragm is put into place prior to intercourse, and is removed 6-8 hours after intercourse. The diaphragm shouldn't interfere with sexual activity and can remain in place during urination and bowel movements. One can shower or bathe while the diaphragm is in place. properly fitted diaphragm is essential for it to be an effective method of birth control. Size should be checked when: - You have just recently started having intercourse - If your weight changes by 20 pounds or more - If you become pregnant - If you have any type of pelvic surgery Some women experience bladder infections after starting to use a diaphragm. If this occurs, talk to a doctor about alternate methods of birth control.

CERVICAL CAP
The Cervical Cap cervical cap is a shaped device the cervix. groove on the cap that and allows the stay in place, by the vaginal often used with cream or gel. prior to fitting, be taken. It is fitted correctly cap to prevent cervical cap barrier and

The latex, domethat fits over There is a inside of the creates a seal cervical cap to which is aided wall. The cap is a spermicide Six months a pap smear will essential to be for a cervical effectively pregnancy. The acts as a

blocks the sperm from passing the cervix from the vagina. This prevents the sperm from reaching the uterus, thus preventing pregnancy. The cap is removed within 48 hours after intercourse. This enables the vagina to naturally promote cleansing. The cervical cap is considered to be 91% effective when used properly. The cap is generally considered less effective for those who have had more than one vaginal birth. Using the cervical cap effectively demands correct placement and consistent use. The cervical cap can be in place for 48 hours, offering an advantage of spontaneous sexual activity. It can be a good alternative for those who have difficulty using a diaphragm. However, the cap can't always be fitted effectively to every shape and size of cervix and it is possible to dislodge the cap during sexual intercourse. Advantages of the Cervical Cap - It can be left in place for up to 48 hours, allowing spontaneous protected intercourse - It requires one small application of spermicide inside the cap at time of insertion - It is less messy than the diaphragm - It is smaller than a diaphragm and less noticeable to either partner - Fewer and less serious side effects than many other forms of birth control are experienced, including the Pill or IUD Disadvantages of the Cervical Cap - It can be trickier to insert and remove than a diaphragm - It can be dislodged from the cervix during intercourse

Contraceptive Sponge

The Contraceptive Sponge

The contraceptive sponge is a small, pillow-shaped polyurethane sponge that contains a spermicide. There is a concave spot on one side of the sponge that fits over the cervix and acts both as a barrier for sperm and helps to keep the sponge in place during intercourse. The opposite side of the sponge has a small loop to assist in the sponge's removal after intercourse. The contraceptive sponge comes in one size and is available over the counter at most drugstores. The contraceptive sponge can be inserted up to 24 hours prior to intercourse, enabling spontaneous sex, and provides effective birth control if intercourse occurs more than once during that period. The sponge is removed 6 hours after intercourse. The sponge is often used in conjunction with other birth control methods, most often condoms. This adds a second element of pregnancy prevention, further decreasing the changes of pregnancy. The contraceptive sponge has several benefits. These include ease of use, affordability and comfort. As well, the sponge is available without a prescription and can be purchased at most drugstores.

2) Hormonal Methods Implants (Norplant)

Norplant (Implants) Norplant requires a surgical procedure using a local anesthetic where non biodegradable silicone rubber capsules are implanted beneath the skin on the arm. The implant process usually takes under 10 minutes and is painless. Progestin is slowly and steadily released at a rate that decreases over time. Norplant is immediately effective for birth control if it is implanted in the first 7 days of the menstrual cycle. Otherwise, it becomes effective within 24 hours. Norplant has proven to be a very effective method of birth control, with effectiveness rates considered to be around 99%. The implants usually stay in place for a period of 5 years, at which time a new set of capsules can be implanted. Norplant has been shown to be most effective for women whose weight is under 155 pounds. Norplant's effectiveness

decreases over time. There are a variety of reasons why some women are not good candidates for Norplant, and a complete medical history should be considered by a doctor prior to the procedure. Advantages of Norplant Norplant implants are highly effective and have been shown to be 99.99% successful No daily pills or requirements prior to having intercourse Require only one visit to the doctor yearly for a regular check up Women using Norplant lose less menstrual blood

Disadvantages of Norplant - Norplant will likely cause irregular menstrual periods - Some - Some arm - No

weight gain has been associated with Norplant women lose hair while using Norplant Implants can cause slight discomfort in the area of the where they are implanted protection from sexually transmitted diseases

Shots (DepoProvera)

Depo-Provera Depo-Provera is an progestin contraceptive method wherein injections are administered every 3 months. It provides effective birth control by inhibiting ovulation as a result of suppressing FSH (Follicle Stimulating Hormone) and LH (Luteinizing Hormone) levels, by the development of a more shallow endometrial lining and by promoting the development of very thick cervical mucus that is difficult for sperm to penetrate. Depo-Provera is considered highly effective. Effectiveness in the first year is around 99.7%. Usually, the first injection of Depo-Provera is administered during the first 5 days of the start of a menstrual cycle. Another injection is administered every 3 months onward. There are certain health conditions that may interfere with the effectiveness of Depo-Provera or that may cause unwanted side effects. These should be discussed thoroughly with a doctor after taking a complete medical history, having a pap smear and testing for any sexually transmitted diseases Advantages of Depo-Provera - Offers long term protection, requiring an injection once every 3 months - No daily requirements to take a pill - Enables spontaneous sexual activity - Highly effective in preventing pregnancy Disadvantages of Depo-Provera

- Irregular menstrual periods or spotting - Menstrual periods stopping altogether - Possibly Some weight gain

Birth Control Pills

The Birth Control Pill ("The Pill")

Often called "the Pill", birth control pills contain two hormones - estrogen and progestin. Birth control pills work by preventing the monthly release of an egg, making pregnancy impossible. The Pill also prevents pregnancy by thickening the mucus of the cervix, making it difficult for sperm to reach both the uterus and fallopian tubes. One pill is taken daily for 3 weeks, at which point, either the woman stops taking a pill for a week or takes a pill without hormones. It is during the fourth week while the pill is stopped that a women menstruates. Different kinds of birth control pills contain different amounts of hormones. It is usually recommended that the lowest possible dose required to be effective be taken. Lower doses usually cause fewer potential side effects. The birth control pill is considered 99.9% effective for those who take it properly. Key to successful use of the Pill is taking it every day and starting a new cycle of pills on time. The Pill also offers other health benefits in addition to preventing pregnancy. It has been shown to protect against certain cancers, for example. However, some side effects are usually experienced for the first few months of taking the Pill, but usually will subside with continued use. Although serious side effects are rare, the Pill is not usually prescribed for women with diabetes, high blood pressure or who are seriously overweight or obese. The birth control pill is not for everyone. Do not take the Pill if you have or exhibit any of the following: Any history of stroke Thrombophlebitis or thromboembolic disorder or a history of blood clots Any history of angina, heart attack or heart failure Any history of kidney disease Those who are over 35 and smoke Migraine headaches High blood pressure Diabetes Active gallbladder disease or disease with jaundice Those over 50 years of age

- Immediately following childbirth - Any medications or psychological illness that would prevent taking the medication consistently or correctly

Chewable Birth Control Pill

Femcon Fe - The Chewable Birth Control Pill

There is a new FDA approved chewable Birth Control Pill and its name is Femcon Fe. This medication is made up of 0.4mg of norethindrone which is a progestin and 35mg of ethinyl estradiol which is the estrogen part. Femcon Fe is a small pill that has a spearmint flavor can be either chewed or swallowed (not recommended to just leave it in your month to dissolve) so long as you drink an 8 ounce drink afterwards. Clinical studies have shown that the Femcon Fe Pills are 92 to 99.7% effective when used properly. Femcon Fe works by releasing a combination of hormones into your body to help prevent ovulation. There are several advantages that Femcon Fe has as a birth control. Provides less spotting or breakthrough bleeding in between periods. Once Femcon Fe is stopped, a woman's capability to become pregnant again returns (once it is out of ones system) Provides an excellent alternative for those having difficulty swallowing pills. It can help to regulate a woman's menstrual periods, lower the flow and lessen menstrual cramps.

In addition to these birth control related benefits, Femcon like other Combination birth control pills can offer other benefits such as decreased chances of developing: -Ovarian Cancer - Ovarian cysts - Excessive body hair - Anemia - Headache - Depression - Vaginal Dryness - Acute Pelvic Inflammatory disease - Acne - Cysts or lumps on the breasts

Nestorone

Nestorone - Contraceptive Birth Control Gel

There is a new birth control contraceptive called Nestorone being developed by Antares Pharma, it currently is in early clinical testing but so far things are looking up for it. What makes this new drug unique is that it is a gel that is applied by rubbing it onto the skin daily. It prevents pregnancy in the similar method by applying the hormones estrogen and progesterone that slowly are absorbed into the bloodstream but unlike other forms of birth control such as the pill or ring there does not seem to be the negative side effects such as cramps, acne, weight gain or other issues. Clinical testing has shown a high rate of success and tolerated very well by most women. During testing 18 women between the ages of 20 to 40 where taking 3mg Nestorone for a 7 month period. In all cases the gel prevented pregnancy and there where no unpleasant side effects. So far research and testing has indicated that Nestorone is safe for breastfeeding women. But these are still early stage tests. Typically medications need 3 stages of testing with increasingly larger number or subjects and for longer periods of time in order to more accurately assess the medications effectiveness. As a result of the long testing phases it would probably be several years before this product would be available for the public. It is the hopes of the creator of Nestorone that this gel will obviously be approved for use as well as be an attractive alternative to existing methods of birth control. Not only does Nestorone have a quick and easy way to take it but so far the lack of side effects looks very good. Some women are not happy with their current form of birth control and there is no doubt that Nestorone may appeal to them along with many others. But I do caution that a study of 18 women is a very small group to gain any real insight into the true potential of such a birth control, but all studies have to start somewhere and so far so good. It will be interesting to see how this particular drug plays out in the long run.

3) IUDs (Intrauterine Devices)

Intrauterine Device (IUD)

An IUD is a small plastic stick shaped like a T with a string at the end. It is placed inside the uterus in order to prevent pregnancy. It is placed inside the uterus by a doctor, where it stays until it is removed by a doctor. The IUD operates by preventing the sperm from joining with an egg. The sperm is unable to penetrate the egg. As well, the IUD works by altering the lining of the uterus. An IUD is a very effective method of birth control. Not only is the IUD itself effective, but there is no work required by the male or female, making mishaps or forgotten pills irrelevant. The IUD is effective immediately once it is in place, and when properly in place, cannot be felt by the woman. There are 2 primary types of IUD. The most frequently used type that is covered with copper can stay in the body for 10 years. Another kind of IUD that contains the hormone progesterone must be replaced yearly. If you use an IUD and are unable to locate the string, contact your physician. Those women who think they may be pregnant should not use an IUD, and if using an IUD, should contact their doctor immediately. Women using an IUD for birth control should be aware that the following symptoms indicate that there is a problem with the IUD: severe cramping or increasing pain in the lower abdomen that may be associated with feeling faint pain or bleeding during sex unexplained fever and/or chills increased or foul smelling discharge a missed, late or unusually light period unexplained vaginal bleeding after the usual adjustment phase after IUD insertion

VASECTOMY

Vasectomy is a surgical procedure for male sterilization and/or permanent birth control. During the procedure, the vasa deferentia of a man are severed, and then tied/sealed in a manner such to prevent sperm from entering into the seminal stream (ejaculate). Vasectomies are usually performed in a physician's office or medical clinic. There are several methods by which a surgeon might complete a vasectomy procedure, all of which occlude (seal) at least one side of each vas deferens. To help reduce anxiety and increase patient comfort, men who have an aversion to needles might opt for the "no-needle" application of anesthesia while the "no-scalpel" or "open-ended" techniques help to speed-up recovery times and increase the chance of healthy recovery. Due to the simplicity of the surgery, a vasectomy usually takes less than 30 minutes to complete. After a short recovery at the doctor's office (usually less than an hour), the patient is sent home to rest. Because the procedure is minimally invasive, many vasectomy patients find that they can resume their typical lifestyle routines within a week, and do so with minimal discomfort. Because the procedure is considered a permanent method of birth control (not easily reversed), men are usually counseled/advised to consider how the long-term outcome of a vasectomy might affect them both emotionally and physically.

TUBAL LIGATION

Tubal ligation or tubectomy (also known as having one's "tubes tied" (ligation)) is a surgical procedure for sterilization in which a woman's fallopian tubes are clamped and blocked, or severed and sealed, either method of which prevents eggs from reaching the uterus for fertilization. Tubal ligation is considered a permanent method of sterilization, and birth control There are mainly four occlusion methods for tubal ligation, typically carried out on the isthmic portion of the fallopian tube, that is, the thin portion of the tube closest to the uterus. Partial salpingectomy, being the most common occlusion method. The fallopian tubes are cut and realigned by suture in a way not allowing free passage. The Pomeroy technique is a widely used version of partial salpingectomy, involving tying a small loop of the tube by suture and cutting off the top segment of the loop. It can easily be applied via laparoscopy. Partial salpingectomy is considered safe, effective and easy to learn. It does not require any special equipment to perform; it can be done with only scissors and suture. Partial salpingectomy is not generally used with laparoscopy.Clips: Clips clamp the tubes and inhibits blood flow to the portion, causing a small amount of scarring or fibrosis, in turn, preventing fertilization. The most commonly used clips are the Filshie clip, made of titanium, and the Wolf clip (or "Hulka clip"), made of plastic. Clips are simple to insert, but require a special tool to put in place.

Silicone rings: Tubal rings, similarly to clips, block the tubes mechanically. It encircles a small loop of the fallopian tube, blocking blood supply to that small loop, resulting in scarring that blocks passage of the sperm or egg. A commonly used type of ring is the Yoon Ring, made of silicone[1]

Electrocoagulation or cauterization: Electric current coagulates or burns a small portion of each fallopian tube. It mostly uses bipolar coagulation, where electric current enters and leaves through two ends of a forceps applied to the tubes. Bipolar coagulation is safer, but slightly less effective than unipolar coagulation, which involves the current leaving through an electrode placed under the thigh It is usually done via laparoscopy.

Bilateral salpingectomy (i.e., surgical removal of the fallopian tubes) is also effective as a tubal ligation procedure.

Lactational amenorrhea method

The lactational amenorrhea method (LAM) is a method of avoiding pregnancies which is based on the natural postnatal infertility that occurs when a woman is amenorrheic and fully breastfeeding. If not combined with chemicals or devices, LAM may be considered natural family planning. For women who meet the criteria (listed below), LAM is 98% - 99.5% effective during the first six months postpartum. Breastfeeding must be the infants only (or almost only) source of nutrition. Feeding formula, pumping instead of nursing,and feeding solids all reduce the effectiveness of LAM. The infant must breastfeed at least every four hours during the day and at least every six hours at night. The infant must be less than six months old. The mother must not have had a period after 56 days post-partum (when determining fertility, bleeding prior to 56 days post-partum can be ignored).

Return of fertility Return of menstruation following childbirth varies widely among individuals. The closer a woman's behavior is to the Seven Standards of ecological breastfeeding, the later (on average) her cycles will return. Average return of menses for women following all seven criteria is 14 months after childbirth, with some reports being as soon as 2 months while others are as late as 42 months. Couples who desire spacing of 18 to 30 months between children can often achieve this through breastfeeding alone. Although the first post-partum cycle is sometimes anovulatory (reducing the likelihood of becoming pregnant again before having a post-partum period), subsequent cycles are almost always ovulatory and therefore must be considered

fertile. However, some women find that breastfeeding interferes with fertility even after ovulation has resumed. Luteal phases being too short to sustain pregnancy is a common example.