BIRTH CONTROL

BIRTH CONTROL

THE PILL


FACTS	MODE OF ACTION
• Two Kinds: "combined Pill," which contains two female hormones, estrogen and progestin, and is taken 21 days out of each month. "Mini-Pill," which contains progestin only and is taken continuously. • Cost of use averages $15 per month - $248-$300 per year1 • Typical first-year failure rate is 3 percent; 4.7 percent for women less than 22 years old2 (Failure rate even higher for imperfect use; i.e. user forgets or "skips" a pill now and then) • No protection against HIV/AIDS	• Through chemical signals to the brain, suppresses ovulation (essential action of estrogens) Thickens cervical mucus, making it impenetrable to sperm (essential action of progestins) • Alters endometrium so uterus is not receptive to implantation of fertilized egg (newly conceived human life); therefore, sometimes acts as abortifacient

POTENTIAL SIDE EFFECTS
In addition to possible nausea, vomiting, headache, and weight gain or loss (Schering Chemicals advertisement for Eugynon 30 Microgynon 30) the Pill also is responsible for: Increased blood pressure (hypertension) Impaired vision, Increased risk of stroke or heart attack, even with new "low" dose pill Possible link to cancer of reproductive organs Possible link to breast cancer Increased risk of gall bladder disease Increased danger of developing liver tumors Difficulty in conceiving after discontinuing use of pill Residual risk of heart attack, even after discontinuation of long-term use Reduced blood levels of essential vitamins Development of depressive personality changes

NORPLANT


FACTS	MODE OF ACTION
Two forms: Norplant and Norplant 2 Series of 6 rubber "rods" or capsules surgically implanted under the skin in the inside portion of a woman's upper arm Contraceptive effects can last for 5 years (however, continuation rates drop 20 percent after one year and to as low as 30 percent by year five) Norplant 2 differs in the number and size of the rods; its contraceptive effects last for 7 years Cost averages $600-$800 for 5-year supply, insertion, and removal	Suppresses ovulation in only about 50 percent of cycles. Progestins cause thickening of the cervical mucus, making sperm migration difficult Just as often, Norplant induces early abortion. The lining of the uterus (endometrium) is altered, making it inhospitable to implantation of fertilized egg (newly conceived human being); hence, sometimes acts as abortifacient

POTENTIAL SIDE EFFECTS
Severe lower abdominal pain Prolonged or heavy vaginal bleeding; or amenorrhea (absence of periods) ⁵ experienced by more than two-thirds of all users Arm pain and infection Expulsion of an implant Migraine headaches, repeated painful headaches, or blurred vision Changes in lipid metabolism (digestion of fats) Ovarian cysts (experienced by 1 in 10 users) High blood pressure, increased risk of heart attack or stroke Hair loss Nervousness Liver Tumors Gallbladder disease

IUD


FACTS	MODE OF ACTION
Plastic device placed in uterus through the cervical canal; may contain trace metals or hormones to increase contraceptive efficacy Only about 84 percent effective (Alan Guttmacher Institute) Cost of IUD insertion and yearly medical fees can total more than $350 per year	Still not completely understood how IUD prevents pregnancy, but seems to create chronic inflammation of the endometrium, which prevents implantation of newly conceived human life; hence abortifacient

POTENTIAL SIDE EFFECTS
Occasional perforation of uterus or cervix requiring surgery Increased risk of miscarriage (spontaneous abortion) Ectopic (extrauterine) pregnancies 10 times above usual incidence in women Pelvic inflammations that can cause sterility Anemia due to excessive menstrual bleeding Embedding, migration of fragmentation of IUD Spotting or prolongation of menstrual flow Presence of actinomyces in pap smears of 90 percent of users; infection of reproductive organs by actinomyces rare, but is typically found in long-term IUD users Increased risk of HIV infection

Condoms


FACTS	MODE OF ACTION
Think rubber or latex sheath worn over the erect penis during intercourse Condoms must be stored in cool, dry place in order to prevent deterioration of rubber; likewise, condoms have limited "shelf life" as condom materials deteriorate over time Use of lubricants and/or spermicides can cause condom failure by accelerating deterioration of condom rubber Cost of one-year use can be more than $63 per year (intercourse 4x weekly)	Traps ejaculate in tip, thereby preventing sperm from reaching ovum (hence it is essential that condom be worn properly and not tear or slip

POTENTIAL SIDE EFFECTS
Condom Failure/Unintended Pregnancy: condoms effective only 84 to 88 percent of the time, at best. (Chance of pregnancy over one-year use is 1 in 6) Pregnancy rate of 18.4 percent among women less than 18 years of age; among unmarried minority women the failure rate of condoms is even higher, some 36 percent; among unmarried Hispanic women the failure rate is as high as 44.5 percent^. RISK OF HIV INFECTION: Contrary to claims that condoms can be an effective means of preventing the spread of AIDS, the fact is that the human immunodeficiency virus is 450 times smaller than a human sperm - obviously, since condoms fail anywhere from 12 to 44 percent of the time in preventing pregnancy, they are even less effective in preventing the transmission of this tiny virus!

SPERMICIDES


FACTS	MODE OF ACTION
Available in many forms, including creams, jellies, suppositories, aerosol foam and foam tablets Only 74.8 percent effective (Alan Guttmacher Institute)	Form chemical barrier at opening to uterus that prevents sperm from reaching egg in uterus; may also destroy or damage sperm

POTENTIAL SIDE EFFECTS
Greater incidence of congenital disorders (Down's Syndrome, limb reduction malformations, malignant neoplasms-cancerous growths, and severe hypospadias) in innocent children who are conceived during use of spermicides. Increased chance of vaginal infections because absorption of spermicide alters vagina's normal chemical environment Possible link to increased risk of HIV/AIDS

DIAPHRAGM


FACTS	MODE OF ACTION
Flexible metal ring covered with rubber in shape of shallow dome Only 84.1 percent effective (Alan Guttmacher Institute) Risk of failure is approximately doubled when the user is less than 30 years old or has intercourse 4 times or more weekly	Placed in vagina to completely encircle the cervix and to prevent sperm from entering the uterus Usually used with spermicidal jelly or cream applied to side of dome facing cervix

POTENTIAL SIDE EFFECTS
New England Journal of Medicine reports evidence of link between diaphragm use and toxic shock syndrome Local skin irritation caused by sensitivity or allergy

CONTRACEPTIVE INJECTIONS


FACTS	MODE OF ACTION
Depo-Provera (medroxy-progesterone acetate) is injected every 3 to 6 months Cost of the drug is $29.50 per injection, or about $120 per year, plus another $80 per year in medical fees for administering the drug (total: about $200 per year)	Prevents pregnancy by inhibiting ovulation Abortifacient: alters normal growth of endometrium and prevents implantation of newly conceived baby

POTENTIAL SIDE EFFECTS
Major disturbances of menstrual pattern. Prolonged and unpredictable delay in return to fertility Mild deterioration of carbohydrate tolerance Severe and prolonged bleeding Decrease in breast milk production Depression and reduction in libido Danger to fetus in event of pregnancy: some women, especially those who are breast-feeding, are already pregnant when they receive first injection and may receive second injection before they know that they are pregnant; drugs of this type are known to be associated with fetal abnormalities, mainly some masculinizing effects in females

STERILIZATION [ Male ]


FACTS	MODE OF ACTION
Called vasectomy: virtually irreversible operation that removes a piece of both the left and the right vas deferens (tubes through which sperm travel from the testes to the prostate) and ties off ends May not be effective for up to 3 months because of residual sperm cells Failure rate of .15 percent; Recannulation (re-establishment of vas deferens by internal healing process) occurs in 1 case per 1,000

POTENTIAL SIDE EFFECTS [ Male ]
Sperm production is same as before, about 50,000 spermatozoa every minute. However, sperm are not ejaculated, so they enter the bloodstream where antibodies are produced to remove the sperm from the bodily system. This can lead to thyroid and joint disorders, heart and circulatory diseases, and diabetes. When the body activates defenses to ward off cells of its own making, as after a vasectomy, the body becomes "auto-immune," that is, allergic to itself. Several studies have found such antibodies generated in response to sperm antigens in 55 to 75 percent of patient of patients within two years after their vasectomies. Two studies in the United States have found that men with vasectomies have an 85-90 percent higher risk of being diagnosed later with prostate cancer than men who elect not to have the surgery. Psychological difficulties, including anxiety and feelings of low self-worth, decreased sexual desire. A standard personality disorder test found that over 40 percent of one vasectomy study group experienced personality disturbances between their first testing and testing a year later, after the operation. Increased risk of kidney problems, including kidney stones.

FACTS

MODE OF ACTION

More or less irreversible technique for preventing conception

Two kinds:

- Tubal Ligation or electrocoagulation, which seals off Fallopian tubes and prevents passage of eggs between ovaries and uterus (overall failure rate of .15 percent)

None

POTENTIAL SIDE EFFECTS [ Female ]

Severe bleeding

Pelvic infection

Ectopic pregnancy (risk as much as 3 times higher)

Subsequent hysterectomy because of severe menstrual problems

Post-operative depression

Sexual dysfunction

Risk of later desire for sterilization reversal

Women who have had tubal ligations report more cramping than they were accustomed to previously, and chances of pregnancy after tubal ligation are 2 to 5 percent