Contraception

• Works by preventing ovulation, fertilisation or implantation of the blastocyst

Behavioural §

Abstinence §

• Refrain from sexual intercourse and/or sexual contact
• Prevents sperm from entering vagina
• Free
• Highest success in preventing pregnancy
• Protect against STIs
• Requires willpower of both partners
• May find it difficult to do for long periods of time

Withdrawal §

• Man removes penis out of vagina during sexual intercourse and ejaculates outside the vagina, away from female’s external genitalia
• Prevents sperm from entering vagina
• Free
• Low success in preventing pregnancy
• Requires willpower and experience from male
• Male’s pre-ejaculate may contain sperm
• Does not protect against STIs

Rhythm §

• Avoids having unprotected sex during fertile phase of woman’s menstrual cycle
• Prevents fertilisation as sperm will not meet ovum
• Free
• Low success in preventing pregnancy
• Does not protect against STIs
• Difficult to adhere to
• Tracked via:
  • Rise in basal body temperature (0.4°C - 0.8°C rise)
  • Cervical mucus turns from white and sticky to clear, slippery and stretchy

Chemical §

Spermicide §

• In foam, cream, jelly, film, suppository or tablet forms
• Inserted into the vagina before sexual interourse
• Inactivates or kills sperm, preventing them from meeting the ovum and thus prevents fertilisation
• Relatively cheap
• Very low success in preventing pregnancy
• Irritates the reproductive organs
• Does not protect against STIs and increases risk of it

Barrier §

Condom §

• Forms a barrier to prevent sperm from entering the vagina as it can’t pass through the material
• Male:
  • Thin rubber/Plastic tube that covers erect penis before sex
  • Small teat at tip collects semen
• Female:
  • Plastic tube with flexible ring at each end that is placed in the vagina before sex
• Moderate success rate
• Relatively cheap
• Protects against STIs
• Single use
• Possible allergies and requires cooperation from both partners

Diaphragm §

• Dome shaped rubber/silicone cap with elastic rim that is placed over the cervix to cover it
• More effective when used with spermicide
• Forms a barrier to prevent sperm from entering the cervix as it can’t pass through the diaphragm
• Relatively cheap and reusable
• Moderate success in preventing pregnancy
• Does not protect against STIs
• Needs to be left inside the vagina of at least six hours after sexual intercourse before being removed
• Increased risk of bacterial infection

Copper Intrauterine Device §

• IUD inserted into uterus by doctor to prevent fertilisation and implantation
• Small deive
• Made of T shaped plastic frame with copper wires around it
• Inserted int uterus by health care provider
• Copper ions are released from device which inactivates sperm
• Very high success in preventing pregnancy
• Effective for 10 to 12 years
• Relatively expensive
• Does not protect against STIs
• Increased bleeding and cramping initially but lessens over time
• May be dislodged
• Increased risk of infections, ectopic pregnancies and sterility

Hormonal IUD §

• Contains synthetic progesterone
• Releases drug at constant, low level over 3-5 years
• Prevent fertilisation
• Prevents implantation of the blastocyst
• Very high success in preventing pregnancy
• Reduce menstrual cramps and bleeding

Hormonal §

Oral Contraceptive Pill §

• Contains synthetic hormones
  • Combination pill (oestrogen and progesterone)
  • Progesterone-only pill
• Synthetic progesterone will thicken crevix mucus to prevent sperm from entering
• Thinning of endometrial lining
• oestrogen and progesterone prevents ovulation
• Prescribed by doctor and must be taken daily
  • 21 pills + 7 days of no pills/placebo pills
• Will have withdrawal bleeding during 7 day period
• High success in preventing pregnancy
• Expensive in the long run
• Does not protect against STIs
• May cause hormonal side effects
• Has to be taken everyday or it will not be effective

Surgical §

Vasectomy §

• Permanently sterilise the male where the sperm ducts are cut and tied
• Prevents fertilisation as the man’s ejaculate will not contain sperm
• Testes still produce sperm but is unable to pass through
• The male is still able to have an erection and ejaculate
• High success in preventing pregnancy
• Expensive
• Permanent
• Does not protect against STIs
• Possible complications during surgery

Tubal Ligation §

• Surgical procedure to permanently sterilise the woman where the oviducts are cut and tied
• Prevents fertilisation as the sperm is unable to travel up to meet the ova
• Ovulation and menstrual cycle still occurs normally
• High success in preventing pregnancy
• Expensive
• Permanent
• Does not protect against STIs
• Possible complications during surgery

Overview §

What does the effectiveness mean? §

Why do some couples still use less effective methods? §

• Cost
• Invasiveness of certain methods
• Religious principles
• Willpower